Holly Lynn Pautz, PA - C
Individual provider Active NPI Physician Assistant · Brillion, WI
NPI 1699971978 · NPPES record last updated Mar 28, 2024
Key facts
- NPI
- 1699971978
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 2141 (WI)
- Practice address
- 964 W Ryan St
Suite B
Brillion, WI 54110-1076 - Phone
- (920) 756-2055
- NPI assigned
- Jun 25, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bellin Memorial Hospital Inc
Practice addresses (Care Compare)
1630 Commanche Ave
Green Bay, WI 54313-5753
Phone (920) 430-4700
2020 S Webster Ave
Accounting
Green Bay, WI 54301-3505
405 Commercial St
Seymour, WI 54165-8474
Phone (920) 833-2318
555 Quality CT
Wrightstown, WI 54180-9006
Phone (920) 532-6320
744 S Webster Ave
Green Bay, WI 54301-3505
Hospital & facility affiliations
- Bellin Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070801000032 | WI | Practitioner - Physician Assistant | 4981795291 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2141 | WI | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bellin Memorial Hospital Inc | Current |
Accepting new patients |
Locations
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
405 Commercial St
Seymour, WI 54165
Phone (920) 833-2318
Interoperability endpoints
- hpautz32236@direct.thedacare.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2141 | WI | Yes |
Addresses
Primary practice location
964 W Ryan St
Suite B
Brillion, WI 54110-1076
Mailing address
PO Box 22487
Green Bay, WI 54305-2487
Phone (920) 445-7210
Other practice location 1
555 Quality Ct
Wrightstown, WI 54180-9006
Phone (920) 532-6320
Other practice location 2
595 County Road R
Denmark, WI 54208-9120
Phone (920) 863-2005
Other practice location 3
723 S Wisconsin St
Pulaski, WI 54162-9303
Phone (920) 822-1100
Other practice location 4
405 Commercial St
Seymour, WI 54165-8474
Phone (920) 833-2318
Other practice location 5
2714 Riverview Dr
Green Bay, WI 54313-6715
Phone (920) 430-4760
Other practice location 6
441 French St
Peshtigo, WI 54157-1203
Phone (715) 582-9949
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1077801 | Other | NATIONAL COMMISSION ON CERTIFICATION OF PHYSICIAN ASSISTANTS |
Other names
- Holly L Vanzeeland
Other providers in Brillion, WI
- Paula Montes Fuentes
- Amanda L Muehlbauer
- Orthopedic & Spine Therapy of
- Orthopedic & Spine Therapy of Brillion, SC
- Melissa Ann Paulow
- Amanda Nicole Peters
- Emily M. Rataichek
- Mary Rothe
- Mark Alan Rysticken
- Shopko Stores Operating Co LLC
All providers in Brillion, WI · Physician Assistant in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.