Individual provider Active NPI

Kathleen M Barta, PA-C

  • Physician Assistant
  • Brookfield, WI
National Provider Identifier
1720038292
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1292-023 Issued in WI
Practice address
150 S Sunny Slope Rd Ste 136
Brookfield, WI 53005-4858
Phone
(262) 786-4550
Fax
(262) 786-4552
NPI assigned
May 12, 2006
Last updated
Dec 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1292-023 WI Primary

Addresses

Primary practice location

150 S Sunny Slope Rd Ste 136
Brookfield, WI 53005-4858

Mailing address

150 S Sunny Slope Rd Ste 136
Brookfield, WI 53005-4858
Phone (262) 786-4550

Other identifiers 1

IdentifierTypeStateIssuer
42997400MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051027001157 WI Practitioner - Physician Assistant 8022035120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Infectious Disease Specialists of SE Wi, SCGroup PAC ID 5890697874, 13 clinicians

Practice addresses (Care Compare)

150 S Sunny Slope Rd
Suite 136
Brookfield, WI 53005-4858
Phone (262) 786-4550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
18104CAMDChiropractor
1292-023WIMDPhysician Assistant
639WIMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1720038292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 S SUNNY SLOPE RD STE 136",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054858",
            "telephone_number": "262-786-4550",
            "fax_number": "262-786-4552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S SUNNY SLOPE RD STE 136",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054858",
            "telephone_number": "262-786-4550",
            "fax_number": "262-786-4552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARTA",
        "first_name": "KATHLEEN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-12",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1292-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42997400",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.