Kristine M Matysiak, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2249-023 Issued in WI

Practice address

323 S. 18TH Avenue
Sturgeon Bay, WI 54235

Phone

(920) 746-0510

NPI assigned

Aug 5, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kristine M. Treml Former name

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

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Door County Memorial HospitalGroup PAC ID 5395735088, 85 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Door County Medical Center Hospital, Sturgeon Bay, WI, CCN 521358

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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

• Door County Memorial Hospital

  • Critical Access Hospital
  • Sturgeon Bay, WI
  • NPI 1093743874
  Medicare reassignment Care Compare group NPD
• Door County Memorial Hospital

  • Rural Health Clinic/Center
  • Sturgeon Bay, WI
  • NPI 1326748104
  NPD
• Saint Raphael Faculty Physicians

  • Internal Medicine Physician
  • New Haven, CT
  • NPI 1932138138

  Physician Assistant

  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Door County Memorial Hospital

  • Critical Access Hospital
  • Sturgeon Bay, WI
  • NPI 1093743874
  Care Compare affiliation
• Door County Memorial Hospital

  • Clinical Medical Laboratory
  • Sturgeon Bay, WI
  • NPI 1811090285

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680825600000",
    "number": "1750572913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S. 18TH AVENUE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "54235",
            "telephone_number": "920-746-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S. 18TH AVENUE",
            "city": "STURGEON BAY",
            "state": "WI",
            "postal_code": "54235",
            "telephone_number": "920-746-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATYSIAK",
        "first_name": "KRISTINE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2023-04-07",
        "certification_date": "2021-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2249-023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTINE",
            "last_name": "TREML",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ashley Anna Maas
• Lynn M Marquardt, DNP, MSN, FNP-BC
• Sandra I Martens, M.D.
• Neil A Masters, P.T.
• Brian Eric Matysiak, MD
• Jeffrey Allen Maurer, PA
• Ashleigh Mayenschein, RN
• Amanda R Maynard, PHARMD
• Susan J McAninch, MSW
• Francis X McCormack, M.D.

• Physician Assistant in Sturgeon Bay, WI
• Providers in Sturgeon Bay, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.