Cynthia A Walters, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1543023 Issued in WI

Practice address

2817 New Pinery Rd
Divine Savior Healthcare Inc
Portage, WI 53901-9257

Phone

(608) 742-4131

Fax

(608) 742-6098

NPI assigned

Nov 22, 2005

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 identifiers 1

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, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lac Du Flambeau Band of Lake Superior Chippewa IndiansGroup PAC ID 5496707242, 19 clinicians

Practice addresses (Care Compare)

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.

• Lac Du Flambeau Band of Lake Superior Chippewa Indians

  • Federally Qualified Health Center (FQHC)
  • Lac Du Flambeau, WI
  • NPI 1134235047
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1132617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1770566911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 387",
            "address_2": "DIVINE SAVIOR HEALTHCARE INC",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539010387",
            "telephone_number": "608-742-4131",
            "fax_number": "608-742-6098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 NEW PINERY RD",
            "address_2": "DIVINE SAVIOR HEALTHCARE INC",
            "city": "PORTAGE",
            "state": "WI",
            "postal_code": "539019257",
            "telephone_number": "608-742-4131",
            "fax_number": "608-742-6098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-22",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1543023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41988100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Vorpahl, PT
• W. S. Goldthorpe, Inc.
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Michael C Walters, MD
• Joseph J Wangerin, PHYSICIAN ASSISTANT
• Kortnee Paige Moore Warner, CF-SLP
• Gregory Weaver, RPH
• Jesse Joseph Weber

• Physician Assistant in Portage, WI
• Providers in Portage, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.