NPIMap

Individual provider Active NPI

Kali Southworth, PA-C

  • Physician Assistant
  • Stevens Point, WI
National Provider Identifier
1770987299
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
3449-23 Issued in WI
Practice address
824 Illinois Ave
Stevens Point, WI 54481-3112
Phone
(715) 346-5000
NPI assigned
Oct 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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 3449-23 WI Primary

Addresses

Primary practice location

824 Illinois Ave
Stevens Point, WI 54481-3112

Mailing address

824 Illinois Ave
Stevens Point, WI 54481-3112
Phone (715) 346-5000

Other practice location 1

900 Illinois Ave
Stevens Point, WI 54481-3114
Phone (715) 346-5000

Other practice location 2

900 Illinois Ave
Stevens Point, WI 54481-3114
Phone (715) 346-5000

Other practice location 3

4131 W Loomis Rd
Suite 300
Greenfield, WI 53221-2057
Phone (414) 325-7246

Other practice location 4

4131 W Loomis Rd
Suite 300
Greenfield, WI 53221-2057
Phone (414) 325-7246

Other names 1

  • Kali Matthias Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150507001018 WI Practitioner - Physician Assistant 6901125236 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2251 N Shore Dr
Rhinelander, WI 54501-6710
Phone (715) 361-2000

824 Illinois Ave
Stevens Point, WI 54481-3112
Phone (715) 344-1600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.84 of 100Reported as group
Quality
86.21
Promoting interoperability
100
Improvement activities
40
Cost
73.25

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Pain Management SC CurrentSince Oct 1, 2014 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Dec 23, 2021 Accepting new patients
Aspirus Merrill Hospital & Clinics, Inc. CurrentSince Sep 30, 2020 Accepting new patients
Advanced Pain Management, SC CurrentSince Oct 1, 2014 Accepting new patients
Aspirus Stevens Point Hospital & Clinics, Inc. CurrentSince Jan 1, 2018 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Dec 23, 2021 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

5900 S Lake Dr
Cudahy, WI 53110
Phone (414) 489-4055

601 S Center Ave
Merrill, WI 54452
Phone (715) 536-5511

4131 W Loomis Rd
Ste 300
Milwaukee, WI 53221
Phone (414) 325-3713

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

900 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

824 Illinois Ave
Stevens Point, WI 54481
Phone (715) 342-7500

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

401 W Mohawk Dr
Tomahawk, WI 54487
Phone (715) 453-7200

333 Pine Ridge Blvd
Ste 320
Wausau, WI 54401

Interoperability endpoints

  • Direct secure messaging: ksouthworth169690@direct.aspirus.org

Organizations & group practices 8

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.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1413158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1770987299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "824 ILLINOIS AVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544813112",
            "telephone_number": "715-346-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "824 ILLINOIS AVE",
            "city": "STEVENS POINT",
            "state": "WI",
            "postal_code": "544813112",
            "telephone_number": "715-346-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Illinois Ave",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544813114",
            "country_code": "US",
            "telephone_number": "715-346-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "900 Illinois Ave",
            "address_purpose": "LOCATION",
            "city": "Stevens Point",
            "state": "WI",
            "postal_code": "544813114",
            "country_code": "US",
            "telephone_number": "715-346-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4131 W Loomis Rd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532212057",
            "country_code": "US",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4131 W Loomis Rd",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Greenfield",
            "state": "WI",
            "postal_code": "532212057",
            "country_code": "US",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUTHWORTH",
        "first_name": "KALI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-13",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "3449-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KALI",
            "last_name": "MATTHIAS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Stevens Point, WI

Sources for this page

Verify at the official NPI Registry.