Active NPI
Melissa Ann Becker, PA-C
- Physician Assistant
- Waukesha, WI
National Provider Identifier
1780132944
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 3894-23
- Practice address
- 725 American Ave
Waukesha, WI 53188-5031 - Phone
- (262) 928-5400
- NPI assigned
- Sep 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 3894-23 | WI | Primary |
Addresses
Primary practice location
725 American Ave
Waukesha, WI 53188-5031
Mailing address
725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-5400
Other practice location 1
791 Summit Ave
Oconomowoc, WI 53066-3896
Phone (262) 569-0259
Other practice location 2
240 Maple Ave
Mukwonago, WI 53149-8475
Phone (262) 521-7761
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780132944 | Medicaid | WI |
Other names 1
- Melissa Ann Kaltenbach
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161111001507 | WI | Practitioner - Physician Assistant | 2163701236 | Reassigns benefits to 6 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2016
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Apogee Medical Group Waukesha SC
Practice addresses (Care Compare)
725 American Ave
Waukesha, WI 53188-5031
Phone (262) 928-5400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3894 | WI | MD | Anesthesiology Physician |
| 3894-23 | WI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apogee Medical Group, Wisconsin, S.C | Current | Accepting new patients |
Locations
125 Hospital Dr
Watertown, WI 53098
Phone (920) 261-4210
Interoperability endpoints
- mkaltenbachpac292573@direct.froedtert.com
Organizations & group practices 6
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473984000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694563200000",
"number": "1780132944",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 AMERICAN AVE",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531885031",
"telephone_number": "262-928-5400",
"fax_number": "262-928-6140"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 AMERICAN AVE",
"city": "WAUKESHA",
"state": "WI",
"postal_code": "531885031",
"telephone_number": "262-928-5400"
}
],
"practiceLocations": [
{
"address_1": "791 Summit Ave",
"address_purpose": "LOCATION",
"city": "Oconomowoc",
"state": "WI",
"postal_code": "530663896",
"country_code": "US",
"telephone_number": "262-569-0259",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "240 Maple Ave",
"address_purpose": "LOCATION",
"city": "Mukwonago",
"state": "WI",
"postal_code": "531498475",
"country_code": "US",
"telephone_number": "262-521-7761",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BECKER",
"first_name": "MELISSA",
"middle_name": "ANN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-16",
"last_updated": "2023-09-13",
"certification_date": "2023-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "WI",
"license": "3894-23",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1780132944",
"state": "WI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MELISSA",
"last_name": "KALTENBACH",
"middle_name": "ANN",
"credential": "PA-C",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Waukesha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 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.