Individual provider Active NPI

Katarzyna Baluta, P.T.

  • Physical Therapist
  • Sparta, WI
National Provider Identifier
1902104102
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12264 Issued in WI
Practice address
310 W Main St
Sparta, WI 54656
Phone
(608) 269-1770
NPI assigned
Mar 11, 2011
Last updated
Mar 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501015478 MI
Physical Therapist 225100000X 12264 WI Primary

Addresses

Primary practice location

310 W Main St
Sparta, WI 54656

Mailing address

200 1St St SW
Rochester, MN 55905-0001
Phone (608) 785-0940

Other names 1

  • Katarzyna Luce Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kluce26638@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131231001683 WI Practitioner - Physical Therapist in Private Practice 4981832698 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12264WIMDAddiction (Substance Use Disorder) Counselor
5501015478MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Jan 31, 2018 Accepting new patients

Locations

310 W Main St
Sparta, WI 54656
Phone (608) 269-1700

Interoperability endpoints

  • Direct secure messaging: kluce26638@ehrdirect.mayoclinicmsg.org

Organizations & group practices 2

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": "1299801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1902104102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 1ST ST SW",
            "city": "ROCHESTER",
            "state": "MN",
            "postal_code": "559050001",
            "telephone_number": "608-785-0940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W MAIN ST",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "54656",
            "telephone_number": "608-269-1770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALUTA",
        "first_name": "KATARZYNA",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-11",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501015478",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "12264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kluce26638@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "310 W Main St",
            "city": "Sparta",
            "state": "WI",
            "country_code": "US",
            "postal_code": "54656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KATARZYNA",
            "last_name": "LUCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sparta, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.