Kathryn J Wallek, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9782 Issued in MN

Practice address

1500 Curve Crest Blvd W
Stillwater, MN 55082-6040

Phone

(651) 439-1234

Fax

(651) 275-3325

NPI assigned

Jun 16, 2006

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

Other names 1

• Kathryn J Altman Former name

Medicare fee-for-service enrollment

Enrolled in MN, WI2 enrollments

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 2

Specialty

Physician Assistant

Education

Saint Louis University School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Amery Regional Medical Center IncGroup PAC ID 2769391960, shared by 7 NPIs, 124 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeview Memorial Hospital Hospital, Stillwater, MN, CCN 240066

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kwallek42046@direct.healthpartners.com

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.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683

  WI

  Medicare reassignment Care Compare group NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Group Health, Inc.

  • Family Medicine Physician
  • Somerset, WI
  • NPI 1215305412
  NPD

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

• Lakeview Memorial Hospital Association Inc

  • General Acute Care Hospital
  • Stillwater, MN
  • NPI 1538138003
  Care Compare affiliation
• Lakeview Memorial Hospital Association Inc

  • Land Ambulance
  • Stillwater, MN
  • NPI 1730213653

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627344000000",
    "number": "1962446955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 CURVE CREST BLVD W",
            "city": "STILLWATER",
            "state": "MN",
            "postal_code": "550826040",
            "telephone_number": "651-439-1234",
            "fax_number": "651-275-3325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLEK",
        "first_name": "KATHRYN",
        "middle_name": "J",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2021-07-27",
        "certification_date": "2021-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "9782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "598401700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "ALTMAN",
            "middle_name": "J",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sheri Vrieze, LADC
• Cheryl Vukmanich, NP-C
• Lily K Wagner
• Jessica Mary Waks, C.N.P.
• Barbara Walker, PSY.D., LP
• Ellie Ann Warmuth, PA-C
• Madison Warner
• Washington County Community Services
• Raymond Watts, MD
• Matthew Kane Weber, DC

• Physician Assistant in Stillwater, MN
• Providers in Stillwater, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.