Individual provider Active NPI

Katherine M Hasselbrink, PA-C

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1992735385
Registry record updated Jan 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1754-023 Issued in WI
Practice address
111 E Wisconsin Ave
Milwaukee, WI 53202-4815
Phone
(414) 290-6720
Fax
(414) 290-6755
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-002263 IL
Physician Assistant 363A00000X 1754-023 WI Primary

Addresses

Primary practice location

111 E Wisconsin Ave
Milwaukee, WI 53202-4815

Mailing address

111 E Wisconsin Ave
Milwaukee, WI 53202-4815
Phone (414) 290-6720

Other identifiers 2

IdentifierTypeStateIssuer
41990900MedicaidWI
P00310241OtherWIMEDICARE RAILROAD

Other names 1

  • Katherine M Bower Former name

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041008000701 WI Practitioner - Physician Assistant 6608835129 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Froedtert South IncGroup PAC ID 9537071196, 158 clinicians

Practice addresses (Care Compare)

6308 8TH Ave
Kenosha, WI 53143-5031
Phone (262) 771-0073

9555 76TH St
Pleasant Prairie, WI 53158-1984
Phone (262) 577-8300

Hospital & facility affiliations

  • Froedtert South Inc. Hospital, Kenosha, WI, CCN 520021

Merit-based Incentive Payment System (MIPS)

Final score
84.74 of 100Reported as group
Quality
73.23
Improvement activities
40
Cost
82.42

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
69.39
Promoting interoperability
100
Improvement activities
40
Cost
74.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
085-002263ILMDPhysician Assistant
1754-023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vituity-Wisconsin Em SC CurrentSince Aug 15, 2023 Accepting new patients
Froedtert South, Inc. CurrentSince Oct 21, 2022 Accepting new patients
Ihc-Libertyville Emergency Physicians, LLC Physician Assistant Past Accepting new patients
Ihc-St. Francis Emergency Physicians, LLC Past Accepting new patients
Health Dynamics, LLC Physician Assistant Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

6308 8th Ave
Kenosha, WI 53143
Phone (262) 653-5300

10256 Old Green Bay Rd
Ste 140
Pleasant Prairie, WI 53158
Phone (262) 217-3455

9555 76th St
Pleasant Prairie, WI 53158
Phone (262) 577-8000

Interoperability endpoints

  • Direct secure messaging: khasselbrink347617@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.

Hospital & facility affiliations 1

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": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1992735385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024815",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 E WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532024815",
            "telephone_number": "414-290-6720",
            "fax_number": "414-290-6755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSELBRINK",
        "first_name": "KATHERINE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-002263",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1754-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41990900",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "P00310241",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHERINE",
            "last_name": "BOWER",
            "middle_name": "M",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.