Katie Balderas, PA-C
NPI 1497184279 · Physician Assistant · Milwaukee, WI
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Katie Balderas, PA-C is a Physician Assistant provider in Milwaukee, WI (NPI 1497184279).
Provider details
- NPI number
- 1497184279
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 3253-23 (WI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
12 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
48 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 17 | $102 |
| Visit Complexity Inherent to Evaluation and Management Associated With Medical Care Services That Serve As the Continuing Focal Point for All Needed Health Care Services And/Or With Medical Care Services That Are Part of Ongoing Care Related to a Patient'SG2211 | 16 | $13 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 15 | $73 |
Typical Medicare-allowed amounts for these services range $13–$102 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 5 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Famotidine | 20 | — |
| Pantoprazole Sodium | 18 | 12 |
| Lipase/Protease/Amylasebrand: Creon | 13 | — |
| Cholestyramine (with Sugar)brand: Cholestyramine | 11 | — |
| Esomeprazole Magnesium | 11 | — |
Medicare Part D only. These counts cover prescriptions paid through Medicare Part D in 2024 — they do notinclude cash-pay, commercial-insurance, Medicaid, or Part B–administered drugs, and badly undercount high cash-pay categories (e.g. GLP-1 weight-loss, testosterone, and ED medications). Any drug with 10 or fewer claims is omitted by CMS, and beneficiary counts under 11 are suppressed — so a missing drug means no Part D record, never zero. This is a factual claims summary, not an endorsement, not medical advice, and not a consumer report. Source: CMS Medicare Part D Prescribers — by Provider and Drug.
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$37 across 1 record (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2013-11-02
- Last updated
- 2026-01-26
- Certified
- 2026-01-26
Frequently asked questions
- What is Katie Balderas's NPI number?
- Katie Balderas's National Provider Identifier (NPI) is 1497184279, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Katie Balderas's specialty?
- Katie Balderas is listed in the NPPES registry with a primary specialty of Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Katie Balderas located?
- Katie Balderas's practice location on file with NPPES is 2801 W Kinnickinnic River Pkwy Ste 1080, Milwaukee, WI 53215-3689.
- What is Katie Balderas's phone number?
- The practice phone number listed in the NPPES registry for Katie Balderas is (414) 908-6506.
- Does Katie Balderas accept Medicare?
- Katie Balderas is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Katie Balderas's NPI active?
- Yes — Katie Balderas's NPI (1497184279) is active in the NPPES registry as of the last update on 2026-01-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.