KATHRYN J WALLEK (PAC) – Physician Assistant, NPI 1962446955
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,032 PHYSICIAN ASSISTANT in MN
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Provider Addresses for KATHRYN J WALLEK (PAC)
33rd Avenue South, Wenonah, Minneapolis, Hennepin County, Minnesota, 55417, United States
MINNEAPOLIS, MN 554254516
Phone: (952) 883-5793
Type: Location
2076, Randy Avenue, White Bear Lake, Ramsey County, Minnesota, 55110, United States
WHITE BEAR LAKE, MN 551104331
Phone:
Type: Mailing
8170 33RD AVE S
MINNEAPOLIS, MN 554254516
Phone:
Type: Mailing
1500 CURVE CREST BLVD W
STILLWATER, MN 550826040
Phone: (651) 439-1234
Fax: (651) 275-3325
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-05-11
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050615000206 | I | Physician Assistant | MN | TBD |
| I20150511002515 | I | Physician Assistant | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 36415 | Insertion of needle into vein for collection of blood sample | 63 | 49 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 60 | 55 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 38 | 34 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 18 | 17 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 12 | 12 | $0 |
Insurance plans in this area (ZIP 55425)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| Clinical Psychologist | MN | |
| Physician Assistant | MN | |
| Pediatric Medicine | MN | |
| O P T O M E T R Y | NJ | |
| Nurse Practitioner | MN | |
| Emergency Medicine | MN | |
| Family Practice | MN | |
| Family Practice | WI | |
| Cardiac Surgery, Thoracic Surgery, Vascular Surgery | MN |
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