KELLY BAKER (PAC) – Physician Assistant, NPI 1043663818
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for KELLY BAKER (PAC)
9000 W WISCONSIN AVE
MILWAUKEE, WI 532264874
Phone: (414) 266-6457
Fax: (414) 266-2294
Type: Mailing
2350 N Lake Dr
SUITE 206
Milwaukee, WI 532114528
Phone: (414) 298-7280
Fax: (414) 298-7281
Type: Location
Columbia College of Nursing, 4425, North Port Washington Road, Grover Heights, Glendale, Milwaukee County, Wisconsin, 53212, United States
GLENDALE, WI 532121082
Phone:
Type: Mailing
2350, North Lake Drive, Northpoint, Milwaukee, Milwaukee County, Wisconsin, 53202, United States
SUITE 206
MILWAUKEE, WI 532114528
Phone: (414) 298-7280
Fax: (414) 298-7281
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $215.
Total Amount is formed as General ($215) + Research ($0) + Ownership ($0) = $215.
Last reported payment date: 2024-10-03 • Largest payer in this snapshot: ABBVIE INC. ($167).
Total Amount
$215
General + Research + Ownership
Payments
4
Total payment records
General Amount
$215
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-03
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $167 |
| Abbott Laboratories | $48 |
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: 2016-10-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20161010002256 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 53226)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Hand Surgery, Plastic And Reconstructive Surgery | WI | |
| O B S T E T R I C S/ G Y N E C O L O G Y | WA | |
| Diagnostic Radiology | WI | |
| D E R M A T O L O G Y | WI | |
| - | WI | |
| - | WI | |
| Physician Assistant | WI | |
| H E M A T O L O G Y/ O N C O L O G Y | WI | |
| - | WI |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.