BRANT MICHAEL BALTHAZOR (MS, PA-C) – Physician Assistant, NPI 1548640774
Physician Assistant
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Profile Insights
NPPES metrics only — not quality of care.
3,678 PHYSICIAN ASSISTANT in WI
Provider Addresses for BRANT MICHAEL BALTHAZOR (MS, PA-C)
3301 W FOREST HOME AVE
MILWAUKEE, WI 532152843
Phone: (414) 389-2377
Type: Mailing
12203 CORPORATE PKWY
MEQUON, WI 530923388
Phone: (262) 387-8200
Type: Location
3624 COUNTY ROAD I
SAUKVILLE, WI 530801446
Phone: (734) 945-3484
Type: Mailing
2124 KOHLER MEMORIAL DR
SHEBOYGAN, WI 530813169
Phone: (883) 821-7246
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 86 Open Payments records for all available years, with a total value of $1,913.
Total Amount is formed as General ($1,913) + Research ($0) + Ownership ($0) = $1,913.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Collegium Pharmaceutical, Inc. ($264).
Total Amount
$1,913
General + Research + Ownership
Payments
86
Total payment records
General Amount
$1,913
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Collegium Pharmaceutical, Inc. | $264 |
| Abbott Laboratories | $223 |
| Spinal Simplicity, LLC | $195 |
| Medtronic, Inc. | $176 |
| PFIZER INC. | $169 |
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: 2020-07-01
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 |
|---|---|---|---|---|
| I20150928002944 | I | Physician Assistant | IL | TBD |
| I20200701001722 | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 58 | 45 | $0 |
| 80307 | Testing for presence of drug, by chemistry analyzers | 39 | 39 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 35 | 29 | $0 |
Insurance plans in this area (ZIP 53215)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PHYSICIAN ASSISTANT | IL | 63048 | Partial removal of spine bone with release of spinal cord and/or nerves | 21 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | WI | |
| Pain Management, Anesthesiology | IL | |
| Nurse Practitioner | WI | |
| Certified Registered Nurse Anesthetist (Crna) | MN | |
| Certified Registered Nurse Anesthetist (Crna) | NY | |
| Pain Management, Anesthesiology | WI | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Physician Assistant | CA | |
| Physician Assistant | WI | |
| Nurse Practitioner | WI |
Reviews
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