Active NPI 1548640774 Individual Practitioner Male Practitioner

Brant Michael Balthazor , MS, PA-C

Physician Assistant • Sheboygan, WI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Brant Balthazor, MS, PA-C is a certified Physician Assistant practicing in Sheboygan, WI. With approximately 11 years of clinical experience since completing medical education in 2015, Brant Balthazor delivers high-quality medical care to the local community at 2124 KOHLER MEMORIAL DR.

Brant Balthazor maintains professional affiliations with Wisconsin Spine And Pain Sc, Progressive Beginnings, Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, testing for presence of drug, by chemistry analyzers, electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

2124 Kohler Memorial Dr

Sheboygan, WI 530813169

Telephone 8838217246

Associated Practice Facility / Clinic

🏢 Sheboygan Medical Center, Llc Facility NPI 1366487241

Medicare Profile & Education

Medical School

Other

Graduation Year

2015

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Sheboygan, WI

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

11 Yrs -1.5 yrs vs City Avg

City Avg: 12.5 Yrs

State Avg: 14.1 Yrs

Regional Practice Density

43 Specialists

Practicing in Sheboygan, WI (3517 Statewide)

Telehealth Adoption Rate

4.7% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

80.3% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Balthazor (11 Years) 11 Yrs

Sheboygan Specialty Average (12.5 Years) 12.5 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	498	259	$325.08	$70.28
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	218	150	$472.81	$96.86
80307 Testing for presence of drug, by chemistry analyzers	191	144	$250.00	$56.27
62370 Electronic analysis reprogramming and refill of spinal canal drug infusion pump by physician	53	23	$434.43	$72.17
76942 Ultrasonic guidance imaging supervision and interpretation for insertion of needle	48	23	$251.15	$45.83

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	58	45	$325.42	$69.32
80307 Testing for presence of drug, by chemistry analyzers	39	39	$250.00	$59.53
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	35	29	$473.79	$99.53

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	24	17	$313.00	$73.34

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	27	21	$295.00	$75.42
19318 Breast reduction	12	12	$26524.38	$209.95

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	59	56	$176.00	$86.43
99213 Established patient office or other outpatient visit, typically 15 minutes	29	28	$141.34	$60.10
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	22	22	$274.00	$135.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	129	118	$176.00	$90.03
99213 Established patient office or other outpatient visit, typically 15 minutes	49	47	$119.00	$61.75
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	37	29	$625.00	$37.42
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	35	35	$274.00	$135.21
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	32	31	$5514.00	$124.64
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	19	19	$240.00	$116.78
22633 Fusion of spine in lower back with partial removal of spine bone and disc	17	17	$5656.00	$264.63
22840 Placement of stabilizing device to back of 1 spine bone in neck	16	16	$2357.00	$109.98
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	15	15	$237.00	$121.74
22551 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc	13	13	$5258.00	$235.10
22845 Placement of stabilizing device to front, 2-3 spine bone segments	12	12	$2280.00	$105.91

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	132	111	$176.00	$88.67
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	84	84	$274.00	$136.69
99213 Established patient office or other outpatient visit, typically 15 minutes	66	63	$119.00	$60.03
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	32	28	$625.00	$35.35
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	30	30	$5514.00	$115.62
63048 Partial removal of spine bone with release of spinal cord and/or nerves	26	12	$3000.00	$30.16
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	24	24	$237.00	$120.04
22840 Placement of stabilizing device to back of 1 spine bone in neck	23	23	$2357.00	$108.36
22633 Fusion of spine in lower back with partial removal of spine bone and disc	18	18	$5656.00	$260.58
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	17	17	$240.00	$115.30
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	11	11	$341.00	$172.54

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	84	82	$119.00	$59.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	81	78	$176.00	$88.09
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	58	58	$274.00	$135.53
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	23	22	$240.00	$114.91
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	21	21	$5514.00	$139.55
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	21	21	$341.00	$170.95
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	19	19	$237.00	$118.81
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	16	15	$625.00	$36.32
22551 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc	12	12	$5258.00	$232.60
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	12	12	$130.00	$60.42
63030 Partial removal of bone with release of spinal cord or spinal nerves of 1 interspace in lower spine	11	11	$4699.00	$135.43
99221 Initial hospital inpatient care per day, typically 30 minutes	11	11	$225.00	$85.51
22840 Placement of stabilizing device to back of 1 spine bone in neck	11	11	$2357.00	$108.49

Medical Specialties & State Licenses

CMS Verified: 2024-01-07

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License WI 4424-023

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License IL 085005469

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

100100767 (WI)

Hospital & Practice Group Affiliations

Wisconsin Spine And Pain Sc

2124 Kohler Memorial Dr, Sheboygan, WI 530813169

Wisconsin Spine And Pain Sc

1000 Gateway Ct, West Bend, WI 530958541

Phone: 4144551153

Wisconsin Spine And Pain Sc

2124 Kohler Memorial Dr, Sheboygan, WI 530813174

Phone: 4144551153

Progressive Beginnings, Llc

1125 N 13th St, Sheboygan, WI 530813281

Phone: 9208031617

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners

Kristin Balthazor , PA-C, MPAS

Physician Assistant

NPI 1649422619

Physician Assistant (Certified), MPAS

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events

📍

Updated Practice Location January 07, 2024

Registered at 2124 KOHLER MEMORIAL DR, SHEBOYGAN, WI 530813169 (Tel: 8838217246)

📍

Updated Business Mailing Address January 07, 2024

Registered at 3624 COUNTY ROAD I, SAUKVILLE, WI 530801446 (Tel: 7349453484)

👤

Provider Name / Credentials Updated January 04, 2021

Recorded as BRANT BALTHAZOR, MS, PA-C

📍

Updated Practice Location August 05, 2020

Registered at 12203 CORPORATE PKWY, MEQUON, WI 530923388 (Tel: 2623878200)

📍

Updated Business Mailing Address August 05, 2020

Registered at 3301 W FOREST HOME AVE, MILWAUKEE, WI 532152843 (Tel: 4143892377)

✅

NPI Profile Active June 09, 2016

NPI status registered as active in NPPES database

📍

Updated Practice Location June 09, 2016

Registered at 375 N WALL ST, STE P530, KANKAKEE, IL 609013483 (Tel: 7349453484)

📍

Updated Business Mailing Address June 09, 2016

Registered at 375 N WALL ST, STE P530, KANKAKEE, IL 609013483 (Tel: 7349453484)

👤

Provider Name / Credentials Updated June 09, 2016

Recorded as BRANT BALTHAZOR, P.A.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) June 09, 2016

Physician Assistant (License #085005469 in IL)

🟢

Initial NPI Registration & Enumeration June 03, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1548640774

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 03, 2015

Last Update: January 07, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

3624 County Road I

Saukville, WI 530801446

Phone: 7349453484

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.