Look up the most recent NPI and PECOS records

Katie Jane Balderas

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

2801 W Kinnickinnic River Pkwy Ste 1080, Milwaukee, WI 53215-3689

PECOS Enrollment

This provider is enrolled in PECOS as KATIE BALDERAS.

Based on the most recent information from CMS, provider Katie Jane Balderas is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:26 AM.

Profile Details

Provider ID
1497184279
Provider Type
Individual
Full Name
Balderas, Katie Jane
Title
Mrs.
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
11/2/2013
Last Updated
1/26/2026

Contact Information

Practice Location

2801 W Kinnickinnic River Pkwy Ste 1080, Milwaukee, WI 53215-3689

(414) 908-6506

(414) 908-6510

Mailing Location

1033 N Mayfair Rd Ste 101, Wauwatosa, WI 53226-3442

(414) 454-0600

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 3253-23 Wisconsin

Katie Jane Balderas

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Giovetti, Lynn

Vahlsing, Olivia Josephine

Mertens, Alix

Koth, Amanda J

Patterson, Katrina

Parisi, Matthew Joseph

Johnson, Russell

Smith, Jerry Wayne

Glodowski, Kelly M

Sherry, Charnai Dawn