Individual ProviderEmily CarrollPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9200 W Wisconsin Ave, Milwaukee, WI 53226(414) 805-6400PECOS EnrollmentBased on the most recent information from CMS, provider Emily Carroll is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1013310887Provider TypeIndividualFull NameCarroll, EmilyCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date10/7/2014Last Updated11/7/2022Contact InformationPractice LocationPractice Address9200 W Wisconsin Ave, Milwaukee, WI 53226Phone(414) 805-6400Fax(414) 955-0213Mailing LocationMailing Address9200 W Wisconsin Ave, Milwaukee, WI 53226-3522Phone(414) 805-6400Fax(414) 955-0213Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense3426-23WisconsinProvider IdentifiersIDDescriptionIssuerID1013310887DescriptionMedicaidIssuerUnlistedWisconsin