Individual ProviderEric KortbeinPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address10625 W North Ave Ste 102, Wauwatosa, WI 53226-2315(414) 858-2216(414) 877-5350PECOS EnrollmentBased on the most recent information from CMS, provider Eric Kortbein 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 ID1093812877Provider TypeIndividualFull NameKortbein, EricCredentialP.A.-CGenderMaleSole ProprietorNoEnumeration Date9/20/2006Last Updated7/21/2022Contact InformationPractice LocationPractice Address10625 W North Ave Ste 102, Wauwatosa, WI 53226-2315Phone(414) 858-2216Fax(414) 858-2230Mailing LocationMailing Address10625 W North Ave Ste 102, Milwaukee, WI 53226-2315Phone(414) 877-5350Fax(414) 877-5360Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense1364WisconsinProvider IdentifiersIDDescriptionIssuerID41931700DescriptionMedicaidIssuerUnlistedWisconsin