Individual ProviderKristin FiedlerPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2901 W Kinnickinnic River Pkwy Ste 316, Milwaukee, WI 53215-3660(414) 385-2601(800) 326-2250PECOS EnrollmentBased on the most recent information from CMS, provider Kristin Fiedler 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 yesterday at 11:26 AM.Profile DetailsProvider ID1205389350Provider TypeIndividualFull NameFiedler, KristinCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date7/25/2016Last Updated1/19/2026Contact InformationPractice LocationPractice Address2901 W Kinnickinnic River Pkwy Ste 316, Milwaukee, WI 53215-3660Phone(414) 385-2601FaxUnlisted FaxMailing LocationMailing AddressPO Box 735044, Chicago, IL 60673-5044Phone(800) 326-2250Fax(833) 437-1275Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense8360WisconsinCode363AS0400XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense50.004742RXOhioCode363AS0400XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA14901TexasProvider IdentifiersIDDescriptionIssuerID100382786DescriptionMedicaidIssuerUnlistedWisconsin