Individual ProviderKyle D. FoxPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9200 W Wisconsin Ave, Milwaukee, WI 53226(414) 805-5400PECOS EnrollmentThis provider is enrolled in PECOS as KYLE FOX.Based on the most recent information from CMS, provider Kyle D. Fox 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 ID1205877339Provider TypeIndividualFull NameFox, Kyle D.CredentialPA-CGenderMaleSole ProprietorNoEnumeration Date6/9/2006Last Updated7/28/2025Contact InformationPractice LocationPractice Address9200 W Wisconsin Ave, Milwaukee, WI 53226Phone(414) 805-5400Fax(414) 955-0115Mailing LocationMailing Address9200 W Wisconsin Ave, Milwaukee, WI 53226-3522Phone(414) 805-5400Fax(414) 955-0115Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense1867WisconsinProvider IdentifiersIDDescriptionIssuerID42872800DescriptionMedicaidIssuerUnlistedWisconsinID1205877339DescriptionMedicaidIssuerUnlistedWisconsin