Individual ProviderLindsey RongstadPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669(414) 649-3370(800) 326-2250PECOS EnrollmentBased on the most recent information from CMS, provider Lindsey Rongstad 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 ID1215556733Provider TypeIndividualFull NameRongstad, LindseyCredentialPA-CGenderFemaleSole ProprietorYesEnumeration Date4/14/2020Last Updated4/18/2024Contact InformationPractice LocationPractice Address2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669Phone(414) 649-3370FaxUnlisted FaxMailing LocationMailing AddressPO Box 735044, Chicago, IL 60673-5044Phone(800) 326-2250FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense5344-023WisconsinCode363AS0400XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID100161950DescriptionMedicaidIssuerUnlistedWisconsin