Individual ProviderCara VincentPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2801 W Kinnickinnic River Pkwy Ste 260, Milwaukee, WI 53215-3631(414) 649-6780(800) 326-2250PECOS EnrollmentBased on the most recent information from CMS, provider Cara Vincent 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 ID1518745090Provider TypeIndividualFull NameVincent, CaraCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date9/18/2023Last Updated1/25/2024Contact InformationPractice LocationPractice Address2801 W Kinnickinnic River Pkwy Ste 260, Milwaukee, WI 53215-3631Phone(414) 649-6780FaxUnlisted FaxMailing LocationMailing AddressPO Box 735044, Chicago, IL 60673-5044Phone(800) 326-2250FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense7623WisconsinProvider IdentifiersIDDescriptionIssuerID100257838DescriptionMedicaidIssuerUnlistedWisconsin