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Todd G Kreisler

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

2901 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3677

PECOS Enrollment

This provider is enrolled in PECOS as TODD KREISLER.

Based on the most recent information from CMS, provider Todd G Kreisler is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:26 AM.

Profile Details

Provider ID
1710963087
Provider Type
Individual
Full Name
Kreisler, Todd G
Credential
P.A.C.

Gender
Male
Sole Proprietor
No
Enumeration Date
12/19/2005
Last Updated
5/8/2024

Contact Information

Practice Location

2901 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3677

(414) 649-3780

Unlisted Fax

Mailing Location

PO Box 735044, Chicago, IL 60673-5044

(800) 326-2250

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 880-023 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 42958800	Description Medicaid	Issuer Unlisted Wisconsin
ID 682000044	Description Other	Issuer MEDICARE Wisconsin

Todd G Kreisler

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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Mustafa, Nesreen

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Ferris, Tara J