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Samantha Elizabeth Fruehauf

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

10625 W North Ave, Wauwatosa, WI 53226-2315

PECOS Enrollment

This provider is enrolled in PECOS as SAMANTHA FRUEHAUF.

Based on the most recent information from CMS, provider Samantha Elizabeth Fruehauf 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 2 days ago.

Profile Details

Provider ID
1740919810
Provider Type
Individual
Full Name
Fruehauf, Samantha Elizabeth
Title
Ms.
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
6/6/2022
Last Updated
3/13/2023

Contact Information

Practice Location

10625 W North Ave, Wauwatosa, WI 53226-2315

(414) 877-5350

Unlisted Fax

Mailing Location

7400 W State St Apt 341, Wauwatosa, WI 53213-2775

(716) 857-1225

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License Unlisted Issuer

Samantha Elizabeth Fruehauf

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Reinhardt, Shelby Rae

Loftis, Patrick

Christen, Kathryn

Mcdonald, Mark C

Thompson, Ronald H

Kortbein, Eric

Hagen, Demi Elisabeth

Scott, Ann P

Kapla, Trent

Gore, Nicholas