Individual ProviderPatrick LoftisPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice AddressFroedtert Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226(414) 805-3666PECOS EnrollmentBased on the most recent information from CMS, provider Patrick Loftis 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 ID1831143007Provider TypeIndividualFull NameLoftis, PatrickTitleMr.CredentialPACGenderMaleSole ProprietorNoEnumeration Date5/20/2006Last Updated6/19/2008Contact InformationPractice LocationPractice AddressFroedtert Hospital, 9200 West Wisconsin Avenue, Milwaukee, WI 53226Phone(414) 805-3666FaxUnlisted FaxMailing LocationMailing Address9200 W Wisconsin Ave, Froedtert Hospital, Milwaukee, WI 53226-3522PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense1247-023WisconsinProvider IdentifiersIDDescriptionIssuerID41934700DescriptionMedicaidIssuerUnlistedWisconsinID009006261VDescriptionOtherIssuerHUMANA