Look up the most recent NPI and PECOS records

Timothy Allen Fehrenbacher

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669

PECOS Enrollment

This provider is enrolled in PECOS as TIMOTHY FEHRENBACHER.

Based on the most recent information from CMS, provider Timothy Allen Fehrenbacher 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
1881740421
Provider Type
Individual
Full Name
Fehrenbacher, Timothy Allen
Title
Mr.
Credential
PAC

Gender
Male
Sole Proprietor
No
Enumeration Date
1/26/2007
Last Updated
12/1/2021

Contact Information

Practice Location

2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669

(414) 649-3240

Unlisted Fax

Mailing Location

3301 W Forest Home Ave, Milwaukee, WI 53215-2843

(414) 389-2233

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 1322 Wisconsin
Code 363AS0400X	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 1322023 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 41924500	Description Medicaid	Issuer Unlisted Wisconsin

Timothy Allen Fehrenbacher

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Faude, Heather L

Stillo, Adam N

Williams, Heather Joy

Tennant, Madeline

Finn, Andrea M

Kuennen, Jessica

Campbell, Spencer A

Glodowski, Kelly M

Krakauer, Julia

Scaletta, Giuseppa