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Cassidy Sarah Mccandless

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 CASSIDY MCCANDLESS.

Based on the most recent information from CMS, provider Cassidy Sarah Mccandless 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
1922511120
Provider Type
Individual
Full Name
Mccandless, Cassidy Sarah
Credential
MS, MPAS, RD, PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
11/9/2017
Last Updated
2/23/2026

Contact Information

Practice Location

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

(414) 649-3750

Unlisted Fax

Mailing Location

PO Box 735044, Chicago, IL 60673-5044

(414) 649-3750

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 7218-23 Wisconsin

Provider Identifiers

ID	Description	Issuer
ID 100228273	Description Medicaid	Issuer Unlisted Wisconsin

Cassidy Sarah Mccandless

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

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Kuennen, Jessica