Individual ProviderTracy BirdNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2801 W Kinnickinnic River Pkwy, Suite 630, Milwaukee, WI 53215-3669(414) 385-1827(414) 385-2429PECOS EnrollmentBased on the most recent information from CMS, provider Tracy Bird 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 ID1013454362Provider TypeIndividualFull NameBird, TracyGenderFemaleSole ProprietorNoEnumeration Date1/25/2017Last Updated11/23/2021Contact InformationPractice LocationPractice Address2801 W Kinnickinnic River Pkwy, Suite 630, Milwaukee, WI 53215-3669Phone(414) 385-1827Fax(414) 385-2408Mailing LocationMailing Address2801 W Kinnickinnic River Pkwy Ste 380, Milwaukee, WI 53215-3632Phone(414) 385-2429Fax(414) 385-2461Provider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense7549WisconsinProvider IdentifiersIDDescriptionIssuerID100065330DescriptionMedicaidIssuerUnlistedWisconsin