Individual ProviderElizabeth MattesNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2801 W Kinnickinnic River Pkwy, Suite 440, Milwaukee, WI 53215-3669(414) 649-3537(800) 325-2250PECOS EnrollmentBased on the most recent information from CMS, provider Elizabeth Mattes 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 ID1205886173Provider TypeIndividualFull NameMattes, ElizabethCredentialAPNPGenderFemaleSole ProprietorNoEnumeration Date5/11/2006Last Updated4/15/2025Contact InformationPractice LocationPractice Address2801 W Kinnickinnic River Pkwy, Suite 440, Milwaukee, WI 53215-3669Phone(414) 649-3537FaxUnlisted FaxMailing LocationMailing AddressPO Box 735044, Chicago, IL 60673-5044Phone(800) 325-2250FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense2757-033WisconsinCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense2757-33WisconsinProvider IdentifiersIDDescriptionIssuerID0346332DescriptionOtherIssuerCRNA CERTWisconsinID100014710DescriptionMedicaidIssuerUnlistedWisconsinIDNPI: 1205886173DescriptionOtherIssuerNPI: 1205886173Wisconsin