Look up the most recent NPI and PECOS records

Samantha Moreno

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

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

(414) 385-1922

PECOS Enrollment

Based on the most recent information from CMS, provider Samantha Moreno 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 2 days ago.

Profile Details

Provider ID
1598484362
Provider Type
Individual
Full Name
Moreno, Samantha
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
8/25/2022
Last Updated
2/6/2023

Contact Information

Practice Location

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

(414) 385-1922

Unlisted Fax

Mailing Location

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

(414) 385-1922

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 13260-33 Wisconsin

Samantha Moreno

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Biddick, Lindsay

Szudrowitz Warner, Danielle K

Dovi, Tracey L

Lesniewski, Jennifer A

Cohn, Casey L.

Budynek, Jackie Julie

Jauregui, Noelle E

Schmitt, Patrick Joseph

Brandt, Lisa Marie

Carman, Emily