Carrie Hofstad, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5059 Issued in WI

Practice address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Phone

(414) 805-6850

Fax

(414) 805-6851

NPI assigned

Jan 25, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Bridgeport, CT
  • NPI 1669445946
  Medicare reassignment NPD
• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment
• Optimus Health Care Inc

  • Federally Qualified Health Center (FQHC)
  • Stamford, CT
  • NPI 1780944736
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1811967425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6850",
            "fax_number": "414-805-6851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-6850",
            "fax_number": "414-805-6851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "805 Atlantic St",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069026805",
            "country_code": "US",
            "telephone_number": "203-327-5111",
            "fax_number": "203-327-2991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOFSTAD",
        "first_name": "CARRIE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "5059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "001303",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margot Lee Hoffmann, LPC
• Paul Joseph Hoffmann, RPH
• Megan Hofmann, PA
• Michelle M Hofmeister
• Sabrina Lauren Hofmeister, D.O
• Kristy Hofstetter, M.S., CCC-SLP
• Nicole A Hoftender, APNP
• Christine Marie Hogan, M.D.
• Colleen Hogan
• Holly Hogan, DDS

• Physician Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.