Individual provider Active NPI

Patrick Loftis, PAC

  • Physician Assistant
  • Milwaukee, WI
National Provider Identifier
1831143007
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1247-023 Issued in WI
Practice address
Froedtert Hospital
9200 West Wisconsin Avenue
Milwaukee, WI 53226
Phone
(414) 805-3666
NPI assigned
May 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1247-023 WI Primary

Addresses

Primary practice location

Froedtert Hospital
9200 West Wisconsin Avenue
Milwaukee, WI 53226

Mailing address

9200 W Wisconsin Ave
Froedtert Hospital
Milwaukee, WI 53226-3522

Other identifiers 2

IdentifierTypeStateIssuer
41934700MedicaidWI
009006261VOtherHUMANA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20080808000436 WI Practitioner - Physician Assistant 4284708231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

13900 W National Ave
New Berlin, WI 53151-9515
Phone (262) 928-4500

N17W24100 Riverwood Dr
Waukesha, WI 53188-1127
Phone (262) 928-4704

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1247-023WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prohealth Medical Group Inc. CurrentSince Sep 1, 2013 Accepting new patients
Prohealth Medical Group Inc CurrentSince Sep 1, 2013 Accepting new patients
Watertown Physician Practices LLC Physician Assistant Past Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

195 Discovery Dr
Brookfield, WI 53045
Phone (262) 513-7100

195 Discovery Dr
Fl 2
Brookfield, WI 53045

2750 Golf Rd
Delafield, WI 53018
Phone (262) 928-4900

240 Maple Ave
Mukwonago, WI 53149
Phone (262) 928-1900

13900 W National Ave
New Berlin, WI 53151
Phone (262) 928-4500

1185 Corporate Center Dr
Ste 150
Oconomowoc, WI 53066
Phone (262) 928-5000

1185 Corporate Center Dr
Ste 155
Oconomowoc, WI 53066
Phone (262) 567-3528

N57W24950 N Corporate Cir
Sussex, WI 53089
Phone (262) 544-4411

808 Cornerstone Xing
Waterford, WI 53185
Phone (262) 500-5292

109 Air Park Dr
Watertown, WI 53094
Phone (262) 928-5100

2130 Big Bend Rd
Waukesha, WI 53189
Phone (262) 928-7555

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

1011 Spring City Dr
Waukesha, WI 53186
Phone (262) 925-0370

20611 Watertown Rd
Ste J
Waukesha, WI 53186
Phone (262) 782-0000

N14W23900 Stone Ridge Dr
Waukesha, WI 53188
Phone (262) 549-3030

721 American Ave
Ste 310
Waukesha, WI 53188
Phone (262) 928-4880

1101 SPG City LN
Waukesha, WI 53186

717 W Moreland Blvd
Waukesha, WI 53188
Phone (262) 542-9100

N16W24131 Riverwood Dr
Waukesha, WI 53188
Phone (262) 696-0696

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1831143007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "address_2": "FROEDTERT HOSPITAL",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FROEDTERT HOSPITAL",
            "address_2": "9200 WEST WISCONSIN AVENUE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-805-3666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOFTIS",
        "first_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1247-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41934700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HUMANA",
            "identifier": "009006261V",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.