Kelle Joell Tomatz, FNP-BC is a medicare enrolled "Physical Therapist" in Wauwatosa, Wisconsin. Her current practice location is
10625 W North Avenue Suite 102, Emergency Medicine Specialists, S.c., Wauwatosa, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(414) 877-5345.
Kelle Joell Tomatz is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1972912764.
Provider's Profile
Full Name | Kelle Joell Tomatz |
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Gender | Female |
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Speciality | Physical Therapist |
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Location | 10625 W North Avenue Suite 102, Wauwatosa, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1972912764
- Provider Enumeration Date: 08/06/2014
- Last Update Date: 08/26/2024
Medicare PECOS Information:
- PECOS PAC ID: 8426270497
- Enrollment ID: I20141106000319
Medical Identifiers
Medical identifiers for Kelle Joell Tomatz such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1972912764 | NPI | - | NPPES |
100040306 | Medicaid | WI | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | 5795 (Wisconsin) | Secondary |
363LF0000X | Nurse Practitioner - Family | 5795-33 (Wisconsin) | Secondary |
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kelle Joell Tomatz allows following entities to bill medicare on her behalf.
Entity Name | Ascension Medical Group-southeast Wisconsin Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1609881077 PECOS PAC ID: 8628980943 Enrollment ID: O20031104000421 |
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Entity Name | Aurora Medical Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
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Entity Name | Lakeshore Medical Clinic Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481 |
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Entity Name | Emergency Medicine Specialists Sc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1568413524 PECOS PAC ID: 8729975461 Enrollment ID: O20040228000032 |
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Entity Name | Aurora Advanced Healthcare Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1265629133 PECOS PAC ID: 3375625833 Enrollment ID: O20080123000694 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kelle Joell Tomatz is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Kelle Joell Tomatz, FNP-BC 790 Remington Blvd, Bolingbrook, IL 60440-4909 Ph: () - | Kelle Joell Tomatz, FNP-BC 10625 W North Avenue Suite 102, Emergency Medicine Specialists, S.c., Wauwatosa, WI 53266-0000 Ph: (414) 877-5345 |
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