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DR. RAYMOND T FEDDERLY MD
NPI 1790736619
Pediatrics - Pediatric Cardiology in Milwaukee, WI

Active since May 15, 2006PECOS EnrolledAccepts Medicare Assignment
9000 W WISCONSIN AVE, PEDIATRIC CARDIOLOGY, MILWAUKEE, WI 53226(414) 266-2380(414) 266-2294 Get Directions Write a Review

NPPES record last updated: March 1, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 11, 2023, Jun 12, 2023 (2 updates tracked since 2023).

About Dr. Raymond T Fedderly Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. RAYMOND T FEDDERLY MD (NPI 1790736619) is an individual pediatric cardiology provider in Milwaukee, Wisconsin, licensed in Wisconsin (32186) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, maintains 6 additional practice locations, and is a graduate of University Of Wisconsin School Of Medicine (1988).

NPPES Registry Identity

NPI1790736619
Entity TypeIndividualMale
Primary Taxonomy2080P0202X
Provider Legal NameDR. RAYMOND T FEDDERLYCredential: MD
Location Address9000 W WISCONSIN AVE, PEDIATRIC CARDIOLOGYMilwaukee, WI 53226-4874
Mailing Address9000 W Wisconsin Ave, Pediatric CardiologyMilwaukee, WI 53226-4874 · (414) 266-2380 · Fax (414) 266-2294
Phone(414) 266-2380
Fax(414) 266-2294
Sole ProprietorNo
Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 1988
Enumeration DateMay 15, 2006
Last NPPES UpdateMarch 1, 20242 updates tracked since enumeration
NPPES CertifiedMarch 1, 2024
✔ NPI 1790736619 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License✔ Licensed in WI · 32186
Definition
A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.
9000 W WISCONSIN AVE, Milwaukee, WI 53226
Open in Google Maps ↗

Secondary Practice Locations 6

Location 12575 E Evergreen DriveAppleton, WI 54913-8904 · Phone (920) 969-5353 · Fax (414) 337-7201
Location 21655 W Mequon RdMequon, WI 53092-3254 · Phone (414) 266-6457 · Fax (414) 266-3261
Location 34805 S Moorland RdNew Berlin, WI 53151-7401 · Phone (262) 798-7200 · Fax (262) 798-7201
Location 43200 Pleasant Valley RdWest Bend, WI 53095-9274 · Phone (262) 836-7300 · Fax (262) 836-7301
Location 5W180N8085 Town Hall RdMenomonee Falls, WI 53051-3518 · Phone (262) 257-5000 · Fax (262) 518-5052
Location 69200 W Wisconsin AveMilwaukee, WI 53226-3522 · Phone (414) 805-6000 · Fax (414) 805-6280

Other Identifiers 2

Other002000115THumana
Medicaid1790736619WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare) and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Raymond T Fedderly Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113960956
PECOS Enrollment IDI20050602001119
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Raymond Fedderly reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Children's Specialty Group, Inc.
Same address
Pediatrics
9000 W WISCONSIN AVE
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • Medicare enrollment name: Childrens Specialty Group Inc
  • 424 clinicians in this Medicare group
NPI 1942970405 (414) 266-2000
The Medical College Of Wisconsin, Inc.
0.1 mi
Internal Medicine
8701 WATERTOWN PLANK RD
Milwaukee, WI 53226
  • Reassigned Medicare billing, Wisconsin enrollment
  • 3,983 clinicians in this Medicare group
NPI 1699720086 (414) 955-7101
Froedtert & the Medical College Of Wisconsin Community Physicians, Inc.
10 mi
Internal Medicine
W180N8000 TOWN HALL RD
Menomonee Falls, WI 53051
  • Reassigned Medicare billing, Wisconsin enrollment
  • 2,294 clinicians in this Medicare group
NPI 1568787448 (262) 255-2500

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. LESLIE L. TALBERT NP
Nurse Practitioner (Pediatrics)
9000 W WISCONSIN AVE, PEDIATRIC CRITICAL CARE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-3360
SARAH MARIE RUMLER DO
Pediatrics (Pediatric Hematology-Oncology)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 955-4170
ALISON COREN
Pediatrics (Pediatric Endocrinology)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-6750
BRANDON PALMER M.D.
Pediatrics
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 337-7050
AIDAN JAMES REID DO
Pediatrics
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-6800
KYNDAL LYN HETTICH RD, CSP, CD
Dietitian, Registered
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-5938
CARISA MARIE DIMATTINA LCSW
Social Worker (Clinical)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 581-4004
BREYA LOGAN WHITEFIELD PHD
Psychologist (Clinical)
9000 W WISCONSIN AVE
MILWAUKEE, WI 53226
Milwaukee County (414) 266-2000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Raymond Fedderly's NPI number?

The NPI number for Raymond Fedderly is 1790736619. It was assigned to this individual provider in the NPPES registry on May 15, 2006.

Where is Raymond Fedderly located?

Raymond Fedderly practices at 9000 W Wisconsin Ave Pediatric Cardiology, Milwaukee, WI 53226. The listed phone number is (414) 266-2380.

What is Raymond Fedderly's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Raymond Fedderly enrolled in Medicare?

Yes. Raymond Fedderly is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Raymond Fedderly's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Raymond Fedderly reassigns Medicare benefits to 3 organizations: Children's Specialty Group, Inc. (Milwaukee, WI), The Medical College Of Wisconsin, Inc. (Milwaukee, WI) and Froedtert & the Medical College Of Wisconsin Community Physicians, Inc. (Menomonee Falls, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Raymond Fedderly's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Raymond Fedderly accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 1 other insurer list Raymond Fedderly as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Raymond Fedderly was last updated on March 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.