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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: August 02, 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
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Secondary Practice Locations 6

Location 12575 E Evergreen DriveAppleton, WI 54913-8904 · Phone (920) 969-5353 · Fax (414) 337-7201
Location 24805 S Moorland RdNew Berlin, WI 53151-7401 · Phone (262) 798-7200 · Fax (262) 798-7201
Location 31655 W Mequon RdMequon, WI 53092-3254 · Phone (414) 266-6457 · Fax (414) 266-3261
Location 4W180N8085 Town Hall RdMenomonee Falls, WI 53051-3518 · Phone (262) 257-5000 · Fax (262) 518-5052
Location 53200 Pleasant Valley RdWest Bend, WI 53095-9274 · Phone (262) 836-7300 · Fax (262) 836-7301
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, and ordering and referring status from the CMS PECOS system.

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.

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.

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.