MEDICARE: MS. SHELBY RAE REINHARDT PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	838923	WI

General Provider Information

NPI Number	:	1538846035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SHELBY RAE REINHARDT PA-C

Provider Business Mailing Address
First Line	:	10625 W NORTH AVE STE 101B
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-2315
Country	:	US
Telephone Number	:	414-877-5350
Fax Number	:

Provider Business Practice Location Address
First Line	:	10625 W NORTH AVE STE 101B
Second Line	:
City	:	WAUWATOSA
State	:	WI
Zip	:	53226-2315
Country	:	US
Telephone Number	:	414-877-5350
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2023
Last Update Date	:	12/12/2025

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