LAURA S OLDENBURG (PA) – Physician Assistant, NPI 1104920107

LAURA S OLDENBURG (PA) is a healthcare provider. based in Wauwatosa, Wisconsin. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 1747023 (WI). The NPI Number for LAURA S OLDENBURG (PA) is 1104920107

Main info

Female
22 Years Of Experience
Accepts Medicare Assignment
Name
LAURA S OLDENBURG (PA)
NPI
1104920107
Phone
(414) 384-6700
Address
3077 N MAYFAIR RD STE 305
Enumeration Date
11 September 2006
Last Update Date
3 March 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4143846700
Graduation Year
2004 (22 years ago)
PAC ID
0648292391
Group Practice PAC ID
5294727152
Professional Enrollment ID
I20051222000427
Address ID
WI531328890FR3111XAVEX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

3,678 PHYSICIAN ASSISTANT in WI

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Provider Addresses for LAURA S OLDENBURG (PA)

  • 305, North Mayfair Road, Wauwatosa, Milwaukee County, Wisconsin, 53226, United States

    WAUWATOSA, WI 532224305

    Phone: (414) 384-6700

    Fax: (414) 727-1058

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2005-12-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20051222000427IPhysician AssistantWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes9161$0
72110X-ray of lower and sacral spine, minimum of 4 views3433$0
72050X-ray of upper spine, 4-5 views1212$0
View full utilization report →

Insurance plans in this area (ZIP 53222)

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Provider's Procedures

LAURA S OLDENBURG (PA) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTWI20610Aspiration and/or injection of large joint or joint capsule145103
PHYSICIAN ASSISTANTWI73562X-ray of knee, 3 views1311

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5294727152View full group profile
NameSpecialtyState
Orthopedic SurgeryWI
Nurse PractitionerWI
Nurse PractitionerWI
Orthopedic SurgeryWI
Orthopedic SurgeryWI
-WI
Nurse PractitionerWI
Physician AssistantWI
Orthopedic SurgeryWI
Orthopedic SurgeryWI

Reviews

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Frequently asked questions

Where can patients find LAURA S OLDENBURG (PA)'s NPI?
You can confirm LAURA S OLDENBURG (PA) with NPI 1104920107; it appears in the national provider directory.
Is LAURA S OLDENBURG (PA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is LAURA S OLDENBURG (PA)?
The page reflects Physician Assistant for LAURA S OLDENBURG (PA). Clinical services aligned with this taxonomy classification.
What location metadata exists for LAURA S OLDENBURG (PA)?
The page summarizes Wauwatosa, Wisconsin for LAURA S OLDENBURG (PA); expand the address list for detail.
What if Wauwatosa, Wisconsin seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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