Individual provider Active NPI

Isaac J Trejo, D.P.M.

  • Podiatrist
  • Milwaukee, WI
National Provider Identifier
1023009891
Registry record updated Feb 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
708 Issued in WI
Practice address
4100 S Howell Ave
Milwaukee, WI 53207-4410
Phone
(414) 483-5566
Fax
(866) 263-5456
NPI assigned
Nov 2, 2005
Last updated
Feb 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 708 WI Primary

Addresses

Primary practice location

4100 S Howell Ave
Milwaukee, WI 53207-4410

Mailing address

6400 Industrial Loop
Greendale, WI 53129-2452
Phone (414) 423-4100

Other identifiers 1

IdentifierTypeStateIssuer
43220700MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040503000995 WI Practitioner - Podiatry 3375531007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
William M. Scholl College of Podiatric Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4100 S Howell Ave
Milwaukee, WI 53207-4410
Phone (414) 483-5566

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
93.46
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
708WIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Foot and Ankle Clinic, Inc. Podiatrist CurrentSince Jul 16, 1995 Accepting new patients
Visiting Medical Doctors Past Accepting new patients
Dolphin Manor Adult Day Program Past Accepting new patients

Locations

149 Wisconsin Ave
Waukesha, WI 53186
Phone (262) 574-9147

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6854/brand/1/csg/1/fhir/r4
  • Direct secure messaging: isaac.trejo.1@6854.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203552000000",
    "number": "1023009891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 INDUSTRIAL LOOP",
            "city": "GREENDALE",
            "state": "WI",
            "postal_code": "531292452",
            "telephone_number": "414-423-4100",
            "fax_number": "414-423-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 S HOWELL AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532074410",
            "telephone_number": "414-483-5566",
            "fax_number": "866-263-5456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREJO",
        "first_name": "ISAAC",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-02",
        "last_updated": "2008-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WI",
            "license": "708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43220700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

Verify at the official NPI Registry.