Active NPI
Isaac J Trejo, D.P.M.
- Podiatrist
- Milwaukee, WI
National Provider Identifier
1023009891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 708
- 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, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 43220700 | Medicaid | WI |
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
Enrollment records 1
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 100
- Quality
- 93.46
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 708 | WI | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Foot and Ankle Clinic, Inc. | Podiatrist | Current | 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
- https://api.platform.athenahealth.com/6854/brand/1/csg/1/fhir/r4
- 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.
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- NPI 1407229396
-
- General Practice Physician
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- NPI 1235443615
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.