NPIMap

Individual provider Active NPI

Treka B Wenner, PA

  • Medical Physician Assistant
  • Edmond, OK
National Provider Identifier
1023182672
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1494 Issued in OK
Practice address
46 E 15TH St
Edmond, OK 73013-4301
Phone
(405) 844-5210
NPI assigned
Nov 17, 2006
Last updated
Feb 12, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1494 OK Primary

Addresses

Primary practice location

46 E 15TH St
Edmond, OK 73013-4301

Mailing address

46 E 15TH St
Edmond, OK 73013-4301
Phone (405) 844-5210

Other identifiers 1

IdentifierTypeStateIssuer
200072440AMedicaidOK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070612000292 OK Practitioner - Physician Assistant 3678671831 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saints Medical Group, LLCGroup PAC ID 7012914898, 430 clinicians

Practice addresses (Care Compare)

2749 Progressive Dr
Edmond, OK 73034-7649
Phone (405) 772-4130

608 NW 9TH St
Oklahoma City, OK 73102-1049

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Oklahoma Communities CurrentSince Jan 1, 2013 Accepting new patients
Mercy Hospital Logan County, Inc CurrentSince Jan 1, 2013 Accepting new patients
Saints Medical Group, LLC CurrentSince Sep 13, 2024 Accepting new patients
Primacare LP Past Accepting new patients
Summit Medical Center Past Accepting new patients
Oca Tricity LP Past Accepting new patients
Mercy Access LLC Past Accepting new patients

Locations

200 S Academy Rd
Guthrie, OK 73044
Phone (405) 260-4165

2825 Parklawn Dr
Oklahoma City, OK 73110
Phone (405) 245-1453

4300 McAuley Blvd
Oklahoma City, OK 73120
Phone (405) 936-5455

608 NW 9th St
Ste 2200
Oklahoma City, OK 73102
Phone (405) 231-3737

8325 NW Expressway
Oklahoma City, OK 73162
Phone (405) 728-8000

Interoperability endpoints

  • Direct secure messaging: twenner516569@direct-ehr-ssmhc.com

Organizations & group practices 10

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1023182672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 E 15TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730134301",
            "telephone_number": "405-844-5210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 E 15TH ST",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730134301",
            "telephone_number": "405-844-5210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENNER",
        "first_name": "TREKA",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OK",
            "license": "1494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200072440A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edmond, OK

Sources for this page

Verify at the official NPI Registry.