Active NPI
Kathryn R Trandem, MD, PHD
- Urology Physician
- Boscobel, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 73669
- Practice address
- 205 Parker St
Boscobel, WI 53805-1642 - Phone
- (608) 375-4112
- NPI assigned
- Jun 18, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 036.154905 | IL | |
| Pediatric Urology Physician | 2088P0231X | 73669 | WI | |
| Urology Physician | 208800000X | 73669 | WI | Primary |
Addresses
Primary practice location
205 Parker St
Boscobel, WI 53805-1642
Mailing address
9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone (414) 266-3794
Other practice location 1
9000 W Wisconsin Ave
Milwaukee, WI 53226-4874
Phone (414) 266-3794
Other practice location 2
2575 E Evergreen Drive
Appleton, WI 54913-8904
Phone (920) 969-5353
Other practice location 3
1506 S Oneida St Ste 500
Appleton, WI 54915-1305
Phone (920) 969-9700
Other practice location 4
1675 Dempster St Fl 3
Park Ridge, IL 60068-1110
Phone (847) 297-8700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053674770 | Medicaid | WI |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/ | ||
| Direct Messaging Address | ktrandem395283@direct.myadvocateaurora.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA, WI, IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036.154905 | IL | MD | Urology Physician |
| 73669 | WI | MD | Pediatric Urology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Healthcare Network | Current | Accepting new patients | |
| Central PA Pharmacy LLC. | Current | Accepting new patients | |
| Memorial Hospital of Boscobel | Current | Accepting new patients | |
| Family Healthcare Network | Current | Accepting new patients | |
| The Medical College of Wisconsin, Inc. | Surgery | Current | Accepting new patients |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| Osf Multi-Specialty Group | Current | Accepting new patients | |
| Family Healthcare Network | Current | Accepting new patients | |
| Advocate Health and Hospitals Corporation | Current | Accepting new patients | |
| UCSF Medical Group Business Services | Current | Accepting new patients | |
| UCSF Medical Group Business Services | Surgery | Current | Accepting new patients |
| Memorial Hospital of Boscobel | Current | Accepting new patients |
Locations
290 N Wayte Ln
Fresno, CA 93701
Phone (559) 459-4101
2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444
400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000
400 Parnassus Ave
#300
San Francisco, CA 94143
Phone (415) 476-2163
400 Parnassus Ave
San Francisco, CA 94143
Phone (415) 353-2000
3333 California St
#S110
San Francisco, CA 94118
Phone (415) 514-2664
305 E Center Ave
Visalia, CA 93291
Phone (559) 737-4792
214 McHenry Rd
Buffalo Grove, IL 60089
Phone (847) 459-1160
29373 Network Pl
Chicago, IL 60673
1675 W Dempster St
Fl 3
Park Ridge, IL 60068
Phone (847) 318-9330
1675 W Dempster St
Park Ridge, IL 60068
Phone (847) 318-9300
420 NE Glen Oak Ave
Ste 201
Peoria, IL 61603
Phone (309) 655-3800
8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050
1506 S Oneida St
Ste 500
Appleton, WI 54915
Phone (920) 738-8050
205 Parker St
Boscobel, WI 53805
Phone (608) 375-4112
9000 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 266-2625
8701 Watertown Plank Rd
Wauwatosa, WI 53226
Phone (414) 456-4100
Interoperability endpoints
- ktrandem822974@direct.emplifyhealth.org
Organizations & group practices 13
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Critical Access Hospital
- Boscobel, WI
- NPI 1760459846
-
- Internal Medicine Physician
- Milwaukee, WI
- NPI 1699720086
Surgery
-
- Multi-Specialty Clinic/Center
- Oak Brook, IL
- NPI 1700824455
-
- Federally Qualified Health Center (FQHC)
- Woodlake, CA
- NPI 1164517744
-
- Internal Medicine Physician
- Peoria, IL
- NPI 1922445527
-
- Internal Medicine Physician
- San Francisco, CA
- NPI 1477624104
Surgery
-
- Medicare Defined Swing Bed Hospital Unit
- Boscobel, WI
- NPI 1497712624
-
- Children's Hospital
- Oak Lawn, IL
- NPI 1508315516
-
- General Acute Care Hospital
- Downers Grove, IL
- NPI 1578670543
-
- Community/Retail Pharmacy
- Patton, PA
- NPI 1578541413
-
- Federally Qualified Health Center (FQHC)
- Delano, CA
- NPI 1063283158
-
- Federally Qualified Health Center (FQHC)
- Fresno, CA
- NPI 1225546575
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712275200000",
"number": "1053674770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "532264874",
"telephone_number": "414-266-3794",
"fax_number": "414-266-1752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "205 PARKER ST",
"city": "BOSCOBEL",
"state": "WI",
"postal_code": "538051642",
"telephone_number": "608-375-4112"
}
],
"practiceLocations": [
{
"address_1": "9000 W Wisconsin Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532264874",
"country_code": "US",
"telephone_number": "414-266-3794",
"fax_number": "414-266-1752",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2575 E Evergreen Drive",
"address_purpose": "LOCATION",
"city": "Appleton",
"state": "WI",
"postal_code": "549138904",
"country_code": "US",
"telephone_number": "920-969-5353",
"fax_number": "414-337-7201",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1506 S Oneida St Ste 500",
"address_purpose": "LOCATION",
"city": "Appleton",
"state": "WI",
"postal_code": "549151305",
"country_code": "US",
"telephone_number": "920-969-9700",
"fax_number": "920-969-7979",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1675 Dempster St Fl 3",
"address_purpose": "LOCATION",
"city": "Park Ridge",
"state": "IL",
"postal_code": "600681110",
"country_code": "US",
"telephone_number": "847-297-8700",
"fax_number": "847-723-9441",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRANDEM",
"first_name": "KATHRYN",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-18",
"last_updated": "2024-04-05",
"certification_date": "2024-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "IL",
"license": "036.154905",
"primary": false
},
{
"code": "2088P0231X",
"taxonomy_group": "",
"desc": "Urology, Pediatric Urology",
"state": "WI",
"license": "73669",
"primary": false
},
{
"code": "208800000X",
"taxonomy_group": "",
"desc": "Urology",
"state": "WI",
"license": "73669",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1053674770",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "1675 Dempster St Fl 3",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681110",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ktrandem395283@direct.myadvocateaurora.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "1675 Dempster St Fl 3",
"city": "Park Ridge",
"state": "IL",
"country_code": "US",
"postal_code": "600681110",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Boscobel, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.