Individual provider Active NPI

Robert Thomas Truppe

  • Medical Physician Assistant
  • Wauwatosa, WI
National Provider Identifier
1124503867
Registry record updated Sep 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4526-23 Issued in WI
Practice address
10625 W North Ave Ste 102
Wauwatosa, WI 53226-2315
Phone
(414) 877-5350
NPI assigned
Sep 28, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2018

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 4526-23 WI Primary

Addresses

Primary practice location

10625 W North Ave Ste 102
Wauwatosa, WI 53226-2315

Mailing address

W177N5423 Legend CT
Menomonee Falls, WI 53051-7858
Phone (414) 531-5673

Other practice location 1

10625 W North Ave
Wauwatosa, WI 53226-2315
Phone (414) 877-5350

Other identifiers 1

IdentifierTypeStateIssuer
917471355OtherWIUNITED HEALTHCARE

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181120000723 WI Practitioner - Physician Assistant 3971857442 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Specialists SCGroup PAC ID 8729975461, 220 clinicians

Practice addresses (Care Compare)

10180 Washington Ave
Mount Pleasant, WI 53177-1604
Phone (262) 687-7550

201 N Mayfair Rd
Wauwatosa, WI 53226-4216
Phone (414) 259-7200

2061 Cheyenne CT
Grafton, WI 53024-9368
Phone (262) 376-1934

375 W River Woods Pkwy
Glendale, WI 53212-1080
Phone (414) 326-1500

5000 W Chambers St
Milwaukee, WI 53210-1650
Phone (414) 447-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Dec 14, 2018 Accepting new patients
Integrated Therapeutic Massage LLC PastSince Aug 1, 2021 Accepting new patients
MCMC Urgicare LLC Past Accepting new patients

Locations

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

19333 W North Ave
Brookfield, WI 53045
Phone (262) 785-2000

10101 S 27th St
Franklin, WI 53132
Phone (414) 325-4700

375 W River Woods Pkwy
Glendale, WI 53212
Phone (414) 326-1500

2301 N Lake Dr
Milwaukee, WI 53211
Phone (414) 270-4932

3237 S 16th St
Milwaukee, WI 53215
Phone (414) 647-5000

5000 W Chambers St
Milwaukee, WI 53210
Phone (414) 447-2089

3801 Spring St
Mount Pleasant, WI 53405
Phone (262) 636-4011

500 S Oakwood Rd
Oshkosh, WI 54904
Phone (920) 223-0501

13111 N Port Washington Rd
Thiensville, WI 53097
Phone (262) 243-7300

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

201 N Mayfair Rd
Wauwatosa, WI 53226
Phone (414) 259-7200

Organizations & group practices 4

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.

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": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538092800000",
    "number": "1124503867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "W177N5423 LEGEND CT",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530517858",
            "telephone_number": "414-531-5673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10625 W NORTH AVE STE 102",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532262315",
            "telephone_number": "414-877-5350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10625 W North Ave",
            "address_purpose": "LOCATION",
            "city": "Wauwatosa",
            "state": "WI",
            "postal_code": "532262315",
            "country_code": "US",
            "telephone_number": "414-877-5350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUPPE",
        "first_name": "ROBERT",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "4526-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "917471355",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.