Active NPI
Joseph Edgar Trader, M.D.
- Orthopaedic Surgery Physician
- Manitowoc, WI
National Provider Identifier
1164513123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- 18035
- Practice address
- 501 N 10TH St
Manitowoc, WI 54220-4039 - Phone
- (920) 682-6376
- Fax
- (920) 682-6778
- NPI assigned
- Sep 27, 2006
- 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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | 18035 | WI | Primary |
Addresses
Primary practice location
501 N 10TH St
Manitowoc, WI 54220-4039
Mailing address
PO Box 907
Manitowoc, WI 54221-0907
Phone (920) 682-6376
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30171800 | Medicaid | WI | |
| 200010934 | Other | WI | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18035 | WI | MD | Orthopaedic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopaedic Associates of Manitowoc LTD | Past | Accepting new patients | |
| Aurora Health Care North, Inc. | Past | Accepting new patients | |
| Baycare Clinic LLP | Orthopaedic Surgery | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- General Acute Care Hospital
- Two Rivers, WI
- NPI 1477508687
-
- Orthopaedic Surgery Physician
- Manitowoc, WI
- NPI 1033201785
-
- Specialist
- Manitowoc, WI
- NPI 1760648885
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159315200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318204800000",
"number": "1164513123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 907",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542210907",
"telephone_number": "920-682-6376",
"fax_number": "920-682-6778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 N 10TH ST",
"city": "MANITOWOC",
"state": "WI",
"postal_code": "542204039",
"telephone_number": "920-682-6376",
"fax_number": "920-682-6778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRADER",
"first_name": "JOSEPH",
"middle_name": "EDGAR",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-27",
"last_updated": "2011-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "WI",
"license": "18035",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30171800",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "200010934",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manitowoc, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.