Individual provider Active NPI

Rajesh M Trivedi, MD

  • Internal Medicine Physician
  • West Bend, WI
National Provider Identifier
1184731291
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
40478 Issued in WI
Practice address
205 Valley Ave
West Bend, WI 53095-5312
Phone
(262) 338-1123
Fax
(262) 338-7684
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 40478 WI Primary

Addresses

Primary practice location

205 Valley Ave
West Bend, WI 53095-5312

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (262) 338-1123

Other identifiers 1

IdentifierTypeStateIssuer
3248100MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address rtrivedi13386@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070611000204 WI Practitioner - Internal Medicine 9133227408 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

1020 N 12TH St
Milwaukee, WI 53233-1308
Phone (414) 219-3056

1032 E Sumner St
Hartford, WI 53027-1608
Phone (262) 673-2300

1061 E Commerce Boulevard
Slinger, WI 53086-9326
Phone (262) 644-2900

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4000

205 Valley Ave
West Bend, WI 53095-5312
Phone (262) 338-1123

2901 W Kinnickinnic River Pkwy
Milwaukee, WI 53215-3677
Phone (414) 649-3990

3003 W Good Hope Rd
Milwaukee, WI 53209-2042
Phone (414) 352-3100

6425 W Mequon Rd
Mequon, WI 53092-1855
Phone (262) 242-0051

975 Port Washington Rd
Grafton, WI 53024-9204
Phone (262) 329-8650

Hospital & facility affiliations

  • Aurora at Home Home health agency, Milwaukee, WI, CCN 527001
  • Aurora Medical Ctr Washington County Hospital, Hartford, WI, CCN 520038
  • Aurora Medical Center Hospital, Grafton, WI, CCN 520207
  • Cedar Lake Health and Rehab Center Nursing home, West Bend, WI, CCN 525465

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40478WIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Apr 1, 2007 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Mar 14, 2011 Accepting new patients
Aurora Medical Group, Inc. Internal Medicine CurrentSince Apr 1, 2007 Accepting new patients
Aurora Advanced Healthcare, Inc. Internal Medicine CurrentSince Mar 14, 2011 Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

2733 S Ridge Rd
Green Bay, WI 54304
Phone (920) 497-6200

1004 E Sumner St
Hartford, WI 53027
Phone (262) 670-7000

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

205 Valley Ave
West Bend, WI 53095
Phone (262) 338-1123

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 6

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1184731291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "262-338-1123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 VALLEY AVE",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530955312",
            "telephone_number": "262-338-1123",
            "fax_number": "262-338-7684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRIVEDI",
        "first_name": "RAJESH",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "40478",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3248100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rtrivedi13386@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "205 Valley Ave",
            "city": "West Bend",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530955312",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "205 Valley Ave",
            "city": "West Bend",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530955312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

Verify at the official NPI Registry.