Individual provider Active NPI

Alyssa N Truong, PA

  • Physician Assistant
  • Wauwatosa, WI
National Provider Identifier
1336335934
Registry record updated Nov 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2192-23 Issued in WI
Practice address
10800 W Capitol Dr
Wauwatosa, WI 53222-1109
Phone
(414) 462-2373
Fax
(414) 462-2393
NPI assigned
Sep 18, 2007
Last updated
Nov 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085003212 IL
Physician Assistant 363A00000X 2192-23 WI Primary

Addresses

Primary practice location

10800 W Capitol Dr
Wauwatosa, WI 53222-1109

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (414) 462-2373

Other practice location 1

N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810
Phone (262) 251-7500

Other identifiers 1

IdentifierTypeStateIssuer
41947200MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address atruong187626@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
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2192WIMDOptometrist
2192-23WIMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: atruong187626@direct.myadvocateaurora.org

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1336335934",
    "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": "414-462-2373",
            "fax_number": "414-462-2393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 W CAPITOL DR",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532221109",
            "telephone_number": "414-462-2373",
            "fax_number": "414-462-2393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "N84W16889 Menomonee Ave",
            "address_purpose": "LOCATION",
            "city": "Menomonee Falls",
            "state": "WI",
            "postal_code": "530512810",
            "country_code": "US",
            "telephone_number": "262-251-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "ALYSSA",
        "middle_name": "N",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-18",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085003212",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2192-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41947200",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "atruong187626@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "N84W16889 Menomonee Ave",
            "city": "Menomonee Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530512810",
            "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": "N84W16889 Menomonee Ave",
            "city": "Menomonee Falls",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530512810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.