Individual provider Active NPI

Bailey Nicole Tresenriter, PA-C

  • Physician Assistant
  • Middlebury, IN
National Provider Identifier
1407101645
Registry record updated Feb 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10001404A Issued in IN
Practice address
801 Wayne St
Middlebury, IN 46540-9074
Phone
(574) 389-1231
Fax
(574) 389-1232
NPI assigned
Jul 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10001404A IN Primary

Addresses

Primary practice location

801 Wayne St
Middlebury, IN 46540-9074

Mailing address

22818 Old US 20
Elkhart, IN 46516-9150
Phone (574) 389-1231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20130730000839 IN Practitioner - Physician Assistant 3476794629 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cameron Memorial Community Hospital IncGroup PAC ID 9234020835, shared by 8 NPIs, 83 clinicians

Practice addresses (Care Compare)

1381 N Wayne St
Angola, IN 46703-2348
Phone (260) 665-8222

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10001404AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cameron Memorial Community Hospital, Inc Physician Assistant CurrentSince Dec 15, 2018 Accepting new patients
Cameron Memorial Community Hospital, Inc. CurrentSince Dec 15, 2018 Accepting new patients
Cameron Memorial Community Hospital Inc Past Accepting new patients

Locations

306 E Maumee St
Angola, IN 46703
Phone (260) 667-5335

416 E Maumee St
Angola, IN 46703
Phone (260) 665-2141

1381 N Wayne St
Angola, IN 46703
Phone (219) 481-4700

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.

NPI Registry JSON

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

{
    "created_epoch": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393459200000",
    "number": "1407101645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22818 OLD US 20",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169150",
            "telephone_number": "574-389-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 WAYNE ST",
            "city": "MIDDLEBURY",
            "state": "IN",
            "postal_code": "465409074",
            "telephone_number": "574-389-1231",
            "fax_number": "574-389-1232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRESENRITER",
        "first_name": "BAILEY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-13",
        "last_updated": "2014-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10001404A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middlebury, IN

Sources for this page

Verify at the official NPI Registry.