Individual provider Active NPI

Trinh Gia Truong, MD

  • Physical Medicine & Rehabilitation Physician
  • Shorewood, WI
National Provider Identifier
1508892217
Registry record updated Jun 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
36462020 Issued in WI
Practice address
4491 N Oakland Ave
Shorewood, WI 53211-1611
Phone
(414) 967-9486
Fax
(414) 967-9508
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 36462020 WI Primary

Addresses

Primary practice location

4491 N Oakland Ave
Shorewood, WI 53211-1611

Mailing address

N82W5858 Orchard Dr
Cedarburg, WI 53012-1417

Other identifiers 1

IdentifierTypeStateIssuer
32119300MedicaidWI

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
I20100712000008 WI Practitioner - Physical Medicine and Rehabilitation 9436257474 Practice locations: Milwaukee, WI; Shorewood, WI

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of California, Davis School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4491 N Oakland Ave
Shorewood, WI 53211-1611
Phone (414) 967-9486

4495 N Oakland Ave
Milwaukee, WI 53211-1611
Phone (414) 967-3550

Hospital & facility affiliations

  • Orthopaedic Hospital of Wisconsin Hospital, Glendale, WI, CCN 520194
  • Froedtert Memorial Lutheran Hospital Hospital, Milwaukee, WI, CCN 520177

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
36462020WIMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kinetic Spine and Pain SC PastSince Dec 1, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: trinh.truong.p1@direct.mmctt.nextgenshare.com
  • Direct secure messaging: trinh.truong.p2@direct.mmctt.nextgenshare.com

Organizations & group practices 1

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": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1508892217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N82W5858 ORCHARD DR",
            "city": "CEDARBURG",
            "state": "WI",
            "postal_code": "530121417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4491 N OAKLAND AVE",
            "city": "SHOREWOOD",
            "state": "WI",
            "postal_code": "532111611",
            "telephone_number": "414-967-9486",
            "fax_number": "414-967-9508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUONG",
        "first_name": "TRINH",
        "middle_name": "GIA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "WI",
            "license": "36462020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32119300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shorewood, WI

Sources for this page

Verify at the official NPI Registry.