Melanie K. Trevino, MD

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

40723 Issued in WI

Practice address

12805 W Burleigh Road
Suite 200
Brookfield, WI 53005-3156

Phone

(262) 797-6434

Fax

(262) 797-6429

NPI assigned

Dec 30, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dermatopathology of Wisconsin SC

  • Clinical Medical Laboratory
  • Brookfield, WI
  • NPI 1164494142

  Dermatology

  NPD (past)

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430438400000",
    "number": "1740267780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD",
            "address_2": "SUTIE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "214-932-8029",
            "fax_number": "610-271-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 W BURLEIGH ROAD",
            "address_2": "SUITE 200",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053156",
            "telephone_number": "262-797-6434",
            "fax_number": "262-797-6429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "MELANIE",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2015-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WV",
            "license": "40723",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "WI",
            "license": "40723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "11-00572",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caron Elizabeth Trataris, LMFT
• Elizabeth Traudt, MD
• Cindy Rose Trecek, MSCCC SLP
• David I Treis
• Sariya Treske, LPC
• Amalia Trier
• Patrick J Triggiano, PHD
• Elaine Tripp, PT
• Angela Marie Trochlell, D.D.S.
• Edward John Trochlell, DDS

• Dermatopathology (Pathology) Physician in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Dermatopathology (Pathology) Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2015; 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.