Individual provider Active NPI

Elizabeth Traudt, MD

  • Surgery Physician
  • Brookfield, WI
National Provider Identifier
1821452988
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
68974-20 Issued in WI
Practice address
17000 W North Ave Ste 107W
Brookfield, WI 53005-4423
Phone
(262) 785-7740
NPI assigned
Apr 5, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 68974-20 WI Primary

Addresses

Primary practice location

17000 W North Ave Ste 107W
Brookfield, WI 53005-4423

Mailing address

17000 W North Ave Ste 107W
Brookfield, WI 53005-4423
Phone (262) 785-7740

Other names 1

  • Elizabeth Pawlak Former name

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
I20210628001004 WI Practitioner - General Surgery 4688914054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ascension Medical Group-Southeast Wisconsin IncGroup PAC ID 8628980943, 551 clinicians

Practice addresses (Care Compare)

17000 W N Ave
Suite 110E
Brookfield, WI 53005-4423
Phone (262) 786-8199

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jun 18, 2021 Accepting new patients
St. Luke'S Health Services, Inc. PastSince Feb 1, 2022 Accepting new patients

Locations

17000 W North Ave
Ste 110E
Brookfield, WI 53005
Phone (262) 786-8199

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

Organizations & group practices 2

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": "1459814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1821452988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 W NORTH AVE STE 107W",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054423",
            "telephone_number": "262-785-7740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 W NORTH AVE STE 107W",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530054423",
            "telephone_number": "262-785-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAUDT",
        "first_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-05",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "68974-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "PAWLAK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brookfield, WI

Sources for this page

Verify at the official NPI Registry.