Individual provider Active NPI

Emily Jean Trentadue, PA-C

  • Physician Assistant
  • Oak Creek, WI
National Provider Identifier
1942218102
Registry record updated Jun 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2037-23 Issued in WI
Practice address
500 W Drexel Ave Ste 300
Oak Creek, WI 53154-2060
Phone
(414) 771-6780
Fax
(414) 238-2424
NPI assigned
Aug 4, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2019

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 2037-23 WI Primary
Physician Assistant 363A00000X 2037-023 WI

Addresses

Primary practice location

500 W Drexel Ave Ste 300
Oak Creek, WI 53154-2060

Mailing address

2885 N Mayfair Rd
Wauwatosa, WI 53222-4404
Phone (414) 771-6780

Other identifiers 1

IdentifierTypeStateIssuer
42888500MedicaidWI

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
I20200415002012 IN Practitioner - Physician Assistant 6002811098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

201 Pennsylvania Pkwy
Carmel, IN 46280-2301
Phone (317) 817-1480

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2037-023WIMDPhysician Assistant
2037-23WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Jun 1, 2020 Accepting new patients
Midwest Area Physicians, LLC Past Accepting new patients
Major Hospital Past Accepting new patients
Cardiovascular Associates of Wisconsin, LLP Past Accepting new patients

Locations

7216 Solutions Ctr
Chicago, IL 60677

201 Pennsylvania Pkwy
Carmel, IN 46280
Phone (317) 817-1254

11725 Illinois St
Carmel, IN 46032
Phone (317) 617-4808

201 Pennsylvania Pkwy
Ste 100
Carmel, IN 46280
Phone (317) 817-1636

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: etrentadue@direct.iuhealth.org

Organizations & group practices 5

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": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560470400000",
    "number": "1942218102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2885 N MAYFAIR RD",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532224404",
            "telephone_number": "414-771-6780",
            "fax_number": "414-238-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W DREXEL AVE STE 300",
            "city": "OAK CREEK",
            "state": "WI",
            "postal_code": "531542060",
            "telephone_number": "414-771-6780",
            "fax_number": "414-238-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRENTADUE",
        "first_name": "EMILY",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2019-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2037-23",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "2037-023",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "42888500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Creek, WI

Sources for this page

Verify at the official NPI Registry.