Individual provider Active NPI

Kelly J Treptow, PA-C

  • Physician Assistant
  • Menomonee Falls, WI
National Provider Identifier
1972151314
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4837-23 Issued in WI
Practice address
N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810
Phone
(262) 251-7500
NPI assigned
Aug 28, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2024

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 4837-23 WI Primary

Addresses

Primary practice location

N84W16889 Menomonee Ave
Menomonee Falls, WI 53051-2810

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (800) 326-2250

Other practice location 1

14555 W National Ave
New Berlin, WI 53151-4494
Phone (800) 649-6000

Other practice location 2

16985 W Bluemound Rd
Brookfield, WI 53005-5909
Phone (414) 649-6000

Other identifiers 1

IdentifierTypeStateIssuer
100093374MedicaidWI

Other names 1

  • Kelly J Meyer Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address kmeyer199425@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191004001672 WI Practitioner - Physician Assistant 0648501627 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians

Practice addresses (Care Compare)

12203 N Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

14555 W National Ave
Suite 120
New Berlin, WI 53151-4494
Phone (262) 827-2955

1640 E Sumner St
Hartford, WI 53027-2684
Phone (262) 670-4000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. CurrentSince Sep 30, 2019 Accepting new patients
Aurora Advanced Healthcare, Inc. CurrentSince May 1, 2020 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince May 1, 2020 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 30, 2019 Accepting new patients

Locations

16985 W Bluemound Rd
Brookfield, WI 53005
Phone (262) 641-8400

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

N84W16889 Menomonee Ave
Menomonee Fls, WI 53051
Phone (262) 251-7500

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2900 W Oklahoma Ave
Ste 414
Milwaukee, WI 53215

3301 W Forest Home Ave
Milwaukee, WI 53215
Phone (414) 389-2233

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

2901 W Kinnickinnic River Pkwy
Ste 414
Milwaukee, WI 53215
Phone (414) 385-8680

14555 W National Ave
New Berlin, WI 53151
Phone (262) 827-2900

Interoperability endpoints

  • Direct secure messaging: kmeyer199425@direct.myadvocateaurora.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.

NPI Registry JSON

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

{
    "created_epoch": "1566950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1972151314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "800-326-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N84W16889 MENOMONEE AVE",
            "city": "MENOMONEE FALLS",
            "state": "WI",
            "postal_code": "530512810",
            "telephone_number": "262-251-7500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14555 W National Ave",
            "address_purpose": "LOCATION",
            "city": "New Berlin",
            "state": "WI",
            "postal_code": "531514494",
            "country_code": "US",
            "telephone_number": "800-649-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16985 W Bluemound Rd",
            "address_purpose": "LOCATION",
            "city": "Brookfield",
            "state": "WI",
            "postal_code": "530055909",
            "country_code": "US",
            "telephone_number": "414-649-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREPTOW",
        "first_name": "KELLY",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-28",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4837-23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100093374",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kmeyer199425@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2900 W Oklahoma Ave Ste 414",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2900 W Oklahoma Ave Ste 414",
            "city": "Milwaukee",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532154330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MEYER",
            "middle_name": "J",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Menomonee Falls, WI

Sources for this page

Verify at the official NPI Registry.