Dr Trevor D Tredennick, MD is a medicare enrolled "Emergency Medicine" physician in Emmett, Idaho. His current practice location is
1202 E Locust St, Emmett, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 365-3561.
Dr Trevor D Tredennick is licensed to practice in Illinois (license number 036-112632) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1649264052.
Physician's Profile
| Full Name | Dr Trevor D Tredennick |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 1202 E Locust St, Emmett, Idaho |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1649264052
- Provider Enumeration Date: 08/31/2005
- Last Update Date: 12/09/2022
Medicare PECOS Information:
- PECOS PAC ID: 0749232643
- Enrollment ID: I20160331001356
Medical Identifiers
Medical identifiers for Dr Trevor D Tredennick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1649264052 | NPI | - | NPPES |
| 8420713 | Medicaid | WA | |
| 036-112632 | Medicaid | IL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 036-112632 (Illinois) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Trevor D Tredennick allows following entities to bill medicare on his behalf.
| Entity Name | Walter Knox Memorial Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063419018
PECOS PAC ID: 7012907785
Enrollment ID: O20040514000512 |
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| Entity Name | Sterling Provider Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205300407
PECOS PAC ID: 2264773373
Enrollment ID: O20190417001724 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Trevor D Tredennick is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Trevor D Tredennick, MD
1202 E Locust St,
Emmett, ID 83617-2715
Ph: (208) 365-3561 | Dr Trevor D Tredennick, MD
1202 E Locust St,
Emmett, ID 83617-2715
Ph: (208) 365-3561 |
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