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Trent Kapla

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

10625 W North Ave, Suite 102, Wauwatosa, WI 53226-2315

PECOS Enrollment

Based on the most recent information from CMS, provider Trent Kapla is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1114377421
Provider Type
Individual
Full Name
Kapla, Trent
Credential
PA-C

Gender
Male
Sole Proprietor
Yes
Enumeration Date
6/16/2016
Last Updated
7/12/2016

Contact Information

Practice Location

10625 W North Ave, Suite 102, Wauwatosa, WI 53226-2315

(414) 877-5350

Unlisted Fax

Mailing Location

2381 Pristine Ln, Suamico, WI 54313-3610

(920) 606-4235

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 3810-23 Wisconsin

Trent Kapla

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Reinhardt, Shelby Rae

Wilkins, Karly D

Corcoran, Jennifer

Carroll, Emily

Farley, Samuel Colt

Smith, Bente E

Ziegler, Zachary Evan

Treat, Matthew W

Jodat, Jacob

Mcdonald, Mark C