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DR. TREVOR D. TREDENNICK M.D.
NPI 1649264052
Emergency Medicine in Emmett, ID

Active since August 31, 2005PECOS Enrolled
1202 E LOCUST ST, EMMETT, ID 83617(208) 365-3561 Get Directions Write a Review

NPPES record last updated: December 9, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Trevor D. Tredennick M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. TREVOR D. TREDENNICK M.D. (NPI 1649264052) is an individual emergency medicine provider in Emmett, Idaho, licensed in Illinois (036-112632) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1649264052
Entity TypeIndividualMale
Primary Taxonomy207P00000X
Provider Legal NameDR. TREVOR D. TREDENNICKCredential: M.D.
Location Address1202 E LOCUST STEmmett, ID 83617-2715
Mailing Address1202 E Locust StEmmett, ID 83617-2715 · (208) 365-3561
Phone(208) 365-3561
Sole ProprietorNo
Enumeration DateAugust 31, 2005
Last NPPES UpdateDecember 9, 2022
NPPES CertifiedDecember 9, 2022
✔ NPI 1649264052 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207P00000X
License✔ Licensed in IL · 036-112632
Definition
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
1202 E LOCUST ST, Emmett, ID 83617
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Other Identifiers 2

Medicaid8420713WA
Medicaid036-112632IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Trevor D. Tredennick M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Trevor Tredennick reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Walter Knox Memorial Hospital
Same address
Family Medicine
1102 E LOCUST ST
Emmett, ID 83617
  • Reassigned Medicare billing, Idaho enrollment
  • 63 clinicians in this Medicare group
NPI 1861284721 (208) 365-6004
Sterling Provider Group
226 mi
Urgent Care
740 S WOODRUFF AVE
Idaho Falls, ID 83401
  • Reassigned Medicare billing, Idaho enrollment
  • 23 clinicians in this Medicare group
NPI 1205300407 (208) 542-9111

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83617 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

WALTER KNOX MEMORIAL HOSPITAL
General Acute Care Hospital (Critical Access)
1202 E LOCUST ST
EMMETT, ID 83617
Gem County (208) 365-3561
MR. KYLE SPENCER CONGER RN
Registered Nurse (Emergency)
1202 E LOCUST ST
EMMETT, ID 83617
Gem County (208) 901-3287
DEBRA ANNE PHILLIPS FNP-BC
Nurse Practitioner (Family)
1202 E LOCUST ST
EMMETT, ID 83617
Gem County (208) 365-3561
CORY ONDLER D.O.
Emergency Medicine
1202 E LOCUST ST
EMMETT, ID 83617
Gem County (208) 365-3561
BRIGHAM HARDY DO
Family Medicine
1202 E LOCUST ST
EMMETT, ID 83617
Gem County (208) 365-3561
WALTER KNOX MEMORIAL HOSPITAL
Medicare Defined Swing Bed Unit
1202 E LOCUST ST
EMMETT, ID 83617
Gem County (208) 365-3561
DR. JEROD L HINES M.D.
Orthopaedic Surgery
1202 E LOCUST ST
EMMETT, ID 83617
Gem County (208) 365-3563
MALERIE ERIN BETTFREUND LMSW
Social Worker
1202 E LOCUST ST
EMMETT, ID 83617
Gem County (208) 901-3206

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Trevor Tredennick's NPI number?

The NPI number for Trevor Tredennick is 1649264052. It was assigned to this individual provider in the NPPES registry on August 31, 2005.

Where is Trevor Tredennick located?

Trevor Tredennick practices at 1202 E Locust St, Emmett, ID 83617. The listed phone number is (208) 365-3561.

What is Trevor Tredennick's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Is Trevor Tredennick enrolled in Medicare?

Yes. Trevor Tredennick is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Trevor Tredennick's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Trevor Tredennick reassigns Medicare benefits to 2 organizations: Walter Knox Memorial Hospital (Emmett, ID) and Sterling Provider Group (Idaho Falls, ID). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Trevor Tredennick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Trevor Tredennick accept?

Health plans from Moda Health Plan, Inc. list Trevor Tredennick as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Trevor Tredennick was last updated on December 9, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.