DR. KATRINA LYNN DESTREE (M.D.) – Emergency Medicine Physician, NPI 1295021079

DR. KATRINA LYNN DESTREE (M.D.) is a healthcare provider. based in Green bay, Wisconsin. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. 735-00 (WI). The NPI Number for DR. KATRINA LYNN DESTREE (M.D.) is 1295021079

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
DR. KATRINA LYNN DESTREE (M.D.)
NPI
1295021079
Phone
(920) 490-9046
Address
1035 KEPLER DR
Enumeration Date
21 June 2011
Last Update Date
21 April 2026

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF WISCONSIN
Secondary Phone
9207945000
Graduation Year
2011 (15 years ago)
PAC ID
9032400072
Group Practice PAC ID
9436067402
Professional Enrollment ID
I20200813001771
Address ID
WI542413900TW5000XDRXX300

Contacts

Secure Messaging
kdestree277650@direct.myadvocateaurora.org
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness95
Years active:14State licenses:2Other names

1,808 EMERGENCY MEDICINE in NC

Provider Addresses for DR. KATRINA LYNN DESTREE (M.D.)

  • 1035 KEPLER DR

    GREEN BAY, WI 543118320

    Phone: (920) 490-9046

    Fax: (920) 405-8005

    Type: Mailing

  • 100 Brewster Blvd

    Camp Lejeune, NC 285472575

    Phone: (910) 450-4357

    Type: Location

  • PO BOX 28900

    GREEN BAY, WI 543240900

    Phone: (920) 490-9046

    Type: Mailing

  • 2845 GREENBRIER RD

    GREEN BAY, WI 543116519

    Phone: (920) 288-4060

    Fax: (920) 288-4067

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-08-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200813001771IEmergency MedicineWITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making147144$0
99284Emergency department visit with moderate level of medical decision making4948$0
99291Critical care, first 30-74 minutes4039$0
View full utilization report →

Insurance plans in this area (ZIP 54311)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9436067402View full group profile
NameSpecialtyState
Emergency MedicineWI
Physician AssistantWI
Emergency MedicineWI
Emergency MedicineWI
Emergency MedicineWV
Emergency MedicineWI
Emergency MedicineWI
Emergency MedicineWI
Physician AssistantWI
Emergency MedicineOR

Reviews

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Frequently asked questions

Can I cross-check DR. KATRINA LYNN DESTREE (M.D.) using NPI 1295021079?
NPI 1295021079 belongs to DR. KATRINA LYNN DESTREE (M.D.); compare other details if you need extra assurance.
Active or inactive — what applies to DR. KATRINA LYNN DESTREE (M.D.)?
You should see DR. KATRINA LYNN DESTREE (M.D.) as active in CMS-hosted NPPES data.
What kind of doctor is DR. KATRINA LYNN DESTREE (M.D.)?
DR. KATRINA LYNN DESTREE (M.D.) is associated with Emergency Medicine Physician in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with DR. KATRINA LYNN DESTREE (M.D.)?
Directory geography for DR. KATRINA LYNN DESTREE (M.D.) centers on Green Bay, Wisconsin.
Can I trust this NPI listing for DR. KATRINA LYNN DESTREE (M.D.)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.