Individual provider Active NPI

Mark A Trott, PA

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1205892924
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00053 Issued in RI
Practice address
845 N Main St
Suite 3
Providence, RI 02904-5700
Phone
(401) 521-7300
Fax
(401) 521-7307
NPI assigned
Apr 21, 2006
Last updated
Feb 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1279 MA
Medical Physician Assistant 363AM0700X 1279 MA
Physician Assistant 363A00000X PA00053 RI Primary
Medical Physician Assistant 363AM0700X PA00053 RI

Addresses

Primary practice location

845 N Main St
Suite 3
Providence, RI 02904-5700

Mailing address

23 Tyler St
Attleboro, MA 02703-5813
Phone (508) 226-3544

Other identifiers 2

IdentifierTypeStateIssuer
PA00053OtherRIUHP RI
0000023500OtherRIBCBS OF RI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070620000628 RI Practitioner - Physician Assistant 6002915774 Reassigns benefits to 1 organization
I20081111000348 MA Practitioner - Physician Assistant 6002915774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1985
Medicare assignment
May accept Medicare assignment
Group practices
Skinpros, LLCGroup PAC ID 8921260951, 8 clinicians

Practice addresses (Care Compare)

1287 N Main St
Providence, RI 02904-1856
Phone (401) 272-2724

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1279MAMDMental Health Counselor
PA00053RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Dermatology and Laser Medicine Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1205892924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 TYLER ST",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027035813",
            "telephone_number": "508-226-3544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 N MAIN ST",
            "address_2": "SUITE 3",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045700",
            "telephone_number": "401-521-7300",
            "fax_number": "401-521-7307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROTT",
        "first_name": "MARK",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1279",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "1279",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00053",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "PA00053",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHP RI",
            "identifier": "PA00053",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF RI",
            "identifier": "0000023500",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.