Active NPI
Jon Paul Trevisani, M.D.
- Plastic Surgery Physician
- Maitland, FL
National Provider Identifier
1316957152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 63930
- Practice address
- 413 Lake Howell Rd
Maitland, FL 32751-5906 - Phone
- (407) 677-8999
- Fax
- (407) 677-5490
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 63930 | FL | Primary |
| Plastic Surgery Physician | 208200000X | 191685-1 | NY |
Addresses
Primary practice location
413 Lake Howell Rd
Maitland, FL 32751-5906
Mailing address
413 Lake Howell Rd
Maitland, FL 32751-5906
Phone (407) 677-8999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63930 | FL | MD | Plastic Surgery Physician |
| 191685-1 | NY | MD | Plastic Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sleep Well Anesthetists | Past | Accepting new patients | |
| Trevisani Centre PA | Plastic Surgery | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Plastic Surgery Physician
- Maitland, FL
- NPI 1679964399
-
- Certified Registered Nurse Anesthetist
- Kissimmee, FL
- NPI 1033978366
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1316957152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "413 LAKE HOWELL RD",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327515906",
"telephone_number": "407-677-8999",
"fax_number": "407-677-5490"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "413 LAKE HOWELL RD",
"city": "MAITLAND",
"state": "FL",
"postal_code": "327515906",
"telephone_number": "407-677-8999",
"fax_number": "407-677-5490"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TREVISANI",
"first_name": "JON",
"middle_name": "PAUL",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "FL",
"license": "63930",
"primary": true
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "NY",
"license": "191685-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maitland, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.