NPIMap

Individual provider Active NPI

Christina Maria Travisono, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1356672463
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00540 Issued in RI
Practice address
164 Summit Ave
Room C70
Providence, RI 02906-2853
Phone
(401) 793-3922
Fax
(401) 435-7069
NPI assigned
Jan 29, 2010
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA00540 RI Primary

Addresses

Primary practice location

164 Summit Ave
Room C70
Providence, RI 02906-2853

Mailing address

PO Box 16149
Rumford, RI 02916-0697
Phone (401) 793-3922

Other identifiers 2

IdentifierTypeStateIssuer
0014665OtherRIMEDICARE PTAN
CD78903MedicaidRI

Other names 1

  • Miss Christina Maria Deleo Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100304000742 RI Practitioner - Physician Assistant 6204971039 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island Dermatology and Cosmetic Center LLCGroup PAC ID 8123007523, 7 clinicians

Practice addresses (Care Compare)

3 Wake Robin Rd
Lincoln, RI 02865-4208
Phone (401) 475-9140

Merit-based Incentive Payment System (MIPS)

Final score
90.23 of 100Reported as group
Quality
95.87
Promoting interoperability
100
Improvement activities
40
Cost
71.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA00540RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. Physician Assistant CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Corporation Current Accepting new patients
Rhode Island Dermatology Obs Past Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

164 Summit Ave
#C70
Providence, RI 02906
Phone (401) 793-3922

164 Summit Ave
Rm C70
Providence, RI 02906
Phone (401) 793-3922

164 Summit Ave
Ste C70
Providence, RI 02906

2 Dudley St
Ste 470
Providence, RI 02905
Phone (401) 274-7546

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: ctravisono9171@brownhealth.medalliesdirect.net

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1356672463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16149",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029160697",
            "telephone_number": "401-793-3922",
            "fax_number": "401-435-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE",
            "address_2": "ROOM C70",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-3922",
            "fax_number": "401-435-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVISONO",
        "first_name": "CHRISTINA",
        "middle_name": "MARIA",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0014665",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CD78903",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "DELEO",
            "middle_name": "MARIA",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.