Tristan Devine, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

101.0134876 Issued in VT

Practice address

128 Lakeside Ave
Burlington, VT 05401-4939

Phone

(802) 657-7000

NPI assigned

Jun 29, 2021

Last updated

Sep 30, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VT

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 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664496000000",
    "number": "1386214674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 LAKESIDE AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 LAKESIDE AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054014939",
            "telephone_number": "802-657-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEVINE",
        "first_name": "TRISTAN",
        "name_prefix": "Dr.",
        "credential": "DNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-29",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0134876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy J Desrault, MSW LICSW
• April Constance Destefano, MD
• Kristen Destigter, MD
• Anusha Devarajan, MBBS
• Deepak Devarajan, D.M.D
• Katherine Ann Devitt, MD
• Celia Devoe
• Lauren Michelle Dewey, PH.D.
• John C Dewitt, MD, PHD
• Kyle Dewitt, PHARMD

• Family Nurse Practitioner in Burlington, VT
• Providers in Burlington, VT by specialty
• Family Nurse Practitioner in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.