Active NPI
Pamela C Trout, M.D.
- Pediatrics Physician
- Winter Park, FL
National Provider Identifier
1467499384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- ME94271
- Practice address
- 201 N Lakemont Ave
Suite 200
Winter Park, FL 32792-3228 - Phone
- (321) 203-4410
- Fax
- (321) 203-4409
- NPI assigned
- May 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | ME94271 | FL | |
| Pediatrics Physician | 208000000X | ME94271 | FL | Primary |
Addresses
Primary practice location
201 N Lakemont Ave
Suite 200
Winter Park, FL 32792-3228
Mailing address
3300 S Fiske Blvd
Rockledge, FL 32955-4306
Phone (321) 203-4410
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 274282900 | Medicaid | FL | |
| NY767 | Other | FL | FL MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210614000699 | FL | Practitioner - Pediatric Medicine | 0042533622 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME94271 | FL | MD | General Practice Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Privia Medical Group Florida, LLC | General Practice | Past | Accepting new patients |
Interoperability endpoints
- pamela.trout.1@8042.direct.athenahealth.com
Organizations & group practices 1
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.
-
- General Practice Physician
- Indialantic, FL
- NPI 1700649043
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623801600000",
"number": "1467499384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3300 S FISKE BLVD",
"city": "ROCKLEDGE",
"state": "FL",
"postal_code": "329554306",
"telephone_number": "321-203-4410",
"fax_number": "321-203-4409"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 N LAKEMONT AVE",
"address_2": "SUITE 200",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327923228",
"telephone_number": "321-203-4410",
"fax_number": "321-203-4409"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TROUT",
"first_name": "PAMELA",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-31",
"last_updated": "2021-06-16",
"certification_date": "2021-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "FL",
"license": "ME94271",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "FL",
"license": "ME94271",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "274282900",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FL MEDICARE",
"identifier": "NY767",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2021; 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.