Individual provider Active NPI

Lara Trevino, NP

  • Adult Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1487046397
Registry record updated Mar 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F307592-1 Issued in NY
Practice address
304 W 88TH St
3D
New York, NY 10024-2227
Phone
(214) 864-4882
NPI assigned
Mar 2, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 691374-1 NY
Adult Health Nurse Practitioner 363LA2200X F307592-1 NY Primary

Addresses

Primary practice location

304 W 88TH St
3D
New York, NY 10024-2227

Mailing address

85 W Burnside Ave
Bronx, NY 10453-4015
Phone (718) 716-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20160518000571 NY Practitioner - Nurse Practitioner 4688963465 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Icahn School of Medicine at Mount SinaiGroup PAC ID 2264691070, 2,809 clinicians

Practice addresses (Care Compare)

55 E 34TH St
New York, NY 10016-4337
Phone (212) 252-6131

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
691374-1NYMDRegistered Nurse
F307592-1NYMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sun River Health Inc Current Accepting new patients
Sun River Health Inc. CurrentSince Mar 2, 2019 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 1, 2019 Accepting new patients
Morris Heights Health Center, Inc. CurrentSince Apr 6, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai CurrentSince Jun 1, 2019 Accepting new patients
Morris Heights Health Center, Inc. CurrentSince Apr 6, 2016 Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients
Icahn School of Medicine at Mount Sinai Past Accepting new patients

Locations

3360 Route 343
Amenia, NY 12501
Phone (845) 373-9006

25 E 183rd St
Bronx, NY 10453
Phone (718) 483-1270

85 W Burnside Ave
Bronx, NY 10453
Phone (718) 483-1270

803 Sterling Pl
Brooklyn, NY 11216
Phone (718) 613-1700

55 E 34th St
New York, NY 10016
Phone (212) 252-6131

5 E 98th St
Fl 5
New York, NY 10029
Phone (212) 241-8234

Networks

  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: lara.trevino@hrh.eclinicaldirectplus.com
  • Direct secure messaging: lara.trevino.1@24265.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1425254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459123200000",
    "number": "1487046397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "85 W BURNSIDE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104534015",
            "telephone_number": "718-716-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 W 88TH ST",
            "address_2": "3D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100242227",
            "telephone_number": "214-864-4882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "LARA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-02",
        "last_updated": "2016-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "691374-1",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F307592-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.