Nicholas Trevino

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT28295 Issued in FL

Practice address

1106 Crane Cove Blvd
Gulf Breeze, FL 32563-3190

Phone

(850) 207-5874

NPI assigned

Apr 17, 2023

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 FL

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pivotal Physical Therapy LLCGroup PAC ID 3870959307, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Pivotal Physical Therapy LLC

  • Physical Therapist
  • Gulf Breeze, FL
  • NPI 1861188344
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1681689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1497441034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 CRANE COVE BLVD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633190",
            "telephone_number": "850-207-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 CRANE COVE BLVD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325633190",
            "telephone_number": "850-207-5874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "NICHOLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-17",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT28295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Tipton
• Joan Catherine Tormes, LPC
• Total Spinal Solutions LLC
• Kendra Nicole Towner
• Tien Mark Duc Tran, M.D.
• Ruth Valeria Trigonis-Quesada, LCSW
• Ashley Truax, SLP
• Amber Baughn Tucei, D.C.
• Cameron Daniels Tucker, RPT
• Frank Charles Tucker Jr., M.D.

• Physical Therapist in Gulf Breeze, FL
• Providers in Gulf Breeze, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.