Organization Active NPI

Trinity Medical Associates L L C

  • Internal Medicine Physician
  • Trinity, FL
National Provider Identifier
1497779169
Registry record updated Jul 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
TRINITY MEDICAL ASSOCIATES L L C
Practice address
3633 Little Road
Suite 101
Trinity, FL 34655-1818
Phone
(727) 375-2222
Fax
(866) 244-2335
NPI assigned
Jul 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2022

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

Authorized official

Name
Mr. Jeffrey Scott Vasta, M.D.NPI 1023097136
Title
M.D.
Phone
(727) 375-2222

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3633 Little Road
Suite 101
Trinity, FL 34655-1818

Mailing address

3633 Little Road
Suite 101
Trinity, FL 34655-1815
Phone (727) 375-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040825001663 FL Part B Supplier - Clinic/Group Practice 3779557533 Receives reassigned benefits from 4 practitioners
Practice locations: Trinity, FL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1010010Trinity Medical Associates LLC3633 Little Rd Ste 101, Trinity, FL 34655Certificate of waiverMar 3, 2027

National Provider Directory

National Provider Directory

Locations

2043 Little Rd
Ste C
Trinity, FL 34655

3633 Little Rd
Ste 101
Trinity, FL 34655
Phone (372) 375-2222

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DJCABD

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1497779169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 LITTLE ROAD",
            "address_2": "SUITE 101",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551815",
            "telephone_number": "727-375-2222",
            "fax_number": "866-244-2335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 LITTLE ROAD",
            "address_2": "SUITE 101",
            "city": "TRINITY",
            "state": "FL",
            "postal_code": "346551818",
            "telephone_number": "727-375-2222",
            "fax_number": "866-244-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRINITY MEDICAL ASSOCIATES L L C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "VASTA",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "M.D.",
        "authorized_official_telephone_number": "727-375-2222",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Trinity, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2022; 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.