Individual provider Active NPI

Diane Trevino, DPM

  • Podiatrist
  • San Antonio, TX
National Provider Identifier
1508837048
Registry record updated May 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1622 Issued in TX
Practice address
177 Thorain Blvd
San Antonio, TX 78212-1227
Phone
(210) 391-8457
NPI assigned
Feb 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 1622 TX Primary

Addresses

Primary practice location

177 Thorain Blvd
San Antonio, TX 78212-1227

Mailing address

177 Thorain Blvd
San Antonio, TX 78212-1227
Phone (210) 391-8457

Other identifiers 2

IdentifierTypeStateIssuer
P00398188OtherTXRAILROAD MEDICARE
018574601MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050303000228 TX Practitioner - Podiatry 0446203335 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
At Home Foot Care PLLCGroup PAC ID 5193989143, 3 clinicians

Practice addresses (Care Compare)

8601 Village Dr
Suite 210
San Antonio, TX 78217-5509
Phone (210) 852-2427

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1904
Removal or shaving of skin growth551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16222TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
At Home Foot Care PLLC Podiatrist CurrentSince Jan 19, 2012 Accepting new patients
Lepow Podiatric Medical Associates Podiatrist Past Accepting new patients
Lepow Podiatric Medical Associates Podiatrist Past Accepting new patients
Home Foot Care, LLP Past Accepting new patients

Locations

8601 Village Dr
Ste 210
San Antonio, TX 78217
Phone (210) 654-8700

Organizations & group practices 4

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": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335916800000",
    "number": "1508837048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 THORAIN BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782121227",
            "telephone_number": "210-391-8457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 THORAIN BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782121227",
            "telephone_number": "210-391-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "DIANE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-01",
        "last_updated": "2012-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "TX",
            "license": "1622",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00398188",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "018574601",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.