Individual provider Active NPI

Elaine Marie Trevisani, ANP

  • Adult Health Nurse Practitioner
  • Utica, NY
National Provider Identifier
1508856675
Registry record updated May 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
F301774-1 Issued in NY
Practice address
110 Business Park Dr
Utica, NY 13502-6302
Phone
(315) 624-7000
NPI assigned
Oct 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X F301774-1 NY Primary

Addresses

Primary practice location

110 Business Park Dr
Utica, NY 13502-6302

Mailing address

110 Business Park Dr
Utica, NY 13502-6302
Phone (315) 624-7000

Other identifiers 1

IdentifierTypeStateIssuer
02642244MedicaidNY

Other names 1

  • Elaine Romano Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20240317000027 PA Practitioner - Nurse Practitioner 1254311087 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Midatlantic Endoscopy LLC Current Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Feb 21, 2024 Accepting new patients
Regional Gastroenterology Associates of Lancaster, LTD. CurrentSince Feb 21, 2024 Accepting new patients

Locations

2112 Harrisburg Pike
Ste 202
Lancaster, PA 17601
Phone (717) 544-3500

Organizations & group practices 3

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304553600000",
    "number": "1508856675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 BUSINESS PARK DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026302",
            "telephone_number": "315-624-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BUSINESS PARK DR",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135026302",
            "telephone_number": "315-624-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVISANI",
        "first_name": "ELAINE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-28",
        "last_updated": "2011-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "F301774-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02642244",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELAINE",
            "last_name": "ROMANO",
            "credential": "NURSE PRACTITIONER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.