Tristan Donnell Trumbull, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5163 Issued in NV

Practice address

6440 Medical Center St
Las Vegas, NV 89148-2443

Phone

(702) 222-1000

NPI assigned

Jul 5, 2023

Last updated

Jul 5, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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 NV, ID2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

University of Nevada, Las Vegas School of Medicine, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pierce Physical Therapy and Sports Rehab LLCGroup PAC ID 6305106857, 3 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pierce Physical Therapy and Sports Rehab LLC

  • Physical Therapist
  • Meridian, ID
  • NPI 1578076519
  Medicare reassignment Care Compare group NPD
• Executive Fitness Inc

  dba Timothy B Soder Physical Therapy

  • Physical Therapist
  • Las Vegas, NV
  • NPI 1881710192
  Medicare reassignment NPD
• Executive Fitness Inc

  dba Tim Soder Physical Therapy

  • Specialist
  • Las Vegas, NV
  • NPI 1144552316
  NPD (past)

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

{
    "created_epoch": "1688515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1598443186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 FLORES CIR",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891230604",
            "telephone_number": "916-806-8229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 MEDICAL CENTER ST",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891482443",
            "telephone_number": "702-222-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUMBULL",
        "first_name": "TRISTAN",
        "middle_name": "DONNELL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-05",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "5163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Octavia Trujilo
• Truman and Dougherty Orthodontics
• Brennan Riley Truman, DMD
• Mark Truman, D.D.S.
• Caitlin Trumbull
• Trumobility Inc.
• Kassandra Trumper, PHARMD
• Trung Xa DDS and Diana Xa DDS, a Professional Corporation (Star Brite Dental)
• Hue Bich Truong-Lee
• Andy Truong

• Physical Therapist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Physical Therapist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 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.