Individual provider Active NPI

Gino Thamas Trevisani, M.D.

  • Colon & Rectal Surgery Physician
  • Burlington, VT
National Provider Identifier
1619912607
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
0420010341 Issued in VT
Practice address
111 Colchester Ave
Burlington, VT 05401-1473
Phone
(802) 847-3330
NPI assigned
Jun 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X 0420010341 VT Primary

Addresses

Primary practice location

111 Colchester Ave
Burlington, VT 05401-1473

Mailing address

585 S Bay Cir
Colchester, VT 05446-3895
Phone (802) 863-0044

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040629000678 VT Practitioner - Colorectal Surgery (Proctology)Practitioner - General Surgery 9133105174 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Colorectal Surgery (Proctology)
Education
University of Vermont College of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwestern Medical Center IncGroup PAC ID 5496714313, 105 clinicians

Practice addresses (Care Compare)

133 Fairfield St
Saint Albans, VT 05478-1726
Phone (802) 524-8852

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy74
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux25
Removal of tissue16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0420010341VTMDColon & Rectal Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Center, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Northwestern Medical Center, Inc. Current Accepting new patients
University of Vermont Medical Center Inc CurrentSince May 1, 2004 Accepting new patients
Northwestern Medical Center, Inc CurrentSince Jul 1, 2024 Accepting new patients
Northwestern Medical Center Inc Past Accepting new patients
Northwestern Medical Center, Inc. Past Accepting new patients
Fletcher Allen Health Care Inc Past Accepting new patients

Locations

111 Colchester Ave
Burlington, VT 05401
Phone (802) 656-2415

1 S Prospect St
Burlington, VT 05401
Phone (802) 847-4531

3 Crest Rd
Saint Albans, VT 05478
Phone (802) 524-4554

133 Fairfield St
Saint Albans, VT 05478
Phone (802) 524-1227

3 Timber Ln
South Burlington, VT 05403
Phone (802) 847-3339

Organizations & group practices 7

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150502400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1619912607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 S BAY CIR",
            "city": "COLCHESTER",
            "state": "VT",
            "postal_code": "054463895",
            "telephone_number": "802-863-0044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLCHESTER AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054011473",
            "telephone_number": "802-847-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVISANI",
        "first_name": "GINO",
        "middle_name": "THAMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "VT",
            "license": "0420010341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.