Amanda C Trout, D.O.

Primary specialty

Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X

License

Q7802 Issued in TX

Practice address

954 Avenida Ponce de Leon
Ste 205- PMB#10600
San Juan, PR 00906

Phone

(847) 275-5961

NPI assigned

Mar 28, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696204800000",
    "number": "1699074823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 AVENIDA PONCE DE LEON",
            "address_2": "STE 205- PMB#10600",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00906",
            "telephone_number": "847-275-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 AVENIDA PONCE DE LEON",
            "address_2": "STE 205- PMB#10600",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "00906",
            "telephone_number": "847-275-5961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUT",
        "first_name": "AMANDA",
        "middle_name": "C",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "Q7802",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "Q7802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "363846202",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Trullenque-Martinez, MD
• Truly Medical Equipment LLC

• Interventional Pain Medicine Physician in San Juan, PR
• Providers in San Juan, PR by specialty
• Interventional Pain Medicine Physician in Puerto Rico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.