Organization Active NPI

Jean L Trescott PHD RN PA

  • Psychologist
  • Miami, FL
National Provider Identifier
1720414394
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
PY4780 Issued in FL
Legal business name
JEAN L TRESCOTT PHD RN PA
Practice address
1031 Ives Dairy Rd
Suite 119
Miami, FL 33179-2538
Phone
(305) 772-0924
Fax
(954) 920-0925
NPI assigned
Sep 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Authorized official

Name
Jean L Trescott, PHDNPI 1528270105
Title
Owner
Phone
(305) 772-0924

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X PY4780 FL Primary

Addresses

Primary practice location

1031 Ives Dairy Rd
Suite 119
Miami, FL 33179-2538

Mailing address

1044 S Northlake Dr
Hollywood, FL 33019-1315
Phone (305) 772-0924

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131112001610 FL Part B Supplier - Clinic/Group Practice 6406082981 Receives reassigned benefits from 1 practitioner
Practice locations: Miami, FL; Aventura, FL; Hollywood, FL

National Provider Directory

National Provider Directory

Locations

1031 Ives Dairy Rd
Ste 119
Miami, FL 33179
Phone (305) 772-0924

1031 Ives Dairy Rd
#119
Miami, FL 33179
Phone (305) 772-0924

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379289600000",
    "number": "1720414394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1044 S NORTHLAKE DR",
            "city": "HOLLYWOOD",
            "state": "FL",
            "postal_code": "330191315",
            "telephone_number": "305-772-0924",
            "fax_number": "954-920-0925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 IVES DAIRY RD",
            "address_2": "SUITE 119",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331792538",
            "telephone_number": "305-772-0924",
            "fax_number": "954-920-0925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEAN L TRESCOTT PHD RN PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-16",
        "last_updated": "2013-09-16",
        "status": "A",
        "authorized_official_last_name": "TRESCOTT",
        "authorized_official_first_name": "JEAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "305-772-0924",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY4780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.