Individual provider Active NPI

Patrick J Trevisani, DPM

  • Podiatrist
  • Casselberry, FL
National Provider Identifier
1790761088
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PO1844 Issued in FL
Practice address
3532 Merivale Dr
Casselberry, FL 32707-6023
Phone
(407) 699-6706
Fax
(407) 699-6706
NPI assigned
Dec 19, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004176 NY
Podiatrist 213E00000X PO1844 FL Primary

Addresses

Primary practice location

3532 Merivale Dr
Casselberry, FL 32707-6023

Mailing address

PO Box 650
Winter Park, FL 32790-0650
Phone (407) 699-6706

Other identifiers 1

IdentifierTypeStateIssuer
029647300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101202001162 FL Practitioner - Podiatry 2961699970 Practice locations: Winter Garden, FL; Sanford, FL; Saint Cloud, FL; Orlando, FL; Casselberry, FL; Debary, FL; Kissimmee, FL

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO1844FLMDPodiatrist
N004176NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Patrick Trevisani DPM Podiatrist PastSince Jan 1, 1985 Accepting new patients

Organizations & group practices 1

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": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1790761088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 650",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327900650",
            "telephone_number": "407-699-6706",
            "fax_number": "407-699-6706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3532 MERIVALE DR",
            "city": "CASSELBERRY",
            "state": "FL",
            "postal_code": "327076023",
            "telephone_number": "407-699-6706",
            "fax_number": "407-699-6706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVISANI",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-19",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004176",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "FL",
            "license": "PO1844",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029647300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Casselberry, FL

Sources for this page

Verify at the official NPI Registry.