Individual provider Active NPI

Amanda Jean Trevino, FNP-C

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1871203448
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1169084 Issued in TX
Practice address
1807 W Slaughter LN Ste 490
Austin, TX 78748-6208
Phone
(512) 282-8967
Fax
(512) 406-7351
NPI assigned
Dec 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1169084 TX Primary

Addresses

Primary practice location

1807 W Slaughter LN Ste 490
Austin, TX 78748-6208

Mailing address

6210 E Hwy 290
Austin, TX 78723-1142
Phone (512) 483-9596

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221229001489 VA Practitioner - Nurse Practitioner 1850761263 Reassigns benefits to 1 organization
I20241127002818 TX Practitioner - Nurse Practitioner 1850761263 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Austin Regional Clinic PAGroup PAC ID 3072507789, 398 clinicians

Practice addresses (Care Compare)

1807 W Slaughter LN
490 Arc Southwest
Austin, TX 78748-6208
Phone (512) 282-8967

Hospital & facility affiliations

  • Sentara Williamsburg Regional Medical Center Hospital, Williamsburg, VA, CCN 490066

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1169084TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jan 1, 2023 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Dec 13, 2022 Accepting new patients
Tidewater Physicians Multispecialty Group PC CurrentSince Jan 1, 2023 Accepting new patients
Austin Regional Clinic, PA CurrentSince Nov 5, 2024 Accepting new patients
Austin Regional Clinic, PA CurrentSince Nov 5, 2024 Accepting new patients

Locations

6210 E Highway 290
Ste 240
Austin, TX 78723

6835 Austin Center Blvd
Austin, TX 78731
Phone (512) 231-5210

6210 E Highway 290
Austin, TX 78723

1807 W Slaughter Ln
Ste 490
Austin, TX 78748
Phone (512) 282-8967

151 Exchange Blvd
Ste 500
Hutto, TX 78634
Phone (512) 846-1244

940 Hesters Crossing Rd
Round Rock, TX 78681
Phone (512) 244-9024

827 Diligence Dr
Ste 100
Newport News, VA 23606

11761 Rock Landing Dr
Ste 8
Newport News, VA 23606

307 Cook Rd
Yorktown, VA 23690
Phone (757) 898-7261

Interoperability endpoints

  • Direct secure messaging: atrevino34750@arcmd.direct-ci.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

Organizations & group practices 5

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 1

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": "1670198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1871203448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HWY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142",
            "telephone_number": "512-483-9596",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 W SLAUGHTER LN STE 490",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787486208",
            "telephone_number": "512-282-8967",
            "fax_number": "512-406-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "AMANDA",
        "middle_name": "JEAN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-05",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1169084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.