Individual provider Active NPI

Jennifer Trevino, OTR/L

  • Occupational Therapist
  • Wesley Chapel, FL
National Provider Identifier
1932644218
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT 13224 Issued in FL
Practice address
1234 Katahdin CT
Wesley Chapel, FL 33543-6860
Phone
(813) 442-1204
NPI assigned
Dec 22, 2016
Last updated
Oct 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Environmental Modification Occupational Therapist 225XE0001X
Ergonomics Occupational Therapist 225XE1200X
Gerontology Occupational Therapist 225XG0600X
Human Factors Occupational Therapist 225XH1300X
Low Vision Occupational Therapist 225XL0004X
Mental Health Occupational Therapist 225XM0800X
Physical Rehabilitation Occupational Therapist 225XP0019X
Occupational Therapist 225X00000X OT 13224 FL Primary

Addresses

Primary practice location

1234 Katahdin CT
Wesley Chapel, FL 33543-6860

Mailing address

1234 Katahdin CT
Wesley Chapel, FL 33543-6860
Phone (813) 442-1204

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200320002048 FL Practitioner - Occupational Therapist in Private Practice 1759719636 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Functionality for Life, LLCGroup PAC ID 4587092465, 2 clinicians

Practice addresses (Care Compare)

1234 Katahdin CT
Wesley Chapel, FL 33543-6860
Phone (813) 442-1204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT 13224FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functionality for Life, LLC Occupational Therapist CurrentSince Jan 1, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1482364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633564800000",
    "number": "1932644218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 KATAHDIN CT",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335436860",
            "telephone_number": "813-442-1204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 KATAHDIN CT",
            "city": "WESLEY CHAPEL",
            "state": "FL",
            "postal_code": "335436860",
            "telephone_number": "813-442-1204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREVINO",
        "first_name": "JENNIFER",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-22",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XE0001X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Environmental Modification",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XE1200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Ergonomics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XG0600X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Gerontology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1300X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Human Factors",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XL0004X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Low Vision",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XM0800X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XP0019X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Physical Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT 13224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wesley Chapel, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.