Physician Compare National (NPI:1790761088)

HEALTHCARE PROVIDER: PATRICK J TREVISANI DPM

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1790761088
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961699970
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101202001162
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TREVISANI
	Individual professional last name
Provider First Name	PATRICK
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1057 WILLA SPRINGS DR
	Group Practice or individual's line 1 address
City	WINTER SPRINGS
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	327085235
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4076968400
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y