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Active NPI 1780705707 Individual Practitioner Male Practitioner

Dr. Jack R Bevivino , MD

Plastic Surgery • Providence, RI

Professional Overview & Biography Verified Profile Summary

Dr. Jack Bevivino, MD is a registered healthcare professional specializing in Plastic Surgery in Providence, RI. Practice services are available at 120 DUDLEY STREET under active NPI credentials.

Frequently performed procedures and clinical services include new patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

120 Dudley Street
Suite #201

Providence, RI 029052431

Telephone 4015219290
Fax 4015219297
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Plastic Surgery in Providence, RI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.8 Yrs
State Avg: 28.9 Yrs
Regional Practice Density
25 Specialists

Practicing in Providence, RI (31 Statewide)

Telehealth Adoption Rate
4.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
36.8% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2017)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
13 13 $250.00 $157.88

Medical Specialties & State Licenses

Plastic Surgery Primary Specialty

NUCC Taxonomy Code: 208200000X

State License RI RIMD05259

A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
9002112 (RI)
Commercial Insurance / Payer ID United Health Care
1300124 (RI)
Commercial Insurance / Payer ID Bcbs
21126 (RI)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Dr. Robert Janigian , MD

Ophthalmology - Retina Specialist

NPI 1831195965

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 120 DUDLEY STREET, SUITE #201, PROVIDENCE, RI 029052431 (Tel: 4015219290)

📍
Updated Business Mailing Address July 08, 2007

Registered at 120 DUDLEY STREET, SUITE #201, PROVIDENCE, RI 029052431 (Tel: 4015219290)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JACK BEVIVINO, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Plastic Surgery (License #RIMD05259 in RI)

🟢
Initial NPI Registration & Enumeration April 03, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1780705707
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 03, 2007
Last Update: July 08, 2007
Sole Proprietor: No

Mailing Address

120 Dudley Street, Suite #201

Providence, RI 029052431

Phone: 4015219290

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.