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JACK R BEVIVINO MD
NPI 1780705707
Plastic Surgery in Providence, RI

Active since April 03, 2007
120 DUDLEY STREET, SUITE #201, PROVIDENCE, RI 02905(401) 521-9290(401) 521-9297 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jack R Bevivino Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK R BEVIVINO MD (NPI 1780705707) is an individual plastic surgery provider in Providence, Rhode Island, licensed in Rhode Island (RIMD05259) and active in the NPI registry since April 2007.

NPPES Registry Identity

NPI1780705707
Entity TypeIndividualMale
Primary Taxonomy208200000X
Provider Legal NameJACK R BEVIVINOCredential: MD
Location Address120 DUDLEY STREET, SUITE #201Providence, RI 02905-2431
Mailing Address120 Dudley Street, Suite #201Providence, RI 02905-2431 · (401) 521-9290 · Fax (401) 521-9297
Phone(401) 521-9290
Fax(401) 521-9297
Sole ProprietorNo
Enumeration DateApril 3, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1780705707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in RI · RIMD05259
Definition
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.
120 DUDLEY STREET, Providence, RI 02905
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Other Identifiers 4

Medicare UPINC90377
Medicaid9002112RI
Other1300124RI · United Health Care
Other21126RI · Bcbs

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNIVERSITY PLASTIC SURGEONS INC
Plastic Surgery
120 DUDLEY STREET, SUITE #201
PROVIDENCE, RI 02905
Providence County (401) 521-9290
ELMWOOD HOME CARE, INC.
Home Health
120 DUDLEY STREET, SUITE 201
PROVIDENCE, RI 02905
Providence County (401) 941-1347
KEYSTONE FAMILY ACUPUNCTURE, INC.
Acupuncturist
120 DUDLEY STREET, SUITE103
PROVIDENCE, RI 02905
Providence County (401) 272-8262
JAHRLING OCULAR PROSTHETICS INC.
Technician/Technologist (Ocularist)
120 DUDLEY STREET, SUITE 202
PROVIDENCE, RI 02905
Providence County (401) 454-4168
DR. ROBERT H JANIGIAN JR. MD
Ophthalmology (Retina Specialist)
120 DUDLEY STREET, SUITE 303
PROVIDENCE, RI 02905
Providence County (401) 369-7773

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Bevivino's NPI number?

The NPI number for Jack Bevivino is 1780705707. It was assigned to this individual provider in the NPPES registry on April 3, 2007.

Where is Jack Bevivino located?

Jack Bevivino practices at 120 Dudley Street Suite #201, Providence, RI 02905. The listed phone number is (401) 521-9290.

What is Jack Bevivino's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

When was this NPI record last updated?

The NPPES record for Jack Bevivino was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.