Dr. Jack R Bevivino , MD
Plastic Surgery • Providence, RI
120 Dudley Street, Suite #201
Providence, RI 029052431
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on April 3, 2007; this date does not establish years in practice.
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Published CMS data list 13 Original Medicare Part B services in 2017.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2017. Published rows only; this is not a quality measure.
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Published Part B service records, 2017:
- 99204 — New patient outpatient office visit: 13 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2017. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2016 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2017). CPT notice
See the full table · Guide: How to read Medicare Part B data
Practice Location & Contact Primary Location
120 Dudley Street
Suite #201
Providence, RI 029052431
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Plastic Surgery: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare-allowed amount
About $2,052 in 2017
The total amount Medicare approved for these services in 2017. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2017.
Paid by Medicare
About $1,499 in 2017
The part of the Medicare-allowed amount that Medicare itself paid in 2017, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2017.
Industry payments (Open Payments)
No Open Payments records are listed for this clinician for 2019–2025.
NPI first issued
2007
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Compared with the same specialty in Providence and Rhode Island
Billing and prescribing volume is not a quality rating.
Medicare Part B
Comparisons use 2024 data. The latest CMS data for Dr. Bevivino are from 2017.
25 active clinicians are listed under Plastic Surgery with a practice address in Providence, RI (30 in Rhode Island).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Providence
4% of these 25 clinicians have the CMS telehealth indicator.
44% of these 25 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
CMS data for Medicare Part B services are available for 2017 only.
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Medicare-allowed amount
CMS data for Medicare-allowed amount are available for 2017 only.
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Paid by Medicare
CMS data for Medicare payment amount are available for 2017 only.
Sources: CMS Medicare Physician & Other Practitioners (2017), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2017; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99204
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more
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13 | 13 | $250.00 | $157.88 |
Source: CMS Part B by Provider and Service, 2017; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Specialties & License Numbers Reported to NPPES
NUCC Taxonomy Code: 208200000X
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
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Ophthalmology - Retina Specialist
Doctor of Medicine (M.D.)
Career & Practice History
NPI enumerated April 03, 2007.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.
NPI Administrative Meta
Other Plastic Surgery Specialists in Providence
- Dr. Rachel Sullivan, MD
- Dr. Patrick Sullivan, MD
- Dr. Solomon Swartz, MD
- Dr. Scott Schmidt, MD
- Dr. Karl Breuing, MD
- Dr. Erik Hoy, MD, MBA
Mailing Address
120 Dudley Street, Suite #201
Providence, RI 029052431
Phone: 4015219290