NPIMap

Individual provider Active NPI

Penny Marie McLean-Nowinski, MSN-CNP

  • Nurse Practitioner
  • Riverside, RI
National Provider Identifier
1013238351
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN01713 Issued in RI
Practice address
1445 Wampanoag TRL Unit 205
Riverside, RI 02915-1019
Phone
(401) 434-0730
Fax
(401) 270-3439
NPI assigned
Jun 22, 2010
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN01713 RI Primary

Addresses

Primary practice location

1445 Wampanoag TRL Unit 205
Riverside, RI 02915-1019

Mailing address

10 Davol SQ Ste 400
Providence, RI 02903-4760
Phone (401) 421-4000

Other identifiers 1

IdentifierTypeStateIssuer
1013238351MedicaidRI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address pmcleannowinski221053@direct.lifespan.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171113000188 RI Practitioner - Nurse Practitioner 5698809812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Kentucky College of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

1445 Wampanoag TRL
Unit 205
Riverside, RI 02915-1019
Phone (401) 434-0730

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. CurrentSince Apr 25, 2021 Accepting new patients
Coastal Medical Physicians, Inc. Nurse Practitioner CurrentSince Apr 25, 2021 Accepting new patients
Lifespan Corporation Current Accepting new patients
Coastal Medical, Inc. Past Accepting new patients

Locations

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

1445 Wampanoag Trl
Unit 205
Riverside, RI 02915
Phone (401) 434-0770

Interoperability endpoints

  • Direct secure messaging: pmcleannowinski221053@brownhealth.medalliesdirect.net

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1013238351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ STE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034760",
            "telephone_number": "401-421-4000",
            "fax_number": "401-272-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 WAMPANOAG TRL UNIT 205",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029151019",
            "telephone_number": "401-434-0730",
            "fax_number": "401-270-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN-NOWINSKI",
        "first_name": "PENNY",
        "middle_name": "MARIE",
        "credential": "MSN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN01713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1013238351",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pmcleannowinski221053@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "1445 Wampanoag Trl Unit 205",
            "city": "Riverside",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029151019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.