Individual provider Active NPI

Jillian Leigh Tucker, APRN

  • Gerontology Nurse Practitioner
  • Cranston, RI
National Provider Identifier
1023885688
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN03876 Issued in RI
Practice address
725 Reservoir Ave Ste 103
Cranston, RI 02910-4451
Phone
(401) 829-4446
Fax
(401) 829-4434
NPI assigned
Dec 5, 2023
Last updated
Jul 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X APRN03876 RI
Gerontology Nurse Practitioner 363LG0600X APRN03876 RI Primary
Primary Care Nurse Practitioner 363LP2300X APRN03876 RI

Addresses

Primary practice location

725 Reservoir Ave Ste 103
Cranston, RI 02910-4451

Mailing address

725 Reservoir Ave Ste 103
Cranston, RI 02910-4451

Other names 1

  • Jillian Leigh Degraide Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240109001630 RI Practitioner - Nurse Practitioner 5092166546 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trucare IncGroup PAC ID 1850646811, 9 clinicians

Practice addresses (Care Compare)

725 Reservoir Ave
Suite 103
Cranston, RI 02910-4451
Phone (401) 944-6889

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN03876RIMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trucare Inc CurrentSince Nov 28, 2023 Accepting new patients

Locations

725 Reservoir Ave
Cranston, RI 02910
Phone (401) 944-3800

725 Reservoir Ave
Ste 103
Cranston, RI 02910
Phone (401) 829-4446

Organizations & group practices 1

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 2

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": "1701734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1023885688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 RESERVOIR AVE STE 103",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RESERVOIR AVE STE 103",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104451",
            "telephone_number": "401-829-4446",
            "fax_number": "401-829-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JILLIAN",
        "middle_name": "LEIGH",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-12-05",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "APRN03876",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "APRN03876",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "RI",
            "license": "APRN03876",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILLIAN",
            "last_name": "DEGRAIDE",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.