Individual provider Active NPI

Jay Cooke Emlen Jr., DPM

  • Foot & Ankle Surgery Podiatrist
  • Dartmouth, MA
National Provider Identifier
1033615125
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DPM00368 Issued in RI
Practice address
537 Faunce Corner Rd
Dartmouth, MA 02747-1242
Phone
(774) 202-7935
Fax
(774) 628-9702
NPI assigned
Apr 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Foot & Ankle Surgery Podiatrist 213ES0103X DPM00368 RI Primary

Addresses

Primary practice location

537 Faunce Corner Rd
Dartmouth, MA 02747-1242

Mailing address

649 East Ave
Pawtucket, RI 02860-6157

Other practice location 1

649 East Ave
Pawtucket, RI 02860-6157
Phone (401) 305-3800

Other practice location 2

950 Warren Ave Ste 103
East Providence, RI 02914-1432
Phone (401) 606-4325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210628000481 RI Practitioner - Podiatry 9931444858 Reassigns benefits to 2 organizations
I20210716000050 MA Practitioner - Podiatry 9931444858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island Foot Care, Inc.Group PAC ID 7214902469, 9 clinicians
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

1524 Atwood Ave
Suite 344
Johnston, RI 02919-3228
Phone (401) 273-5800

537 Faunce Corner Rd
FL 2
Dartmouth, MA 02747-1242
Phone (401) 305-5088

593 Eddy St
Providence, RI 02903-4923

649 E Ave
Pawtucket, RI 02860-6157
Phone (401) 305-5088

950 Warren Ave
Suite 103
East Providence, RI 02914-1432
Phone (401) 606-4325

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue305
Removal of skin lesions75
Removal of nail tissue2531
Removal or shaving of skin growth888
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2510MAMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Aug 31, 2021 Accepting new patients
Rhode Island Foot Care, Inc Foot & Ankle Surgery CurrentSince Jun 16, 2021 Accepting new patients
Rhode Island Hospital CurrentSince Aug 31, 2021 Accepting new patients
Rhode Island Hospital Past Accepting new patients
Lifespan of Massachusetts - Fall River Inc PastSince Jul 1, 2021 Accepting new patients

Locations

537 Faunce Corner Rd
Fl 2
North Dartmouth, MA 02747
Phone (401) 305-5088

537 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 672-0545

537 Faunce Corner Rd
Ste 2
North Dartmouth, MA 02747

738 Washington St
South Attleboro, MA 02703
Phone (508) 761-6025

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

950 Warren Ave
Ste 103
East Providence, RI 02914
Phone (401) 606-4325

649 East Ave
Pawtucket, RI 02860
Phone (401) 305-3800

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1033615125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "649 EAST AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028606157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 FAUNCE CORNER RD",
            "city": "DARTMOUTH",
            "state": "MA",
            "postal_code": "027471242",
            "telephone_number": "774-202-7935",
            "fax_number": "774-628-9702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "649 East Ave",
            "address_purpose": "LOCATION",
            "city": "Pawtucket",
            "state": "RI",
            "postal_code": "028606157",
            "country_code": "US",
            "telephone_number": "401-305-3800",
            "fax_number": "401-305-3803",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "950 Warren Ave Ste 103",
            "address_purpose": "LOCATION",
            "city": "East Providence",
            "state": "RI",
            "postal_code": "029141432",
            "country_code": "US",
            "telephone_number": "401-606-4325",
            "fax_number": "401-606-4329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMLEN",
        "first_name": "JAY",
        "middle_name": "COOKE",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-05",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "RI",
            "license": "DPM00368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.