Individual provider Active NPI

Jonathan Trent Vanadore, DO

  • Emergency Medicine Physician
  • Warwick, RI
National Provider Identifier
1043773286
Registry record updated May 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO01267 Issued in RI
Practice address
455 Toll Gate Rd
Warwick, RI 02886-2770
Phone
(401) 737-7010
NPI assigned
Apr 12, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X DO01267 RI Primary

Addresses

Primary practice location

455 Toll Gate Rd
Warwick, RI 02886-2770

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230607000522 RI Practitioner - Emergency Medicine 6406183623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Campbell Univ School of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
DO01267RIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Jul 23, 2023 Accepting new patients
Affinity Physicians LLC. Emergency Medicine CurrentSince Jul 23, 2023 Accepting new patients

Locations

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 2

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 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": "1555027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1043773286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-737-7010",
            "fax_number": "401-736-4546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862770",
            "telephone_number": "401-737-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANADORE",
        "first_name": "JONATHAN",
        "middle_name": "TRENT",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-12",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "DO01267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.