Stephanie Jo Penchuk, PHYSICIAN

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD08739 Issued in RI

Practice address

41 Sanderson Rd Ste 202
Smithfield, RI 02917-2603

Phone

(401) 231-3138

Fax

(401) 231-4757

NPI assigned

Dec 4, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: spnechuk@wih.cernerdirect.carene.org

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063570224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 SANDERSON RD STE 202",
            "city": "SMITHFIELD",
            "state": "RI",
            "postal_code": "02917",
            "telephone_number": "401-231-3138",
            "fax_number": "401-231-4757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 SANDERSON RD STE 202",
            "city": "SMITHFIELD",
            "state": "RI",
            "postal_code": "029172603",
            "telephone_number": "401-231-3138",
            "fax_number": "401-231-4757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENCHUK",
        "first_name": "STEPHANIE",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "PHYSICIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD08739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENCE",
            "identifier": "73004",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SP40427",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD08739",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Orthopedics Rhode Island, Inc
• Robin M. Orticerio, LATC
• Prany Ou
• Michelle Lynn Pavao, PHARMD
• Claire Pelham, LICSW
• Keith A Perry, M.D.
• Peter C Brasch MD LLC
• Peter C. Brasch, MD, LLC
• Emily Peters, PA-C
• Phalanx Med Rhode Island, LLC

• Pediatrics Physician in Smithfield, RI
• Providers in Smithfield, RI by specialty
• Pediatrics Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.