Individual provider Active NPI

Janet L Wilterdink, MD

  • Neurology Physician
  • Providence, RI
National Provider Identifier
1144263971
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD08262 Issued in RI
Practice address
2 Dudley St
Suite 555
Providence, RI 02905-3236
Phone
(401) 444-6168
NPI assigned
Jun 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD08262 RI Primary

Addresses

Primary practice location

2 Dudley St
Suite 555
Providence, RI 02905-3236

Mailing address

1 Hoppin St
Suite 318
Providence, RI 02903-4141
Phone (401) 793-8382

Other identifiers 1

IdentifierTypeStateIssuer
7003353MedicaidRI

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
I20100813000071 RI Practitioner - Neurology 7618001660 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Geisel School of Medicine at Dartmouth, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-3777

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Feb 1, 2021 Accepting new patients
Brown Neurology Neurology CurrentSince Jul 1, 1993 Accepting new patients
Rhode Island Hospital CurrentSince Feb 1, 2021 Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

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

2 Dudley St
Ste 555
Providence, RI 02905
Phone (401) 444-4169

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

1 Hoppin St
Ste 318
Providence, RI 02903

593 Eddy St
Providence, RI 02903

34 Parsonage St
#191
Providence, RI 02903

593 Eddy St
#5
Providence, RI 02903
Phone (401) 444-3032

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1150156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1144263971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 HOPPIN ST",
            "address_2": "SUITE 318",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034141",
            "telephone_number": "401-793-8382",
            "fax_number": "401-793-8312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST",
            "address_2": "SUITE 555",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053236",
            "telephone_number": "401-444-6168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILTERDINK",
        "first_name": "JANET",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "RI",
            "license": "MD08262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7003353",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.