Individual provider Active NPI

John N Gaitanis, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Providence, RI
National Provider Identifier
1225065394
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
MD11298 Issued in RI
Practice address
593 Eddy St
George Building
Providence, RI 02903-4923
Phone
(401) 444-4000
NPI assigned
Jun 26, 2006
Last updated
Aug 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 213712 MA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X MD11298 RI Primary

Addresses

Primary practice location

593 Eddy St
George Building
Providence, RI 02903-4923

Mailing address

1 Hoppin St
Suite 318
Providence, RI 02903-4141
Phone (781) 352-4777

Other practice location 1

115 Norwood Park S
Ste 106
Norwood, MA 02062-4641
Phone (781) 352-4777

Other practice location 2

2 Dudley Street
Ste 2
Providence, RI 02905-3236
Phone (781) 352-4777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA, CO, OR, TX5 enrollments
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 5

Enrollment IDStateProvider typePAC IDDetails
I20040205000118 RI Practitioner - Neurology 3375436215 Reassigns benefits to 4 organizations
I20081104000294 MA Practitioner - Neurology 3375436215 Reassigns benefits to 1 organization
I20241223003044 CO Practitioner - Neurology 3375436215 Reassigns benefits to 2 organizations
I20250407001823 OR Practitioner - Neurology 3375436215 Reassigns benefits to 1 organization
I20251008004019 TX Practitioner - PsychiatryPractitioner - Neurology 3375436215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carepoint Inpatient Blue Sky Neurology PLLCGroup PAC ID 9436456118, 39 clinicians
Carepoint Inpatient Blue Sky Neurology - Texas, PLLCGroup PAC ID 1557776036, 39 clinicians
Precision Neurology Associates PLLCGroup PAC ID 3375055122, 2 clinicians

Practice addresses (Care Compare)

10101 Ridgegate Pkwy
Lone Tree, CO 80124-5522
Phone (720) 225-1000

1139 E Sonterra Blvd
San Antonio, TX 78258-4347
Phone (210) 638-2000

115 Norwood Park S
Suite 106
Norwood, MA 02062-4633
Phone (347) 805-4641

1310 McCullough Ave
San Antonio, TX 78212-5601
Phone (210) 757-2200

1501 S Potomac St
Aurora, CO 80012-5411
Phone (303) 695-2600

1719 E 19TH Ave
Presbyterian St Lukes
Denver, CO 80218-1235
Phone (303) 839-6000

2 Dudley St
Providence, RI 02905-3236
Phone (347) 805-4641

501 E Hamden Ave
Englewood, CO 80113-2702
Phone (303) 788-6911

7700 Floyd Curl Dr
San Antonio, TX 78229-3902
Phone (210) 575-4000

9191 Grant St
Thornton, CO 80229-4361
Phone (303) 450-4482

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213712MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Precision Neurology Associates PLLC Neurology With Special Qualifications in Child Neurology CurrentSince Aug 18, 2025 Accepting new patients
Salem Health Current Accepting new patients
Pna Group Neurology With Special Qualifications in Child Neurology CurrentSince Nov 30, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 23, 2023 Accepting new patients
Salem Health CurrentSince Apr 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 23, 2023 Accepting new patients
Carepoint Inpatient Blue Sky Neurology PLLC CurrentSince Jun 3, 2025 Accepting new patients
Salem Health CurrentSince Apr 1, 2025 Accepting new patients
Blue Sky Telehealth, LLC Neurology With Special Qualifications in Child Neurology CurrentSince Dec 1, 2024 Accepting new patients
Rhode Island Hospital CurrentSince Jul 23, 2023 Accepting new patients
Carepoint Inpatient Blue Sky Neurology - Texas, PLLC CurrentSince Aug 6, 2025 Accepting new patients
Rhode Island Hospital CurrentSince Jul 23, 2023 Accepting new patients

Locations

501 E Hampden Ave
Englewood, CO 80113
Phone (303) 788-5300

5600 S Quebec St
Ste 312A
Greenwood Village, CO 80111
Phone (303) 343-6272

115 Norwood Park S
Ste 105
Norwood, MA 02062

115 Norwood Park S
Ste 106
Norwood, MA 02062
Phone (347) 805-4641

665 Winter St SE
Salem, OR 97301
Phone (503) 370-5634

890 Oak St SE
Salem, OR 97301
Phone (503) 585-0830

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

701 George Washington Hwy
Ste 104
Lincoln, RI 02865
Phone (401) 444-8311

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

1 A St
Providence, RI 02919
Phone (401) 444-5685

1 Hoppin St
Ste 3
Providence, RI 02903
Phone (401) 793-8400

1 Hoppin St
Ste 318
Providence, RI 02903

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

2 Dudley St
Ste 2
Providence, RI 02905
Phone (347) 805-4641

2 Dudley St
Ste 530
Providence, RI 02905
Phone (401) 444-3799

593 Eddy St
Providence, RI 02903

593 Eddy St
Lowr
Providence, RI 02903
Phone (401) 444-4471

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

1139 E Sonterra Blvd
San Antonio, TX 78258
Phone (210) 638-2000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AJBJDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/AJBJDD/Endpoint/AJBJDD

Organizations & group practices 12

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1225065394",
    "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": "781-352-4777",
            "fax_number": "781-352-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "GEORGE BUILDING",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Norwood Park S",
            "address_2": "Ste 106",
            "address_purpose": "LOCATION",
            "city": "Norwood",
            "state": "MA",
            "postal_code": "020624641",
            "country_code": "US",
            "telephone_number": "781-352-4777",
            "fax_number": "781-352-4778",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2 Dudley Street",
            "address_2": "Ste 2",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053236",
            "country_code": "US",
            "telephone_number": "781-352-4777",
            "fax_number": "781-352-4778",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAITANIS",
        "first_name": "JOHN",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-26",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MA",
            "license": "213712",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "RI",
            "license": "MD11298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.