NPIMap

Individual provider Active NPI

Colette R Whitby, MD

  • Surgery Physician
  • Woonsocket, RI
National Provider Identifier
1225096480
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
220095 Issued in MA
Practice address
115 Cass Ave
Woonsocket, RI 02895-4705
Phone
(401) 766-2970
NPI assigned
May 3, 2006
Last updated
May 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 220095 MA Primary

Addresses

Primary practice location

115 Cass Ave
Woonsocket, RI 02895-4705

Mailing address

20 Cumberland Hill Rd Unit 202
Woonsocket, RI 02895-4854
Phone (401) 766-2970

Other identifiers 3

IdentifierTypeStateIssuer
2038790MedicaidMA
AH14988OtherHARVARD PILGRIM
468774OtherTUFTS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240314003963 RI Practitioner - General Surgery 4284624966 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prime Healthcare Services Landmark LLCGroup PAC ID 3274761069, shared by 5 NPIs, 48 clinicians

Practice addresses (Care Compare)

20 Cumberland Hill Rd
Unit 102
Woonsocket, RI 02895-4854
Phone (401) 769-4100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Mastectomy1-10
Removal of tissue94
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prime Healthcare Services Landmark LLC Surgery CurrentSince Sep 9, 2024 Accepting new patients
Prime Healthcare Services Landmark LLC Surgery CurrentSince Jan 1, 2024 Accepting new patients
Prime Healthcare Services Landmark LLC CurrentSince Jan 1, 2024 Accepting new patients
Nashoba Valley Surgical LLC Surgery PastSince Oct 1, 2006 Accepting new patients
Central Ma Cardiovascular Physicians Inc PastSince Jul 5, 2009 Accepting new patients
Nashoba Surgical Associates Surgery Past Accepting new patients
Nashoba Surgical Associates, Inc. Surgery Past Accepting new patients
Prime Healthcare Services Landmark LLC Surgery Past Accepting new patients

Locations

115 Cass Ave
Woonsocket, RI 02895
Phone (401) 356-1701

20 Cumberland Hill Rd
Woonsocket, RI 02895
Phone (401) 597-0985

20 Cumberland Hill Rd
Unit 102
Woonsocket, RI 02895

20 Cumberland Hill Rd
Unit 202
Woonsocket, RI 02895
Phone (401) 765-1750

206 Cass Ave
Woonsocket, RI 02895
Phone (401) 597-5070

Organizations & group practices 8

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 4

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1225096480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CUMBERLAND HILL RD UNIT 202",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954854",
            "telephone_number": "401-766-2970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954705",
            "telephone_number": "401-766-2970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITBY",
        "first_name": "COLETTE",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "220095",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2038790",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AH14988",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "468774",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.