Individual provider Active NPI

Tara Lin Panciotti, FNP-C, FNP-BC

  • Family Nurse Practitioner
  • Bristol, RI
National Provider Identifier
1255030532
Registry record updated Oct 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN03724 Issued in RI
Practice address
1180 Hope St
Bristol, RI 02809-1126
Phone
(401) 253-8900
NPI assigned
Feb 27, 2023
Last updated
Oct 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN03724 RI Primary
Registered Nurse 163W00000X RN2361401 MA
Registered Nurse 163W00000X RN60216 RI

Addresses

Primary practice location

1180 Hope St
Bristol, RI 02809-1126

Mailing address

14 Elmdale St
Seekonk, MA 02771-5118

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240119002052 RI Practitioner - Nurse Practitioner 0840642385 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical Associates of Ri, Inc.Group PAC ID 3375432040, 32 clinicians

Practice addresses (Care Compare)

950 Warren Ave
East Providence, RI 02914-1414
Phone (401) 253-8900

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2361401MAMDRegistered Nurse
RN60216RIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Associates of Ri Inc CurrentSince Nov 11, 2023 Accepting new patients
Medical Associates of Rhode Island, Inc. Past Accepting new patients

Locations

1180 Hope St
Bristol, RI 02809
Phone (401) 253-8900

950 Warren Ave
East Providence, RI 02914
Phone (401) 253-8900

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IGJCAA
  • Direct secure messaging: tara.panciotti@maori.eclinicaldirectplus.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1677456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697932800000",
    "number": "1255030532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 ELMDALE ST",
            "city": "SEEKONK",
            "state": "MA",
            "postal_code": "027715118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 HOPE ST",
            "city": "BRISTOL",
            "state": "RI",
            "postal_code": "028091126",
            "telephone_number": "401-253-8900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANCIOTTI",
        "first_name": "TARA",
        "middle_name": "LIN",
        "name_prefix": "Mrs.",
        "credential": "FNP-C, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-10-22",
        "certification_date": "2023-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN03724",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2361401",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "RI",
            "license": "RN60216",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, RI

Sources for this page

Verify at the official NPI Registry.