Individual provider Active NPI

Michelle C. Vannieuwenhuize, M.D.

  • Internal Medicine Physician
  • Lincoln, RI
National Provider Identifier
1386653343
Registry record updated Nov 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD11885 Issued in RI
Practice address
6 Blackstone Valley PL
Building #3 Suite 305
Lincoln, RI 02865-1179
Phone
(401) 334-1097
Fax
(401) 305-5497
NPI assigned
Aug 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD11885 RI Primary

Addresses

Primary practice location

6 Blackstone Valley PL
Building #3 Suite 305
Lincoln, RI 02865-1179

Mailing address

6 Blackstone Valley PL
Building #3 Suite 305
Lincoln, RI 02865-1179
Phone (401) 334-1097

Other identifiers 2

IdentifierTypeStateIssuer
29892-8OtherRIBLUE CROSS
412860OtherRIBLUE CHIP

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
I20051024000451 RI Practitioner - Internal Medicine 2062438500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6 Blackstone Valley PL
Suite 305
Lincoln, RI 02865-1112
Phone (401) 334-1097

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Landmark Medical Center Hospital, Woonsocket, RI, CCN 410011
  • Our Lady of Fatima Hospital Hospital, North Providence, RI, CCN 410005
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Michelle C. Vannieuwenhuize, MD LLC Internal Medicine CurrentSince Jan 1, 2010 Accepting new patients

Locations

132 Old River Rd
Ste 108
Lincoln, RI 02865
Phone (401) 334-1044

6 Blackstone Valley Pl
Ste 305
Lincoln, RI 02865
Phone (401) 334-1097

Organizations & group practices 1

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 8

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": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416268800000",
    "number": "1386653343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BLACKSTONE VALLEY PL",
            "address_2": "BUILDING #3 SUITE 305",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028651179",
            "telephone_number": "401-334-1097",
            "fax_number": "401-305-5497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BLACKSTONE VALLEY PL",
            "address_2": "BUILDING #3 SUITE 305",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028651179",
            "telephone_number": "401-334-1097",
            "fax_number": "401-305-5497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANNIEUWENHUIZE",
        "first_name": "MICHELLE",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-07",
        "last_updated": "2014-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD11885",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "29892-8",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "412860",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln, RI

Sources for this page

Verify at the official NPI Registry.