NPIMap

Individual provider Active NPI

Keryann Estrela, DNP

  • Gerontology Nurse Practitioner
  • Middletown, RI
National Provider Identifier
1396336475
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN02439 Issued in RI
Practice address
99 E Main Rd Ste 19a
Middletown, RI 02842-4957
Phone
(401) 846-0055
Fax
(401) 606-4510
NPI assigned
Feb 1, 2021
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X APRN02439 RI Primary

Addresses

Primary practice location

99 E Main Rd Ste 19a
Middletown, RI 02842-4957

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541

Other identifiers 1

IdentifierTypeStateIssuer
APRN02439OtherRISTATE LICENSE BOARD

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
I20210920003245 RI Practitioner - Nurse Practitioner 0446657365 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

639 Metacom Ave
Warren, RI 02885-2348
Phone (401) 245-1500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN02439RIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. CurrentSince Feb 1, 2024 Accepting new patients
Coastal Medical Physicians, Inc. CurrentSince Feb 1, 2024 Accepting new patients
Lifespan Corporation Current Accepting new patients
Coastal Medical, Inc. Past Accepting new patients
Coastal Medical Physicians, Inc. PastSince Nov 8, 2025 Accepting new patients

Locations

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

99 E Main Rd
Ste 19A
Middletown, RI 02842
Phone (401) 846-0055

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

639 Metacom Ave
Warren, RI 02885
Phone (401) 245-1500

Interoperability endpoints

  • Direct secure messaging: kestrela12641@brownhealth.medalliesdirect.net

Organizations & group practices 5

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 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": "1612137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1396336475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 E MAIN RD STE 19A",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028424957",
            "telephone_number": "401-846-0055",
            "fax_number": "401-606-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESTRELA",
        "first_name": "KERYANN",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-01",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "APRN02439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE BOARD",
            "identifier": "APRN02439",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

Verify at the official NPI Registry.