Individual provider Active NPI

Ridiane Denis, RN, MD

  • Registered Nurse
  • Malden, MA
National Provider Identifier
1477989002
Registry record updated Aug 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN264097 Issued in MA
Practice address
868 Salem St
Malden, MA 02148-4436
Phone
(617) 959-7561
NPI assigned
Sep 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X RN264097 MA
Health Educator 174H00000X
Registered Nurse 163W00000X RN264097 MA Primary

Addresses

Primary practice location

868 Salem St
Malden, MA 02148-4436

Mailing address

868 Salem St
Malden, MA 02148-4436
Phone (617) 959-7561

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN264097MAMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Clinical Resources CurrentSince Aug 4, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1379116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722470400000",
    "number": "1477989002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "868 SALEM ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484436",
            "telephone_number": "617-959-7561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "868 SALEM ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021484436",
            "telephone_number": "617-959-7561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENIS",
        "first_name": "RIDIANE",
        "credential": "RN, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-14",
        "last_updated": "2024-08-01",
        "certification_date": "2024-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "MA",
            "license": "RN264097",
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN264097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.