Active NPI
Jessica McIntyre, M.D.
- Pediatrics Physician
- Providence, RI
National Provider Identifier
1487032959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- LP03422
- Practice address
- 593 Eddy St
Providence, RI 02903-4923 - Phone
- (401) 444-4471
- Fax
- (401) 444-7574
- NPI assigned
- May 15, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | LP03422 | RI | Primary |
Addresses
Primary practice location
593 Eddy St
Providence, RI 02903-4923
Mailing address
593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4471
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elliot Professional Services | Current | Accepting new patients | |
| Elliot Hospital of the City of Manchester | Past | Accepting new patients |
Locations
1 Elliot Way
Unit 1
Manchester, NH 03103
1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271
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 and National Provider Directory roles.
-
- Internal Medicine Physician
- Manchester, NH
- NPI 1285627935
-
- General Acute Care Hospital
- Manchester, NH
- NPI 1902996028
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456185600000",
"number": "1487032959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "593 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034923",
"telephone_number": "401-444-4471",
"fax_number": "401-444-7574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "593 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034923",
"telephone_number": "401-444-4471",
"fax_number": "401-444-7574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCINTYRE",
"first_name": "JESSICA",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-15",
"last_updated": "2016-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "RI",
"license": "LP03422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.