Individual provider Active NPI

Beata Felicia Nelken, MD

  • Pediatrics Physician
  • Woonsocket, RI
National Provider Identifier
1518922095
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD11561 Issued in RI
Practice address
450 Clinton St
Thundermist Health Center
Woonsocket, RI 02895-3207
Phone
(401) 767-4100
Fax
(401) 235-6899
NPI assigned
Apr 19, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD11561 RI Primary
Public Health & General Preventive Medicine Physician 2083P0901X MD11561 RI

Addresses

Primary practice location

450 Clinton St
Thundermist Health Center
Woonsocket, RI 02895-3207

Mailing address

450 Clinton St
Thundermist Health Center
Woonsocket, RI 02895-3207
Phone (401) 767-4100

Other identifiers 1

IdentifierTypeStateIssuer
BN54275MedicaidRI

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
I20050228000626 RI Practitioner - Pediatric Medicine 7113970369 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD11561RIMDPublic Health & General Preventive Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blackstone Valley Community Health Care, Inc. CurrentSince Jan 4, 2016 Accepting new patients
Jenks Park Pediatrics, Inc. Pediatrics CurrentSince Jan 21, 2020 Accepting new patients
Thundermist Health Center Past Accepting new patients
Thundermist Health Center Past Accepting new patients
Memorial Hospital Past Accepting new patients
Blackstone Valley Community Health Care, Inc. PastSince Jan 4, 2016 Accepting new patients

Locations

9 Chestnut St
Central Falls, RI 02863
Phone (401) 722-0081

577 Broad St
Central Falls, RI 02863
Phone (401) 305-1950

577 Broad St
#1
Central Falls, RI 02863
Phone (401) 339-7046

39 East Ave
Pawtucket, RI 02860
Phone (401) 722-0081

Interoperability endpoints

  • Direct secure messaging: jenksparkpedi@jppi-ri.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • FHIR API: https://fhir4.healow.com/fhir/r4/DCBEAA

Organizations & group practices 6

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": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1518922095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "address_2": "THUNDERMIST HEALTH CENTER",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "address_2": "THUNDERMIST HEALTH CENTER",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELKEN",
        "first_name": "BEATA",
        "middle_name": "FELICIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-19",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD11561",
            "primary": true
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "RI",
            "license": "MD11561",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "BN54275",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.