Individual provider Active NPI

Elizabeth Noreen Mintzes, NP

  • Pediatric Nurse Practitioner
  • Providence, RI
National Provider Identifier
1568878627
Registry record updated Sep 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN02236 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-6195
Fax
(401) 444-6378
NPI assigned
Jul 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN2297622 MA
Pediatric Nurse Practitioner 363LP0200X APRN02236 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

280 Chestnut St
2ND Floor
Springfield, MA 01199-1001
Phone (413) 794-5700

Other practice location 1

759 Chestnut Street
Sw3500
Springfield, MA 01107-1619
Phone (413) 794-9338

Other practice location 2

593 Eddy Street
Hasbro Suite 105
Providence, RI 02903-4923
Phone (401) 444-5241

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200205001431 RI Practitioner - Nurse Practitioner 8820317704 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-5241

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2297622MAMDPediatric Nurse Practitioner
APRN02236RIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Jan 6, 2020 Accepting new patients
Rhode Island Hospital CurrentSince Jan 6, 2020 Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

593 Eddy St
Ste 105
Providence, RI 02903
Phone (401) 444-5241

593 Eddy St
Providence, RI 02903

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

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

Organizations & group practices 3

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": "1404864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600300800000",
    "number": "1568878627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 CHESTNUT ST",
            "address_2": "2ND FLOOR",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011991001",
            "telephone_number": "413-794-5700"
        },
        {
            "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": "401-444-6195",
            "fax_number": "401-444-6378"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "759 Chestnut Street",
            "address_2": "SW3500",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011071619",
            "country_code": "US",
            "telephone_number": "413-794-9338",
            "fax_number": "413-794-9754",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "593 Eddy Street",
            "address_2": "Hasbro Suite 105",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-5241",
            "fax_number": "401-444-3872",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINTZES",
        "first_name": "ELIZABETH",
        "middle_name": "NOREEN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-09",
        "last_updated": "2020-09-17",
        "certification_date": "2020-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2297622",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "RI",
            "license": "APRN02236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.