Jenna Marie Iannuccilli, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD16838 Issued in RI

Practice address

400 Massasoit Ave Ste 300
East Providence, RI 02914-2012

Phone

(401) 434-2704

Fax

(401) 434-4054

NPI assigned

Jul 13, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Critical Care (Intensivists)Also: Internal Medicine

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Healthcare Services Landmark LLCGroup PAC ID 3274761069, 48 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Landmark Medical Center Hospital, Woonsocket, RI, CCN 410011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jenna.iannuccilli.2@9000.direct.athenahealth.com

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.

• Prime Healthcare Services Landmark LLC

  • Hematology & Oncology Physician
  • Woonsocket, RI
  • NPI 1518388651
  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD
• Prime Healthcare Services Landmark LLC

  • General Acute Care Hospital
  • Woonsocket, RI
  • NPI 1699752923
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prime Healthcare Services Landmark LLC

  • General Acute Care Hospital
  • Woonsocket, RI
  • NPI 1699752923
  Care Compare affiliation
• Prime Healthcare Services-Landmark LLC

  • Psychiatric Hospital Unit
  • Woonsocket, RI
  • NPI 1396722666
  Care Compare affiliation

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

{
    "created_epoch": "1468368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611014400000",
    "number": "1609229798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MASSASOIT AVE STE 300",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029142012",
            "telephone_number": "401-434-2704",
            "fax_number": "401-434-4054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "825 Chalkstone Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084728",
            "country_code": "US",
            "telephone_number": "401-456-2033",
            "fax_number": "401-456-6809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IANNUCCILLI",
        "first_name": "JENNA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-13",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP03816",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD16838",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey I Hunt, M.D.
• Kristen J. Hylan, FNP
• Dino B Iacobo, OTRL
• Gregory Iafrate, MD
• Kimberly A Iannotti, AGACNP-BC
• Erica Igle, RN
• Amelia Iglesias, CCC-SLP
• Independence, LLC
• Linda Cleary Ingle, MSPT
• Melissa E Ings, ACNP-BC

• Internal Medicine Physician in East Providence, RI
• Providers in East Providence, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.