Amy Egolf, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD15497 Issued in RI

Practice address

1011 Veterans Memorial Pkwy
Riverside, RI 02915

Phone

(401) 432-1000

Fax

(401) 432-1500

NPI assigned

Apr 19, 2012

Last updated

Jun 12, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Amelia Nebenhaus Former name

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

Psychiatry

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793

  Child & Adolescent Psychiatry

  Medicare reassignment Care Compare group NPD
• Emma Pendleton Bradley Hospital

  • Psychiatric Hospital
  • Riverside, RI
  • NPI 1578768867
  Medicare reassignment NPD
• Emma Pendleton Bradley Hospital

  • Psychiatry Physician
  • Riverside, RI
  • NPI 1073705943
  NPD
• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD

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

{
    "created_epoch": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1619234341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054513",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "02915",
            "telephone_number": "401-432-1000",
            "fax_number": "401-432-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EGOLF",
        "first_name": "AMY",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-19",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "RI",
            "license": "MD15497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMELIA",
            "last_name": "NEBENHAUS",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• East Bay Community Action Program
• East Bay Community Action Program
• Sarah Elizabeth Eaton, NP
• Yasmin Echeverri, RN
• Rebecca Egge, DPT
• Hannah Ellerkamp, PSYD
• Andrew Delwyn Ellison, MS, LMFT
• Charlene A Ellsworth, MD
• Alaa Elnajjar, MD
• Emma Pendleton Bradley Hospital

• Child & Adolescent Psychiatry Physician in Riverside, RI
• Providers in Riverside, RI by specialty
• Child & Adolescent Psychiatry Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; 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.