Individual provider Active NPI

Jeffrey Nadelson, M.D.

  • Gastroenterology Physician
  • Providence, RI
National Provider Identifier
1619263399
Registry record updated Aug 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
MD16090 Issued in RI
Practice address
33 Staniford St FL 1
Providence, RI 02905
Phone
(978) 289-0745
NPI assigned
Jun 22, 2011
Last updated
Aug 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD16090 RI
Internal Medicine Physician 207R00000X LP02295 RI
Internal Medicine Physician 207R00000X 261952 MA
Gastroenterology Physician 207RG0100X MD16090 RI Primary

Addresses

Primary practice location

33 Staniford St FL 1
Providence, RI 02905

Mailing address

33 Staniford St FL 1
Providence, RI 02905-3100
Phone (978) 289-0745

Other practice location 1

956 Court Ave Ste H314
Memphis, TN 38103-2814
Phone (978) 289-0745

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
I20180618003108 RI Practitioner - Internal MedicinePractitioner - Gastroenterology 3173763901 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Gastroenterology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Gastroenterology, LLCGroup PAC ID 3678762804, 99 clinicians

Practice addresses (Care Compare)

33 Staniford St
Providence, RI 02905-3105
Phone (401) 421-8800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy74
Upper gastrointestinal (GI) endoscopy for acid reflux111

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
261952MAMDInternal Medicine Physician
LP02295RIMDInternal Medicine Physician
MD16090RIMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. Internal Medicine Current Accepting new patients
University Gastroenterology, LLC Gastroenterology CurrentSince Aug 1, 2018 Accepting new patients

Locations

33 Staniford St
Providence, RI 02905
Phone (401) 274-1810

33 Staniford St
#1
Providence, RI 02905
Phone (401) 649-4229

33 Staniford St
#2
Providence, RI 02905

Interoperability endpoints

  • Direct secure messaging: jnadelson@direct.carene.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533686400000",
    "number": "1619263399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 STANIFORD ST FL 1",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053100",
            "telephone_number": "978-289-0745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 STANIFORD ST FL 1",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02905",
            "telephone_number": "978-289-0745"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "956 Court Ave Ste H314",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381032814",
            "country_code": "US",
            "telephone_number": "978-289-0745",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NADELSON",
        "first_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-22",
        "last_updated": "2018-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD16090",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP02295",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "261952",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "RI",
            "license": "MD16090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.