Individual provider Active NPI

Nicole L Grenier, M.D.

  • Dermatology Physician
  • Warwick, RI
National Provider Identifier
1689899734
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
MD13784 Issued in RI
Practice address
400 Bald Hill Rd
Warwick, RI 02886-1617
Phone
(401) 444-7959
Fax
(401) 738-3857
NPI assigned
Apr 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X MD13784 RI Primary

Addresses

Primary practice location

400 Bald Hill Rd
Warwick, RI 02886-1617

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779

Other practice location 1

65 Village Square Dr Ste 201
South Kingstown, RI 02879-2569
Phone (401) 444-7959

Other identifiers 1

IdentifierTypeStateIssuer
1689899734MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20120220000011 RI Practitioner - Dermatology 5092839225 Reassigns benefits to 2 organizations
I20160601001920 MA Practitioner - Dermatology 5092839225 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Warren Alpert Medical School of Brown University, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Nantucket Dermatology LLCGroup PAC ID 7719147917, 7 clinicians
Brown Dermatology IncGroup PAC ID 3870872773, 28 clinicians

Practice addresses (Care Compare)

17 Wells St
Suite 203
Westerly, RI 02891-2923
Phone (401) 348-0660

185 A High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

185 High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

4 /2 Bartlett Rd
Nantucket, MA 02554-4381
Phone (781) 398-2225

400 Bald Hill Rd
FL 2
Warwick, RI 02886-1617
Phone (401) 444-7959

5 Federal St
Unit 1881
Nantucket, MA 02554-1703

593 Eddy St
Providence, RI 02903-4923

593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172

593 Eddy St George BLDG 1St Floor
Providence, RI 02903-4923
Phone (401) 793-9166

65 Village Square Dr
Suite 201
South Kingstown, RI 02879-2569
Phone (401) 444-7959

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision28
Removal of skin lesions749
Removal or shaving of skin growth1-10
Skin biopsy225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD13784RIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Nantucket Dermatology, LLC Dermatology CurrentSince Mar 30, 2016 Accepting new patients
Brown Dermatology, Inc. Dermatology CurrentSince Jan 1, 2017 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2026 Accepting new patients
Dermatology Consultants of S FL PA Dermatology Past Accepting new patients
Skin and Cancer Associates Dermatology PastSince Mar 17, 2014 Accepting new patients

Locations

4 Bartlett Rd
Nantucket, MA 02554
Phone (508) 325-4777

5 Federal St
Unit 1881
Nantucket, MA 02554

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

15 La Salle Sq
Providence, RI 02903

593 Eddy St
Providence, RI 02903

110 Elm St
Fl 2
Providence, RI 02903

593 Eddy St
#10
Providence, RI 02903
Phone (401) 444-7024

110 Elm St
Providence, RI 02903
Phone (401) 443-4992

65 Village Square Dr
Ste 201
South Kingstown, RI 02879
Phone (401) 515-7979

400 Bald Hill Rd
Warwick, RI 02886
Phone (401) 352-0005

400 Bald Hill Rd
Ste 526
Warwick, RI 02886
Phone (401) 738-4323

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JCEBBD
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

Hospital & facility affiliations 6

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": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1689899734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "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": "400 BALD HILL RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861617",
            "telephone_number": "401-444-7959",
            "fax_number": "401-738-3857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "65 Village Square Dr Ste 201",
            "address_purpose": "LOCATION",
            "city": "South Kingstown",
            "state": "RI",
            "postal_code": "028792569",
            "country_code": "US",
            "telephone_number": "401-444-7959",
            "fax_number": "401-515-7910",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRENIER",
        "first_name": "NICOLE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-16",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "MD13784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1689899734",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.