Individual provider Active NPI

Ronnelle King, M.D.

  • Neonatal-Perinatal Medicine Physician
  • Springfield, MA
National Provider Identifier
1689930307
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
License
264622 Issued in MA
Practice address
759 Chestnut Street
W2810
Springfield, MA 01107-1619
Phone
(413) 794-5370
Fax
(413) 794-5100
NPI assigned
Apr 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine Physician 2080N0001X 264622 MA Primary

Addresses

Primary practice location

759 Chestnut Street
W2810
Springfield, MA 01107-1619

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20151029000745 MA Practitioner - Pediatric Medicine 8729227509 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
264622MAMDNeonatal-Perinatal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Pediatric Associates Inc CurrentSince Jul 1, 2019 Accepting new patients
Melrosewakefield Healthcare, Inc. Past Accepting new patients
Tufts Medical Center, Inc. Past Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#1
Boston, MA 02111

Interoperability endpoints

  • Direct secure messaging: rking29194@tuftsmedicine.direct-ci.com

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": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1689930307",
    "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": "759 CHESTNUT STREET",
            "address_2": "W2810",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071619",
            "telephone_number": "413-794-5370",
            "fax_number": "413-794-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "RONNELLE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-06",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": "MA",
            "license": "264622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.