Individual provider Active NPI

John S Vitelli, MD

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1740268754
Registry record updated Aug 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD08534 Issued in RI
Practice address
345 Blackstone Blvd
Providence, RI 02906-4800
Phone
(401) 455-6362
NPI assigned
Jan 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD08534 RI Primary

Addresses

Primary practice location

345 Blackstone Blvd
Providence, RI 02906-4800

Mailing address

345 Blackstone Blvd
Providence, RI 02906-4800
Phone (401) 455-6362

Other identifiers 9

IdentifierTypeStateIssuer
1093831646OtherRIBUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
P00434711OtherRIMEDICARE RAILRAOD
1104801349OtherRIBUTLER HOSPITAL NPI
20333-3OtherRIBLUE CROSS
22860-8OtherRIBCBS - MIRIAM
04-03704OtherRIUNITED HEALTHCARE
7008653MedicaidRI
408074OtherRIBLUE CHIP
119023709OtherRIMEDICARE ID-TYPE UNSPECIFIED

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jvitelli8958@direct.carene.org Health Information Exchange (HIE)

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
I20040706000280 RI Practitioner - Internal Medicine 4183601487 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

455 Tollgate Rd
Warwick, RI 02886-2759

Hospital & facility affiliations

  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD08534RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. Internal Medicine CurrentSince Jul 1, 2016 Accepting new patients
Affinity Physicians LLC CurrentSince Jul 1, 2016 Accepting new patients
Mineral Spring Primary Care Associates, LLC Internal Medicine PastSince Sep 1, 2014 Accepting new patients
Kevin E Baill, MD and Associates, LLC Past Accepting new patients

Locations

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

100 Ray Dr
Providence, RI 02906
Phone (401) 455-6663

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: jvitelli8958@direct.carene.org

Organizations & group practices 4

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 2

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": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1740268754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064800",
            "telephone_number": "401-455-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 BLACKSTONE BLVD",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029064800",
            "telephone_number": "401-455-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITELLI",
        "first_name": "JOHN",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-09",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD08534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE",
            "identifier": "1093831646",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILRAOD",
            "identifier": "P00434711",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUTLER HOSPITAL NPI",
            "identifier": "1104801349",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "20333-3",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - MIRIAM",
            "identifier": "22860-8",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "04-03704",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7008653",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "408074",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "119023709",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jvitelli8958@direct.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "345 Blackstone Blvd",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029064800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.