Individual provider Active NPI

Eleni T Pappas, DPM

  • Podiatrist
  • Wakefield, RI
National Provider Identifier
1790741791
Registry record updated Oct 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
227 Issued in RI
Practice address
70 Kenyon Ave
South County Medical Office Building Suite #212
Wakefield, RI 02879
Phone
(401) 789-8912
Fax
(401) 782-8702
NPI assigned
Apr 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 227 RI Primary

Addresses

Primary practice location

70 Kenyon Ave
South County Medical Office Building Suite #212
Wakefield, RI 02879

Mailing address

70 Kenyon Ave
South County Medical Office Building Suite #212
Wakefield, RI 02879
Phone (401) 789-8912

Other identifiers 6

IdentifierTypeStateIssuer
003951OtherRIBLUE CHIP
EP04169MedicaidRI
4267870001OtherDMERC
7004050MedicaidRI
70188OtherRIBCBS
480027257OtherRR MCR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
227RIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
South County Foot & Ankle, Inc. Podiatrist Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: epappas@scpai-ri.direct.office.nextgen.com

Organizations & group practices 1

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317945600000",
    "number": "1790741791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 KENYON AVE",
            "address_2": "SOUTH COUNTY MEDICAL OFFICE BUILDING SUITE #212",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "02879",
            "telephone_number": "401-789-8912",
            "fax_number": "401-782-8702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 KENYON AVE",
            "address_2": "SOUTH COUNTY MEDICAL OFFICE BUILDING SUITE #212",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "02879",
            "telephone_number": "401-789-8912",
            "fax_number": "401-782-8702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPAS",
        "first_name": "ELENI",
        "middle_name": "T",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2011-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "227",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "003951",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EP04169",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "4267870001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004050",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "70188",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "480027257",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.