Individual provider Active NPI

Tammy L Van Dine, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Warwick, RI
National Provider Identifier
1851556328
Registry record updated May 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DPM00331 Issued in RI
Practice address
1087 Warwick Ave
Warwick, RI 02888-3545
Phone
(401) 354-7966
Fax
(401) 941-0315
NPI assigned
Jul 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X LPR00076 RI
Foot & Ankle Surgery Podiatrist 213ES0103X DPM00331 RI Primary

Addresses

Primary practice location

1087 Warwick Ave
Warwick, RI 02888-3545

Mailing address

1087 Warwick Ave
Warwick, RI 02888-3545
Phone (401) 354-7966

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110620000400 RI Practitioner - Podiatry 2668650763 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
New York College of Podiatric Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South County Foot and Ankle, Inc.Group PAC ID 2365574928, 5 clinicians

Practice addresses (Care Compare)

1075 Smith St
Providence, RI 02908-2700
Phone (401) 354-7966

Merit-based Incentive Payment System (MIPS)

Final score
91.79 of 100Reported as group
Quality
81.09
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of skin lesions21
Removal of nail tissue1713
Removal or shaving of skin growth526

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPR00076RIMDPodiatrist
DPM00331RIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
South County Foot & Ankle, Inc. Podiatrist CurrentSince Jun 9, 2011 Accepting new patients

Locations

1075 Smith St
Ste 2
Providence, RI 02908
Phone (401) 369-9224

1075 Smith St
Providence, RI 02908
Phone (401) 369-9224

1087 Warwick Ave
Warwick, RI 02888
Phone (401) 354-7966

1087 Warwick Ave
Rear
Warwick, RI 02888
Phone (401) 383-2200

1087 Warwick Ave
Unit 1
Warwick, RI 02888
Phone (401) 354-7966

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": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368144000000",
    "number": "1851556328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1087 WARWICK AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883545",
            "telephone_number": "401-354-7966",
            "fax_number": "401-941-0315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1087 WARWICK AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883545",
            "telephone_number": "401-354-7966",
            "fax_number": "401-941-0315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DINE",
        "first_name": "TAMMY",
        "middle_name": "L",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-24",
        "last_updated": "2013-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "LPR00076",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "RI",
            "license": "DPM00331",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.