Individual provider Active NPI

Jason P Mallette, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • Warwick, RI
National Provider Identifier
1871724740
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
DPM00334 Issued in RI
Practice address
1050 Warwick Ave
Warwick, RI 02888-3655
Phone
(401) 354-7966
NPI assigned
Jul 27, 2009
Last updated
Jun 5, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Foot & Ankle Surgery Podiatrist 213ES0103X DPM00334 RI Primary

Addresses

Primary practice location

1050 Warwick Ave
Warwick, RI 02888-3655

Mailing address

1050 Warwick Ave
Warwick, RI 02888-3655
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
I20120906000220 RI Practitioner - Podiatry 8325295884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2009
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)

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

Hospital & facility affiliations

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
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Removal of tissue22
Removal of skin lesions12
Removal of nail tissue1212
Removal or shaving of skin growth513

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DPM00334RIMDFoot & Ankle Surgery Podiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
South County Foot & Ankle, Inc. Foot & Ankle Surgery CurrentSince Jun 10, 2012 Accepting new patients
Bernard G Coppolelli DPM, Inc Foot & Ankle Surgery CurrentSince Dec 12, 2012 Accepting new patients

Locations

134 Sandy Bottom Rd
Coventry, RI 02816
Phone (401) 821-0332

280 Front St
Lincoln, RI 02865
Phone (401) 273-0600

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

Interoperability endpoints

  • Direct secure messaging: jmallette@kent.cernerdirect.carene.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1871724740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 WARWICK AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883655",
            "telephone_number": "401-354-7966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 WARWICK AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883655",
            "telephone_number": "401-354-7966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLETTE",
        "first_name": "JASON",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-27",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "RI",
            "license": "DPM00334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.