Individual provider Active NPI

Gerald Mark Tarnoff, MD

  • Child & Adolescent Psychiatry Physician
  • Riverside, RI
National Provider Identifier
1881600153
Registry record updated May 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
MD07782 Issued in RI
Practice address
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone
(401) 432-1000
Fax
(401) 432-1506
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD07782 RI
Child & Adolescent Psychiatry Physician 2084P0804X MD07782 RI Primary

Addresses

Primary practice location

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061

Mailing address

1011 Veterans Memorial Parkway
Bradley Hospital
East Providence, RI 02915
Phone (401) 432-1000

Other identifiers 6

IdentifierTypeStateIssuer
1104801349OtherRIBUTLER HOSPITAL NPI
1093831646OtherRIBUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
25397-2OtherRIBLUE CROSS
15-58434OtherRIUNITED BEHAVIORAL HEALTH
7001761MedicaidRI
203937OtherRIBLUE CHIP

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
I20040710000043 RI Practitioner - Psychiatry 2961480587 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Chicago College of Medicine and Surgery, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone (401) 432-1000

593 Eddy St
Providence, RI 02903-4923

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD07782RIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Physician Group, Inc. Psychiatry CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Corporation Current Accepting new patients
Emma Pendleton Bradley Hospital CurrentSince May 28, 2013 Accepting new patients
Emma Pendleton Bradley Hospital Psychiatry CurrentSince May 28, 2013 Accepting new patients

Locations

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

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
Providence, RI 02903

1011 Veterans Memorial Pkwy
Riverside, RI 02915
Phone (401) 432-1000

Interoperability endpoints

  • Direct secure messaging: gtarnoff6978@brownhealth.medalliesdirect.net

Organizations & group practices 5

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430956800000",
    "number": "1881600153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PARKWAY",
            "address_2": "BRADLEY HOSPITAL",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "02915",
            "telephone_number": "401-432-1000",
            "fax_number": "401-432-1506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-432-1000",
            "fax_number": "401-432-1506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARNOFF",
        "first_name": "GERALD",
        "middle_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2015-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD07782",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "RI",
            "license": "MD07782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUTLER HOSPITAL NPI",
            "identifier": "1104801349",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE",
            "identifier": "1093831646",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "25397-2",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "15-58434",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7001761",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "203937",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.