Individual provider Active NPI

Jill Moretti, PCNS

  • Psychiatric/Mental Health Nurse Practitioner
  • Wakefield, RI
National Provider Identifier
1891721510
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APRN Issued in RI
Practice address
70 Kenyon Ave
Suite 326
Wakefield, RI 02879-4239
Phone
(401) 788-1277
Fax
(401) 788-1514
NPI assigned
Jun 24, 2006
Last updated
Dec 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN RI Primary
Psychiatric/Mental Health Registered Nurse 163WP0808X PPNS00031 RI

Addresses

Primary practice location

70 Kenyon Ave
Suite 326
Wakefield, RI 02879-4239

Mailing address

PO Box 229
Wakefield, RI 02880-0229
Phone (401) 788-3337

Other identifiers 4

IdentifierTypeStateIssuer
05-0468084OtherRIUNITED HEALTH PLANS
30553-6OtherRIBLUE CROSS & BLUE SHIELD
P00302348OtherRIRAILROAD MEDICARE
406676OtherRICOORDINATED HEALTH PLANS

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051227000292 RI Practitioner - Certified Clinical Nurse Specialist (CNS) 3971525429 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Clinical Nurse Specialist (CNS)
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Delta Consultants of South County IncGroup PAC ID 8426063553, 14 clinicians

Practice addresses (Care Compare)

24 Salt Pond Rd
D4
Wakefield, RI 02879-4334
Phone (401) 789-3694

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Consultants of South County Inc CurrentSince Apr 4, 2017 Accepting new patients
Align Physical Therapy CurrentSince Apr 4, 2017 Accepting new patients

Locations

24 Salt Pond Rd
Ste D4
Wakefield, RI 02879
Phone (401) 667-4965

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450051200000",
    "number": "1891721510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 229",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028800229",
            "telephone_number": "401-788-3337",
            "fax_number": "401-788-3939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 KENYON AVE",
            "address_2": "SUITE 326",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028794239",
            "telephone_number": "401-788-1277",
            "fax_number": "401-788-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORETTI",
        "first_name": "JILL",
        "credential": "PCNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-24",
        "last_updated": "2015-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "APRN",
            "primary": true
        },
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "RI",
            "license": "PPNS00031",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PLANS",
            "identifier": "05-0468084",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHIELD",
            "identifier": "30553-6",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00302348",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COORDINATED HEALTH PLANS",
            "identifier": "406676",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

Verify at the official NPI Registry.