Elise C Piebenga, MD

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

MD421773 Issued in PA

Practice address

130 S. Bryn Mawr Ave.
Bryn Mawr, PA 19010-3121

Phone

(610) 526-3000

Fax

(302) 651-5948

NPI assigned

May 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: epiebenga36299@direct.nemours.org

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.

• Rhode Island Hospital

  • Specialist
  • Providence, RI
  • NPI 1093849036
  NPD (past)
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1104233832
  NPD (past)
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1588659528
  NPD (past)
• Rhode Island Hospital

  • Plastic and Reconstructive Surgery Physician
  • Providence, RI
  • NPI 1851729511
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1891740783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 191",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "ROCKLAND",
            "state": "DE",
            "postal_code": "197320191",
            "telephone_number": "302-651-6212",
            "fax_number": "302-651-4945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S. BRYN MAWR AVE.",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "610-526-3000",
            "fax_number": "302-651-5948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIEBENGA",
        "first_name": "ELISE",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "11970",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "PA",
            "license": "MD421773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EP59268",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Linnea Phillips, CNM, WHNP
• Chloe Phipps, OTR/L
• Brittany Piacentine
• Clarke U. Piatt, M.D.
• Charles A Picchioni, DMD
• Carly Noel Piel, PA-C
• Madeline Piersol
• Antoinette Pineda
• Michael James Pino, PHARM.D
• Karen Piotrowicz, CRNA

• Hospitalist Physician in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Hospitalist Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 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.