Stephanie M Peduto, M.D.
Individual provider Active NPI Pediatrics Physician · Cumberland, RI
NPI 1891790283 · NPPES record last updated Nov 20, 2013
Key facts
- NPI
- 1891790283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- MD09602 (RI)
- Practice address
- 2 Meehan LN
Cumberland, RI 02864-1413 - Phone
- (401) 658-2525
- Fax
- (401) 658-3031
- NPI assigned
- Jun 14, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
- Opted out of Medicare
- Yes, effective May 8, 2016 through May 8, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD09602 | RI | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Just Kids R.I. Sick Care LLC | Pediatrics | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD09602 | RI | Yes |
Addresses
Primary practice location
2 Meehan LN
Cumberland, RI 02864-1413
Mailing address
2 Meehan LN
Cumberland, RI 02864-1413
Phone (401) 658-2525
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9094598 | Medicaid | RI | |
| PY01057 | Medicaid | RI |
Other providers in Cumberland, RI
- Amanda G Patnaude
- Paul W. Santoro, Inc.
- Peak Physical Therapy, LLC
- Pediatric Neurology, Inc.
- Magda Pedraza
- Jessica L Peipock
- Jennifer Lynn Perreault
- Sarah Nichole Perry
- Personal Home Health Services, Inc
- Physicians of Rhode Island Enterprises Incorporated
All providers in Cumberland, RI · Pediatrics Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 20, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.