Active NPI
Stephanie M Peduto, M.D.
- Pediatrics Physician
- Cumberland, RI
National Provider Identifier
1891790283
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD09602
- Practice address
- 2 Meehan LN
Cumberland, RI 02864-1413 - Phone
- (401) 658-2525
- Fax
- (401) 658-3031
- NPI assigned
- Jun 14, 2005
- Last updated
- Nov 20, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD09602 | RI | Primary |
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 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PY01057 | Medicaid | RI | |
| 9094598 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: 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
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- 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 |
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Cumberland, RI
- NPI 1811253370
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118707200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1384905600000",
"number": "1891790283",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 MEEHAN LN",
"city": "CUMBERLAND",
"state": "RI",
"postal_code": "028641413",
"telephone_number": "401-658-2525",
"fax_number": "401-658-3031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 MEEHAN LN",
"city": "CUMBERLAND",
"state": "RI",
"postal_code": "028641413",
"telephone_number": "401-658-2525",
"fax_number": "401-658-3031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDUTO",
"first_name": "STEPHANIE",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-14",
"last_updated": "2013-11-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "RI",
"license": "MD09602",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PY01057",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9094598",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cumberland, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.