Individual provider Active NPI

Nicholas Gelormini, M.D.

  • Psychiatry Physician
  • Johnston, RI
National Provider Identifier
1992970248
Registry record updated Nov 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD14572 Issued in RI
Practice address
1443 Hartford Ave
Johnston, RI 02919-3224
Phone
(401) 553-1000
Fax
(401) 722-5280
NPI assigned
Apr 28, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD14572 RI Primary

Addresses

Primary practice location

1443 Hartford Ave
Johnston, RI 02919-3224

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4513
Phone (401) 444-6779

Other identifiers 1

IdentifierTypeStateIssuer
GH57134MedicaidRI

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
I20140630000243 RI Practitioner - Psychiatry 8921223207 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Newport County Community Mental Health Center, Inc.Group PAC ID 9830089812, 28 clinicians

Practice addresses (Care Compare)

65 Valley Rd
Middletown, RI 02842-5234
Phone 40184612131117

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD14572RIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Newport County Community Mental Health Center, Inc CurrentSince Jan 1, 2022 Accepting new patients
Gateway Healthcare Inc CurrentSince Mar 10, 2013 Accepting new patients

Locations

1516 Atwood Ave
Johnston, RI 02919
Phone (401) 463-8829

42 Valley Rd
Middletown, RI 02842
Phone (401) 843-1213

65 Valley Rd
Middletown, RI 02842
Phone (401) 431-9870

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

1 Virginia Ave
Ste 200
Providence, RI 02905

1443 Hartford Ave
Providence, RI 02919
Phone (401) 273-8100

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1209340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542585600000",
    "number": "1992970248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054513",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1443 HARTFORD AVE",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193224",
            "telephone_number": "401-553-1000",
            "fax_number": "401-722-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELORMINI",
        "first_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-28",
        "last_updated": "2018-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD14572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GH57134",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, RI

Sources for this page

Verify at the official NPI Registry.