DR. ELIZABETH G DE JESUS (NPI# 1134206360) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134206360 |
| Entity Type | Individual |
| Full Name | DR. ELIZABETH G DE JESUS |
| Credential | M.D. |
| Practice Address |
1596 Broad St Cranston RI 02905-4130 |
| Practice Telephone | 4014615400 |
| Practice Fax Number | 4014619039 |
| Mailing Telephone | 4014615400 |
| Mailing Fax Number | 4014619039 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2011-10-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | MD10197 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | UNITED HEALTH CARE | 04-02873 | 01 |
| RI | 9002877 | 05 | |
| RI | AETNA | 3358011 | 01 |
| RI | CIGNA | 5488229 | 01 |
| RI | BLUE SHIELD | 26781 | 01 |
| RI | CAQH ID NUMBER | 11649828 | 01 |
| RI | BLUE CHIP | 406045 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457753584 | Elizabeth Anne Enriquez De Jesus | Nurse Practitioner | 1305 York Ave, 4th Floor, New York, NY 10021-5663 | 2014-09-19 |
| Street Address |
1596 BROAD ST |
| City | CRANSTON |
| State | RI |
| Zip Code | 02905-4130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346307485 | Primary Care Medical Associates of Cranston Inc | Internal Medicine | 1596 Broad St, Cranston, RI 02905-4130 | 2007-01-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477100808 | Raisa Emilia Garcia-diaz | Counselor | 66 Pavilion Avenue, Providence, RI 02905 | 2019-08-21 |
| 1962976571 | Nike A. Kendall | Social Worker | Program In Women's Oncology, 101 Dudley Street, Providence, RI 02905 | 2019-01-16 |
| 1891265443 | Carolyn Te Young | Pathology | 1320 Narragansett Blvd, Cranston, RI 02905 | 2018-11-27 |
| 1417427071 | Julianne Elizabeth Houtchens | Dietitian, Registered | Adult Primary Care 245 Chapman Street, Providence, RI 02905 | 2018-11-27 |
| 1922577394 | Dilenia C Cruz | Health Educator | 335r Prairie Ave., Suite 2b, Providence, RI 02905 | 2018-11-15 |
| 1639653116 | Varina S. Gunn | Health Educator | 335r Prarie Ave., Suite 2b, Providence, RI 02905 | 2018-09-20 |
| 1427590421 | Cardea Healthcare LLC | In Home Supportive Care | 100 Pavilion Avenue, Suite 101, Providence, RI 02905 | 2016-11-08 |
| 1265884597 | Maxwell King | Physical Therapy Assistant | 48 Moorland Avenue, Cranston, RI 02905 | 2016-07-11 |
| 1346698024 | Samantha Lea Colli | Physician Assistant | 100 Dudley St Fl 3, Providence, RI 02905 | 2016-06-02 |
| 1346697448 | Amy Jean Simpson | Marriage & Family Therapist | 1981 Broad Street, Cranston, RI 02905 | 2016-05-18 |
| Find all providers in zip 02905 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134388820 | Leonard A Mannarelli II, D.o. Inc. | Internal Medicine | 135 Atwood Ave, Cranston, RI 02920-4131 | 2008-06-06 |
| 1720247919 | Amrut R Patel Md | Internal Medicine | 1370 Cranston Street, Cranston, RI 02920-6758 | 2008-06-03 |
| 1437317286 | Paul George Varghese | Internal Medicine | 41 Alderbrook Dr, Cranston, RI 02920-3423 | 2008-05-29 |
| 1073780276 | Steven Michael Sepe | Internal Medicine | 25 Belle Isle Way, Cranston, RI 02921-3542 | 2008-05-15 |
| 1669651162 | James K. Cardi,m.d.,inc | Internal Medicine | 677 Atwood Ave, Cranston, RI 02920-5322 | 2007-10-31 |
| 1699970657 | Brian Patrick Daly | Internal Medicine | Eleanor Slater Hospital, 111 Howard Avenue, Cranston, RI 02920-0292 | 2007-06-19 |
| 1710098249 | Ralph F Santoro | Internal Medicine | 725 Reservoir Ave Ste 103, Cranston, RI 02910-4451 | 2006-08-31 |
| 1487761417 | Manish B. Desai | Internal Medicine | 75 Castleton Dr, Cranston, RI 02921-2418 | 2006-08-24 |
| 1265549711 | Luisa Isabel Miller | Internal Medicine | 111 Howard Avenue, Eleanor Slater Hospital, Cranston, RI 02920 | 2006-08-23 |
| 1114944006 | Usha Panneerselvam | Internal Medicine | 351 Budlong Rd, Cranston, RI 02920-6001 | 2006-07-16 |
| Find all providers in CRANSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.