DR. NATHANIEL JOSEF JELLINEK (NPI# 1245256528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245256528 |
| Entity Type | Individual |
| Full Name | DR. NATHANIEL JOSEF JELLINEK |
| Credential | MD |
| Practice Address |
1672 S County Trl Suite 101 East Greenwich RI 02818-5098 |
| Practice Telephone | 4048856647 |
| Practice Fax Number | 4018856639 |
| Mailing Telephone | 4048856647 |
| Mailing Fax Number | 4018856639 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2012-09-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 11514 | RI | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
11514 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | NJ53855 | 05 |
| Street Address |
1672 S COUNTY TRL SUITE 101 |
| City | EAST GREENWICH |
| State | RI |
| Zip Code | 02818-5098 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033192976 | Susan M Sweeney | Dermatology | 1672 S County Trl, 101, East Greenwich, RI 02818-5098 | 2005-11-23 |
| 1740666932 | Jeffrey Viveiros | Nurse Practitioner | 1672 S County Trl, East Greenwich, RI 02818-5098 | 2015-08-11 |
| 1245677368 | Elizabeth Butler | Pediatrics | 1672 S County Trl, Suite 201, East Greenwich, RI 02818-5098 | 2013-05-30 |
| 1043599269 | John B Kelly IIi | Dermatology | 1672 S County Trl, East Greenwich, RI 02818-5098 | 2011-08-04 |
| 1447545603 | Thomas J Knackstedt | Dermatology | 1672 S County Trl, East Greenwich, RI 02818-5098 | 2011-06-16 |
| 1710286331 | Evan Scott Minior | Nurse Practitioner | 1672 S County Trl, Suite 302, East Greenwich, RI 02818-5098 | 2011-03-22 |
| 1376864371 | Mohsin Kamal Malik | Dermatology | 1672 S County Trl, Suite 101, East Greenwich, RI 02818-5098 | 2010-06-14 |
| 1588983993 | Andrea M. Doyle, M.d., LLC | Plastic Surgery | 1672 S County Trl, Suite 302, East Greenwich, RI 02818-5098 | 2010-05-25 |
| 1902040835 | Dermatology Professionals Inc. | Dermatology | 1672 S County Trl, East Greenwich, RI 02818-1629 | 2009-04-22 |
| 1437316676 | Alyssa Bishop Findley | Dermatology | 1672 S County Trl, Suite 101, East Greenwich, RI 02818-5098 | 2008-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447875489 | Connor Michael Hagerty | Dentist | 61 Cedar Ave, #5, East Greenwich, RI 02818 | 2020-06-16 |
| 1467086777 | Kimberly Olson | Social Worker | 4372 Post Road, East Greenwich, RI 02818 | 2020-02-25 |
| 1154977106 | Pappas Physical Therapy LLC | Durable Medical Equipment & Medical Supplies | 1000 Division Road, Suite 100, East Greenwich, RI 02818 | 2019-08-15 |
| 1184270464 | Pappas Physical Therapy LLC | Durable Medical Equipment & Medical Supplies | 5805 Post Road, Unit 1, East Greenwich, RI 02818 | 2019-08-13 |
| 1003390428 | Liana Marie Waybright | Dietitian, Registered | East Greenwich Specialty Clinic, 1454 South County Trail, East Greenwich, RI 02818 | 2018-09-21 |
| 1053805614 | Danielle Moreau | Physical Therapist | 5750 Post Rd Ste 2a, East Greenwich, RI 02818 | 2018-06-18 |
| 1508385345 | Rhode Island Limb Co Inc | Physical Therapist | 63 Cedar Ave Unit 12, East Greenwich, RI 02818 | 2017-09-13 |
| 1407202963 | Doris Major Howie | Registered Nurse | 4512 Post Rd., East Greenwich, RI 02818 | 2016-05-13 |
| 1851648760 | Christi L Saurette | Social Worker | 3285 South County Trail, Suite 2b, East Greenwich, RI 02818 | 2012-08-09 |
| 1811257934 | Elizabeth Decker | Internal Medicine | 1407 S County Trl Ste 410, East Greenwich, RI 02818 | 2012-05-23 |
| Find all providers in zip 02818 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437316676 | Alyssa Bishop Findley | Dermatology | 1672 S County Trl, Suite 101, East Greenwich, RI 02818-5098 | 2008-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730538026 | Brown Dermatology, Inc. | Dermatology | 593 Eddy St, Apc-10, Providence, RI 02903-4923 | 2016-06-07 |
| 1700176849 | Aspire Dermatology LLC | Dermatology | 51 Long Wharf Mall, Newport, RI 02840-2906 | 2011-04-11 |
| 1770770547 | Surgical & Cosmetic Dermatology of Rhode Island, LLC | Dermatology | 1 Randall Sq, Suite 306, Providence, RI 02904-2709 | 2007-09-26 |
| City | EAST GREENWICH |
| Zip Code | 02818 |
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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.