STEFAN GRAVENSTEIN (NPI# 1447224191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447224191 |
| Entity Type | Individual |
| Full Name | STEFAN GRAVENSTEIN |
| Credential | MD |
| Practice Address |
593 Eddy St Providence RI 02903 |
| Mailing Address |
110 Elm St Providence RI 02903-4626 |
| Practice Telephone | 4014445248 |
| Practice Fax Number | 4014443397 |
| Enumeration Date | 2006-02-16 |
| Last Update Date | 2019-11-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QG0300X |
Family Medicine Specialization: Geriatric Medicine |
MD12353 | RI | Allopathic & Osteopathic Physicians |
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
35.120371 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 0075808 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 11100 Euclid Ave, Cleveland, OH 441061716 | 2168446300 |
| Street Address |
593 EDDY ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952306185 | Mitchel A Sklar | Internal Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2005-06-15 |
| 1376140707 | Kristen Marie Czekanski | Student in an Organized Health Care Education/Training Program | 593 Eddy St, Providence, RI 02903-4923 | 2020-10-08 |
| 1326645300 | Elizabeth Stefanilo | Nurse Practitioner | 593 Eddy St, Providence, RI 02903-4923 | 2020-10-03 |
| 1841807633 | Julie Walden | Student in an Organized Health Care Education/Training Program | 593 Eddy St, Providence, RI 02903-4923 | 2020-09-26 |
| 1417567751 | Yigit Baykara | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2020-08-02 |
| 1588273064 | Cassandra Pagnotta | Dietitian, Registered | 593 Eddy St, Providence, RI 02903-4923 | 2020-07-30 |
| 1982213294 | Sabitha Sasidharan Pillai | Pediatrics | 593 Eddy St, Providence, RI 02903-4923 | 2020-07-23 |
| 1861019481 | Courtney Pedersen | Emergency Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-30 |
| 1508483496 | Mohammad Hisham Hout | Urology | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-26 |
| 1639796642 | Benjamin Hagan | Emergency Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475755 | Sarah Fellows | Student in an Organized Health Care Education/Training Program | 350 Eddy Street, Uri Nursing Education Center, Providence, RI 02903 | 2020-10-20 |
| 1093328262 | Esther Robbins | Social Worker | 290 West Exchange St., Suite 100, Providence, RI 02903 | 2020-08-27 |
| 1720619489 | Ivy Marie Mcdonald | Behavioral Analyst | 290 W Exchange St #101, Providence, RI 02903 | 2020-01-31 |
| 1447802707 | Natalie Monaghan, LLC | Social Worker | 545 South Water Street, Providence, RI 02903 | 2019-07-16 |
| 1760049522 | Daniel Steven Alanko | Pediatrics | 293 Eddy Street, Providence, RI 02903 | 2019-05-28 |
| 1154894368 | Margaret Emily Dyson | Behavior Technician | 290 W. Exchange St, Providence, RI 02903 | 2019-01-10 |
| 1497235014 | Yao Zhou Liu | Surgery | 593 Eddy St - Rhode Island Hospital, Providence, RI 02903 | 2018-08-14 |
| 1558840645 | Tamara Gore | Behavior Technician | 290 W Exchange Street Suite 101, Providence, RI 02903 | 2018-08-09 |
| 1437642709 | Adrian Cotarelo | Student in an Organized Health Care Education/Training Program | 174 Wickenden St, Apt. 3rd Floor, Providence, RI 02903 | 2018-06-12 |
| 1356833024 | Natalie Rita Noonan | Clinical Neuropsychologist | 593 Eddy St Ste 430, Providence, RI 02903 | 2018-05-30 |
| Find all providers in zip 02903 | ||||
| Taxonomy Code | 207QG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Geriatric Medicine |
| A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital. |
| 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 Family Medicine, 2007. http://wwwtheabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497948566 | Tsewang Gyurmey | Family Medicine | 225 Chapman St, Providence, RI 02905-4533 | 2007-08-22 |
| 1508863432 | Jennifer Mcinnes Ritzau | Family Medicine | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2005-07-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336140797 | Thomas E Mcgue | Family Medicine | 43 Smith Rd, Newport, RI 02841-1006 | 2005-08-09 |
| 1770580458 | Cynthia L Holzer | Family Medicine | 27 Pilgrim Pkwy, Warwick, RI 02888-4120 | 2005-07-07 |
| 1639176357 | John A Stoukides | Family Medicine | 1018 Waterman Ave, East Providence, RI 02914 | 2005-07-07 |
| 1659882504 | Encompass Pediatrics, LLC. | Family Medicine | 126 Prospect St Ste 202, Pawtucket, RI 02860 | 2017-10-18 |
| 1982803359 | Nadia Mujahid | Family Medicine | 375 Wampanoag Trl, Suite 102, Riverside, RI 02915-2212 | 2007-07-16 |
| 1811910334 | Alfred A Arcand | Family Medicine | 1079 Main St, Suite A, West Warwick, RI 02893-3715 | 2006-07-25 |
| 1962439786 | Syed R Mehdi | Family Medicine | 450 Clinton Street, Thundermist Health Center, Woonsocket, RI 02895 | 2006-06-27 |
| 1336189406 | John B Murphy | Family Medicine | 407 East Ave, Suite 110, Pawtucket, RI 02860-5299 | 2006-06-07 |
| 1598721656 | Lisa B Bob | Family Medicine | 407 East Ave, Suite 110, Pawtucket, RI 02860-5290 | 2006-04-26 |
| City | PROVIDENCE |
| Zip Code | 02903 |
Please comment or provide details below to improve the information on STEFAN GRAVENSTEIN.
| 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.