DR. STEPHEN PETTERUTI (NPI# 1972504280) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972504280 |
| Entity Type | Individual |
| Full Name | DR. STEPHEN PETTERUTI |
| Credential | D.O. |
| Practice Address |
250 Centerville Rd Bldg E Warwick RI 02886-2778 |
| Mailing Address |
250 Centerville Rd Building E Warwick RI 02886-4400 |
| Practice Telephone | 4019215934 |
| Practice Fax Number | 4019215936 |
| Mailing Telephone | 4019215934 |
| Mailing Fax Number | 4019215936 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2012-08-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 413 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | BCBS CHIP | 203583 | 01 |
| RI | 9003104 | 05 | |
| RI | BLUE CROSS BLUE SHIELD | 23631-3 | 01 |
| RI | AETNA | 2654722 | 01 |
| RI | UNITED HEALTH | 0101123 | 01 |
| Street Address |
250 CENTERVILLE RD BLDG E |
| City | WARWICK |
| State | RI |
| Zip Code | 02886-2778 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386178747 | Shannon Petteruti | Nurse Practitioner | 250 Centerville Rd, Bldg E, Warwick, RI 02886-4400 | 2017-04-12 |
| 1326212515 | Kari Elizabeth Bandola | Physical Therapist | 250 Centerville Rd, Warwick, RI 02886-4382 | 2008-04-17 |
| 1417132549 | Petteruti Family Practice Inc | Family Medicine | 250 Centerville Rd, Building E, Warwick, RI 02886-4382 | 2008-01-08 |
| 1831173301 | Medical & Renal Asso Inc | Internal Medicine | 250 Centerville Rd, Warwick Executive Park, Warwick, RI 02886-4382 | 2005-11-30 |
| 1710969027 | Nelson J Chu | Internal Medicine | 250 Centerville Rd, Bldg. E, Warwick, RI 02886-4382 | 2005-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528694445 | Sheri Lynn Sklarz | Specialist | 300 Quaker Lane, Miracle Ear Suite C15, Warwick, RI 02886 | 2020-03-23 |
| 1316581424 | Dr. Degiulio & Associates Inc | Optometrist | 400 Bald Hill Road Ste 163, Warwick Mall, Warwick, RI 02886 | 2019-10-31 |
| 1255813291 | Samantha Pena Moore | Behavioral Analyst | 3446 Post Road, Warwick, RI 02886 | 2018-09-06 |
| 1912496209 | Martin Jude Cotti | Internal Medicine | 455 Toll Gate Rd., Warwick, RI 02886 | 2018-05-02 |
| 1447764261 | Cynthia A Lessard | Nurse Practitioner | 15 Health Lane, Warwick, RI 02886 | 2017-12-01 |
| 1538687520 | David A. Bennett | Registered Nurse | 2756 Post Road, Warwick, RI 02886 | 2017-08-30 |
| 1427585223 | Brittany Teixeira | Counselor | 85 Earl Street, Warwick, RI 02886 | 2017-05-11 |
| 1497125199 | Aiden Philip Cwynar | Optometrist | 1050 Centerville Road, Warwick, RI 02886 | 2015-10-07 |
| 1104221738 | Wilfredo L Sancianco Dmd Inc | Preferred Provider Organization | 3411 W Shiore Rd, Warwick, RI 02886 | 2014-10-24 |
| 1831508662 | Matthew Bryant Mitchell | Physical Therapist | 400 Bald Hill Rd #511, Warwick, RI 02886 | 2014-08-06 |
| Find all providers in zip 02886 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, 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 Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497253322 | Medi Health and Wellness, LLC | Family Medicine | 80 Lambert Lind Hwy, Warwick, RI 02886-1071 | 2018-01-25 |
| 1831418599 | Ariana Paula Bensusan | Family Medicine | 15 Health Ln # 2d, Warwick, RI 02886 | 2010-05-20 |
| 1396996534 | Totalhealth LLC | Family Medicine | 300 Toll Gate Rd Ste Ll1, Warwick, RI 02886-4448 | 2008-10-07 |
| 1750589719 | Edward F Asprinio | Family Medicine | 3246 W Shore Rd, Warwick, RI 02886-7560 | 2007-07-10 |
| 1073733911 | Wilhelmus Albert Vanhaaren | Family Medicine | 399 Algonquin Dr, Warwick, RI 02888-5535 | 2007-04-25 |
| 1689750044 | Lucille C Vega | Family Medicine | 962 Warwick Avenue, Warwick, RI 02888 | 2006-10-28 |
| 1881709616 | Joseph Anthony Grande | Family Medicine | 1243 Post Rd, Unit A, Warwick, RI 02888-3221 | 2006-08-20 |
| 1619991064 | Elisabeth K Farnum | Family Medicine | 215 Tall Gate Rd, Suite 104, Warwick, RI 02886 | 2006-07-27 |
| 1457370561 | Makeen Khalil Yacoub | Family Medicine | 9 Grand Street, Warwick, NY 10990 | 2006-07-19 |
| 1760419675 | Tej Varna Bansal | Family Medicine | 215 Tollgate Road, Suite 309 310, Warwick, RI 02886-4458 | 2006-06-27 |
| Find all providers in WARWICK | ||||
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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.