JONATHAN DAVID TATUM
NPI 1285138586
Pediatrics - Pediatric Endocrinology in Providence, RI

Q: What is Jonathan Tatum's NPI number?

The NPI number for Jonathan Tatum is 1285138586. It was assigned to this individual provider in the NPPES registry on March 21, 2018.

Q: What is Jonathan Tatum's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Endocrinology, with taxonomy code 2080P0205X.

Q: When was this NPI record last updated?

The NPPES record for Jonathan Tatum was last updated on August 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 21, 2018PECOS EnrolledAccepts Medicare Assignment

111 PLAIN STREET 3RD FLOOR SUITE 101, PROVIDENCE, RI 02902(401) 444-5504 Get Directions Write a Review

NPPES record last updated: August 6, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 6, 2024, Mar 21, 2018 (2 updates tracked since 2018).

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About Jonathan David Tatum NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JONATHAN DAVID TATUM (NPI 1285138586) is an individual pediatric endocrinology provider in Providence, Rhode Island, licensed in Rhode Island (MD19694) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS and is a graduate of Tulane University School Of Medicine (2018).

NPPES Registry Identity

NPI1285138586

Entity TypeIndividualMale

Primary Taxonomy2080P0205X

Provider Legal NameJONATHAN DAVID TATUM

Location Address111 PLAIN STREET 3RD FLOOR SUITE 101Providence, RI 02902-3026

Mailing Address117 Ellenfield St Ste 101Providence, RI 02905-4541 · (401) 444-6779

Phone(401) 444-5504

Sole ProprietorNo

Medical School CMSTulane University School Of MedicineGraduated 2018

Enumeration DateMarch 21, 2018

Last NPPES UpdateAugust 6, 20242 updates tracked since enumeration

NPPES CertifiedAugust 6, 2024

✔ NPI 1285138586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric EndocrinologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0205X

License✔ Licensed in RI · MD19694

Definition

A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

111 PLAIN STREET 3RD FLOOR SUITE 101, Providence, RI 02902

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jonathan David Tatum is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4385175546

PECOS Enrollment IDI20240930002047

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02902 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$134.17 typical visit price

range $58.57 – $177.03

Typical copayment $33.54 (range $14.64 – $44.25)

Most-billed visit code 99204

Established Patient

$103.10 typical visit price

range $18.92 – $144.38

Typical copayment $25.77 (range $4.73 – $36.09)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. LOGAN BENJAMIN GREENBLATT MD

Pediatrics

111 PLAIN STREET 3RD FLOOR SUITE 101
PROVIDENCE, RI 02902

Providence County (401) 444-5504

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jonathan Tatum's NPI number?

The NPI number for Jonathan Tatum is 1285138586. It was assigned to this individual provider in the NPPES registry on March 21, 2018.

Where is Jonathan Tatum located?

Jonathan Tatum practices at 111 Plain Street 3rd Floor Suite 101, Providence, RI 02902. The listed phone number is (401) 444-5504.

What is Jonathan Tatum's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Endocrinology, with taxonomy code 2080P0205X.

Is Jonathan Tatum enrolled in Medicare?

Yes. Jonathan Tatum is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jonathan Tatum was last updated on August 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.