Eugenie Atallah
Individual provider Active NPI Neurology Physician · Providence, RI
NPI 1003392689 · NPPES record last updated Apr 10, 2024
Key facts
- NPI
- 1003392689
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- MD19563 (RI)
- Practice address
- 593 Eddy St
Providence, RI 02903-4923 - Phone
- (401) 606-2645
- Fax
- (401) 606-4386
- NPI assigned
- Jul 17, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 13
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Rhode Island Hospital
Practice addresses (Care Compare)
593 Eddy St
Providence, RI 02903-4923
Phone (401) 606-2645
Hospital & facility affiliations
- Hopehealth Hospice & Palliative Care
- Rhode Island Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240701003145 | RI | Practitioner - Neurology | 6406243682 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| GA91180 | GA | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rhode Island Hospital | Current |
Accepting new patients | |
| Rhode Island Hospital | Current |
Accepting new patients |
Locations
1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000
593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
593 Eddy St
Providence, RI 02903
593 Eddy St
Bldg 2ND
Providence, RI 02903
Phone (401) 444-4076
Interoperability endpoints
- eatallah19479@gwmfa.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurocritical Care Physician | 2084A2900X | MD19563 | RI | |
| Neurology Physician | 2084N0400X | GA91180 | GA | |
| Neurology Physician | 2084N0400X | MD19563 | RI | Yes |
Addresses
Primary practice location
593 Eddy St
Providence, RI 02903-4923
Mailing address
117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (202) 826-8608
Other practice location 1
1364 Clifton Rd NE
Atlanta, GA 30322-1059
Phone (404) 712-2000
Other providers in Providence, RI
- Asthenis, LLC
- Cristian Astudillo
- Bassam Aswad
- Michael Kemal Atalay
- Carl Atallah
- Marcy Atkins
- James Atkinson
- Sri Sai Swetha Atluri
- Jennifer Attalla
- Jessica R Attar
All providers in Providence, RI · Neurology Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.