Individual provider Active NPI

Michael S Siclari, MD

  • Emergency Medicine Physician
  • Pawtucket, RI
National Provider Identifier
1033226444
Registry record updated Jun 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD06991 Issued in RI
Practice address
111 Brewster Street
Pawtucket, RI 02860-4400
Phone
(401) 729-2419
Fax
(401) 729-2517
NPI assigned
Aug 23, 2006
Last updated
Jun 6, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD06991 RI Primary

Addresses

Primary practice location

111 Brewster Street
Pawtucket, RI 02860-4400

Mailing address

111 Brewster Street
Wood BLDG #516
Pawtucket, RI 02860-4400
Phone (401) 729-3481

Other practice location 1

593 Eddy Street
Claverick 2
Providence, RI 02903
Phone (401) 444-4000

Other identifiers 2

IdentifierTypeStateIssuer
7002026MedicaidRI
939025129OtherRIRI MEDICARE GROUP NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040303000191 RI Practitioner - Emergency Medicine 9830086917 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Geisel School of Medicine at Dartmouth, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Brown Emergency MedicineGroup PAC ID 7214833169, 140 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-7024

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.45 of 100Reported as group
Quality
85.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Blackstone Valley Community Health Care, Inc. CurrentSince May 1, 2016 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Feb 1, 2026 Accepting new patients
Lifespan Physician Group, Inc. Emergency Medicine CurrentSince Feb 1, 2026 Accepting new patients
Brown Emergency Medicine Emergency Medicine CurrentSince Jul 1, 2024 Accepting new patients
Emergency Medicine Physicians of Providence County, LLC Emergency Medicine Past Accepting new patients
Blackstone Valley Community Health Care, Inc. PastSince May 1, 2016 Accepting new patients

Locations

1000 Broad St
Central Falls, RI 02863
Phone (401) 722-0081

9 Chestnut St
Central Falls, RI 02863
Phone (401) 722-0081

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

39 East Ave
Pawtucket, RI 02860
Phone (401) 722-0081

593 Eddy St
Providence, RI 02903

593 Eddy St
#2
Providence, RI 02903
Phone (401) 519-1604

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: michael.siclari.p1@direct.bvchc.nextgenshare.com
  • Direct secure messaging: michael.siclari.p8@direct.bvchc.nextgenshare.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1033226444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BREWSTER STREET",
            "address_2": "WOOD BLDG #516",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604400",
            "telephone_number": "401-729-3481",
            "fax_number": "401-729-2721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BREWSTER STREET",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604400",
            "telephone_number": "401-729-2419",
            "fax_number": "401-729-2517"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy Street",
            "address_2": "Claverick 2",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "02903",
            "country_code": "US",
            "telephone_number": "401-444-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SICLARI",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2024-06-06",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "MD06991",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7002026",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI MEDICARE GROUP NUMBER",
            "identifier": "939025129",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.