Individual provider Active NPI

Mery Deeb, MD

  • Rheumatology Physician
  • Pawtucket, RI
National Provider Identifier
1053980573
Registry record updated May 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD21385 Issued in RI
Practice address
407 East Ave Ste 200
Pawtucket, RI 02860-5282
Phone
(401) 606-1620
Fax
(401) 721-5709
NPI assigned
Jun 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X MD21385 RI Primary

Addresses

Primary practice location

407 East Ave Ste 200
Pawtucket, RI 02860-5282

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779

Other practice location 1

2 Dudley St Ste 370
Providence, RI 02905-3248
Phone (401) 444-2248

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
I20260603001566 RI Practitioner - Rheumatology 3779984893

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

15 La Salle SQ
Providence, RI 02903-1814

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD21385RIMDRheumatology Physician

NPI Registry JSON

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

{
    "created_epoch": "1624060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779408000000",
    "number": "1053980573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 EAST AVE STE 200",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605282",
            "telephone_number": "401-606-1620",
            "fax_number": "401-721-5709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Dudley St Ste 370",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053248",
            "country_code": "US",
            "telephone_number": "401-444-2248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEEB",
        "first_name": "MERY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-19",
        "last_updated": "2026-05-22",
        "certification_date": "2026-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "RI",
            "license": "MD21385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.