Ethan H Kisch, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD10208 Issued in RI

Practice address

75 Lambert Lind Hwy
120-100
Warwick, RI 02886-1131

Phone

(401) 681-4274

Fax

(401) 681-4285

NPI assigned

Mar 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Hri Clinics, Inc.

  • Community/Behavioral Health Agency
  • Woburn, MA
  • NPI 1598707002
  Medicare reassignment NPD
• Hri Clinics Inc

  • Community/Behavioral Health Agency
  • Norwell, MA
  • NPI 1922123199
  NPD
• The May Institute, Inc

  • Behavior Analyst
  • Randolph, MA
  • NPI 1356318125
  NPD (past)

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1063480002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 LAMBERT LIND HWY",
            "address_2": "120-100",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861131",
            "telephone_number": "401-681-4274",
            "fax_number": "401-681-4285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 LAMBERT LIND HWY",
            "address_2": "120-100",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861131",
            "telephone_number": "401-681-4274",
            "fax_number": "401-681-4285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISCH",
        "first_name": "ETHAN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD10208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ava King-Byrne, DNP, NP-C
• Anna R King, D.O.
• Michael Paul King
• Pauline King, LMHC
• Katherine Kinsella, ED.D, LMFT, LMHC
• Sara A Kitson
• Ethan Klausmeyer, PA-C
• Justin Everett Kleiner, MD
• Harley Klemola, M.S. BCBA
• Luke Klumpp, PA-C, AT

• Psychiatry Physician in Warwick, RI
• Providers in Warwick, RI by specialty
• Psychiatry Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.