Individual provider Active NPI

Aaron Paul Wheeler, M.D.

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1104278472
Registry record updated Apr 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD16617 Issued in RI
Practice address
164 Summit Ave
Providence, RI 02906-2853
Phone
(401) 793-4489
Fax
(401) 793-4047
NPI assigned
Jul 11, 2016
Last updated
Apr 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD16617 RI Primary

Addresses

Primary practice location

164 Summit Ave
Providence, RI 02906-2853

Mailing address

20 Blackstone Blvd Apt 14
Providence, RI 02906-5448
Phone (085) 234-7865

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
I20190702000226 RI Practitioner - Internal Medicine 6305131376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-4102

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16617RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Prime Healthcare Services Landmark LLC CurrentSince Nov 9, 2019 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Prime Healthcare Services Landmark LLC CurrentSince Nov 9, 2019 Accepting new patients
Lifespan Corporation Current Accepting new patients

Locations

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

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

115 Cass Ave
Woonsocket, RI 02895
Phone (401) 356-1701

Interoperability endpoints

  • Direct secure messaging: awheeler172679@brownhealth.medalliesdirect.net

Organizations & group practices 5

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 5

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554422400000",
    "number": "1104278472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BLACKSTONE BLVD APT 14",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065448",
            "telephone_number": "085-234-7865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-4489",
            "fax_number": "401-793-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "AARON",
        "middle_name": "PAUL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2019-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD16617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.