Brown Medicine

Organization Active NPI Endocrinology, Diabetes & Metabolism Physician · Riverside, RI

NPI 1104564137 · NPPES record last updated Feb 14, 2024

Key facts

NPI
1104564137
Entity type
Organization (NPI type 2)
Primary specialty
Endocrinology, Diabetes & Metabolism Physician 207RE0101X
Legal business name
BROWN MEDICINE
Practice address
375 Wampanoag TRL
Riverside, RI 02915-2232
Phone
(401) 444-7793
NPI assigned
May 20, 2022
Organization subpart
No

Authorized official

Name
Donna Gordon
Title
RCM Director
Phone
(401) 443-5107

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Corporate family (same tax ID) 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 53

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 53

Medicare participation

Medicare fee-for-service enrollment
Enrolled in RI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040219000354 RI Part B Supplier - Clinic/Group Practice 0446159776 Receives reassigned benefits from 259 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: East Providence, RI; Warwick, RI; Smithfield, RI; Riverside, RI; Providence, RI; Newport, RI; Lincoln, RI; East Greenwich, RI

National Provider Directory

Tax ID family
Karen Chase NPP (7 organizations share this tax ID)

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJFJAA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207K00000X
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Endocrinology, Diabetes & Metabolism Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RE0101X Yes
Infectious Disease Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RI0200X
Rheumatology Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207RR0500X
Addiction Medicine (Preventive Medicine) Physician
Group: 193200000X MULTI-SPECIALTY GROUP
2083A0300X
Medical Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363AM0700X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X
Family Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363LF0000X

Addresses

Primary practice location

375 Wampanoag TRL
Riverside, RI 02915-2232

Mailing address

Dept 3010, PO Box 986524
Boston, MA 02298-6524
Phone (401) 443-4992

Other providers in Riverside, RI

All providers in Riverside, RI · Endocrinology, Diabetes & Metabolism Physician in Rhode Island

Sources for this page

Verify at the official NPI Registry.