NPIMap

Organization Active NPI

Brown Medicine

  • Endocrinology, Diabetes & Metabolism Physician
  • Riverside, RI
National Provider Identifier
1104564137
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
BROWN MEDICINE
Practice address
375 Wampanoag TRL
Riverside, RI 02915-2232
Phone
(401) 444-7793
NPI assigned
May 20, 2022
Last updated
Feb 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Authorized official

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Nurse Practitioner 363L00000X
Family Nurse Practitioner 363LF0000X
Allergy & Immunology Physician 207K00000X
Internal Medicine Physician 207R00000X
Endocrinology, Diabetes & Metabolism Physician 207RE0101X Primary
Infectious Disease Physician 207RI0200X
Rheumatology Physician 207RR0500X
Addiction Medicine (Preventive Medicine) Physician 2083A0300X

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

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

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory
Tax ID family
Jose Behar MD7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Interoperability endpoints

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

Practitioners & affiliated clinicians

Practitioners 52

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707868800000",
    "number": "1104564137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3010, PO BOX 986524",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986524",
            "telephone_number": "401-443-4992",
            "fax_number": "401-537-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152232",
            "telephone_number": "401-444-7793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-20",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "RCM DIRECTOR",
        "authorized_official_telephone_number": "401-443-5107"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.