Alvin C Bacon, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO 00461 Issued in RI

Practice address

598 Great Rd
Lower Level
North Smithfield, RI 02896-6810

Phone

(401) 534-6784

Fax

(401) 534-5460

NPI assigned

Aug 9, 2006

Last updated

Mar 7, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

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

Specialty

Family Practice

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alvin C. Bacon, Inc

  • Family Medicine Physician
  • North Smithfield, RI
  • NPI 1538431036
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331078400000",
    "number": "1104836568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 CHAMBLY AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028881805",
            "telephone_number": "401-534-6784",
            "fax_number": "401-534-5460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 GREAT RD",
            "address_2": "LOWER LEVEL",
            "city": "NORTH SMITHFIELD",
            "state": "RI",
            "postal_code": "028966810",
            "telephone_number": "401-534-6784",
            "fax_number": "401-534-5460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "ALVIN",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2012-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO 00461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "0100801",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "588384",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2460971003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "400400",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USFHP",
            "identifier": "795932",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9025378",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristin Elaine Anderson, PTA
• Brianna Arpie-Otfinoski
• Dora Arsenault, CCC-SLP
• Dennis Joseph Aumentado, M.D.
• Devin K Azulay
• Monika Maria Bailey
• Tanisha K Baker, MASSAGE THERAPIST
• Roger Beaudet, OD
• Deborah Ann Beauvais, NP
• Daniel James Becker, D.C.

• Family Medicine Physician in North Smithfield, RI
• Providers in North Smithfield, RI by specialty
• Family Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.