Individual provider Active NPI

Michael D Stein, M.D.

  • Internal Medicine Physician
  • Riverside, RI
National Provider Identifier
1114964301
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD07323 Issued in RI
Practice address
375 Wampanoag TRL
Suite 301
Riverside, RI 02915-2232
Phone
(401) 649-4050
Fax
(401) 649-4051
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 160428 MA
Internal Medicine Physician 207R00000X MD07323 RI Primary

Addresses

Primary practice location

375 Wampanoag TRL
Suite 301
Riverside, RI 02915-2232

Mailing address

17 Virginia Ave
Suite 107
Providence, RI 02905-4406
Phone (401) 443-4992

Other identifiers 2

IdentifierTypeStateIssuer
9006420MedicaidRI
110234606OtherRIRAILROAD

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
I20040614000451 RI Practitioner - Internal Medicine 7315832144 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
160428MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Brown Medicine Internal Medicine CurrentSince Jan 1, 2000 Accepting new patients
Brown Medicine CurrentSince Jan 1, 2000 Accepting new patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Brown Medicine Internal Medicine Past Accepting new patients
Sstar of Rhode Island, Inc. PastSince Dec 7, 2011 Accepting new patients

Locations

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

17 Virginia Ave
Ste 107
Providence, RI 02905
Phone (401) 784-4923

593 Eddy St
Providence, RI 02903

111 Plain St
Fl 2
Providence, RI 02903
Phone (401) 444-1770

2 Dudley St
Ste 370
Providence, RI 02905
Phone (401) 444-3600

375 Wampanoag Trl
Ste 301
Riverside, RI 02915
Phone (401) 649-4050

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1114964301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 VIRGINIA AVE",
            "address_2": "SUITE 107",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054406",
            "telephone_number": "401-443-4992",
            "fax_number": "401-784-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 WAMPANOAG TRL",
            "address_2": "SUITE 301",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152232",
            "telephone_number": "401-649-4050",
            "fax_number": "401-649-4051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEIN",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "160428",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD07323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9006420",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "110234606",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.