Individual provider Active NPI

Joseph A. Wyllie, DO

  • Cardiovascular Disease Physician
  • East Greenwich, RI
National Provider Identifier
1124046040
Registry record updated Nov 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
DO00420 Issued in RI
Practice address
1377 South County Trail
East Greenwich, RI 02818
Phone
(401) 226-7590
Fax
(401) 886-7571
NPI assigned
Jul 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X DO00420 RI Primary

Addresses

Primary practice location

1377 South County Trail
East Greenwich, RI 02818

Mailing address

1377 South County Trail
East Greenwich, RI 02818
Phone (401) 226-7590

Other identifiers 1

IdentifierTypeStateIssuer
9003694MedicaidRI

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
I20040429000147 RI Practitioner - Cardiovascular Disease (Cardiology) 7719974906 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of New England, College of Osteo Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians

Practice addresses (Care Compare)

1180 Hope St
Bristol, RI 02809-1126
Phone (401) 228-2024

1454 S County TRL
Suite 2000
East Greenwich, RI 02818-1750
Phone (401) 606-1100

164 Summit Ave
Providence, RI 02906-2853

185 A High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

185 High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

2 Dudley St
Providence, RI 02905-3248
Phone (401) 272-1800

208 Collyer St
Suite 100
Providence, RI 02904-1560
Phone (401) 793-7191

25 S County Commons Way
Suite 2
Wakefield, RI 02879-8271
Phone (401) 606-1004

407 E Ave
Suite 120
Pawtucket, RI 02860-5290
Phone (401) 475-2505

41 Sanderson Rd
Suite 103
Smithfield, RI 02917-2611
Phone (401) 606-1004

593 Eddy St
Providence, RI 02903-4923

593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172

593 Eddy St George BLDG 1St Floor
Providence, RI 02903-4923
Phone (401) 793-9166

900 Warren Ave
East Providence, RI 02914-1430

950 Warren Ave
FL 2
East Providence, RI 02914-1432
Phone (401) 606-1004

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009
  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008
  • South County Hospital Inc Hospital, Wakefield, RI, CCN 410008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Sep 1, 2012 Accepting new patients
The Miriam Hospital Cardiovascular Disease CurrentSince Jan 1, 2012 Accepting new patients
The Miriam Hospital CurrentSince Jan 1, 2012 Accepting new patients
The Miriam Hospital Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 1, 2012 Accepting new patients
The Miriam Hospital Current Accepting new patients
Lifespan Corporation Current Accepting new patients
Rhode Island Cardiology Center Cardiovascular Disease Past Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

1454 S County Trl
Ste 2200
East Greenwich, RI 02818
Phone (401) 444-8516

1377 S County Trl
East Greenwich, RI 02818
Phone (401) 886-7590

950 Warren Ave
#2
East Providence, RI 02914

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

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

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

593 Eddy St
Providence, RI 02903

2 Dudley St
Ste 360
Providence, RI 02905
Phone (401) 274-7546

208 Collyer St
Ste 100
Providence, RI 02904
Phone (401) 793-7191

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: jwyllie12372@brownhealth.medalliesdirect.net

Organizations & group practices 9

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.

Hospital & facility affiliations 9

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1258416000000",
    "number": "1124046040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1377 SOUTH COUNTY TRAIL",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "02818",
            "telephone_number": "401-226-7590",
            "fax_number": "401-886-7571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1377 SOUTH COUNTY TRAIL",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "02818",
            "telephone_number": "401-226-7590",
            "fax_number": "401-886-7571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WYLLIE",
        "first_name": "JOSEPH",
        "middle_name": "A.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-18",
        "last_updated": "2009-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "DO00420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9003694",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenwich, RI

Sources for this page

Verify at the official NPI Registry.