Kardous Primary Care Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

10089 Issued in RI

Legal business name

KARDOUS PRIMARY CARE INC

Practice address

1145 Reservoir Ave
Ste 301
Cranston, RI 02920

Phone

(401) 946-5001

Fax

(401) 946-5101

NPI assigned

Nov 28, 2005

Organization subpart

No

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

Authorized official

Name

Antioan Kardous, MDNPI 1538142252

Title

President

Phone

(401) 946-5001

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Antioan Kardous, MD

  • Internal Medicine Physician
  • Cranston, RI
  • NPI 1538142252
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526428800000",
    "number": "1134102841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1145 RESERVOIR AVE",
            "address_2": "STE 301",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029206055",
            "telephone_number": "401-946-5001",
            "fax_number": "401-946-5101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 RESERVOIR AVE",
            "address_2": "STE 301",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "02920",
            "telephone_number": "401-946-5001",
            "fax_number": "401-946-5101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARDOUS PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-28",
        "last_updated": "2018-05-16",
        "status": "A",
        "authorized_official_last_name": "KARDOUS",
        "authorized_official_first_name": "ANTIOAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-946-5001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "10089",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "408195",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DB0254",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "272209",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9003208",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph V. Centofanti, MD
• Plakyil Joseph Joseph, M.D.
• Penny Joslin Melfi, LCMT
• Justice Assistance
• Neetu Kainth, DMD
• Antioan Kardous, MD
• Karen M. Mega, DMD Inc.
• Ahnise Kassab, DC
• Rama Kattan, RDN
• Craig Paul Kaufmann, M.D.

• Internal Medicine Physician in Cranston, RI
• Providers in Cranston, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.