Fawazat Maria Agoro, PMHNP
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Providence, RI
NPI 1134849334 · NPPES record last updated Sep 11, 2026
Key facts
- NPI
- 1134849334
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- APRN04593 (RI)
- Practice address
- 1075 Smith St
Providence, RI 02908-2700 - Phone
- (401) 369-9224
- NPI assigned
- Aug 30, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
98 Hyde St
Cranston, RI 02920-6317
PO Box
Suite 393
Seekonk, MA 02771-0393
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260622000722 | RI | Practitioner - Nurse Practitioner | 1355814401 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN03235 | RI | MD | Family Nurse Practitioner |
| APRN04593 | RI | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rhode Island State Psychiatric Hospital | Current |
Accepting new patients | |
| Providence Behavioral Health Associates Inc | Current |
Accepting new patients |
Locations
1598 S County Trl
Ste 102
East Greenwich, RI 02818
Phone (401) 369-9224
1075 Smith St
Ste 2
Providence, RI 02908
Phone (401) 369-9224
1075 Smith St
Providence, RI 02908
Phone (401) 369-9224
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN03235 | RI | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | APRN04593 | RI | Yes |
Addresses
Primary practice location
1075 Smith St
Providence, RI 02908-2700
Mailing address
1075 Smith St Ste 2
Providence, RI 02908-2700
Other practice location 1
1300 Division Rd Ste 301
West Warwick, RI 02893-7558
Phone (401) 369-9224
Other providers in Providence, RI
- Mofoluso O Agbelese
- Ankita Aggarwal
- Rahul Aggarwal
- Suchit K Aggarwal
- Aliia Agliullina
- Linda Agoro
- Jalixa Agudelo
- Brigida Aguiar
- Bryana Michelle Aguiar
- Deanna Aguiar
All providers in Providence, RI · Psychiatric/Mental Health Nurse Practitioner in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.