Individual provider Active NPI

Roy Souaid, M.D.

  • Internal Medicine Physician
  • Cranston, RI
National Provider Identifier
1174975445
Registry record updated Jun 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD16758 Issued in RI
Practice address
1500 Pontiac Ave
Cranston, RI 02920-4486
Phone
(401) 944-4300
Fax
(401) 464-4071
NPI assigned
Jul 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD16758 RI Primary

Addresses

Primary practice location

1500 Pontiac Ave
Cranston, RI 02920-4486

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190828000607 RI Practitioner - Internal Medicine 6103112123 Reassigns benefits to 1 organization
I20230731003379 MA Practitioner - Internal Medicine 6103112123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Medical Care of Boston Management CorporationGroup PAC ID 6800787714, 293 clinicians

Practice addresses (Care Compare)

88 Wharf St
Milton, MA 02186-3429
Phone (617) 696-7601

Hospital & facility affiliations

  • Visiting Nurse Association of Boston Home health agency, Dorchester, MA, CCN 227068
  • Caretenders Home health agency, Needham Heights, MA, CCN 227269
  • Beth Israel Deaconess Hospital - Milton Hospital, Milton, MA, CCN 220108
  • Beth Israel Deaconess Medical Center Hospital, Boston, MA, CCN 220086
  • Beth Israel Deaconess Hospital - Needham Hospital, Needham, MA, CCN 220083
  • Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16758RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Medical Care of Boston Management Corporation Internal Medicine CurrentSince Aug 16, 2023 Accepting new patients

Locations

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

1500 Pontiac Ave
Ste 101
Cranston, RI 02920
Phone (401) 371-0223

1500 Pontiac Ave
Cranston, RI 02920
Phone (401) 529-1819

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

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

Interoperability endpoints

  • Direct secure messaging: rsouaid255274@direct.bilh.masshiway.net

Organizations & group practices 3

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 6

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561075200000",
    "number": "1174975445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PONTIAC AVE",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029204486",
            "telephone_number": "401-944-4300",
            "fax_number": "401-464-4071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUAID",
        "first_name": "ROY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2019-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD16758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.