NPIMap

Individual provider Active NPI

Mark Conrad Muetterties, MD

  • Emergency Medicine Physician
  • Newport, RI
National Provider Identifier
1184681082
Registry record updated Jun 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD10743 Issued in RI
Practice address
11 Friendship St
Newport, RI 02840-2271
Phone
(401) 845-1593
Fax
(401) 847-0650
NPI assigned
Apr 26, 2006
Last updated
Jun 4, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD10743 RI Primary

Addresses

Primary practice location

11 Friendship St
Newport, RI 02840-2271

Mailing address

11 Friendship St
Newport, RI 02840-2271
Phone (401) 845-1593

Other identifiers 2

IdentifierTypeStateIssuer
U400167716OtherRIMEDICARE NGS
7057902MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, CT, MA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20050926001154 RI Practitioner - Emergency Medicine 2365476561 Reassigns benefits to 1 organization
I20150423002079 CT Practitioner - Emergency Medicine 2365476561 Reassigns benefits to 1 organization
I20161116001962 MA Practitioner - Emergency Medicine 2365476561 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
JS Weill Medical College, Cornell University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The William W Backus HospitalGroup PAC ID 0749170645, 248 clinicians
First Physicians CorporationGroup PAC ID 0244518454, 28 clinicians

Practice addresses (Care Compare)

326 Washington St
Norwich, CT 06360-2740
Phone (860) 889-8331

43 High St
Wareham, MA 02571-2097
Phone (508) 973-7215

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score
97.8 of 100Reported as group
Quality
90
Promoting interoperability
100
Improvement activities
40
Cost
78.43

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Hospitals Group, Inc Current Accepting new patients
Southcoast Hospitals Group Inc CurrentSince Nov 20, 2016 Accepting new patients
The William W Backus Hospital CurrentSince Aug 4, 2014 Accepting new patients
Emergency Care Services of New England PC Emergency Medicine CurrentSince May 17, 2018 Accepting new patients
William W Backus Hospital CurrentSince Aug 4, 2014 Accepting new patients
Southcoast Hospitals Group, Inc CurrentSince Nov 20, 2016 Accepting new patients
Ambulatory Care Physicians at CDH, PC Emergency Medicine Past Accepting new patients

Locations

326 Washington St
Norwich, CT 06360
Phone (860) 701-0140

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

874 Purchase St
New Bedford, MA 02740
Phone (508) 992-6553

43 High St
Wareham, MA 02571
Phone (508) 273-4200

200 High Service Ave
North Providence, RI 02904
Phone (401) 456-3000

Interoperability endpoints

  • Direct secure messaging: mmuetterties37471@direct.southcoast.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433376000000",
    "number": "1184681082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 FRIENDSHIP ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402271",
            "telephone_number": "401-845-1593",
            "fax_number": "401-847-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FRIENDSHIP ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402271",
            "telephone_number": "401-845-1593",
            "fax_number": "401-847-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUETTERTIES",
        "first_name": "MARK",
        "middle_name": "CONRAD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2015-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "MD10743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE NGS",
            "identifier": "U400167716",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7057902",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, RI

Sources for this page

Verify at the official NPI Registry.