Individual provider Active NPI

Tamara Koritarov, DO

  • Gastroenterology Physician
  • Warwick, RI
National Provider Identifier
1194286799
Registry record updated Jun 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
DO01191 Issued in RI
Practice address
455 Toll Gate Rd
Warwick, RI 02886-2770
Phone
(401) 737-7010
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Gastroenterology Physician 207RG0100X DO01191 RI Primary
Internal Medicine Physician 207R00000X LP04714 RI

Addresses

Primary practice location

455 Toll Gate Rd
Warwick, RI 02886-2770

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2770
Phone (401) 737-7010

Other practice location 1

455 Toll Gate RD ASP Bld
Warwick, RI 02886
Phone (401) 738-6611

Other practice location 2

101 Dudley St
Providence, RI 02905-2401
Phone (401) 274-1122

Other practice location 3

1050 Main St
East Greenwich, RI 02818-3161
Phone (401) 453-7953

Other practice location 4

100 Dudley St Fl 3
Providence, RI 02905-3233
Phone (401) 453-7953

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
I20190731003075 RI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 6103152962

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2770

Hospital & facility affiliations

  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. Internal Medicine Current Accepting new patients

Locations

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

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

Interoperability endpoints

  • Direct secure messaging: tkoritarov@direct.carene.org

Organizations & group practices 1

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 2

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": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782345600000",
    "number": "1194286799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862770",
            "telephone_number": "401-737-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862770",
            "telephone_number": "401-737-7010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Toll Gate RD   ASP Bld",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "02886",
            "country_code": "US",
            "telephone_number": "401-738-6611",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-274-1122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 Main St",
            "address_purpose": "LOCATION",
            "city": "East Greenwich",
            "state": "RI",
            "postal_code": "028183161",
            "country_code": "US",
            "telephone_number": "401-453-7953",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Dudley St Fl 3",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053233",
            "country_code": "US",
            "telephone_number": "401-453-7953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORITAROV",
        "first_name": "TAMARA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2026-06-25",
        "certification_date": "2026-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "RI",
            "license": "DO01191",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP04714",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.