Samuel Edwin Donovan

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

LP04395 Issued in RI

Practice address

111 Brewster St
Pawtucket, RI 02860

Phone

(401) 729-2304

NPI assigned

Mar 30, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Specialty

Family PracticeAlso: Hospitalist

Education

University of Rochester School of Medicine and Dentistry, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cayuga Medical Associates PCGroup PAC ID 6709897960, 278 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• VNS Ithaca Tompkins Co Chha Home health agency, Ithaca, NY, CCN 337212
• Hospicare & Palliative Care Services Hospice, Ithaca, NY, CCN 331512
• Cayuga Medical Center at Ithaca Hospital, Ithaca, NY, CCN 330307

Merit-based Incentive Payment System (MIPS)

Final score

94.27 of 100Reported as apm

Quality

82.87

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sdonovan19980@direct.xtensys.com

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.

• Cayuga Medical Associates, PC

  • Internal Medicine Physician
  • Ithaca, NY
  • NPI 1679525455
  Medicare reassignment Care Compare group NPD
• Cayuga Medical Center at Ithaca

  • General Acute Care Hospital
  • Ithaca, NY
  • NPI 1962422733
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Cayuga Medical Center at Ithaca

  • General Acute Care Hospital
  • Ithaca, NY
  • NPI 1962422733
  Care Compare affiliation
• Hospicare and Palliative Care Services of Tompkins County, Inc.

  • Community Based Hospice Care Agency
  • Ithaca, NY
  • NPI 1730185737
  Care Compare affiliation
• Visiting Nurse Service of Ithaca and Tompkins County Inc

  • Home Health Agency
  • Ithaca, NY
  • NPI 1447257928
  Care Compare affiliation

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530835200000",
    "number": "1215433230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 SCHOOL ST",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024721415",
            "telephone_number": "617-549-4262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BREWSTER ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "02860",
            "telephone_number": "401-729-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "SAMUEL",
        "middle_name": "EDWIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "LP04395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrew William Dixon, M.D.
• DNC Quality Behavioral Health Services
• Akira DO
• Robin M Dolan, PT
• Cary Donaldson, LCSW
• Donya a Powers MD
• Jon M. Dooley, MD
• Claudia Dorego
• Tracy Dorgan, COTA
• Doyle Respiratory LLC

• Family Medicine Physician in Pawtucket, RI
• Providers in Pawtucket, RI by specialty
• Family Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.