Individual provider Active NPI

Philomene Fortes

  • Family Nurse Practitioner
  • Pawtucket, RI
National Provider Identifier
1235568171
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN01560 Issued in RI
Practice address
39 East Ave
Pawtucket, RI 02860-4003
Phone
(401) 722-0081
Fax
(401) 312-0318
NPI assigned
Nov 1, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN01560 RI Primary

Addresses

Primary practice location

39 East Ave
Pawtucket, RI 02860-4003

Mailing address

4404 Queensbury Rd
Riverdale, MD 20737-1068

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170803001267 RI Practitioner - Nurse Practitioner 8426368978 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blackstone Valley Community Health Care IncGroup PAC ID 8628045762, 49 clinicians

Practice addresses (Care Compare)

39 E Ave
Pawtucket, RI 02860-4003
Phone (401) 312-9813

9 Chestnut St
Central Falls, RI 02863-2005
Phone (401) 722-0081

Hospital & facility affiliations

  • Women & Infants Hospital of Rhode Island Hospital, Providence, RI, CCN 410010
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN01560RIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Blackstone Valley Community Health Care, Inc. CurrentSince Oct 18, 2021 Accepting new patients
Suburban Nephrology Associates LLC PastSince Oct 1, 2008 Accepting new patients
Blackstone Valley Community Health Care, Inc. Past Accepting new patients
C&S Anesthesia LLC PastSince May 1, 2021 Accepting new patients

Locations

1000 Broad St
Central Falls, RI 02863
Phone (401) 722-0081

9 Chestnut St
Central Falls, RI 02863
Phone (401) 722-0081

1145 Main St
Pawtucket, RI 02860
Phone (401) 305-5280

39 East Ave
Pawtucket, RI 02860
Phone (401) 722-0081

Interoperability endpoints

  • Direct secure messaging: pfortes@direct.carene.org
  • Direct secure messaging: philomene.fortes.p1@direct.bvchc.nextgenshare.com

Organizations & group practices 4

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": "1383264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1235568171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4404 QUEENSBURY RD",
            "city": "RIVERDALE",
            "state": "MD",
            "postal_code": "207371068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 EAST AVE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604003",
            "telephone_number": "401-722-0081",
            "fax_number": "401-312-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORTES",
        "first_name": "PHILOMENE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-01",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "RI",
            "license": "APRN01560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.