Mary Karen Emanuel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

00999 Issued in RI

Practice address

300 Centerville Rd Ste 110
Warwick, RI 02886-0200

Phone

(401) 615-2299

Fax

(401) 615-7529

NPI assigned

Aug 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: memanuel221064@brownhealth.medalliesdirect.net

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.

• Coastal Medical Physicians, Inc.

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1780273540
  Medicare reassignment
• Coastal Medical Physicians, Inc.

  • Internal Medicine Physician
  • Riverside, RI
  • NPI 1093678104
  NPD
• Lifespan Corporation

  • Children's Rehabilitation Hospital
  • Providence, RI
  • NPI 1790221232
  NPD
• Coastal Medical, Inc.

  • Non-Pharmacy Dispensing Site
  • East Providence, RI
  • NPI 1144361718
  NPD (past)

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1235655341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ STE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034760",
            "telephone_number": "401-421-4000",
            "fax_number": "401-272-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CENTERVILLE RD STE 110",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028860200",
            "telephone_number": "401-615-2299",
            "fax_number": "401-615-7529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMANUEL",
        "first_name": "MARY",
        "middle_name": "KAREN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "00999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235655341",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "memanuel221064@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "300 Centerville Rd Ste 110",
            "city": "Warwick",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028860200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Elizabeth a White LMHC LLC
• Christine L Ellis
• Lisa Ellis, PT
• Robert G Ellison, M.D.
• Rebecca Elsing, LMHC
• Stacey L Emmett, RN
• Susan Elisabet Enck, PH.D.
• Endovascular & Interventional Associates Inc
• Faith E Engelmann
• Ray English Jr., DMD

• Physician Assistant in Warwick, RI
• Providers in Warwick, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.