NPIMap

Individual provider Active NPI

Thomas A. Bledsoe, MD

  • Internal Medicine Physician
  • Riverside, RI
National Provider Identifier
1245277953
Registry record updated Sep 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD08111 Issued in RI
Practice address
375 Wampanoag TRL
Suite 201
Riverside, RI 02915-2232
Phone
(401) 649-4020
Fax
(401) 649-4021
NPI assigned
Jun 1, 2006
Last updated
Sep 12, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD08111 RI Primary

Addresses

Primary practice location

375 Wampanoag TRL
Suite 201
Riverside, RI 02915-2232

Mailing address

17 Virginia Ave
Suite 107
Providence, RI 02905-4406
Phone (401) 443-4992

Other identifiers 2

IdentifierTypeStateIssuer
9006673MedicaidRI
110222755OtherRIRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000483 RI Practitioner - Internal Medicine 8224012687 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Warren Alpert Medical School of Brown University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians
Brown MedicineGroup PAC ID 0446159776, 220 clinicians

Practice addresses (Care Compare)

375 Wampanoag TRL
Riverside, RI 02915-2232
Phone (401) 649-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD08111RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Brown Medicine Internal Medicine CurrentSince Jan 1, 2000 Accepting new patients
Brown Medicine CurrentSince Jan 1, 2000 Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

17 Virginia Ave
Ste 107
Providence, RI 02905
Phone (401) 784-4923

285 Governor St
Ste 200
Providence, RI 02906
Phone (401) 228-3480

593 Eddy St
Providence, RI 02903

593 Eddy St
#5
Providence, RI 02903
Phone (401) 444-3032

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

375 Wampanoag Trl
Ste 102
Riverside, RI 02915
Phone (401) 649-4010

375 Wampanoag Trl
Ste 201
Riverside, RI 02915
Phone (401) 649-4020

Organizations & group practices 5

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 10

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473638400000",
    "number": "1245277953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 VIRGINIA AVE",
            "address_2": "SUITE 107",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054406",
            "telephone_number": "401-443-4992",
            "fax_number": "401-784-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 WAMPANOAG TRL",
            "address_2": "SUITE 201",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152232",
            "telephone_number": "401-649-4020",
            "fax_number": "401-649-4021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEDSOE",
        "first_name": "THOMAS",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2016-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD08111",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9006673",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "110222755",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.