Individual provider Active NPI

Shirlene Yaa Gyanowa Obuobi, MD

  • Cardiovascular Disease Physician
  • East Providence, RI
National Provider Identifier
1255825386
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD19750 Issued in RI
Practice address
950 Warren Ave Ste 201
East Providence, RI 02914-1432
Phone
(401) 606-1004
NPI assigned
Jun 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 125.072456 IL
Cardiovascular Disease Physician 207RC0000X MD19750 RI Primary

Addresses

Primary practice location

950 Warren Ave Ste 201
East Providence, RI 02914-1432

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

Other practice location 1

5841 S Maryland Ave Ste Mc7082
Chicago, IL 60637-1465
Phone (773) 795-0232

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
I20241001004063 RI Practitioner - Cardiovascular Disease (Cardiology) 5294082178 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Chicago, Pritzker School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000

950 Warren Ave
FL 2
East Providence, RI 02914-1432
Phone (401) 606-1004

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.072456ILMDInternal Medicine Physician
MD19750RIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Single Specialty CurrentSince Aug 15, 2024 Accepting new patients
Lifespan Physician Group, Inc. Single Specialty CurrentSince Aug 15, 2024 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Aug 15, 2024 Accepting new patients
The Miriam Hospital CurrentSince Aug 15, 2024 Accepting new patients
The Miriam Hospital Single Specialty Current Accepting new patients
The Miriam Hospital Single Specialty Current Accepting new patients
Rhode Island Hospital CurrentSince Aug 15, 2024 Accepting new patients
The Miriam Hospital Single Specialty CurrentSince Aug 15, 2024 Accepting new patients
Lifespan Physician Group, Inc. Single Specialty Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

1454 S County Trl
Ste 2200
East Greenwich, RI 02818
Phone (401) 444-8516

950 Warren Ave
Ste 201
East Providence, RI 02914
Phone (855) 332-8474

950 Warren Ave
Fl 2
East Providence, RI 02914

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

407 East Ave
Ste 130
Pawtucket, RI 02860
Phone (401) 475-2505

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

593 Eddy St
Providence, RI 02903

146 W River St
#11A
Providence, RI 02904
Phone (401) 606-8250

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

208 Collyer St
Ste 100
Providence, RI 02904
Phone (401) 793-7191

593 Eddy St
Bldg 1ST
Providence, RI 02903

Organizations & group practices 9

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 8

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": "1529539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1255825386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WARREN AVE STE 201",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141432",
            "telephone_number": "401-606-1004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5841 S Maryland Ave Ste Mc7082",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606371465",
            "country_code": "US",
            "telephone_number": "773-795-0232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBUOBI",
        "first_name": "SHIRLENE",
        "middle_name": "YAA GYANOWA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-21",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.072456",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "MD19750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.