Individual provider Active NPI

Samira Ouklilane, NP

  • Gerontology Nurse Practitioner
  • Providence, RI
National Provider Identifier
1265048250
Registry record updated Feb 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN02343 Issued in RI
Practice address
100 Dudley St
Providence, RI 02905-3233
Phone
(401) 453-7950
NPI assigned
Sep 16, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN02343 RI
Adult Health Nurse Practitioner 363LA2200X APRN02343 RI
Gerontology Nurse Practitioner 363LG0600X APRN02343 RI Primary

Addresses

Primary practice location

100 Dudley St
Providence, RI 02905-3233

Mailing address

100 Dudley St
Providence, RI 02905-3233

Other practice location 1

101 Dudley St
Providence, RI 02905-2401
Phone (401) 274-7950

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address souklilane@wih.cernerdirect.carene.org Health Information Exchange (HIE)

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
I20210302001795 RI Practitioner - Nurse Practitioner 3072929868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Hospital & facility affiliations

  • Women & Infants Hospital of Rhode Island Hospital, Providence, RI, CCN 410010
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APRN02343RIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. CurrentSince Mar 25, 2021 Accepting new patients
Affinity Physicians LLC CurrentSince Mar 25, 2021 Accepting new patients

Locations

100 Dudley St
Providence, RI 02905
Phone (401) 274-2300

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: souklilane@wih.cernerdirect.carene.org
  • Direct secure messaging: souklilane@direct.carene.org

Organizations & group practices 2

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": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644796800000",
    "number": "1265048250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053233",
            "telephone_number": "401-453-7950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-274-7950",
            "fax_number": "401-453-7658",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OUKLILANE",
        "first_name": "SAMIRA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2022-02-14",
        "certification_date": "2022-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN02343",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "RI",
            "license": "APRN02343",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "RI",
            "license": "APRN02343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "souklilane@wih.cernerdirect.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "101 Dudley St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029052401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.