NPIMap

Organization Active NPI

Prospect Chartercare RWMC, LLC

Doing business as Roger Williams Medical Center

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1285059287
Registry record updated Aug 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PROSPECT CHARTERCARE RWMC, LLC
Doing business as
Roger Williams Medical Center
Practice address
825 Chalkstone Ave
Providence, RI 02908-4728
Phone
(401) 456-2000
Fax
(401) 456-2029
NPI assigned
Feb 27, 2014
Last updated
Aug 4, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2025

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

Authorized official

Name
Alfredo Alvarez Sabillo
Title
Senior Vice President
Phone
(310) 422-6137

Specialties & licenses 14

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X HOS00133 RI
Addiction (Substance Use Disorder) Psychologist 103TA0400X NU
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X NU
Specialist 174400000X NU
Internal Medicine Physician 207R00000X NU Primary
Addiction Medicine (Internal Medicine) Physician 207RA0401X NU
Hematology & Oncology Physician 207RH0003X NU
Pulmonary Disease Physician 207RP1001X NU
Orthopaedic Surgery Physician 207X00000X NU
Addiction Psychiatry Physician 2084P0802X NU
Surgery Physician 208600000X NU
Surgical Oncology Physician 2086X0206X NU
Foot & Ankle Surgery Podiatrist 213ES0103X NU

Addresses

Primary practice location

825 Chalkstone Ave
Providence, RI 02908-4728

Mailing address

825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-2000

Other practice location 1

50 Maude St
Providence, RI 02908-4325
Phone (401) 456-2464

Other names 1

  • Roger Williams Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140728001672 RI Part B Supplier - Clinic/Group Practice 0547492696 Receives reassigned benefits from 182 practitioners
1 other NPI on this enrollment
Practice locations: Warren, RI; E Providence, RI; Wakefield, RI; Providence, RI; North Providence, RI; Lincoln, RI; Johnston, RI; Greenville, RI…

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

725 Reservoir Ave
Ste 202
Cranston, RI 02910
Phone (401) 943-8824

425 Albion Rd
Lincoln, RI 02865
Phone (401) 333-1473

50 Maude St
Providence, RI 02908
Phone (401) 456-2200

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Chartercare Home Health ServicesProvidence, RI, CCN 417029 Home health agency 5% Or Greater Indirect Ownership Interest (100%) Nov 16, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 189

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 189

NPI Registry JSON

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

{
    "created_epoch": "1393459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754265600000",
    "number": "1285059287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2000",
            "fax_number": "401-456-2029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 CHALKSTONE AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029084728",
            "telephone_number": "401-456-2000",
            "fax_number": "401-456-2029"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 Maude St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084325",
            "country_code": "US",
            "telephone_number": "401-456-2464",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROSPECT CHARTERCARE RWMC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-27",
        "last_updated": "2025-08-04",
        "certification_date": "2025-08-04",
        "status": "A",
        "authorized_official_last_name": "SABILLO",
        "authorized_official_first_name": "ALFREDO",
        "authorized_official_middle_name": "ALVAREZ",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "310-422-6137"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "RI",
            "license": "HOS00133",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Roger Williams Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Roger Williams Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.