NPIMap

Individual provider Active NPI

Carla Marie Vaccaro, M.D.

  • Family Medicine Physician
  • Jamestown, RI
National Provider Identifier
1285613448
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD10354 Issued in RI
Practice address
20 Southwest Ave
Jamestown, RI 02835-1120
Phone
(401) 423-2616
Fax
(401) 423-3485
NPI assigned
Jan 15, 2006
Last updated
Apr 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD10354 RI Primary

Addresses

Primary practice location

20 Southwest Ave
Jamestown, RI 02835-1120

Mailing address

4 Ranger CT
Jamestown, RI 02835-1837
Phone (401) 423-2616

Other identifiers 1

IdentifierTypeStateIssuer
0171565MedicaidMA

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
I20110810000335 RI Practitioner - Family Practice 2062575558 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 1997
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

Practice addresses (Care Compare)

20 Southwest Ave
Jamestown, RI 02835-1120
Phone (401) 423-2616

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD10354RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. CurrentSince Feb 1, 2024 Accepting new patients
Carla Vaccaro MD LLC Family Medicine Current Accepting new patients
Silver Spring Health Care Management, Inc. Family Medicine CurrentSince Jun 1, 2022 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Coastal Medical Physicians, Inc. Family Medicine CurrentSince Feb 1, 2024 Accepting new patients
Lifespan Corporation Current Accepting new patients
Silver Spring Health Care Management, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Merrimack Family Medicine PC Family Medicine Past Accepting new patients
LGH Professional Services LLC Past Accepting new patients

Locations

3461 S County Trl
Ste 301
East Greenwich, RI 02818
Phone (401) 471-6285

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

20 Southwest Ave
Jamestown, RI 02835
Phone (401) 423-2520

6 Blackstone Valley Pl
Lincoln, RI 02865
Phone (401) 333-3111

14 Woodruff Ave
Narragansett, RI 02882
Phone (401) 661-8088

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

79 Turnpike Ave
Portsmouth, RI 02871
Phone (401) 683-7434

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

100 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000

268 Post Rd
Ste 203
Westerly, RI 02891
Phone (401) 604-2530

Interoperability endpoints

  • Direct secure messaging: cvaccaro9187@brownhealth.medalliesdirect.net

Organizations & group practices 10

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 11

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": "1137283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335139200000",
    "number": "1285613448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RANGER CT",
            "city": "JAMESTOWN",
            "state": "RI",
            "postal_code": "028351837",
            "telephone_number": "401-423-2616",
            "fax_number": "401-423-3485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 SOUTHWEST AVE",
            "city": "JAMESTOWN",
            "state": "RI",
            "postal_code": "028351120",
            "telephone_number": "401-423-2616",
            "fax_number": "401-423-3485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VACCARO",
        "first_name": "CARLA",
        "middle_name": "MARIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-15",
        "last_updated": "2012-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD10354",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0171565",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamestown, RI

Sources for this page

Verify at the official NPI Registry.