John A Phillip, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

RI08221 Issued in RI

Practice address

1524 Atwood Ave
Suite 245
Johnston, RI 02919-3228

Phone

(401) 443-5559

Fax

(401) 443-5562

NPI assigned

Nov 21, 2005

Last updated

Dec 20, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

General Surgery

Education

Other, 1985

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of Fatima Hospital Hospital, North Providence, RI, CCN 410005
• The Miriam Hospital Hospital, Providence, RI, CCN 410012

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.phillip.1@28642.direct.athenahealth.com

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.

• Phillip Surgical LLC

  • Surgery Physician
  • Johnston, RI
  • NPI 1851098602
  Medicare reassignment NPD Authorized official
• Prospect Chartercare Physicians, LLC

  dba CharterCARE Medical Associates

  • Internal Medicine Physician
  • Cranston, RI
  • NPI 1629493135

  Surgery

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Prospect Chartercare Sjhsri, LLC

  dba Our Lady of Fatima Hospital

  • General Acute Care Hospital
  • North Providence, RI
  • NPI 1871918870
  Care Compare affiliation
• The Miriam Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1487649430
  Care Compare affiliation

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703030400000",
    "number": "1285617696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1524 ATWOOD AVE STE 245",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193228",
            "telephone_number": "401-443-5559",
            "fax_number": "401-443-5562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1524 ATWOOD AVE",
            "address_2": "SUITE 245",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193228",
            "telephone_number": "401-443-5559",
            "fax_number": "401-443-5562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIP",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "RI08221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7002899",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "RI08221",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE #",
            "identifier": "1700281",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP #",
            "identifier": "004509",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristen Marie Peters, LICSW
• Michael Anthony Pezza, D.C.
• Charles Minh Pham, D.M.D.
• Phillip Surgical LLC
• Angela Y Phillip
• Jessica L Piccoli
• Katherine Pierce, RN, FNP-C
• Steven Domenic Pirri Jr.
• Pocasset Bay Al Operator, LLC (Anchor Bay at Pocasset)
• Pocasset LP (Pocasset Bay Retirement Living)

• Surgery Physician in Johnston, RI
• Providers in Johnston, RI by specialty
• Surgery Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.