Individual provider Active NPI

Kenneth M Segal, D.P.M.

  • Podiatrist
  • Providence, RI
National Provider Identifier
1285691576
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
DPM00193 Issued in RI
Practice address
677 Hope St
Providence, RI 02906-2651
Phone
(401) 421-7466
Fax
(401) 751-3883
NPI assigned
Apr 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X DPM00193 RI Primary

Addresses

Primary practice location

677 Hope St
Providence, RI 02906-2651

Mailing address

677 Hope St
Providence, RI 02906-2651
Phone (401) 421-7466

Other identifiers 3

IdentifierTypeStateIssuer
7194OtherRIBLUE CROSS
0619880001OtherRIDME
9007194MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20041110000457 RI Practitioner - Podiatry 1850354895 Practice locations: Providence, RI
I20140807001992 MA Practitioner - Podiatry 1850354895 Practice locations: Providence, RI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1535MAMDChiropractor
DPM00193RIMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Carelink, Inc. Current Accepting new patients

Locations

400 Massasoit Ave
Ste 300B
East Providence, RI 02914

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1285691576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "677 HOPE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062651",
            "telephone_number": "401-421-7466",
            "fax_number": "401-751-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 HOPE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062651",
            "telephone_number": "401-421-7466",
            "fax_number": "401-751-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGAL",
        "first_name": "KENNETH",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-28",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "DPM00193",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "7194",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DME",
            "identifier": "0619880001",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9007194",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.