Organization Active NPI

Seaside Primary Care

  • Family Nurse Practitioner
  • Westerly, RI
National Provider Identifier
1295492411
Registry record updated Nov 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
SEASIDE PRIMARY CARE
Practice address
27 East Ave
Westerly, RI 02891-3107
Phone
(401) 246-8496
Fax
(860) 495-5116
NPI assigned
Nov 22, 2021
Last updated
Nov 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2021

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

Authorized official

Name
Mrs. Debra L Furtado, DNP,APRN,FNPNPI 1609346741
Title
Owner
Phone
(401) 246-8496

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X NU Primary

Addresses

Primary practice location

27 East Ave
Westerly, RI 02891-3107

Mailing address

27 East Ave
Westerly, RI 02891-3107
Phone (401) 246-8496

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220111000494 RI Part B Supplier - Clinic/Group Practice 5395137970 Receives reassigned benefits from 1 practitioner
Practice locations: Westerly, RI

National Provider Directory

National Provider Directory

Locations

27 East Ave
Westerly, RI 02891
Phone (401) 348-8138

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1637539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637539200000",
    "number": "1295492411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 EAST AVE",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028913107",
            "telephone_number": "401-246-8496",
            "fax_number": "860-495-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 EAST AVE",
            "city": "WESTERLY",
            "state": "RI",
            "postal_code": "028913107",
            "telephone_number": "401-246-8496",
            "fax_number": "860-495-5116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEASIDE PRIMARY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-22",
        "last_updated": "2021-11-22",
        "certification_date": "2021-11-22",
        "status": "A",
        "authorized_official_last_name": "FURTADO",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-246-8496",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "DNP,APRN,FNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westerly, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.