Organization Active NPI

Peris Medical Corporation

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1295952802
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD10391 Issued in RI
Legal business name
PERIS MEDICAL CORPORATION
Practice address
655 Broad Street
Suite 201
Providence, RI 02907-1510
Phone
(401) 383-6748
NPI assigned
Apr 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Authorized official

Name
Dr. Emilio Rodriguez-Peris, M.D.
Title
Propietor
Phone
(401) 226-6248

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X MD10391 RI Primary

Addresses

Primary practice location

655 Broad Street
Suite 201
Providence, RI 02907-1510

Mailing address

655 Broad Street
Suite 201
Providence, RI 02907-1510
Phone (401) 383-6748

Other identifiers 1

IdentifierTypeStateIssuer
ER48067MedicaidRI

National Provider Directory

National Provider Directory

Locations

21 Peace St
Fl 5
Providence, RI 02907
Phone (401) 383-6748

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301616000000",
    "number": "1295952802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "655 BROAD STREET",
            "address_2": "SUITE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071510",
            "telephone_number": "401-383-6748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 BROAD STREET",
            "address_2": "SUITE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071510",
            "telephone_number": "401-383-6748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERIS MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2011-04-01",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ-PERIS",
        "authorized_official_first_name": "EMILIO",
        "authorized_official_title_or_position": "PROPIETOR",
        "authorized_official_telephone_number": "401-226-6248",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD10391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ER48067",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.