Jonathan G Sabourin, DPM

Primary specialty

PodiatristTaxonomy code 213E00000X

License

DPM00316 Issued in RI

Practice address

850 Aquidneck Ave Ste 15
Middletown, RI 02842-7280

Phone

(401) 849-2157

Fax

(401) 848-8441

NPI assigned

Apr 8, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in RI, MA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Podiatry

Education

Kent State University College of Podiatric Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Foot and Ankle IncGroup PAC ID 0143586883, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074
• Saint Anne'S Hospital Hospital, Fall River, MA, CCN 220020
• Newport Hospital Hospital, Newport, RI, CCN 410006

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/20650/brand/1/csg/1/fhir/r4

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.

• Coastal Foot & Ankle Inc

  • Foot & Ankle Surgery Podiatrist
  • Middletown, RI
  • NPI 1275052755

  Foot & Ankle Surgery, MA, RI

  Medicare reassignment Care Compare group NPD Authorized official
• Coastal Foot & Ankle Inc

  • Podiatrist
  • Fall River, MA
  • NPI 1497230171
  NPD Authorized official
• Alan R. Nowick, DPM

  • Podiatrist
  • Providence, RI
  • NPI 1962437442
  NPD (past)
• Federal Hill Podiatry Group

  • Foot & Ankle Surgery Podiatrist
  • Providence, RI
  • NPI 1194846154

  Foot & Ankle Surgery

  NPD (past)
• Tollgate Chiropractic LTD

  • Chiropractor
  • Warwick, RI
  • NPI 1982909073
  NPD (past)
• Coastal Foot and Ankle, LLC

  • Podiatrist
  • Lewes, DE
  • NPI 1427195874
  NPD (past)

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

• Newport Hospital

  • General Acute Care Hospital
  • Newport, RI
  • NPI 1457346413

  Hospital

  Care Compare affiliation
• Lifespan of Massachusetts - Fall River Inc

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1972330165

  Hospital

  Care Compare affiliation
• Southcoast Hospitals Group, Inc

  • General Acute Care Hospital
  • Wareham, MA
  • NPI 1922024835

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1144454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1306809603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 AQUIDNECK AVE STE 15",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028427280",
            "telephone_number": "401-849-2157",
            "fax_number": "401-848-8441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 AQUIDNECK AVE STE 15",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028427280",
            "telephone_number": "401-849-2157",
            "fax_number": "401-848-8441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Hanover St Ste 2C",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027205451",
            "country_code": "US",
            "telephone_number": "508-258-1717",
            "fax_number": "774-365-6272",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SABOURIN",
        "first_name": "JONATHAN",
        "middle_name": "G",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-08",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "RI",
            "license": "DPM00316",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "MA",
            "license": "2210",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "RI",
            "license": "DPM00316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "212867",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7056541",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "411583",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Norman Eric Rudolph, MD
• Russell a Settipane MD
• Carol Marie Ryan, M.D.
• Meghan Ryan, LCSW
• Olivia Anne Ryding, OTR/L
• Sakonnet Eye Care, Inc.
• Antoine Salloum, MD
• Amy C Sanborn
• Paul E Sanders, LMHC, LCDP
• Victor Sandman

• All providers in Middletown, RI
• Podiatrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.