Individual provider Active NPI

Jerome M Larkin, MD

  • Infectious Disease Physician
  • Providence, RI
National Provider Identifier
1306884689
Registry record updated Feb 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD11946 Issued in RI
Practice address
593 Eddy St
Gerry 113
Providence, RI 02903-4923
Phone
(401) 444-8130
Fax
(401) 444-8154
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD11946 RI Primary

Addresses

Primary practice location

593 Eddy St
Gerry 113
Providence, RI 02903-4923

Mailing address

PO Box 1358
Providence, RI 02901-1358

Other identifiers 2

IdentifierTypeStateIssuer
7058131MedicaidRI
3170411MedicaidMA

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20051201000291 RI Practitioner - Infectious Disease 0446270722 Reassigns benefits to 3 organizations
I20220302001989 MA Practitioner - Infectious Disease 0446270722 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD11946RIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sturdy Memorial Hospital Inc CurrentSince Feb 23, 2022 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2015 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2015 Accepting new patients
The Miriam Hospital CurrentSince Dec 12, 2011 Accepting new patients
Sturdy Health, Inc. Infectious Disease Past Accepting new patients

Locations

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

593 Eddy St
Providence, RI 02903

1125 N Main St
Providence, RI 02904
Phone (401) 793-2928

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

593 Eddy St
Ste 113
Providence, RI 02903
Phone (401) 444-8130

593 Eddy St
#113
Providence, RI 02903
Phone (401) 444-8130

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

Organizations & group practices 6

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234224000000",
    "number": "1306884689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1358",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029011358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "GERRY 113",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8130",
            "fax_number": "401-444-8154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARKIN",
        "first_name": "JEROME",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2009-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "RI",
            "license": "MD11946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7058131",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3170411",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.