Prospect Chartercare RWMC, LLC

Organization Active NPI Cardiovascular Disease Physician · Providence, RI

NPI 1326463548 · NPPES record last updated Jan 11, 2021

Key facts

NPI
1326463548
Entity type
Organization (NPI type 2)
Primary specialty
Cardiovascular Disease Physician 207RC0000X
Legal business name
PROSPECT CHARTERCARE RWMC, LLC
Practice address
825 Chalkstone Ave
Providence, RI 02908-4728
Phone
(401) 456-2000
Fax
(401) 456-2029
NPI assigned
Feb 25, 2014
Organization subpart
No

Authorized official

Name
Robert Jon Elders
Title
Secretary
Phone
(714) 788-1249

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 198

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

View all 198

Medicare participation

Medicare fee-for-service enrollment
Enrolled in RI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20140728001672 RI Part B Supplier - Clinic/Group Practice 0547492696 Receives reassigned benefits from 182 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Warren, RI; E Providence, RI; Wakefield, RI; Providence, RI; North Providence, RI; Lincoln, RI; Johnston, RI; Greenville, RI…

National Provider Directory

Locations

1539 Atwood Ave
Johnston, RI 02919
Phone (401) 272-3410

2 Atlantic Blvd
North Providence, RI 02911
Phone (401) 231-0450

Interoperability endpoints

  • Direct secure messaging: riacobucci@direct.chartercare.org
  • Direct secure messaging: rafael.liporaci@direct.chartercare.org
  • Direct secure messaging: keya.malhotra@direct.chartercare.org
  • Direct secure messaging: jbonadona@direct.chartercare.org
  • Direct secure messaging: leanne.nadeau@direct.chartercare.org
  • Direct secure messaging: psampath@direct.chartercare.org
  • Direct secure messaging: andrea.demers@direct.chartercare.org
  • Direct secure messaging: shahzad.khurshid@direct.chartercare.org
  • Direct secure messaging: rbrown@direct.chartercare.org
  • Direct secure messaging: vincent.perrelli@direct.chartercare.org
  • Direct secure messaging: diane.dubois_hall@direct.chartercare.org
  • Direct secure messaging: kristine.mortel@direct.chartercare.org
  • Direct secure messaging: peter.ameck@direct.chartercare.org
  • Direct secure messaging: anna.bunch@direct.chartercare.org
  • Direct secure messaging: ralph.santoro@direct.chartercare.org
  • Direct secure messaging: jeffrey.drogin@direct.chartercare.org
  • Direct secure messaging: maria.soriano@direct.chartercare.org
  • Direct secure messaging: neenoofar.haneef@direct.chartercare.org
  • Direct secure messaging: egrote@direct.chartercare.org
  • Direct secure messaging: jstoukid@direct.chartercare.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
133N00000X
Cardiovascular Disease Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
207RC0000X Yes

Addresses

Primary practice location

825 Chalkstone Ave
Providence, RI 02908-4728

Mailing address

825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-2000

Other names

  • Roger Williams Medical Center Doing business as

Other providers in Providence, RI

All providers in Providence, RI · Cardiovascular Disease Physician in Rhode Island

Sources for this page

Verify at the official NPI Registry.