NPIMap

Organization Active NPI

Brown Urology, Inc.

Doing business as Collyer Street Operatory

  • Ambulatory Surgical Clinic/Center
  • Providence, RI
National Provider Identifier
1336658145
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
BROWN UROLOGY, INC.
Doing business as
Collyer Street Operatory
Practice address
195 Collyer St Ste 104
Providence, RI 02904-1869
Phone
(401) 276-2026
Fax
(401) 276-2025
NPI assigned
Sep 25, 2017
Last updated
Jan 16, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
BROWN UROLOGY, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

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

Authorized official

Name
Dr. Mark Sigman, MDNPI 1114038155
Title
President
Phone
(401) 421-0710

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208800000X
Ambulatory Surgical Clinic/Center 261QA1903X Primary
Durable Medical Equipment & Medical Supplies 332B00000X

Addresses

Primary practice location

195 Collyer St Ste 104
Providence, RI 02904-1869

Mailing address

110 Elm St FL 3
Providence, RI 02903-4626
Phone (401) 443-4379

Other names 1

  • Collyer Street Operatory Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20171206000082 RI Part B Supplier - Clinic/Group Practice 7810254513 Receives reassigned benefits from 41 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: East Providence, RI; Newport, RI; Providence, RI
O20210222001270 RI Part B Supplier - Ambulatory Surgical Center 7810254513 Practice locations: Providence, RI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336658145. Details of each certification follow.

Ambulatory surgical center certification: CCN 41C0001021

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Brown Urology, Inc DBA Collyer Street Operatory
Certification status
Active
Provider type (POS)
Ambulatory surgical center
Participating since
Mar 7, 2022
Last certification
Feb 7, 2022
Facility address
195 Collyer Street
Providence, RI 02904

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Brown Urology Inc5 organizations share this tax ID, including this one
Part of
Brown Urology Inc

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

110 Elm St
Fl 3
Providence, RI 02903

827 N Main St
Ste 4
Providence, RI 02904
Phone (401) 276-2060

900 Douglas Pike
Ste B2
Smithfield, RI 02917

Practitioners & affiliated clinicians

Practitioners 37

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.

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1336658145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 ELM ST FL 3",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034626",
            "telephone_number": "401-443-4379",
            "fax_number": "401-537-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 COLLYER ST STE 104",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041869",
            "telephone_number": "401-276-2026",
            "fax_number": "401-276-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROWN UROLOGY, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BROWN UROLOGY, INC.",
        "enumeration_date": "2017-09-25",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "SIGMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-421-0710",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Urology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Collyer Street Operatory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.