NPIMap

Organization Active NPI

Primary Care Medical Associates of Cranston Inc

  • Internal Medicine Physician
  • Cranston, RI
National Provider Identifier
1346307485
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
10197 Issued in RI
Legal business name
PRIMARY CARE MEDICAL ASSOCIATES OF CRANSTON INC
Practice address
1596 Broad St
Cranston, RI 02905-4130
Phone
(401) 461-5400
Fax
(401) 461-9039
NPI assigned
Jan 1, 2007
Last updated
Mar 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Dr. Elizabeth G Dejesus, M.D.NPI 1134206360
Title
Medical Director
Phone
(401) 461-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 10197 RI Primary

Addresses

Primary practice location

1596 Broad St
Cranston, RI 02905-4130

Mailing address

1596 Broad St
Cranston, RI 02905-4130
Phone (401) 461-5400

National Provider Directory

National Provider Directory

Locations

1596 Broad St
Cranston, RI 02905
Phone (401) 461-5400

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1167609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1346307485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1596 BROAD ST",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029054130",
            "telephone_number": "401-461-5400",
            "fax_number": "401-461-9039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1596 BROAD ST",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029054130",
            "telephone_number": "401-461-5400",
            "fax_number": "401-461-9039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE MEDICAL ASSOCIATES OF CRANSTON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-01",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "DEJESUS",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "401-461-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "10197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; 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.