Primary Care Medical Associates of Cranston Inc

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

Organization subpart

No

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.

Title

Medical Director

Phone

(401) 461-5400

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

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

• Levis M. Guzman, MD

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1154363695
  NPD (past)
• Carlos Lira, MD

  • Internal Medicine Physician
  • Boynton Beach, FL
  • NPI 1376598045
  NPD (past)

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": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PC54016",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "2982",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "469187",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADVANTRA",
            "identifier": "759600",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Les R Prasad, D.D.S
• Robert Pratt, DC
• Premier Home Care LLC
• Premium Home Health Care
• Prescription Compounding Specialists of Ri, Inc.
• Emily Primiano, MASTERS
• Kayla Prior, PT
• Procare Therapy Services, Inc
• Teresa Jean Proctor, PT
• Kimberly Anna Propert, MSN, FNP-BC

• Internal Medicine Physician in Cranston, RI
• Providers in Cranston, RI by specialty
• Internal Medicine Physician in Rhode Island

• 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.