Individual provider Active NPI

Lunia Estela Collado, MD

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1346801404
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD18725 Issued in RI
Practice address
650 Branch Ave Ste 6
Providence, RI 02904-1728
Phone
(401) 753-0336
Fax
(401) 519-6985
NPI assigned
Jun 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD18725 RI Primary

Addresses

Primary practice location

650 Branch Ave Ste 6
Providence, RI 02904-1728

Mailing address

PO Box 746088
Atlanta, GA 30374-6088
Phone (312) 733-9730

Other identifiers 2

IdentifierTypeStateIssuer
CLP04767OtherRIRI DEPARTMENT OF HEALTH
LP04767OtherRIRI DEPARTMENT OF HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20220919001198 RI Practitioner - Internal Medicine 2163757204 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh - Ri Physicians Group PCGroup PAC ID 5193051936, 32 clinicians

Practice addresses (Care Compare)

650 Branch Ave
Suite 6
Providence, RI 02904-1728
Phone (401) 536-9144

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD18725RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osh - Ri Physicians Group, PC Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

650 Branch Ave
Providence, RI 02904

650 Branch Ave
Ste 6
Providence, RI 02904
Phone (401) 233-5055

300 Quaker Ln
Warwick, RI 02886
Phone (401) 233-5051

Organizations & group practices 1

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": "1561593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1346801404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746088",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746088",
            "telephone_number": "312-733-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 BRANCH AVE STE 6",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041728",
            "telephone_number": "401-753-0336",
            "fax_number": "401-519-6985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLADO",
        "first_name": "LUNIA",
        "middle_name": "ESTELA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-27",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD18725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI DEPARTMENT OF HEALTH",
            "identifier": "CLP04767",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI DEPARTMENT OF HEALTH",
            "identifier": "LP04767",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.