Active NPI
Amrit Pathak, MD
- Internal Medicine Physician
- Providence, RI
National Provider Identifier
1356725063
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD16202
- Practice address
- 593 Eddy St
Providence, RI 02903 - Phone
- (401) 444-4000
- NPI assigned
- Jul 13, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Internal Medicine Physician | 207R00000X | MD16202 | RI | Primary |
Addresses
Primary practice location
593 Eddy St
Providence, RI 02903
Mailing address
117 Ellenfield St Ste 101
Providence, RI 02905-4513
Phone (401) 444-6779
Other practice location 1
827 Linden Ave
Baltimore, MD 21201-4606
Phone (410) 225-8790
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: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Physician Group, Inc. | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Current | Accepting new patients |
Locations
185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050
117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318
593 Eddy St
Providence, RI 02903
Interoperability endpoints
- apathak635255@direct.healthsystem.virginia.edu
Organizations & group practices 2
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.
-
- General Practice Physician
- Providence, RI
- NPI 1407116643
-
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1436745600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527638400000",
"number": "1356725063",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "117 ELLENFIELD ST STE 101",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029054513",
"telephone_number": "401-444-6779",
"fax_number": "401-444-6912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "593 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "02903",
"telephone_number": "401-444-4000"
}
],
"practiceLocations": [
{
"address_1": "827 Linden Ave",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212014606",
"country_code": "US",
"telephone_number": "410-225-8790",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PATHAK",
"first_name": "AMRIT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-13",
"last_updated": "2018-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "RI",
"license": "MD16202",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.