Individual provider Active NPI

Rafael Enrique Liporaci Lucena, MD

  • Internal Medicine Physician
  • Pawtucket, RI
National Provider Identifier
1366715633
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD15059 Issued in RI
Practice address
174 Armistice Blvd
Pawtucket, RI 02860-3280
Phone
(401) 723-7578
NPI assigned
Feb 17, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

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 MD15059 RI Primary

Addresses

Primary practice location

174 Armistice Blvd
Pawtucket, RI 02860-3280

Mailing address

3 Regency PLZ
Apt 709E
Providence, RI 02903-3161
Phone (917) 297-0916

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
I20151103001817 RI Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2860702859 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare Physicians, LLC Internal Medicine CurrentSince Sep 1, 2015 Accepting new patients
Prospect Chartercare RWMC, LLC Current Accepting new patients

Locations

1681 Cranston St
Cranston, RI 02920
Phone (401) 944-6889

174 Armistice Blvd
Pawtucket, RI 02860
Phone (401) 723-7578

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

Interoperability endpoints

  • Direct secure messaging: rafael.liporaci@direct.chartercare.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1366715633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 REGENCY PLZ",
            "address_2": "APT 709E",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029033161",
            "telephone_number": "917-297-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 ARMISTICE BLVD",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028603280",
            "telephone_number": "401-723-7578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPORACI LUCENA",
        "first_name": "RAFAEL",
        "middle_name": "ENRIQUE",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-17",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD15059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.