Active NPI
Timothy Mariano, M.D., PH.D.
- Psychiatry Physician
- Providence, RI
National Provider Identifier
1366737280
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD14597
- Practice address
- 830 Chalkstone Ave
Providence, RI 02908-4734 - Phone
- (401) 273-7100
- NPI assigned
- Jun 20, 2011
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 263908 | MA | |
| Psychiatry Physician | 2084P0800X | MD14597 | RI | Primary |
Addresses
Primary practice location
830 Chalkstone Ave
Providence, RI 02908-4734
Mailing address
830 Chalkstone Ave
Providence, RI 02908-4734
Phone (401) 273-7100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151119000014 | MA | Practitioner - Psychiatry | 2466677927 | Reassigns benefits to 1 organization |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 263908 | MA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Child and Family Psychological Services, PLLC | Psychiatry | Current | Accepting new patients |
| The Providence Center | Psychiatry | Past | Accepting new patients |
Locations
110 Hartwell Ave
Ste 330
Lexington, MA 02421
Phone (617) 852-1334
2 Newton Executive Park
Newtonville, MA 02462
Phone (617) 313-7267
89 Access Rd
Ste 24
Norwood, MA 02062
Phone (781) 336-5040
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.
-
- Psychologist
- Norwood, MA
- NPI 1912987181
MA, Psychiatry
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1763078400000",
"number": "1366737280",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 CHALKSTONE AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029084734",
"telephone_number": "401-273-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 CHALKSTONE AVE",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029084734",
"telephone_number": "401-273-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARIANO",
"first_name": "TIMOTHY",
"name_prefix": "Dr.",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-20",
"last_updated": "2025-11-14",
"certification_date": "2025-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "263908",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "RI",
"license": "MD14597",
"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 Nov 14, 2025; 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.