Denis E Moonan Jr., M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

MD05654 Issued in RI

Practice address

1515 Smith St
Suite N
North Providence, RI 02911-2947

Phone

(401) 353-0555

Fax

(401) 353-7079

NPI assigned

Nov 16, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Prospect Chartercare RWMC, LLC

  • Internal Medicine Physician
  • Providence, RI
  • NPI 1285059287

  Addiction Medicine

  Medicare reassignment NPD
• Prospect Chartercare RWMC, LLC

  • Cardiovascular Disease Physician
  • Providence, RI
  • NPI 1326463548
  NPD

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473379200000",
    "number": "1386626174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 SMITH ST",
            "address_2": "SUITE N",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029112947",
            "telephone_number": "401-353-0555",
            "fax_number": "401-353-7079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SMITH ST",
            "address_2": "SUITE N",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029112947",
            "telephone_number": "401-353-0555",
            "fax_number": "401-353-7079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONAN",
        "first_name": "DENIS",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-16",
        "last_updated": "2016-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "RI",
            "license": "MD05654",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "RI",
            "license": "MD05654",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "RI",
            "license": "MD05654",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9002408",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "24088",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher James Mollica, MA
• Marisol Monge, LMT
• Ashley Monger, PA-C
• Rafael Montalvo Ayala, MD
• Nola A Monti, CRNA
• Samantha Berenice Mora, DDS
• Christine Lee Moreau, LCSW
• Moshlaw Transport
• Nancy Serabian
• Rodrigo Nardi, M.D.

• Geriatric Medicine (Internal Medicine) Physician in North Providence, RI
• Providers in North Providence, RI by specialty
• Geriatric Medicine (Internal Medicine) Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2016; 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.

Verify at the official NPI Registry.