Marshall Benjamin Wold, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD10337 Issued in RI

Practice address

610 Wampanoag TRL
Riverside, RI 02915-1504

Phone

(401) 431-9870

Fax

(401) 435-7486

NPI assigned

Nov 23, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Specialty

Psychiatry

Education

Albany Medical College of Union University, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Bay Community Action ProgramGroup PAC ID 1951298595, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• East Bay Community Action Program

  • Community Health Clinic/Center
  • Riverside, RI
  • NPI 1609925122
  Medicare reassignment Care Compare group NPD
• East Bay Community Action Program

  • Community/Behavioral Health Agency
  • Riverside, RI
  • NPI 1609239920
  NPD
• East Bay Community Action Program

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Riverside, RI
  • NPI 1487916136
  NPD (past)
• Waterbury Hospital

  • General Acute Care Hospital
  • Waterbury, CT
  • NPI 1184615114
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701129600000",
    "number": "1396728200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 MIDDLE HWY",
            "city": "BARRINGTON",
            "state": "RI",
            "postal_code": "028061205",
            "telephone_number": "401-241-7736",
            "fax_number": "401-435-7486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029151504",
            "telephone_number": "401-431-9870",
            "fax_number": "401-435-7486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLD",
        "first_name": "MARSHALL",
        "middle_name": "BENJAMIN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2023-11-28",
        "certification_date": "2021-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "RI",
            "license": "MD10337",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF RI",
            "identifier": "25677-7",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "15-61526",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "408303",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7058679",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melanie F Willis, LICSW
• Christie Wilson, LMFT
• Lois C Winslet
• Peyton N Winstead Norwood, LISCW
• Mandy Witkin, LICSW
• Michael Wolfe
• Richard Craig Wood I, DMD
• Tony C Wu, M.D.
• Shannon Yager, LICSW
• Andrea Yattaw, LCSW

• Child & Adolescent Psychiatry Physician in Riverside, RI
• Providers in Riverside, RI by specialty
• Child & Adolescent Psychiatry Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.