NPIMap

Individual provider Active NPI

Kristine May Angeles Mortel-Duque, M.D

  • Internal Medicine Physician
  • Woonsocket, RI
National Provider Identifier
1396905832
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD13092 Issued in RI
Practice address
25 John a Cummings Way
Box # 3
Woonsocket, RI 02895-3224
Phone
(401) 766-6066
Fax
(401) 766-6672
NPI assigned
Jun 9, 2008
Last updated
Jan 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD13092 RI Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD13092 RI

Addresses

Primary practice location

25 John a Cummings Way
Box # 3
Woonsocket, RI 02895-3224

Mailing address

1525 Wampanoag TRL Ste 202
Riverside, RI 02915-1038
Phone (508) 361-0405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091028000266 RI Practitioner - Internal MedicinePractitioner - Geriatric Medicine 2062559883 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
By Faith LLCGroup PAC ID 2163944471, 2 clinicians
Prospect Chartercare RWMC, LLCGroup PAC ID 0547492696, 66 clinicians

Practice addresses (Care Compare)

1525 Wampanoag TRL
Suite 202
Riverside, RI 02915-1038
Phone (401) 365-6113

425 Albion Rd
Lincoln, RI 02865-4204
Phone (401) 333-1473

825 Chalkstone Ave
Providence, RI 02908-4735

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD13092RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare RWMC, LLC Internal Medicine CurrentSince Jun 1, 2014 Accepting new patients
Prospect Chartercare RWMC, LLC CurrentSince Jun 1, 2014 Accepting new patients
Chartercare Roger Williams Medical Center Internal Medicine CurrentSince Aug 1, 2025 Accepting new patients
By Faith LLC Internal Medicine CurrentSince Feb 28, 2025 Accepting new patients
Pulmonary and Sleep Office of New England PC Past Accepting new patients

Locations

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

1525 Wampanoag Trl
Ste 202
Riverside, RI 02915
Phone (401) 203-3636

Interoperability endpoints

  • Direct secure messaging: kristine.mortel.1@32919.direct.athenahealth.com
  • Direct secure messaging: kristine.mortel@direct.chartercare.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1396905832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 WAMPANOAG TRL STE 202",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029151038",
            "telephone_number": "508-361-0405",
            "fax_number": "401-766-6672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 JOHN A CUMMINGS WAY",
            "address_2": "BOX # 3",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953224",
            "telephone_number": "401-766-6066",
            "fax_number": "401-766-6672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTEL-DUQUE",
        "first_name": "KRISTINE MAY",
        "middle_name": "ANGELES",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD13092",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "RI",
            "license": "MD13092",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.