Active NPI
Brian P Casserly, M.D.
- Pulmonary Disease Physician
- Pawtucket, RI
National Provider Identifier
1407073901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MD12646
- Practice address
- 111 Brewster St
Pulmonary Department
Pawtucket, RI 02860-4400 - Phone
- (401) 729-2636
- Fax
- (401) 729-2157
- NPI assigned
- Apr 19, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | MD12646 | RI | Primary |
Addresses
Primary practice location
111 Brewster St
Pulmonary Department
Pawtucket, RI 02860-4400
Mailing address
111 Brewster St
Pulmonary Department
Pawtucket, RI 02860-4400
Phone (401) 729-2636
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007060296 | Other | RI | MEDICARE PTAN |
| BC72040 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital | Pulmonary Disease | Past | Accepting new patients |
Organizations & group practices 1
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": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1273708800000",
"number": "1407073901",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 BREWSTER ST",
"address_2": "PULMONARY DEPARTMENT",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028604400",
"telephone_number": "401-729-2636",
"fax_number": "401-729-2157"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 BREWSTER ST",
"address_2": "PULMONARY DEPARTMENT",
"city": "PAWTUCKET",
"state": "RI",
"postal_code": "028604400",
"telephone_number": "401-729-2636",
"fax_number": "401-729-2157"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSERLY",
"first_name": "BRIAN",
"middle_name": "P",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-19",
"last_updated": "2010-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "RI",
"license": "MD12646",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "007060296",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "BC72040",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pawtucket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.