NPIMap

Organization Active NPI

Diabetes & Endocrinology Associates, Inc.

  • Endocrinology, Diabetes & Metabolism Physician
  • Providence, RI
National Provider Identifier
1407954415
Registry record updated Jan 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
Legal business name
DIABETES & ENDOCRINOLOGY ASSOCIATES, INC.
Practice address
100 Highland Ave
Providence, RI 02906-2740
Phone
(401) 351-7100
NPI assigned
Sep 21, 2006
Last updated
Jan 12, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2015

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

Authorized official

Name
Charles B Kahn, M.D.
Title
President
Phone
(401) 351-7100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X NU Primary

Addresses

Primary practice location

100 Highland Ave
Providence, RI 02906-2740

Mailing address

100 Highland Ave
Providence, RI 02906-2740
Phone (401) 351-7100

Other identifiers 1

IdentifierTypeStateIssuer
9000831MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070129000662 RI Part B Supplier - Clinic/Group Practice 0749281087 Receives reassigned benefits from 6 practitioners
Practice locations: Lincoln, RI; Providence, RI; Warwick, RI

National Provider Directory

National Provider Directory

Locations

49 Seekonk St
Providence, RI 02906
Phone (401) 230-1126

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421020800000",
    "number": "1407954415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062740",
            "telephone_number": "401-351-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGHLAND AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062740",
            "telephone_number": "401-351-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIABETES & ENDOCRINOLOGY ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2015-01-12",
        "status": "A",
        "authorized_official_last_name": "KAHN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-351-7100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000831",
            "state": "RI"
        }
    ],
    "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 Jan 12, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.