Individual provider Active NPI

Tanya Orie Rogo, M.D.

  • Pediatric Infectious Diseases Physician
  • Bronx, NY
National Provider Identifier
1417123886
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Infectious Diseases PhysicianTaxonomy code 2080P0208X
License
MD13436 Issued in RI
Practice address
1276 Fulton Ave RM 208
Bronx, NY 10456-3402
Phone
(171) 890-1891
Fax
(718) 901-8918
NPI assigned
May 5, 2008
Last updated
Jul 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 13436 RI
Pediatrics Physician 208000000X 288135 NY
Pediatric Infectious Diseases Physician 2080P0208X MD13436 RI Primary

Addresses

Primary practice location

1276 Fulton Ave RM 208
Bronx, NY 10456-3402

Mailing address

1276 Fulton Ave RM 208
Bronx, NY 10456-3402
Phone (718) 901-8918

Other practice location 1

593 Eddy Street
Providence, RI 02903-4970
Phone (401) 519-1604

Other practice location 2

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-6195

Other practice location 3

101 Dudley St
Providence, RI 02905-2401
Phone (401) 274-1122

Other identifiers 1

IdentifierTypeStateIssuer
939025129OtherRIRI MEDICARE GROUP

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20110315000029 RI Practitioner - Pediatric Medicine 7416139316 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13436RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Sep 1, 2021 Accepting new patients
Affinity Physicians LLC. Pediatrics CurrentSince Sep 1, 2021 Accepting new patients
The Miriam Hospital CurrentSince Aug 6, 2022 Accepting new patients
Rhode Island Hospital Pediatrics CurrentSince Sep 1, 2021 Accepting new patients
Rhode Island Hospital CurrentSince Sep 1, 2021 Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

1125 N Main St
Providence, RI 02904
Phone (401) 793-2928

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

180 Corliss St
Ste E1
Providence, RI 02904
Phone (401) 793-2928

593 Eddy St
Providence, RI 02903

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626739200000",
    "number": "1417123886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE RM 208",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "718-901-8918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1276 FULTON AVE RM 208",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104563402",
            "telephone_number": "171-890-1891",
            "fax_number": "718-901-8918"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy Street",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034970",
            "country_code": "US",
            "telephone_number": "401-519-1604",
            "fax_number": "401-272-0538",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-6195",
            "fax_number": "401-444-6378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-274-1122",
            "fax_number": "401-453-7571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGO",
        "first_name": "TANYA",
        "middle_name": "ORIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-05",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "13436",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "288135",
            "primary": false
        },
        {
            "code": "2080P0208X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Infectious Diseases",
            "state": "RI",
            "license": "MD13436",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI MEDICARE GROUP",
            "identifier": "939025129",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.