Individual provider Active NPI

Carla M Quadros, NP

  • Acute Care Nurse Practitioner
  • Riverside, RI
National Provider Identifier
1417144908
Registry record updated Mar 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APRN00681 Issued in RI
Practice address
375 Wampanoag TRL
Riverside, RI 02915-2232
Phone
(401) 649-4070
Fax
(401) 649-4071
NPI assigned
Sep 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN00681 RI
Acute Care Nurse Practitioner 363LA2100X APRN00681 RI Primary

Addresses

Primary practice location

375 Wampanoag TRL
Riverside, RI 02915-2232

Mailing address

Dept 3010, PO Box 986524
Boston, MA 02298-6524
Phone (401) 443-4992

Other practice location 1

593 Eddy St
Claverick 2
Providence, RI 02903-4923
Phone (401) 444-4000

Other identifiers 2

IdentifierTypeStateIssuer
CQ40407MedicaidRI
001310501OtherMEDICARE

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091012000312 RI Practitioner - Nurse Practitioner 2668518283 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Brown MedicineGroup PAC ID 0446159776, 220 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-4102

375 Wampanoag TRL
Riverside, RI 02915-2232
Phone (401) 649-4010

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN00681RIMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Brown Medicine Nurse Practitioner CurrentSince Aug 1, 2023 Accepting new patients
The Miriam Hospital CurrentSince Jan 1, 2022 Accepting new patients
Brown Medicine Nurse Practitioner Current Accepting new patients
Lifespan Physician Group, Inc. Nurse Practitioner CurrentSince Jan 1, 2022 Accepting new patients
The Miriam Hospital Current Accepting new patients
The Miriam Hospital CurrentSince Jan 1, 2022 Accepting new patients
The Miriam Hospital Current Accepting new patients
Brown Medicine Nurse Practitioner Past Accepting new patients

Locations

450 Veterans Memorial Pkwy
East Providence, RI 02914
Phone (401) 431-0080

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

407 East Ave
Ste 120
Pawtucket, RI 02860
Phone (401) 725-4700

593 Eddy St
#2
Providence, RI 02903
Phone (401) 519-1604

208 Collyer St
Ste 100
Providence, RI 02904
Phone (401) 793-7191

110 Elm St
Providence, RI 02903
Phone (401) 443-4992

593 Eddy St
Providence, RI 02903

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

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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": "1190851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1417144908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3010, PO BOX 986524",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986524",
            "telephone_number": "401-443-4992",
            "fax_number": "401-537-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152232",
            "telephone_number": "401-649-4070",
            "fax_number": "401-649-4071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 EDDY ST",
            "address_2": "CLAVERICK 2",
            "address_purpose": "LOCATION",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUADROS",
        "first_name": "CARLA",
        "middle_name": "M",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-27",
        "last_updated": "2024-03-01",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN00681",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "RI",
            "license": "APRN00681",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CQ40407",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "001310501",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.