Active NPI
Michael P Vezeridis, MD
- Surgery Physician
- Providence, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- MD06270
- Practice address
- 2 Dudley St
Suite 470
Providence, RI 02905-3236 - Phone
- (401) 331-1036
- Fax
- (401) 868-2317
- NPI assigned
- Nov 16, 2005
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | MD06270 | RI | Primary |
Addresses
Primary practice location
2 Dudley St
Suite 470
Providence, RI 02905-3236
Mailing address
PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9006495 | Medicaid | RI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Michael.Vezeridis.usasurg@direct-address.net | Direct |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- Other, 1967
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
593 Eddy St
Providence, RI 02903-4923
950 Warren Ave
Suite 103
East Providence, RI 02914-1432
Phone (401) 606-4325
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 423 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD06270 | RI | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Corporation | Current | Accepting new patients | |
| Rhode Island Hospital | Current | Accepting new patients | |
| Rhode Island Hospital | Current | Accepting new patients | |
| Rhode Island Hospital | Past | Accepting new patients |
Locations
1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000
950 Warren Ave
Ste 103
East Providence, RI 02914
Phone (401) 606-4325
2 Dudley St
Ste 190
Providence, RI 02905
Phone (401) 228-0555
2 Dudley St
Ste 470
Providence, RI 02905
Phone (401) 274-7546
593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280
Interoperability endpoints
- michael.vezeridis.usasurg@direct-address.net
- mvezeridis15009@brownhealth.medalliesdirect.net
Organizations & group practices 4
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.
-
- Multi-Specialty Clinic/Center
- Providence, RI
- NPI 1154537520
-
- Children's Rehabilitation Hospital
- Providence, RI
- NPI 1790221232
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
-
- General Acute Care Hospital
- Providence, RI
- NPI 1588659528
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Providence, RI
- NPI 1588659528
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580256000000",
"number": "1437131430",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 16149",
"city": "RUMFORD",
"state": "RI",
"postal_code": "029160697",
"telephone_number": "401-453-9625",
"fax_number": "401-435-7069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 DUDLEY ST",
"address_2": "SUITE 470",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029053236",
"telephone_number": "401-331-1036",
"fax_number": "401-868-2317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VEZERIDIS",
"first_name": "MICHAEL",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-11-16",
"last_updated": "2020-01-29",
"certification_date": "2020-01-29",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "RI",
"license": "MD06270",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9006495",
"state": "RI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Michael.Vezeridis.usasurg@direct-address.net",
"affiliation": "N",
"endpointDescription": "Direct",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2 Dudley St",
"address_2": "Suite 470",
"city": "Providence",
"state": "RI",
"country_code": "US",
"postal_code": "029053236",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.