NPIMap

Individual provider Active NPI

Warren E Licht, MD

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1447298641
Registry record updated Nov 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD08167 Issued in RI
Practice address
909 N Main St
Suite 300
Providence, RI 02904-5752
Phone
(401) 273-4064
Fax
(401) 273-1268
NPI assigned
Jun 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD08167 RI Primary

Addresses

Primary practice location

909 N Main St
Suite 300
Providence, RI 02904-5752

Mailing address

PO Box 1358
Providence, RI 02901-1358

Other identifiers 1

IdentifierTypeStateIssuer
7004159MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040614000017 RI Practitioner - Internal Medicine 6204819899 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians
Brown MedicineGroup PAC ID 0446159776, 220 clinicians

Practice addresses (Care Compare)

909 N Main St
Suite 300
Providence, RI 02904-5752
Phone (401) 649-4000

Hospital & facility affiliations

  • Concord Health Services Home health agency, Cranston, RI, CCN 417049
  • Amedisys Home Health Care Home health agency, Warwick, RI, CCN 417036
  • Elara Caring Home health agency, Warwick, RI, CCN 417035
  • Hopehealth Hospice & Palliative Care Hospice, Providence, RI, CCN 411500
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009
  • Newport Hospital Hospital, Newport, RI, CCN 410006
  • Women & Infants Hospital of Rhode Island Hospital, Providence, RI, CCN 410010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD08167RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Brown Medicine CurrentSince Jan 1, 2000 Accepting new patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Brown Medicine Internal Medicine CurrentSince Jan 1, 2000 Accepting new patients

Locations

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

909 N Main St
Ste 300
Providence, RI 02904
Phone (401) 273-4064

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

593 Eddy St
#5
Providence, RI 02903
Phone (401) 444-3032

593 Eddy St
Providence, RI 02903

909 N Main St
Providence, RI 02904
Phone (401) 273-4064

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

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447718400000",
    "number": "1447298641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1358",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029011358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 N MAIN ST",
            "address_2": "SUITE 300",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045752",
            "telephone_number": "401-273-4064",
            "fax_number": "401-273-1268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHT",
        "first_name": "WARREN",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2015-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD08167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004159",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.