Individual provider Active NPI

Farrel Ivan Klein, M.D.

  • Psychiatry Physician
  • Newport, RI
National Provider Identifier
1447364559
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD06671 Issued in RI
Practice address
19 Friendship St
G20
Newport, RI 02840-2272
Phone
(401) 845-4340
Fax
(401) 845-4359
NPI assigned
Aug 18, 2006
Last updated
Sep 27, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD06671 RI Primary

Addresses

Primary practice location

19 Friendship St
G20
Newport, RI 02840-2272

Mailing address

19 Friendship St
Suite G20
Newport, RI 02840-2272
Phone (401) 845-4340

Other identifiers 1

IdentifierTypeStateIssuer
7002464MedicaidRI

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
I20120208000009 RI Practitioner - Psychiatry 5395902043 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD06671RIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. Psychiatry CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients

Locations

19 Friendship St
Unit G20
Newport, RI 02840
Phone (401) 845-1562

79 Turnpike Ave
Portsmouth, RI 02871
Phone (401) 683-7434

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

593 Eddy St
Providence, RI 02903

Organizations & group practices 2

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1447364559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 FRIENDSHIP ST",
            "address_2": "SUITE G20",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402272",
            "telephone_number": "401-845-4340",
            "fax_number": "401-845-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 FRIENDSHIP ST",
            "address_2": "G20",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402272",
            "telephone_number": "401-845-4340",
            "fax_number": "401-845-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "FARREL",
        "middle_name": "IVAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD06671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7002464",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, RI

Sources for this page

Verify at the official NPI Registry.