Organization Active NPI

Premier Medical Group, Professional Corporation

  • Medical Specialty Clinic/Center
  • East Providence, RI
National Provider Identifier
1457545782
Registry record updated Sep 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
MD09655 Issued in RI
Legal business name
PREMIER MEDICAL GROUP, PROFESSIONAL CORPORATION
Practice address
400 Warren Ave
Suite 01
East Providence, RI 02914-3807
Phone
(401) 438-7778
Fax
(401) 438-9388
NPI assigned
Aug 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2010

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

Authorized official

Name
Dr. Muhammad S Akhtar, M.D.NPI 1548238918
Title
President
Phone
(401) 438-7778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X MD09655 RI Primary

Addresses

Primary practice location

400 Warren Ave
Suite 01
East Providence, RI 02914-3807

Mailing address

400 Warren Ave
Suite 01
East Providence, RI 02914-3807
Phone (401) 438-7778

Other names 1

  • MUHAMMAD AKHTAR, MD Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080519000496 RI Part B Supplier - Clinic/Group Practice 2567531478 Receives reassigned benefits from 1 practitioner
Practice locations: East Providence, RI

National Provider Directory

National Provider Directory

Locations

400 Warren Ave
Ste 1
East Providence, RI 02914
Phone (401) 438-7778

999 S Broadway
Ste 200
East Providence, RI 02914
Phone (401) 438-7778

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284595200000",
    "number": "1457545782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 WARREN AVE",
            "address_2": "SUITE 01",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029143807",
            "telephone_number": "401-438-7778",
            "fax_number": "401-438-9388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 WARREN AVE",
            "address_2": "SUITE 01",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029143807",
            "telephone_number": "401-438-7778",
            "fax_number": "401-438-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER MEDICAL GROUP, PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-29",
        "last_updated": "2010-09-16",
        "status": "A",
        "authorized_official_last_name": "AKHTAR",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-438-7778",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "RI",
            "license": "MD09655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MUHAMMAD AKHTAR, MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in East Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.