Individual provider Active NPI

Michael Simonetti, PA-C

  • Physician Assistant
  • Warwick, RI
National Provider Identifier
1467429910
Registry record updated Dec 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00225 Issued in RI
Practice address
125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone
(401) 432-2520
Fax
(401) 453-8220
NPI assigned
Mar 3, 2006
Last updated
Dec 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA1130 MA
Physician Assistant 363A00000X PA00225 RI Primary

Addresses

Primary practice location

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785

Mailing address

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone (401) 432-2520

Other practice location 1

400 Putnam Pike
Smithfield, RI 02917-2408
Phone (401) 757-6160

Other practice location 2

211 Park St
Attleboro, MA 02703-3137
Phone (508) 222-5200

Other practice location 3

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-3850

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080229000630 RI Practitioner - Physician Assistant 0749202422 Reassigns benefits to 2 organizations
I20201016000248 MA Practitioner - Physician Assistant 0749202422 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island Medical Imaging IncGroup PAC ID 8022097815, 107 clinicians

Practice addresses (Care Compare)

1 Kettle Point Ave
East Providence, RI 02914-5375
Phone (401) 626-3900

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.17 of 100Reported as group
Quality
82.44
Improvement activities
40
Cost
86.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA00225RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Corporation Current Accepting new patients
Rhode Island Medical Imaging Inc CurrentSince Jun 25, 2014 Accepting new patients
Newport County Medical Treatment Office Past Accepting new patients
Nes Rhode Island, Inc. Past Accepting new patients

Locations

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

982 Tiogue Ave
Coventry, RI 02816
Phone (401) 615-3140

20 Catamore Blvd
East Providence, RI 02914
Phone (401) 432-2520

1637 Mineral Spring Ave
Ste 115
North Providence, RI 02904
Phone (401) 353-0330

200 High Service Ave
North Providence, RI 02904
Phone (401) 456-3000

1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500

593 Eddy St
Providence, RI 02903

125 Metro Center Blvd
Ste 2000
Warwick, RI 02886
Phone (401) 432-2520

Interoperability endpoints

  • Direct secure messaging: michael.simonetti.1@31278.direct.athenahealth.com
  • Direct secure messaging: msimonetti14914@brownhealth.medalliesdirect.net

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1141344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671580800000",
    "number": "1467429910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2520",
            "fax_number": "401-453-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2520",
            "fax_number": "401-453-8220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Putnam Pike",
            "address_purpose": "LOCATION",
            "city": "Smithfield",
            "state": "RI",
            "postal_code": "029172408",
            "country_code": "US",
            "telephone_number": "401-757-6160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "211 Park St",
            "address_purpose": "LOCATION",
            "city": "Attleboro",
            "state": "MA",
            "postal_code": "027033137",
            "country_code": "US",
            "telephone_number": "508-222-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-3850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONETTI",
        "first_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-03",
        "last_updated": "2022-12-21",
        "certification_date": "2022-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA1130",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.