Individual provider Active NPI

Hilary Cerullo, DO

  • Psychiatry Physician
  • Cranston, RI
National Provider Identifier
1467514182
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
DO00624 Issued in RI
Practice address
989 Reservoir Ave Ste 101
Cranston, RI 02910-5138
Phone
(401) 572-3313
NPI assigned
Dec 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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 DO00624 RI Primary

Addresses

Primary practice location

989 Reservoir Ave Ste 101
Cranston, RI 02910-5138

Mailing address

4800 N Scottsdale Rd Ste 2500
Scottsdale, AZ 85251-7630

Other practice location 1

593 Eddy St
Potter 3
Providence, RI 02903-4923
Phone (401) 444-3534

Other identifiers 1

IdentifierTypeStateIssuer
DO00624OtherRISTATE OF RHODE ISLAND MEDICAL LICENSE

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
I20240731001275 RI Practitioner - Osteopathic Manipulative MedicinePractitioner - Psychiatry 6103993001 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative MedicineAlso: Psychiatry
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Child and Family Psychiatry, Inc.Group PAC ID 5294173464, 90 clinicians

Practice addresses (Care Compare)

989 Reservoir Ave
Suite 101
Cranston, RI 02910-5138
Phone (401) 572-3313

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychiatry, Inc. Psychiatry CurrentSince Jun 20, 2024 Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

989 Reservoir Ave
Ste 101
Cranston, RI 02910
Phone (401) 572-3313

1035 Post Rd
Warwick, RI 02888
Phone (401) 941-2830

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.hilarycerullo@151046.advancedmd-direct.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1467514182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "989 RESERVOIR AVE STE 101",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029105138",
            "telephone_number": "401-572-3313"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_2": "Potter 3",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-3534",
            "fax_number": "401-444-7865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CERULLO",
        "first_name": "HILARY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-16",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "DO00624",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF RHODE ISLAND MEDICAL LICENSE",
            "identifier": "DO00624",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.