NPIMap

Individual provider Active NPI

Carla C Moreira, MD

  • Vascular Surgery Physician
  • Providence, RI
National Provider Identifier
1487815478
Registry record updated Jun 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
MD14998 Issued in RI
Practice address
2 Dudley St
Suite 470
Providence, RI 02905-3236
Phone
(401) 272-1800
Fax
(401) 435-7069
NPI assigned
Jun 23, 2008
Last updated
Jun 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X LP01478 RI
Vascular Surgery Physician 2086S0129X MD14998 RI Primary

Addresses

Primary practice location

2 Dudley St
Suite 470
Providence, RI 02905-3236

Mailing address

PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625

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
I20150731014293 RI Practitioner - Vascular Surgery 8921230020 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
University Surgical Associates, Inc.Group PAC ID 4082503032, 105 clinicians

Practice addresses (Care Compare)

2 Dudley St
Suite 470
Providence, RI 02905-3248
Phone (401) 272-1800

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal27
Leg revascularization (restoring blood flow)11
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP01478RIMDSurgery Physician
MD14998RIMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Current Accepting new patients
University Surgical Associates, Inc. Surgery CurrentSince Aug 1, 2015 Accepting new patients
Lifespan Physician Group, Inc. Surgery CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

1407 S County Trl
Ste 423
East Greenwich, RI 02818
Phone (401) 228-0590

1524 Atwood Ave
Ste 335
Johnston, RI 02919
Phone (401) 553-8318

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

2 Dudley St
Ste 470
Providence, RI 02905
Phone (401) 274-7546

Interoperability endpoints

  • Direct secure messaging: carla.moreira.usasurg@direct-address.net

Organizations & group practices 5

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433462400000",
    "number": "1487815478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16149",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029160697",
            "telephone_number": "401-453-9625",
            "fax_number": "401-435-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST",
            "address_2": "SUITE 470",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053236",
            "telephone_number": "401-272-1800",
            "fax_number": "401-435-7069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOREIRA",
        "first_name": "CARLA",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2015-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "LP01478",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "RI",
            "license": "MD14998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.