Active NPI
Matthew Ballenberger, MD
- Pulmonary Disease Physician
- Riverside, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- MD19716
- Practice address
- 375 Wampanoag TRL
Riverside, RI 02915-2232 - Phone
- (401) 649-4070
- Fax
- (401) 649-4071
- NPI assigned
- Mar 20, 2017
- Last updated
- May 30, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 73520 | CT | |
| Internal Medicine Physician | 207R00000X | 306174 | NY | |
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | MD19716 | RI | |
| Pulmonary Disease Physician | 207RP1001X | MD19716 | RI | Primary |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | MD19716 | RI |
Addresses
Primary practice location
375 Wampanoag TRL
Riverside, RI 02915-2232
Mailing address
Dept 3010, PO Box 986524
Boston, MA 02298-6524
Phone (833) 924-5546
Other practice location 1
20 York St
New Haven, CT 06510-3220
Phone (203) 688-4242
Other practice location 2
100 E 77th St
New York, NY 10075-1850
Phone (212) 434-2140
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY, RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pulmonary Disease
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
146 W River St
Suite 11a
Providence, RI 02904-2609
Phone (401) 606-8250
164 Summit Ave
Providence, RI 02906-2853
185 A High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050
185 High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050
375 Wampanoag TRL
Riverside, RI 02915-2232
Phone (401) 649-4010
593 Eddy St
Providence, RI 02903-4923
593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172
593 Eddy St George BLDG 1St Floor
Providence, RI 02903-4923
Phone (401) 793-9166
900 Douglas Pike
Smithfield, RI 02917-1879
Phone (401) 618-5507
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73520 | CT | MD | Internal Medicine Physician |
| 306174 | NY | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North Shore-Lij Medical PC | Internal Medicine | Current | Accepting new patients |
| Rhode Island Hospital | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Current | Accepting new patients | |
| The Miriam Hospital | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Current | Accepting new patients | |
| Brown Medicine | Internal Medicine | Current | Accepting new patients |
| Brown Medicine | Current | Accepting new patients | |
| The Miriam Hospital | Current | Accepting new patients | |
| North Shore - Lij Medical PC | Internal Medicine | Current | Accepting new patients |
| Rhode Island Hospital | Current | Accepting new patients | |
| Brown Medicine | Critical Care Medicine | Past | Accepting new patients |
| Rhode Island Hospital | Past | Accepting new patients |
Locations
20 York St
North Haven, CT 06510
Phone (203) 688-2433
300 Community Dr
Manhasset, NY 11030
100 E 77th St
New York, NY 10075
Phone (212) 434-2606
972 Brush Hollow Rd
Westbury, NY 11590
1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000
185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050
110 Elm St
Providence, RI 02903
Phone (401) 443-4992
146 W River St
#11A
Providence, RI 02904
Phone (401) 606-8250
164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104
593 Eddy St
Providence, RI 02903
593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280
375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010
Organizations & group practices 12
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.
-
- Internal Medicine Physician
- Riverside, RI
- NPI 1689626764
-
dba Brown Health Medical Group
- General Practice Physician
- Providence, RI
- NPI 1407116643
-
- Multi-Specialty Clinic/Center
- Providence, RI
- NPI 1154537520
-
- General Acute Care Hospital
- Providence, RI
- NPI 1770520462
-
dba NHPP Cardiology at Great Neck
- Urology Physician
- Great Neck, NY
- NPI 1053688572
Internal Medicine
-
- Gastroenterology Physician
- Providence, RI
- NPI 1730827767
-
dba Brown Health Medical Group
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
-
- Cardiac Rehabilitation Clinic/Center
- East Greenwich, RI
- NPI 1518482389
-
dba NSLIJ Medical In Queens
- Internal Medicine Physician
- New Hyde Park, NY
- NPI 1790043479
-
- General Acute Care Hospital
- Providence, RI
- NPI 1588659528
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Newport, RI
- NPI 1457346413
-
- General Acute Care Hospital
- Providence, RI
- NPI 1588659528
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
-
- General Acute Care Hospital
- Providence, RI
- NPI 1487649430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1489968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717027200000",
"number": "1497296685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT 3010, PO BOX 986524",
"city": "BOSTON",
"state": "MA",
"postal_code": "022986524",
"telephone_number": "833-924-5546"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 WAMPANOAG TRL",
"city": "RIVERSIDE",
"state": "RI",
"postal_code": "029152232",
"telephone_number": "401-649-4070",
"fax_number": "401-649-4071"
}
],
"practiceLocations": [
{
"address_1": "20 York St",
"address_purpose": "LOCATION",
"city": "New Haven",
"state": "CT",
"postal_code": "065103220",
"country_code": "US",
"telephone_number": "203-688-4242",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "100 E 77th St",
"address_purpose": "LOCATION",
"city": "New York",
"state": "NY",
"postal_code": "100751850",
"country_code": "US",
"telephone_number": "212-434-2140",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BALLENBERGER",
"first_name": "MATTHEW",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-03-20",
"last_updated": "2024-05-30",
"certification_date": "2024-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "CT",
"license": "73520",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "NY",
"license": "306174",
"primary": false
},
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "RI",
"license": "MD19716",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "RI",
"license": "MD19716",
"primary": true
},
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "RI",
"license": "MD19716",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Riverside, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.