Individual provider Active NPI

Charles R Rardin, MD

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Providence, RI
National Provider Identifier
1497788657
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
MD11196 Issued in RI
Practice address
101 Plain St
Providence, RI 02903-4828
Phone
(401) 453-7560
Fax
(401) 453-7573
NPI assigned
Jul 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X MD11196 RI
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X MD11196 RI Primary

Addresses

Primary practice location

101 Plain St
Providence, RI 02903-4828

Mailing address

101 Dudley St
Providence, RI 02905-2401
Phone (401) 274-1100

Other practice location 1

101 Dudley St
Providence, RI 02905-2401
Phone (401) 274-1100

Other identifiers 1

IdentifierTypeStateIssuer
1497788657MedicaidRI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address crardin@wih.cernerdirect.carene.org Direct
Direct Messaging Address crardin@direct.carene.org Health Information Exchange (HIE)

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
I20120307000241 RI Practitioner - Obstetrics/Gynecology 7214958677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Rochester School of Medicine and Dentistry, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD11196RIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. Obstetrics & Gynecology CurrentSince Jan 1, 2017 Accepting new patients
Women & Infants Hospital of Rhode Island CurrentSince Jan 31, 2018 Accepting new patients
Affinity Physicians LLC CurrentSince Jan 1, 2017 Accepting new patients
Wih Faculty Physicians, Inc Obstetrics & Gynecology Past Accepting new patients

Locations

373 New Boston Rd
Ste 3
Fall River, MA 02720
Phone (508) 235-3500

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

101 Plain St
Providence, RI 02903
Phone (401) 272-7127

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

101 Plain St
Ste 5
Providence, RI 02903
Phone (401) 453-7560

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: crardin@direct.carene.org

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1152403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1497788657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052401",
            "telephone_number": "401-274-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PLAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034828",
            "telephone_number": "401-453-7560",
            "fax_number": "401-453-7573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-274-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RARDIN",
        "first_name": "CHARLES",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-09",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "RI",
            "license": "MD11196",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "RI",
            "license": "MD11196",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1497788657",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crardin@wih.cernerdirect.carene.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "101 Dudley St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029052401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crardin@direct.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "101 Plain St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029034828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.