Individual provider Active NPI

Jamil Rashid Halaby III, NP

  • Primary Care Nurse Practitioner
  • East Providence, RI
National Provider Identifier
1508519943
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN03533 Issued in RI
Practice address
950 Warren Ave Ste 201
East Providence, RI 02914-1432
Phone
(855) 332-8474
Fax
(401) 606-1153
NPI assigned
Jan 26, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Primary Care Nurse Practitioner 363LP2300X APRN03533 RI Primary

Addresses

Primary practice location

950 Warren Ave Ste 201
East Providence, RI 02914-1432

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230508000092 RI Practitioner - Nurse Practitioner 2961867361 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
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
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-4102

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Miriam Hospital Current Accepting new patients
Rhode Island Hospital CurrentSince Nov 21, 2023 Accepting new patients
Rhode Island Hospital CurrentSince Nov 21, 2023 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jun 12, 2023 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jun 12, 2023 Accepting new patients
The Miriam Hospital CurrentSince Jun 12, 2023 Accepting new patients
The Miriam Hospital CurrentSince Jun 12, 2023 Accepting new patients
The Miriam Hospital Current Accepting new patients
Rhode Island Hospital Past Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

1454 S County Trl
Ste 2200
East Greenwich, RI 02818
Phone (401) 444-8516

950 Warren Ave
Ste 201
East Providence, RI 02914
Phone (855) 332-8474

900 Warren Ave
Ste 302
East Providence, RI 02914
Phone (401) 444-8344

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

407 East Ave
Ste 130
Pawtucket, RI 02860
Phone (401) 475-2505

593 Eddy St
Bldg 1ST
Providence, RI 02903

208 Collyer St
Ste 100
Providence, RI 02904
Phone (401) 793-7191

2 Dudley St
Providence, RI 02905
Phone (401) 444-2299

593 Eddy St
Providence, RI 02903

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

41 Sanderson Rd
Ste 103
Smithfield, RI 02917
Phone (401) 349-0366

Organizations & group practices 10

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": "1643155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681257600000",
    "number": "1508519943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WARREN AVE STE 201",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141432",
            "telephone_number": "855-332-8474",
            "fax_number": "401-606-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALABY",
        "first_name": "JAMIL",
        "middle_name": "RASHID",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-26",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "RI",
            "license": "APRN03533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.