NPIMap

Individual provider Active NPI

Raquel M. Carneiro, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Riverside, RI
National Provider Identifier
1508812942
Registry record updated Jul 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
MD15968 Issued in RI
Practice address
375 Wampanoag TRL Ste 202B
Riverside, RI 02915-2234
Phone
(401) 649-4090
Fax
(401) 649-4091
NPI assigned
May 26, 2006
Last updated
Jul 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036115616 IL
Endocrinology, Diabetes & Metabolism Physician 207RE0101X MD15968 RI Primary

Addresses

Primary practice location

375 Wampanoag TRL Ste 202B
Riverside, RI 02915-2234

Mailing address

17 Virginia Ave Ste 107
Providence, RI 02905-4406
Phone (877) 771-7401

Other practice location 1

2650 Ridge Ave
Dept of Medicine, ATTN: Nancy Kawada
Evanston, IL 60201-1718
Phone (847) 570-2502

Other practice location 2

100 Dudley St
Providence, RI 02905-3233
Phone (401) 453-7950

Other identifiers 1

IdentifierTypeStateIssuer
036115616OtherILIL STATE LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rcarneiro@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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171109001848 RI Practitioner - Endocrinology 6002828464 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

117 Ellenfield St
Suite 101
Providence, RI 02905-4513

17 Virginia Ave
Suite 107
Providence, RI 02905-4406

455 Toll Gate Rd
Warwick, RI 02886-2770

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD15968RIMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Aug 1, 2020 Accepting new patients
Rhode Island Hospital CurrentSince Mar 6, 2018 Accepting new patients
Affinity Physicians LLC. Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Rhode Island Hospital CurrentSince Mar 6, 2018 Accepting new patients
Endeavor Health Medical Group Past Accepting new patients
Women & Infants Hospital of Rhode Island Past Accepting new patients
Endeavor Health Medical Group Internal Medicine Past Accepting new patients

Locations

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

245 Chapman St
Ste 300
Providence, RI 02905
Phone (401) 444-4741

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

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

Organizations & group practices 7

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 9

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1508812942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 VIRGINIA AVE STE 107",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054406",
            "telephone_number": "877-771-7401",
            "fax_number": "401-784-4902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 WAMPANOAG TRL STE 202B",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152234",
            "telephone_number": "401-649-4090",
            "fax_number": "401-649-4091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Ridge Ave",
            "address_2": "Dept of Medicine, ATTN: Nancy Kawada",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "602011718",
            "country_code": "US",
            "telephone_number": "847-570-2502",
            "fax_number": "847-570-0758",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053233",
            "country_code": "US",
            "telephone_number": "401-453-7950",
            "fax_number": "401-453-7748",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARNEIRO",
        "first_name": "RAQUEL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036115616",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "RI",
            "license": "MD15968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE LICENSE",
            "identifier": "036115616",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rcarneiro@direct.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "100 Dudley St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029053233",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.