NPIMap

Individual provider Active NPI

Peter Thomas Evangelista, MD

  • Diagnostic Radiology Physician
  • Warwick, RI
National Provider Identifier
1508854472
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD11408 Issued in RI
Practice address
125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone
(401) 432-2520
Fax
(401) 453-8220
NPI assigned
Oct 13, 2005
Last updated
Apr 2, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X MD11408 RI Primary
Diagnostic Radiology Physician 2085R0202X 217024 MA

Addresses

Primary practice location

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785

Mailing address

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone (401) 432-2520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040712000240 RI Practitioner - Diagnostic Radiology 7214915719 Reassigns benefits to 1 organization
I20180928000995 MA Practitioner - Diagnostic Radiology 7214915719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Connecticut School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island Medical Imaging IncGroup PAC ID 8022097815, shared by 2 NPIs, 107 clinicians

Practice addresses (Care Compare)

211 Park St
Attleboro, MA 02703-3143
Phone (508) 222-5200

450 Veterans Memorial Pkwy
BLDG 2
East Providence, RI 02914-5300
Phone (401) 435-3041

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.17 of 100Reported as group
Quality
82.44
Improvement activities
40
Cost
86.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
217024MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Medical Imaging Inc Diagnostic Radiology CurrentSince Jun 26, 2022 Accepting new patients
Lifespan Corporation Current Accepting new patients
Rhode Island Medical Imaging Inc Diagnostic Radiology CurrentSince Jul 1, 2004 Accepting new patients

Locations

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

20 Catamore Blvd
East Providence, RI 02914
Phone (401) 432-2520

450 Veterans Memorial Pkwy
Bldg 2
East Providence, RI 02914
Phone (401) 435-3041

1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500

593 Eddy St
Providence, RI 02903

125 Metro Center Blvd
Ste 2000
Warwick, RI 02886
Phone (401) 432-2520

Interoperability endpoints

  • Direct secure messaging: pevangelista15503@brownhealth.medalliesdirect.net

Organizations & group practices 3

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1508854472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2520",
            "fax_number": "401-453-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2520",
            "fax_number": "401-453-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANGELISTA",
        "first_name": "PETER",
        "middle_name": "THOMAS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD11408",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "217024",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.