NPIMap

Individual provider Active NPI

Shirley Wu

  • Emergency Medicine Physician
  • Providence, RI
National Provider Identifier
1528293362
Registry record updated Jul 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD15448 Issued in RI
Practice address
593 Eddy St
Claverick 2
Providence, RI 02903-4923
Phone
(401) 444-5411
Fax
(401) 272-0538
NPI assigned
May 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 4301094172 MI
Emergency Medicine Physician 207P00000X MD15448 RI Primary

Addresses

Primary practice location

593 Eddy St
Claverick 2
Providence, RI 02903-4923

Mailing address

125 Whipple St
3Rd Floor
Providence, RI 02908-3258
Phone (401) 854-2504

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
I20160827000289 RI Practitioner - Emergency Medicine 1951550425 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Brown Emergency MedicineGroup PAC ID 7214833169, 140 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000

Hospital & facility affiliations

  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Women & Infants Hospital of Rhode Island Hospital, Providence, RI, CCN 410010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301094172MIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2020 Accepting new patients
Brown Emergency Medicine Emergency Medicine CurrentSince Sep 1, 2016 Accepting new patients
Lifespan Physician Group, Inc. Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients

Locations

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

125 Whipple St
Ste 3
Providence, RI 02908
Phone (401) 854-2504

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

593 Eddy St
Providence, RI 02903

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

593 Eddy St
#2
Providence, RI 02903
Phone (401) 519-1604

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

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 6

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": "1242950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468195200000",
    "number": "1528293362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WHIPPLE ST",
            "address_2": "3RD FLOOR",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029083258",
            "telephone_number": "401-854-2504",
            "fax_number": "401-427-7795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "CLAVERICK 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5411",
            "fax_number": "401-272-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WU",
        "first_name": "SHIRLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-22",
        "last_updated": "2016-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301094172",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "MD15448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.