Individual provider Active NPI

Jeffrey D Hughes, PSY.D.

  • Clinical Psychologist
  • Providence, RI
National Provider Identifier
1548346240
Registry record updated Mar 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS00979 Issued in RI
Practice address
340 Broadway
Providence, RI 02909-1102
Phone
(401) 243-7210
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS00979 RI Primary

Addresses

Primary practice location

340 Broadway
Providence, RI 02909-1102

Mailing address

340 Broadway Ste 2
Providence, RI 02909-1102
Phone (401) 243-7210

Other practice location 1

789 Park Ave
Cranston, RI 02910-2036
Phone (401) 243-7210

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070320000583 RI Practitioner - Clinical Psychologist 3072616671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1981 Broad St
Cranston, RI 02905-3430
Phone (401) 243-7210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PS00979RIMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeffrey D Hughes, PSYD LLC Clinical CurrentSince Jul 26, 2011 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

789 Park Ave
Cranston, RI 02910
Phone (401) 243-7210

1981 Broad St
Cranston, RI 02905
Phone (401) 243-7210

340 Broadway
Ste 2
Providence, RI 02909
Phone (401) 243-7210

Organizations & group practices 2

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583971200000",
    "number": "1548346240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 BROADWAY STE 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029091102",
            "telephone_number": "401-243-7210",
            "fax_number": "401-489-7862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 BROADWAY",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029091102",
            "telephone_number": "401-243-7210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "789 Park Ave",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029102036",
            "country_code": "US",
            "telephone_number": "401-243-7210",
            "fax_number": "401-489-7862",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2020-03-12",
        "certification_date": "2020-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS00979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.