Individual provider Active NPI

Olivier M Gherardi

  • Family Medicine Physician
  • Warwick, RI
National Provider Identifier
1558324970
Registry record updated Jun 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
DO00489 Issued in RI
Practice address
17 Airport Rd
Warwick, RI 02889-1001
Phone
(401) 606-2520
Fax
(401) 384-7190
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 270994 MA
Family Medicine Physician 207Q00000X DO00489 RI Primary

Addresses

Primary practice location

17 Airport Rd
Warwick, RI 02889-1001

Mailing address

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

Other practice location 1

78 Sutton Ave
Oxford, MA 01540-1813
Phone (508) 499-1760

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080213000190 RI Practitioner - Family Practice 3779666870 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

17 Airport Rd
Warwick, RI 02889-1001
Phone (401) 606-2520

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
270994MAMDFamily Medicine Physician
DO00489RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Warwick Urgent Care Partners Past Accepting new patients
D Halpren Ruder Inc Past Accepting new patients

Locations

1360 W Main Rd
Middletown, RI 02842
Phone (401) 606-3110

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

400 Bald Hill Rd
Ste 511
Warwick, RI 02886
Phone (401) 737-4420

17 Airport Rd
Warwick, RI 02889
Phone (401) 606-2520

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 1

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1558324970",
    "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": "17 AIRPORT RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028891001",
            "telephone_number": "401-606-2520",
            "fax_number": "401-384-7190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "78 Sutton Ave",
            "address_purpose": "LOCATION",
            "city": "Oxford",
            "state": "MA",
            "postal_code": "015401813",
            "country_code": "US",
            "telephone_number": "508-499-1760",
            "fax_number": "508-499-1757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GHERARDI",
        "first_name": "OLIVIER",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "270994",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "DO00489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.