Individual provider Active NPI

Anthony Henriques, NP

  • Nurse Practitioner
  • Providence, RI
National Provider Identifier
1568072510
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN02313 Issued in RI
Practice address
164 Summit Ave # C70
Providence, RI 02906-2853
Phone
(401) 793-4545
Fax
(401) 793-7866
NPI assigned
Aug 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN02313 RI Primary

Addresses

Primary practice location

164 Summit Ave # C70
Providence, RI 02906-2853

Mailing address

PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201006000560 RI Practitioner - Nurse Practitioner 3173942406 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Surgical Associates, Inc.Group PAC ID 4082503032, 105 clinicians

Practice addresses (Care Compare)

2 Dudley St
Suite 470
Providence, RI 02905-3248
Phone (401) 272-1800

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN02313RIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Current Accepting new patients
University Surgical Associates, Inc. CurrentSince Oct 15, 2020 Accepting new patients
Lifespan Physician Group, Inc. Nurse Practitioner CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Rhode Island Hospital Nurse Practitioner Past Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

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

164 Summit Ave
#C70
Providence, RI 02906
Phone (401) 793-3922

164 Summit Ave
Ste C70
Providence, RI 02906

2 Dudley St
Ste 470
Providence, RI 02905
Phone (401) 274-7546

Organizations & group practices 6

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": "1596585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1568072510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16149",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029160697",
            "telephone_number": "401-453-9625",
            "fax_number": "401-435-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE # C70",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-4545",
            "fax_number": "401-793-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENRIQUES",
        "first_name": "ANTHONY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-05",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN02313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.