Individual provider Active NPI

Edward J Wing, MD

  • Infectious Disease Physician
  • Providence, RI
National Provider Identifier
1578503694
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
MD09727 Issued in RI
Practice address
164 Summit Ave
Fain BLDG., Suite E
Providence, RI 02906-2853
Phone
(401) 793-2928
Fax
(401) 793-7401
NPI assigned
Jun 7, 2006
Last updated
Nov 15, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X MD09727 RI Primary

Addresses

Primary practice location

164 Summit Ave
Fain BLDG., Suite E
Providence, RI 02906-2853

Mailing address

PO Box 1358
Providence, RI 02901-1358

Other identifiers 1

IdentifierTypeStateIssuer
9025364MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621000035 RI Practitioner - Infectious DiseasePractitioner - Internal Medicine 7517852346 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Miriam Hospital CurrentSince Mar 1, 2016 Accepting new patients
The Miriam Hospital CurrentSince Mar 1, 2016 Accepting new patients
Lifespan Corporation Current Accepting new patients

Locations

1125 N Main St
Providence, RI 02904
Phone (401) 793-2928

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

164 Summit Ave
Ste E
Providence, RI 02906
Phone (401) 793-2928

593 Eddy St
Providence, RI 02903

Interoperability endpoints

  • Direct secure messaging: ewing28890@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.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1578503694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1358",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029011358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE",
            "address_2": "FAIN BLDG., SUITE E",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-2928",
            "fax_number": "401-793-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WING",
        "first_name": "EDWARD",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-07",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "RI",
            "license": "MD09727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9025364",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.