Organization Active NPI

Luciano Sztulman MD Inc

  • Obstetrics & Gynecology Physician
  • Providence, RI
National Provider Identifier
1588685754
Registry record updated May 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
10209 Issued in RI
Legal business name
LUCIANO SZTULMAN MD INC
Practice address
1 Randall SQ
Suite 401
Providence, RI 02904-2709
Phone
(401) 521-1006
Fax
(401) 521-1009
NPI assigned
Jul 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2010

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

Authorized official

Name
Luciano Sztulman, MDNPI 1669492070
Title
Owner
Phone
(401) 521-1006

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X 10209 RI Primary

Addresses

Primary practice location

1 Randall SQ
Suite 401
Providence, RI 02904-2709

Mailing address

1 Randall SQ
Suite 401
Providence, RI 02904-2709
Phone (401) 521-1006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060303000649 RI Part B Supplier - Clinic/Group Practice 0345256095 Receives reassigned benefits from 1 practitioner
Practice locations: Providence, RI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0954287Luciano Sztulman MD1 Randall Square Suite 401, Providence, RI 02904Certificate of waiverMar 7, 2027

National Provider Directory

National Provider Directory

Locations

829 S Main St
Ste 2
Fall River, MA 02724
Phone (866) 736-6434

1 Randall Sq
Ste 401
Providence, RI 02904
Phone (401) 521-1006

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273622400000",
    "number": "1588685754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 RANDALL SQ",
            "address_2": "SUITE 401",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042709",
            "telephone_number": "401-521-1006",
            "fax_number": "401-521-1009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RANDALL SQ",
            "address_2": "SUITE 401",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042709",
            "telephone_number": "401-521-1006",
            "fax_number": "401-521-1009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUCIANO SZTULMAN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-22",
        "last_updated": "2010-05-12",
        "status": "A",
        "authorized_official_last_name": "SZTULMAN",
        "authorized_official_first_name": "LUCIANO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-521-1006",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "RI",
            "license": "10209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.