Individual provider Active NPI

Patricia J Flanagan, MD

  • Pediatrics Physician
  • Providence, RI
National Provider Identifier
1609820026
Registry record updated Jan 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
I07412 Issued in RI
Practice address
593 Eddy St
Lower Level
Providence, RI 02903-4923
Phone
(401) 444-5980
Fax
(401) 444-3873
NPI assigned
May 20, 2006
Last updated
Jan 30, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X I07412 RI Primary

Addresses

Primary practice location

593 Eddy St
Lower Level
Providence, RI 02903-4923

Mailing address

593 Eddy St
Hasbro 122
Providence, RI 02903-4923
Phone (401) 444-6484

Other identifiers 1

IdentifierTypeStateIssuer
7004788MedicaidRI

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
I20051108000501 RI Practitioner - Pediatric Medicine 7719905769 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
I07412RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Corporation Current Accepting new patients
Rhode Island Hospital Pediatrics CurrentSince Nov 1, 2019 Accepting new patients
Rhode Island Hospital CurrentSince Nov 1, 2019 Accepting new patients

Locations

1454 S County Trl
Ste 1300
East Greenwich, RI 02818
Phone (401) 432-6800

1 Hoppin St
Providence, RI 02903
Phone (401) 444-3996

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

593 Eddy St
#122
Providence, RI 02903
Phone (401) 444-6195

593 Eddy St
Lowr
Providence, RI 02903
Phone (401) 444-4471

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

Interoperability endpoints

  • Direct secure messaging: pflanagan15509@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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201651200000",
    "number": "1609820026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "HASBRO 122",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-6484",
            "fax_number": "401-444-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "LOWER LEVEL",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5980",
            "fax_number": "401-444-3873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLANAGAN",
        "first_name": "PATRICIA",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2008-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "I07412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7004788",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.