Organization Active NPI

Pilgrim Park Medical Associates LTD.

  • Family Medicine Physician
  • Warwick, RI
National Provider Identifier
1619067386
Registry record updated Feb 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PILGRIM PARK MEDICAL ASSOCIATES LTD.
Practice address
1243 Post Rd
Unit a
Warwick, RI 02888-3221
Phone
(401) 941-2999
Fax
(401) 941-5830
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2010

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

Authorized official

Name
Dr. Joseph Anthony Grande, D.O.NPI 1881709616
Title
President
Phone
(401) 941-2999

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1243 Post Rd
Unit a
Warwick, RI 02888-3221

Mailing address

1243 Post Rd
Unit a
Warwick, RI 02888-3221
Phone (401) 941-2999

Other names 1

  • Pilgrim Park Physicians Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041214000823 RI Part B Supplier - Clinic/Group Practice 9234196916 Receives reassigned benefits from 2 practitioners
Practice locations: Warwick, 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
41D1011967Pilgrim Park Medical Associates1243 Post Road, Warwick, RI 02888Certificate of waiverApr 28, 2027

National Provider Directory

National Provider Directory

Locations

1243 Post Rd
#A
Warwick, RI 02888
Phone (401) 941-2999

1243 Post Rd
Warwick, RI 02888
Phone (401) 941-2999

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": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267142400000",
    "number": "1619067386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 POST RD",
            "address_2": "UNIT A",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883221",
            "telephone_number": "401-941-2999",
            "fax_number": "401-941-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 POST RD",
            "address_2": "UNIT A",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028883221",
            "telephone_number": "401-941-2999",
            "fax_number": "401-941-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PILGRIM PARK MEDICAL ASSOCIATES LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2010-02-26",
        "status": "A",
        "authorized_official_last_name": "GRANDE",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-941-2999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pilgrim Park Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 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.