NPIMap

Individual provider Active NPI

Jay M. Baruch, M.D.

  • Emergency Medicine Physician
  • Providence, RI
National Provider Identifier
1619950581
Registry record updated Aug 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD10404 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 519-1604
Fax
(401) 272-0538
NPI assigned
Nov 23, 2005
Last updated
Aug 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD10404 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

PO Box 9484
Providence, RI 02940-9484
Phone (401) 854-2508

Other identifiers 9

IdentifierTypeStateIssuer
12/29/2008OtherMATUFTS HEALTH PLAN
407365OtherRIBLUECHIP
JB33017MedicaidRI
04/15/2009OtherRIUNITED HEALTHCARE
10/30/2008OtherRINHPRI
1619959581OtherRINPI
25129-5OtherRIBCBSRI GROUP
007060262OtherRIRI MEDICARE (UEMF)
2152401MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060731000383 RI Practitioner - Emergency Medicine 5496768905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York at Stony Brook, School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Brown Emergency MedicineGroup PAC ID 7214833169, 140 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD10404RIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2020 Accepting new patients
Lifespan Physician Group, Inc. Current Accepting new patients
Lifespan Physician Group, Inc. Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients
Lifespan Corporation Current Accepting new patients
Brown Emergency Medicine Emergency Medicine CurrentSince Jul 1, 2008 Accepting new patients
Memorial Hospital Past Accepting new patients
SHS Ventures, Inc Past Accepting new patients

Locations

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

125 Whipple St
Ste 3
Providence, RI 02908
Phone (401) 854-2504

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

593 Eddy St
Providence, RI 02903

Interoperability endpoints

  • Direct secure messaging: jbaruch11176@brownhealth.medalliesdirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 4

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312416000000",
    "number": "1619950581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9484",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029409484",
            "telephone_number": "401-854-2508",
            "fax_number": "401-854-2519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-519-1604",
            "fax_number": "401-272-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARUCH",
        "first_name": "JAY",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2011-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "MD10404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "12/29/2008",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECHIP",
            "identifier": "407365",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JB33017",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "04/15/2009",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHPRI",
            "identifier": "10/30/2008",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1619959581",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSRI GROUP",
            "identifier": "25129-5",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI MEDICARE (UEMF)",
            "identifier": "007060262",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2152401",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.