Individual provider Active NPI

Thomas J Guilmette

  • Clinical Neuropsychologist
  • Providence, RI
National Provider Identifier
1629140595
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PS00271 Issued in RI
Practice address
21 Peace St
Providence, RI 02907-1510
Phone
(401) 456-3309
NPI assigned
Nov 15, 2006
Last updated
Sep 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PS00271 RI Primary
Psychologist 103T00000X PS00271 RI

Addresses

Primary practice location

21 Peace St
Providence, RI 02907-1510

Mailing address

200 High Service Ave
North Providence, RI 02904-5113

Other identifiers 1

IdentifierTypeStateIssuer
PS00271OtherRILICENSE NUMBER

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060329000117 RI Practitioner - Clinical Psychologist 3375559107 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Neuropsychology Partners, IncGroup PAC ID 4981624244, 5 clinicians

Practice addresses (Care Compare)

450 Veterans Memorial Pkwy
Suite 8B
East Providence, RI 02914-5315
Phone (401) 529-4884

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PS00271RIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare Sjhsri, LLC CurrentSince Jun 1, 2014 Accepting new patients
Prospect Chartercare Sjhsri, LLC CurrentSince Jun 1, 2014 Accepting new patients
Neuropsychology Partners, Inc Clinical Neuropsychologist CurrentSince Dec 17, 2018 Accepting new patients
St. Joseph Health Services of Rhode Island Past Accepting new patients

Locations

450 Veterans Memorial Pkwy
Ste 8B
East Providence, RI 02914
Phone (401) 529-4884

2 Wake Robin Rd
Lincoln, RI 02865
Phone (401) 333-1747

200 High Service Ave
North Providence, RI 02904
Phone (401) 456-3000

200 High Service Ave
#3
North Providence, RI 02904
Phone (401) 456-3649

21 Peace St
Providence, RI 02907
Phone (401) 456-3000

Organizations & group practices 4

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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190851200000",
    "number": "1629140595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HIGH SERVICE AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029045113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PEACE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071510",
            "telephone_number": "401-456-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILMETTE",
        "first_name": "THOMAS",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "RI",
            "license": "PS00271",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "RI",
            "license": "PS00271",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "PS00271",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.