Active NPI
Theodor Ene, M.D.
- Child & Adolescent Psychiatry Physician
- Providence, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Child & Adolescent Psychiatry Physician
- License
- MD14263
- Practice address
- 345 Blackstone Blvd
Providence, RI 02906-4800 - Phone
- (401) 455-6200
- Fax
- (401) 455-6309
- NPI assigned
- May 20, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 238333 | MA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | 238333 | MA | |
| Child & Adolescent Psychiatry Physician | 2084P0804X | MD14263 | RI | Primary |
| Psychiatry Physician | 2084P0800X | MD14263 | RI |
Addresses
Primary practice location
345 Blackstone Blvd
Providence, RI 02906-4800
Mailing address
345 Blackstone Blvd
Providence, RI 02906-4800
Phone (401) 455-6200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010
455 Tollgate Rd
Warwick, RI 02886-2759
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 238333 | MA | MD | Child & Adolescent Psychiatry Physician |
| MD14263 | RI | MD | Child & Adolescent Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Affinity Physicians LLC | Current | Accepting new patients | |
| Edward M. Kennedy Community Health Center, Inc | Current | Accepting new patients | |
| Edward M. Kennedy Community Health Center, Inc | Current | Accepting new patients | |
| Affinity Physicians LLC. | Psychiatry | Current | Accepting new patients |
Locations
19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122
650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318
345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375
455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000
Interoperability endpoints
- tene@direct.carene.org
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 and National Provider Directory roles.
-
- Federally Qualified Health Center (FQHC)
- Worcester, MA
- NPI 1609842152
-
- Anesthesiology Physician
- Providence, RI
- NPI 1053038471
-
- Federally Qualified Health Center (FQHC)
- Worcester, MA
- NPI 1316324650
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463529600000",
"number": "1629235486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "345 BLACKSTONE BLVD",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064800",
"telephone_number": "401-455-6200",
"fax_number": "401-455-6309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "345 BLACKSTONE BLVD",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029064800",
"telephone_number": "401-455-6200",
"fax_number": "401-455-6309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENE",
"first_name": "THEODOR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-20",
"last_updated": "2016-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "238333",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "MA",
"license": "238333",
"primary": false
},
{
"code": "2084P0804X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
"state": "RI",
"license": "MD14263",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "RI",
"license": "MD14263",
"primary": false
}
],
"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 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.