Individual provider Active NPI

Zachary John Quay-de la Vallee, MD

  • Otolaryngology Physician
  • Providence, RI
National Provider Identifier
1629481825
Registry record updated Aug 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD16762 Issued in RI
Practice address
148 W River St Ste 2a
Providence, RI 02904-2615
Phone
(617) 636-5000
Fax
(401) 727-1979
NPI assigned
Jun 4, 2014
Last updated
Aug 5, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD16762 RI Primary

Addresses

Primary practice location

148 W River St Ste 2a
Providence, RI 02904-2615

Mailing address

148 W River St Ste 2a
Providence, RI 02904-2615
Phone (401) 616-1719

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
I20190730002376 RI Practitioner - Otolaryngology 6204135726 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Southern California Keck School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ri Ear Nose and Throat Physicians IncGroup PAC ID 8921109448, 7 clinicians

Practice addresses (Care Compare)

148 W River St
Suite 2a
Providence, RI 02904-2615
Phone (401) 728-0140

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16762RIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ri Ear Nose & Throat Physicians Inc. Otolaryngology CurrentSince Sep 15, 2019 Accepting new patients

Locations

2138 Mendon Rd
Ste 204
Cumberland, RI 02864
Phone (401) 228-6450

148 W River St
Ste 2A
Providence, RI 02904
Phone (401) 728-0140

Organizations & group practices 1

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 6

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": "1401840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564963200000",
    "number": "1629481825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 W RIVER ST STE 2A",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042615",
            "telephone_number": "401-616-1719",
            "fax_number": "401-727-1979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 W RIVER ST STE 2A",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042615",
            "telephone_number": "617-636-5000",
            "fax_number": "401-727-1979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUAY-DE LA VALLEE",
        "first_name": "ZACHARY",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-04",
        "last_updated": "2019-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "RI",
            "license": "MD16762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.