NPIMap

Individual provider Active NPI

Cassandra Leigh Carberry, M.D.

  • Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
  • Providence, RI
National Provider Identifier
1639231673
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianTaxonomy code 207VF0040X
License
CMD13051 Issued in RI
Practice address
101 Plain St Ste 5
Providence, RI 02903-4829
Phone
(401) 453-7560
Fax
(401) 453-7573
NPI assigned
Dec 15, 2006
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 239751 NY
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician 207VF0040X CMD13051 RI Primary

Addresses

Primary practice location

101 Plain St Ste 5
Providence, RI 02903-4829

Mailing address

101 Plain St Ste 5
Providence, RI 02903-4829
Phone (917) 749-0634

Other practice location 1

462 1st Ave
9E2
New York, NY 10016-9196
Phone (212) 263-3150

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
I20090912000020 RI Practitioner - Obstetrics/GynecologyPractitioner - Other (Physician) 4789730979 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Medical School at San Antonio, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
239751NYMDObstetrics & Gynecology Physician
CMD13051RIMDFemale Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Jan 1, 2017 Accepting new patients
Affinity Physicians LLC. Obstetrics & Gynecology CurrentSince Jan 1, 2017 Accepting new patients
Women & Infants Hospital of Rhode Island Past Accepting new patients

Locations

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: ccarberry@direct.carene.org
  • Direct secure messaging: ccarberry@wih.cernerdirect.carene.org

Organizations & group practices 3

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 8

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1639231673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 PLAIN ST STE 5",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034829",
            "telephone_number": "917-749-0634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 PLAIN ST STE 5",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034829",
            "telephone_number": "401-453-7560",
            "fax_number": "401-453-7573"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "462 1st Ave",
            "address_2": "9E2",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100169196",
            "country_code": "US",
            "telephone_number": "212-263-3150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARBERRY",
        "first_name": "CASSANDRA",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "239751",
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "RI",
            "license": "CMD13051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.