Individual provider Active NPI

Robert Arthur Brogan, MD

  • Pediatric Adolescent Medicine Physician
  • East Greenwich, RI
National Provider Identifier
1639260656
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
03183 Issued in RI
Practice address
27 Division St
East Greenwich, RI 02818-3872
Phone
(401) 884-2150
Fax
(401) 884-1750
NPI assigned
Sep 27, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 03183 RI Primary

Addresses

Primary practice location

27 Division St
East Greenwich, RI 02818-3872

Mailing address

27 Division St
East Greenwich, RI 02818-3872
Phone (401) 884-2150

Other identifiers 6

IdentifierTypeStateIssuer
00010MedicaidRI
000340OtherRIBLUE CHIP OF RHODE ISLAND
406-494OtherRITUFTS HEALTH PLAN
3747OtherRINEIGHBORHOOD HEALTH PLAN
148-1OtherRIBLUE CROSS OF RHODE ISLAN
1200100OtherRIUNITED HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
03183RIMDPediatric Adolescent Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1639260656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 DIVISION ST",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028183872",
            "telephone_number": "401-884-2150",
            "fax_number": "401-884-1750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 DIVISION ST",
            "city": "EAST GREENWICH",
            "state": "RI",
            "postal_code": "028183872",
            "telephone_number": "401-884-2150",
            "fax_number": "401-884-1750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROGAN",
        "first_name": "ROBERT",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "RI",
            "license": "03183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00010",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP OF RHODE ISLAND",
            "identifier": "000340",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "406-494",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "3747",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF RHODE ISLAN",
            "identifier": "148-1",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PLAN",
            "identifier": "1200100",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Greenwich, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.