Active NPI
Aquilla Jane Chase, MD
- Emergency Medicine Physician
- Providence, RI
National Provider Identifier
1639868573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- CLP05849
- Practice address
- 593 Eddy St
Providence, RI 02903-4923 - Phone
- (401) 444-8704
- Fax
- (401) 444-5088
- NPI assigned
- May 5, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | CLP05849 | RI | Primary |
Addresses
Primary practice location
593 Eddy St
Providence, RI 02903-4923
Mailing address
593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-8704
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230511001866 | RI | Order and Referring Only - Emergency Medicine | 0446616767 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CLP05849 | RI | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687478400000",
"number": "1639868573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "593 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034923",
"telephone_number": "401-444-8704",
"fax_number": "401-444-5088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "593 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034923",
"telephone_number": "401-444-8704",
"fax_number": "401-444-5088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHASE",
"first_name": "AQUILLA",
"middle_name": "JANE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-05-05",
"last_updated": "2023-06-23",
"certification_date": "2023-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "RI",
"license": "CLP05849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Providence, RI
- Chartercare Roger Williams Medical Center
- Chartercare Roger Williams Medical Center
- Chartercare Roger Williams Medical Center
- Ashley Leslie Chartier, AGACNP-BC
- Debra B Charzewski, CCC-SLP
- Kristen Chase, CRNA
- William A Chase, III, LICSW
- Cathy C Chason, LIC. AC.
- Kalyn Chattelle, BA
- Avishek Chatterjee, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2023; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.