Organization Active NPI

Tanya J. Becker MD, Inc.

  • Pediatrics Physician
  • Pawtucket, RI
National Provider Identifier
1669819827
Registry record updated May 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD10708 Issued in RI
Legal business name
TANYA J. BECKER MD, INC.
Practice address
59 Prospect St
Suite C
Pawtucket, RI 02860-4482
Phone
(401) 728-9206
Fax
(401) 722-6960
NPI assigned
May 29, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2013

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

Authorized official

Name
Tanya Jean Becker, MD
Title
Owner/President
Phone
(401) 728-9206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X MD10708 RI Primary

Addresses

Primary practice location

59 Prospect St
Suite C
Pawtucket, RI 02860-4482

Mailing address

59 Prospect St
Suite C
Pawtucket, RI 02860-4482
Phone (401) 728-9206

Other identifiers 8

IdentifierTypeStateIssuer
543748627OtherRIUHC
TB55273MedicaidRI
275263078AOtherRINHP
963015OtherRICIGNA
AA26320OtherRIHP
2011993783OtherRITRICARE
29029-4OtherRIBCBS
2033621OtherRIFIRST HEALTH

National Provider Directory

National Provider Directory

Locations

59 Prospect St
Ste C
Pawtucket, RI 02860
Phone (401) 728-9206

NPI Registry JSON

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

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369785600000",
    "number": "1669819827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 PROSPECT ST",
            "address_2": "SUITE C",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604482",
            "telephone_number": "401-728-9206",
            "fax_number": "401-722-6960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 PROSPECT ST",
            "address_2": "SUITE C",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604482",
            "telephone_number": "401-728-9206",
            "fax_number": "401-722-6960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANYA J. BECKER MD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-05-29",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "401-728-9206",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD10708",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "543748627",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "TB55273",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "275263078A",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "963015",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HP",
            "identifier": "AA26320",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "2011993783",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "29029-4",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2033621",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2013; 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.