NPIMap

Individual provider Active NPI

Walter A. Hollinger, MD

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1679663405
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD11613 Issued in RI
Practice address
21 Peace St
Providence, RI 02907-1510
Phone
(401) 456-3649
NPI assigned
Oct 13, 2006
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD11613 RI Primary

Addresses

Primary practice location

21 Peace St
Providence, RI 02907-1510

Mailing address

17117 Patriot Way
West Greenwich, RI 02817-6021

Other identifiers 1

IdentifierTypeStateIssuer
7057054MedicaidRI

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
I20041227000049 RI Practitioner - Internal Medicine 0648238584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Pennsylvania State University College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prospect Chartercare Sjhsri LLCGroup PAC ID 7315179314, 32 clinicians

Practice addresses (Care Compare)

2 Wake Robin Rd
Fatima Hospital Wound Care Group
Lincoln, RI 02865-4295
Phone (401) 334-3830

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD11613RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chartercare Our Lady of Fatima Hospital CurrentSince Aug 1, 2025 Accepting new patients
Chartercare Our Lady of Fatima Hospital Internal Medicine Current Accepting new patients
Prospect Chartercare Sjhsri, LLC Internal Medicine CurrentSince Jun 1, 2014 Accepting new patients
Prospect Chartercare Sjhsri, LLC CurrentSince Jun 1, 2014 Accepting new patients

Locations

2 Wake Robin Rd
Lincoln, RI 02865
Phone (401) 333-1747

200 High Service Ave
North Providence, RI 02904
Phone (401) 456-3000

21 Peace St
Providence, RI 02907
Phone (401) 456-3000

825 Chalkstone Ave
Ofc
Providence, RI 02908
Phone (401) 456-2525

877 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2145

Interoperability endpoints

  • Direct secure messaging: walter.hollinger.1@9000.direct.athenahealth.com

Organizations & group practices 4

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": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1679663405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17117 PATRIOT WAY",
            "city": "WEST GREENWICH",
            "state": "RI",
            "postal_code": "028176021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 PEACE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029071510",
            "telephone_number": "401-456-3649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGER",
        "first_name": "WALTER",
        "middle_name": "A.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD11613",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7057054",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.