Individual provider Active NPI

Peter Amberg Hollmann, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Riverside, RI
National Provider Identifier
1679687289
Registry record updated Mar 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
MD05708 Issued in RI
Practice address
375 Wampanoag TRL
Riverside, RI 02915-2232
Phone
(401) 649-4010
Fax
(401) 649-4011
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD05708 RI
Geriatric Medicine (Internal Medicine) Physician 207RG0300X MD05708 RI Primary

Addresses

Primary practice location

375 Wampanoag TRL
Riverside, RI 02915-2232

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050701000474 RI Practitioner - Geriatric MedicinePractitioner - Internal Medicine 2860438678 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brown Medicine CurrentSince Jul 1, 2014 Accepting new patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Brown Medicine Internal Medicine CurrentSince Jul 1, 2014 Accepting new patients

Locations

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

15 La Salle Sq
Providence, RI 02903

110 Elm St
Providence, RI 02903
Phone (401) 443-4992

593 Eddy St
Providence, RI 02903

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

17 Virginia Ave
Ste 107
Providence, RI 02905
Phone (401) 784-4923

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

375 Wampanoag Trl
Ste 102
Riverside, RI 02915
Phone (401) 649-4010

Interoperability endpoints

  • Direct secure messaging: peter.hollmann.1@2097.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Saint Elizabeth at Home CorpWarwick, RI, CCN 417038 Home health agency Corporate Director (100%) Dec 7, 2015

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772755200000",
    "number": "1679687289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152232",
            "telephone_number": "401-649-4010",
            "fax_number": "401-649-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLMANN",
        "first_name": "PETER",
        "middle_name": "AMBERG",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2026-03-06",
        "certification_date": "2026-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD05708",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "RI",
            "license": "MD05708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.