NPIMap

Organization Active NPI

Brown Medicine

  • Internal Medicine Physician
  • Riverside, RI
National Provider Identifier
1689626764
Registry record updated Feb 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BROWN MEDICINE
Practice address
375 Wampanoag TRL
Riverside, RI 02915-2232
Phone
(401) 649-4010
NPI assigned
May 17, 2006
Last updated
Feb 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2025

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

Authorized official

Name
Donna Gordon
Title
Revenue Cycle Director
Phone
(401) 443-5107

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Critical Care Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RC0200X
Endocrinology, Diabetes & Metabolism PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RE0101X
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
Infectious Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RI0200X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X
Pulmonary Disease PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RP1001X
Rheumatology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RR0500X
Sleep Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RS0012X
Foot Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0131X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364SP0808X

Addresses

Primary practice location

375 Wampanoag TRL
Riverside, RI 02915-2232

Mailing address

Dept 3010, PO Box 986524
Boston, MA 02298-6524
Phone (401) 443-4992

Other practice location 1

235 Plain St Ste 201
Providence, RI 02905-3242
Phone (401) 861-8830

Other practice location 2

43 Jefferson Blvd Ste 2
Warwick, RI 02888-1078
Phone (401) 941-2830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040107000043 MA Part B Supplier - Clinic/Group Practice 0446159776 Receives reassigned benefits from 4 practitioners
1 other NPI on this enrollment
Practice locations: Attleboro, MA
O20040219000354 RI Part B Supplier - Clinic/Group Practice 0446159776 Receives reassigned benefits from 259 practitioners
5 other NPIs on this enrollment
Practice locations: East Providence, RI; Warwick, RI; Smithfield, RI; Riverside, RI; Providence, RI; Newport, RI; Lincoln, RI; East Greenwich, RI

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
41D0083287Brown Medicine43 Jefferson Blvd, Warwick, RI 02888Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations (25 of 39)

22 Mill St
Ste 208
Arlington, MA 02476
Phone (781) 646-2848

100 Hospital Rd
Ste 3AB
Leominster, MA 01453
Phone (508) 534-3179

1454 S County Trl
Ste 1749
East Greenwich, RI 02818

142A Danielson Pike
Unit 8
Foster, RI 02825
Phone (401) 647-3702

407 East Ave
Ste 110
Pawtucket, RI 02860
Phone (401) 722-2225

111 Plain St
Fl 2
Providence, RI 02903
Phone (401) 444-1770

111 Plain St
Fl 3
Providence, RI 02903
Phone (401) 444-3355

164 Summit Ave
Fl 2
Providence, RI 02906
Phone (401) 793-4636

164 Summit Ave
Ste 2C
Providence, RI 02906

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

180 Corliss St
Ste E1
Providence, RI 02904
Phone (401) 793-2928

2 Dudley St
Ste G95
Providence, RI 02905
Phone (401) 444-3355

235 Plain St
Ste 306
Providence, RI 02905
Phone (401) 331-7160

349 Huntington Ave
Providence, RI 02909
Phone (401) 346-4932

393 Eddy St
Providence, RI 02903

593 Eddy St
#421
Providence, RI 02903

593 Eddy St
#952
Providence, RI 02903

593 Eddy St
Bldg 328
Providence, RI 02903

593 Eddy St
Ste 113
Providence, RI 02903
Phone (401) 444-8130

593 Eddy St
Ste 9
Providence, RI 02903

593 Eddy St
Ste APC7
Providence, RI 02903

593 Eddy St
Ste JB105
Providence, RI 02903

593 Eddy St
Ste MAIN7
Providence, RI 02903

999 N Main St
Providence, RI 02904

375 Wampanoag Trl
Fl 1
Riverside, RI 02915

Practitioners & affiliated clinicians

Practitioners 285

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 285

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739404800000",
    "number": "1689626764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3010, PO BOX 986524",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986524",
            "telephone_number": "401-443-4992",
            "fax_number": "401-537-7241"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Plain St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053242",
            "country_code": "US",
            "telephone_number": "401-861-8830",
            "fax_number": "401-351-2378",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "43 Jefferson Blvd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028881078",
            "country_code": "US",
            "telephone_number": "401-941-2830",
            "fax_number": "401-941-6886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BROWN MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2025-02-13",
        "certification_date": "2025-02-13",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
        "authorized_official_telephone_number": "401-443-5107"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.