Individual provider Active NPI

Thomas Raymond Leddy, MD

  • Ophthalmology Physician
  • Warwick, RI
National Provider Identifier
1689631699
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD04438 Issued in RI
Practice address
390 Toll Gate Rd
Suite 112
Warwick, RI 02886-4326
Phone
(401) 732-2662
Fax
(401) 732-2669
NPI assigned
Apr 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X MD04438 RI Primary

Addresses

Primary practice location

390 Toll Gate Rd
Suite 112
Warwick, RI 02886-4326

Mailing address

390 Toll Gate Rd
Suite 112
Warwick, RI 02886-4326
Phone (401) 732-2662

Other identifiers 1

IdentifierTypeStateIssuer
9000459MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD04438RIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ezra L. Galler, M.D., LTD. Ophthalmology CurrentSince Jul 1, 2022 Accepting new patients

Locations

100 Highland Ave
Ste 304
Providence, RI 02906
Phone (401) 331-2130

390 Toll Gate Rd
Ste 107
Warwick, RI 02886
Phone (401) 732-2662

390 Toll Gate Rd
Ste 112
Warwick, RI 02886
Phone (401) 732-2662

Organizations & group practices 1

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1689631699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 TOLL GATE RD",
            "address_2": "SUITE 112",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864326",
            "telephone_number": "401-732-2662",
            "fax_number": "401-732-2669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 TOLL GATE RD",
            "address_2": "SUITE 112",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028864326",
            "telephone_number": "401-732-2662",
            "fax_number": "401-732-2669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDDY",
        "first_name": "THOMAS",
        "middle_name": "RAYMOND",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "RI",
            "license": "MD04438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000459",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.