NPIMap

Organization Active NPI

Prime Healthcare Services Landmark LLC

Doing business as Landmark Medical Center

  • General Acute Care Hospital
  • Woonsocket, RI
National Provider Identifier
1699752923
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
00117 Issued in RI
Legal business name
PRIME HEALTHCARE SERVICES LANDMARK LLC
Doing business as
Landmark Medical Center
Practice address
115 Cass Ave
Woonsocket, RI 02895-4705
Phone
(401) 769-4100
Fax
(401) 769-1744
NPI assigned
Dec 28, 2005
Last updated
Jun 14, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Christopher Doan
Title
Managing Associate General Counsel
Phone
(310) 259-4706

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 00117 RI Primary

Addresses

Primary practice location

115 Cass Ave
Woonsocket, RI 02895-4705

Mailing address

196 Cass Ave
Woonsocket, RI 02895-4712
Phone (401) 769-4100

Other identifiers 12

IdentifierTypeStateIssuer
7000251MedicaidMA
7029241MedicaidMA
903289OtherMATUFTS HEALTH PLAN INPAT.
H00104OtherRIBLUE CHIP
0000000010OtherRIBLUE CROSS
000000001930OtherRINEIGHBORHOOD HEALTH PLAN
5000704OtherRIUNITED HEALTHCARE
222921474OtherRITRICARE
OP00011MedicaidRI
4100011MedicaidRI
900934OtherMAHARVARD PILGRIM HEALTH
903288OtherMATUFTS HEALTH PLAN OUTPT

Other names 1

  • Landmark Medical Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140127000031 RI Part A Provider - Hospital 3274761069 1 other NPI on this enrollment
Practice locations: North Smithfield, RI; Woonsocket, RI; Smithfield, RI; Cumberland, RI

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699752923. Details of each certification follow.

Hospital certification: CCN 410011

Legal name
PRIME HEALTHCARE SERVICES LANDMARK LLC
Doing business as
LANDMARK MEDICAL CENTER
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 2, 2019
Beds
214
Ownership / control type
Private (not for profit)
Most recent change of ownership
Dec 31, 2013 (4 total)
Organization structure
LLCNon-profit
Incorporated
Oct 12, 2012 in DE
Enrollment address
115 Cass Ave
Woonsocket, RI 28954705
Other Hospital Practice Location
Hospital subgroups
General, Acute care

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 1

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Landmark Medical CenterCCN 410011 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2138 Mendon Rd
Ste 101B
Cumberland, RI 02864
Phone (401) 305-7604

132 Old River Rd
Ste 203
Lincoln, RI 02865
Phone (401) 334-2949

116 Eddie Dowling Hwy
North Smithfield, RI 02896
Phone (401) 766-0800

501 Great Rd
#325
North Smithfield, RI 02896
Phone (401) 766-4302

594 Great Rd
Ste 104
North Smithfield, RI 02896
Phone (401) 399-4989

41 Sanderson Rd
Ste 108
Smithfield, RI 02917
Phone (401) 519-3335

166 Cass Ave
Woonsocket, RI 02895
Phone (401) 767-3600

186 Cass Ave
Woonsocket, RI 02895
Phone (401) 769-9355

219 Cass Ave
Ste 3
Woonsocket, RI 02895
Phone (401) 767-1585

219 Cass Ave
Ste H
Woonsocket, RI 02895
Phone (401) 768-6014

255 Cass Ave
Woonsocket, RI 02895
Phone (401) 762-5599

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Prime Healthcare Services, Inc Organization, Ontario, CA Corporation, For-profit Operational/Managerial Control Jan 1, 2014
Steven Aleman Individual Corporate OfficerCorporate Chief Financial Officer Jun 1, 2020
Christopher Doan Individual Corporate OfficerChief Compliance Counsel Apr 24, 2017
Margaret Macek Individual Corporate OfficerChief Nursing Officer Apr 29, 2022
Corporate DirectorDirector Apr 29, 2022
Michael Souza Individual Corporate OfficerChief Executive Officer Feb 1, 2017
Corporate DirectorDirector Feb 1, 2017
W-2 Managing EmployeeChief Executive Officer Feb 1, 2017
Prime Healthcare Foundation Inc Organization, Ontario, CA Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 1, 2017 100%
Stanley Balon Individual Corporate DirectorDirector Apr 29, 2022
Shaun Cournoyer Individual Corporate DirectorDirector Apr 29, 2022

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Rehabilitation Hospital of Rhode IslandNorth Smithfield, RI, CCN 413025 Hospital 5% Or Greater Direct Ownership Interest (40%) Apr 1, 2021

Owned or controlled facilities with NPI records 1

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

Facilities with the same owner 95

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 95

Practitioners & affiliated clinicians

Practitioners 157

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 157

Affiliated clinicians 187

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 187

NPI Registry JSON

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1699752923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954712",
            "telephone_number": "401-769-4100",
            "fax_number": "401-765-6024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CASS AVE",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954705",
            "telephone_number": "401-769-4100",
            "fax_number": "401-769-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME HEALTHCARE SERVICES LANDMARK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "DOAN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "MANAGING ASSOCIATE GENERAL COUNSEL",
        "authorized_official_telephone_number": "310-259-4706"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "RI",
            "license": "00117",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000251",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7029241",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN INPAT.",
            "identifier": "903289",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "H00104",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0000000010",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "000000001930",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "5000704",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "222921474",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OP00011",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4100011",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH",
            "identifier": "900934",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN OUTPT",
            "identifier": "903288",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Landmark Medical Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Landmark Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.