Fauzia Wali-Khan, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MD16933 Issued in RI

Practice address

63 Eddie Dowling Hwy Ste 9
North Smithfield, RI 02896-7322

Phone

(401) 414-3485

Fax

(401) 414-3486

NPI assigned

Sep 22, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA, RI2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

First Psychiatric Planners, Inc 11 clinicians

Spectrum Neuro Behavioral Care LLC 57 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Spectrum Neuro Behavioral Care LLC

  • Community/Behavioral Health Agency
  • North Smithfield, RI
  • NPI 1356906572

  MA, RI

  Medicare reassignment Care Compare group NPD
• First Psychiatric Planners, Inc

  • Psychiatric Hospital
  • Brookline, MA
  • NPI 1093714412

  MA

  Medicare reassignment Care Compare group NPD
• Hri Hospital, Inc

  • Psychiatric Hospital
  • Brookline, MA
  • NPI 1518938174

  MA

  Medicare reassignment NPD

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

{
    "created_epoch": "1127347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583884800000",
    "number": "1699761965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 LINCOLN ST STE 203",
            "city": "FRAMINGHAM",
            "state": "MA",
            "postal_code": "017028264",
            "telephone_number": "713-893-6214",
            "fax_number": "401-414-3486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 EDDIE DOWLING HWY STE 9",
            "city": "NORTH SMITHFIELD",
            "state": "RI",
            "postal_code": "028967322",
            "telephone_number": "401-414-3485",
            "fax_number": "401-414-3486"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "67 Union St",
            "address_purpose": "LOCATION",
            "city": "Natick",
            "state": "MA",
            "postal_code": "017607700",
            "country_code": "US",
            "telephone_number": "508-650-7031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "736 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021352907",
            "country_code": "US",
            "telephone_number": "617-789-2007",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "61 Lincoln St Ste 203",
            "address_purpose": "LOCATION",
            "city": "Framingham",
            "state": "MA",
            "postal_code": "017028264",
            "country_code": "US",
            "telephone_number": "713-893-6214",
            "fax_number": "401-414-3486",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "72 E Bluff Rd",
            "address_purpose": "LOCATION",
            "city": "Ashland",
            "state": "MA",
            "postal_code": "017212352",
            "country_code": "US",
            "telephone_number": "401-414-3485",
            "fax_number": "401-414-3486",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALI-KHAN",
        "first_name": "FAUZIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-22",
        "last_updated": "2020-03-11",
        "certification_date": "2020-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "219392",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD16933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110035934A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2034191",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• University Medical Center LLC
• Betty A Upham, R.N.
• Glenda Gabriela Vasquez, DPT, PT
• Walgreen Co
• Walgreen Co.
• Amy A Whalen
• Why Weight Inc
• Nancy Leigh Wilson, M.T.
• Joanna C Wood, LICSW
• Woodland Convalescent Center Inc

• All providers in North Smithfield, RI
• Psychiatry Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.