Individual provider Active NPI

Deborah E Carranza

  • Clinical Social Worker
  • Providence, RI
National Provider Identifier
1700119062
Registry record updated Sep 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
01121 Issued in RI
Practice address
117 Ellenfield St
Suite 101
Providence, RI 02905-4513
Phone
(401) 444-6779
NPI assigned
Sep 17, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 01121 RI Primary

Addresses

Primary practice location

117 Ellenfield St
Suite 101
Providence, RI 02905-4513

Mailing address

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-4300

Other identifiers 1

IdentifierTypeStateIssuer
ISW01121OtherRILICENSE

Other names 1

  • Deborah E Hughes-Carranza Professional name

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091124000346 RI Practitioner - Clinical Social Worker 1153460548 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-4300

593 Eddy St
Providence, RI 02903-4923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01121RIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Prospect Chartercare Sjhsri, LLC CurrentSince Jun 1, 2014 Accepting new patients
Lifespan Physician Group, Inc. Clinical CurrentSince Feb 29, 2016 Accepting new patients
Prospect Chartercare Sjhsri, LLC CurrentSince Jun 1, 2014 Accepting new patients

Locations

2 Wake Robin Rd
Lincoln, RI 02865
Phone (401) 333-1747

200 High Service Ave
North Providence, RI 02904
Phone (401) 456-3000

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

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

593 Eddy St
Providence, RI 02903

Organizations & group practices 3

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": "1253145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1700119062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-4300",
            "fax_number": "401-793-4312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST",
            "address_2": "SUITE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054513",
            "telephone_number": "401-444-6779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRANZA",
        "first_name": "DEBORAH",
        "middle_name": "E",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-17",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "RI",
            "license": "01121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ISW01121",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEBORAH",
            "last_name": "HUGHES-CARRANZA",
            "middle_name": "E",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.