Individual provider Active NPI

Maggie Bacon, MB BCH BAO

  • Emergency Medicine Physician
  • Warwick, RI
National Provider Identifier
1710506274
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD19876 Issued in RI
Practice address
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone
(401) 737-7010
NPI assigned
Apr 14, 2020
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD19876 RI Primary

Addresses

Primary practice location

455 Toll Gate Rd
Warwick, RI 02886-2759

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2759

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230911003587 MA Practitioner - Emergency Medicine 0840614830 Reassigns benefits to 3 organizations
I20240806000845 RI Practitioner - Emergency Medicine 0840614830 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sturdy Memorial Hospital IncGroup PAC ID 4981653789, 39 clinicians
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

211 Park St
Attleboro, MA 02703-3143
Phone (508) 236-8110

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

575 Beech St
Holyoke, MA 01040-2223
Phone (413) 534-2697

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.49 of 100Reported as group
Quality
69.5
Promoting interoperability
100
Improvement activities
40
Cost
72.15

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19876RIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Sep 1, 2024 Accepting new patients
Lakes/National Emergency Physicians Inc Emergency Medicine CurrentSince Jul 22, 2023 Accepting new patients
Affinity Physicians LLC. Emergency Medicine CurrentSince Sep 1, 2024 Accepting new patients
Western Mass Physician Associates Inc CurrentSince Nov 1, 2024 Accepting new patients
Sturdy Memorial Hospital Inc Emergency Medicine CurrentSince Aug 5, 2024 Accepting new patients
Western Mass Physician Associates Inc CurrentSince Nov 1, 2024 Accepting new patients
Sturdy Health, Inc. Past Accepting new patients

Locations

10 Hospital Dr
Ste 306
Holyoke, MA 01040
Phone (413) 539-6830

15 Hospital Dr
Ste 50
Holyoke, MA 01040
Phone (413) 534-2826

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1586822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1710506274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-737-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACON",
        "first_name": "MAGGIE",
        "credential": "MB BCH BAO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-14",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "MD19876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.