Individual provider Active NPI

Pamela Quiteria Fernandes, MD

  • Internal Medicine Physician
  • Woonsocket, RI
National Provider Identifier
1710666474
Registry record updated Jun 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
LP06411 Issued in RI
Practice address
115 Cass Ave FL 3
Woonsocket, RI 02895-4731
Phone
(401) 769-4100
NPI assigned
Jul 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MT229219 PA
Internal Medicine Physician 207R00000X LP06411 RI Primary

Addresses

Primary practice location

115 Cass Ave FL 3
Woonsocket, RI 02895-4731

Mailing address

115 Cass Ave FL 3
Woonsocket, RI 02895-4731
Phone (401) 769-4100

Other practice location 1

559 W Germantown Pike
East Norriton, PA 19403-4250
Phone (484) 622-1000

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250203002218 RI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 5698205888

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT229219PAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718928000000",
    "number": "1710666474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 CASS AVE FL 3",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954731",
            "telephone_number": "401-769-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 CASS AVE FL 3",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028954731",
            "telephone_number": "401-769-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "559 W Germantown Pike",
            "address_purpose": "LOCATION",
            "city": "East Norriton",
            "state": "PA",
            "postal_code": "194034250",
            "country_code": "US",
            "telephone_number": "484-622-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FERNANDES",
        "first_name": "PAMELA",
        "middle_name": "QUITERIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2024-06-21",
        "certification_date": "2024-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "PA",
            "license": "MT229219",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP06411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woonsocket, RI

Sources for this page

Verify at the official NPI Registry.