Individual provider Active NPI

Roger D. Raymond, M.D.

  • Cardiovascular Disease Physician
  • East Providence, RI
National Provider Identifier
1710908298
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD04120 Issued in RI
Practice address
950 Warren Ave
2ND Floor
East Providence, RI 02914-1432
Phone
(401) 606-1004
Fax
(401) 606-1153
NPI assigned
Jul 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD04120 RI Primary

Addresses

Primary practice location

950 Warren Ave
2ND Floor
East Providence, RI 02914-1432

Mailing address

950 Warren Ave
2ND Floor
East Providence, RI 02914-1432
Phone (401) 606-1004

Other identifiers 1

IdentifierTypeStateIssuer
7000379MedicaidRI

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
I20041022000009 RI Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 5193786390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Jefferson Medical College of Thomas Jefferson University, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

185 A High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

185 High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

208 Collyer St
Suite 301a
Providence, RI 02904-1560
Phone (401) 725-4888

900 Warren Ave
East Providence, RI 02914-1430

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4120RIMDPharmacist
MD04120RIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Miriam Hospital Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 1, 2012 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 1, 2012 Accepting new patients
The Miriam Hospital Cardiovascular Disease CurrentSince Jan 1, 2012 Accepting new patients
The Miriam Hospital Current Accepting new patients
Lifespan Corporation Current Accepting new patients
The Miriam Hospital CurrentSince Jan 1, 2012 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

1377 S County Trl
East Greenwich, RI 02818
Phone (401) 886-7590

900 Warren Ave
Ste 302
East Providence, RI 02914
Phone (401) 444-8344

950 Warren Ave
Fl 2
East Providence, RI 02914

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

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

2 Dudley St
Ste 360
Providence, RI 02905
Phone (401) 274-7546

208 Collyer St
Ste 100
Providence, RI 02904
Phone (401) 793-7191

Interoperability endpoints

  • Direct secure messaging: rraymond16128@brownhealth.medalliesdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1710908298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "950 WARREN AVE",
            "address_2": "2ND FLOOR",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141432",
            "telephone_number": "401-606-1004",
            "fax_number": "401-606-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "950 WARREN AVE",
            "address_2": "2ND FLOOR",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141432",
            "telephone_number": "401-606-1004",
            "fax_number": "401-606-1153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "ROGER",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "MD04120",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7000379",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.