Individual provider Active NPI

Douglas G Shemin, MD

  • Nephrology Physician
  • Riverside, RI
National Provider Identifier
1710934724
Registry record updated Nov 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
MD06411 Issued in RI
Practice address
375 Wampanoag TRL
Riverside, RI 02915-2232
Phone
(404) 649-4060
Fax
(401) 649-4061
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X MD06411 RI Primary

Addresses

Primary practice location

375 Wampanoag TRL
Riverside, RI 02915-2232

Mailing address

Dept 3010, PO Box 986524
Boston, MA 02298-6524
Phone (401) 443-4992

Other practice location 1

250 Centerville Rd Bldg E
Warwick, RI 02886-4400
Phone (401) 490-3838

Other identifiers 2

IdentifierTypeStateIssuer
2094452MedicaidMA
9006511MedicaidRI

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
I20040614000092 RI Practitioner - NephrologyPractitioner - Internal Medicine 5395630123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
State University of New York at Buffalo School of Medicine
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brown MedicineGroup PAC ID 0446159776, 220 clinicians

Practice addresses (Care Compare)

375 Wampanoag TRL
Riverside, RI 02915-2232
Phone (401) 649-4010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD06411RIMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brown Medicine Nephrology CurrentSince Jan 1, 2000 Accepting new patients
Brown Medicine Nephrology CurrentSince Jan 1, 2000 Accepting new patients

Locations

593 Eddy St
Providence, RI 02903

110 Elm St
Providence, RI 02903
Phone (401) 443-4992

375 Wampanoag Trl
Ste 302A
Riverside, RI 02915
Phone (401) 649-4060

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

Organizations & group practices 2

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": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763424000000",
    "number": "1710934724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT 3010, PO BOX 986524",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022986524",
            "telephone_number": "401-443-4992",
            "fax_number": "401-784-4913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 WAMPANOAG TRL",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029152232",
            "telephone_number": "404-649-4060",
            "fax_number": "401-649-4061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "250 Centerville Rd Bldg E",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028864400",
            "country_code": "US",
            "telephone_number": "401-490-3838",
            "fax_number": "401-490-3827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEMIN",
        "first_name": "DOUGLAS",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2025-11-18",
        "certification_date": "2025-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "RI",
            "license": "MD06411",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2094452",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9006511",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.