Individual provider Active NPI

Karl Heinz Breuing, MD

  • Plastic Surgery Physician
  • Providence, RI
National Provider Identifier
1720044472
Registry record updated Apr 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
MD14821 Issued in RI
Practice address
235 Plain St
Ste 501
Providence, RI 02905-3240
Phone
(401) 444-5495
Fax
(401) 444-5716
NPI assigned
Apr 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X MD14821 RI Primary

Addresses

Primary practice location

235 Plain St
Ste 501
Providence, RI 02905-3240

Mailing address

117 Ellefield Street
Suite 101
Providence, RI 02905-4513
Phone (401) 444-4318

Other identifiers 1

IdentifierTypeStateIssuer
1720044472MedicaidRI

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
I20150305000499 RI Practitioner - Plastic and Reconstructive Surgery 4688674484 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
Other, 1980
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)

235 Plain St
Suite 501
Providence, RI 02905-3243
Phone (401) 444-5495

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD14821RIMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. Plastic Surgery CurrentSince Mar 29, 2015 Accepting new patients
Rhode Island Hospital CurrentSince Jan 1, 2019 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

950 Warren Ave
Ste 103
East Providence, RI 02914
Phone (401) 606-4325

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

235 Plain St
Ste 203
Providence, RI 02905
Phone (401) 444-2701

593 Eddy St
Providence, RI 02903

235 Plain St
Ste 501
Providence, RI 02905
Phone (401) 277-0701

2 Dudley St
Ste 460
Providence, RI 02905
Phone (401) 331-2303

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

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.

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": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1430179200000",
    "number": "1720044472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLEFIELD STREET",
            "address_2": "SUITE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054513",
            "telephone_number": "401-444-4318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 PLAIN ST",
            "address_2": "STE 501",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053240",
            "telephone_number": "401-444-5495",
            "fax_number": "401-444-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREUING",
        "first_name": "KARL",
        "middle_name": "HEINZ",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2015-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "RI",
            "license": "MD14821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720044472",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.