Blackstone Valley Foot and Ankle Inc.

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

DPM00327 Issued in RI

Legal business name

BLACKSTONE VALLEY FOOT AND ANKLE INC.

Practice address

345 Armistice Blvd
Pawtucket, RI 02861-2429

Phone

(401) 725-5576

Fax

(401) 725-2640

NPI assigned

Oct 14, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Joseph Kevin Domenico, DPMNPI 1972780583

Title

Owner

Phone

(401) 725-5576

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in RI2 enrollments

Enrollment records 2

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/15217/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph K Domenico, D.P.M.

  • Foot & Ankle Surgery Podiatrist
  • North Smithfield, RI
  • NPI 1972780583

  Foot & Ankle Surgery, RI

  Medicare reassignment Care Compare group NPD Authorized official
• Brad Michael Ciano, DPM

  • Podiatrist
  • Cumberland, RI
  • NPI 1194013177
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1492992000000",
    "number": "1720482193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 ARMISTICE BLVD",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028612429",
            "telephone_number": "401-725-5576",
            "fax_number": "401-725-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 ARMISTICE BLVD",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028612429",
            "telephone_number": "401-725-5576",
            "fax_number": "401-725-2640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACKSTONE VALLEY FOOT AND ANKLE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-14",
        "last_updated": "2017-04-24",
        "status": "A",
        "authorized_official_last_name": "DOMENICO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "KEVIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-725-5576",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "RI",
            "license": "DPM00327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blackstone Valley Community Action Program, Inc.
• Blackstone Valley Community Action Program, Inc.
• Blackstone Valley Community Health Care
• Blackstone Valley Community Health Care, Inc.
• Blackstone Valley Community Health Care, Inc.
• Blackstone Valley Youth & Family Collaborative
• Pat Blais
• Ruben Blanco, OT
• Steven Blazar, MD
• Lianne Blinn, LICSW

• All providers in Pawtucket, RI
• Foot & Ankle Surgery Podiatrist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.