NPIMap

Individual provider Active NPI

Nishay Tariq, MD

  • Geriatric Medicine (Family Medicine) Physician
  • Cranston, RI
National Provider Identifier
1720644909
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X
License
MD19165 Issued in RI
Practice address
75 Sockanosset Cross Rd Ste 100
Cranston, RI 02920-5558
Phone
(401) 946-6200
Fax
(401) 275-1992
NPI assigned
May 14, 2019
Reactivated
Feb 27, 2020
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X MD19165 RI Primary

Addresses

Primary practice location

75 Sockanosset Cross Rd Ste 100
Cranston, RI 02920-5558

Mailing address

75 Sockanosset Cross Rd Ste 100
Cranston, RI 02920-5558
Phone (401) 946-6200

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ntariq210768@direct.lifespan.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230606001541 RI Practitioner - Family PracticePractitioner - Geriatric Medicine 9133586274 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

75 Sockanosset Cross Rd
Cranston, RI 02920-5558
Phone (401) 946-6200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19165RIMDGeriatric Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Coastal Medical Physicians, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Lifespan Corporation Current Accepting new patients
Coastal Medical, Inc. Past Accepting new patients

Locations

75 Sockanosset Cross Rd
Ste 100
Cranston, RI 02920
Phone (401) 736-4500

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

10 Davol Sq
Ste 300
Providence, RI 02903

Interoperability endpoints

  • Direct secure messaging: ntariq210768@brownhealth.medalliesdirect.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1557792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1720644909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 SOCKANOSSET CROSS RD STE 100",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029205558",
            "telephone_number": "401-946-6200",
            "fax_number": "401-275-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 SOCKANOSSET CROSS RD STE 100",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029205558",
            "telephone_number": "401-946-6200",
            "fax_number": "401-275-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARIQ",
        "first_name": "NISHAY",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-14",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "deactivation_date": "2020-01-13",
        "reactivation_date": "2020-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "RI",
            "license": "MD19165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ntariq210768@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "75 Sockanosset Cross Rd Ste 100",
            "city": "Cranston",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029205558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.