Cynthia Ann Fahey, PAC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA00575 Issued in RI

Practice address

799 Hope St
Providence, RI 02906-3635

Phone

(508) 479-1632

NPI assigned

Oct 6, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Cynthia Ann Ferris Former name

Medicare fee-for-service enrollment

Enrolled in MA, RI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Minuteclinic Diagnostic of Rhode Island, LLC

  • Family Nurse Practitioner
  • Woonsocket, RI
  • NPI 1649511841
  Medicare reassignment
• Prospect Chartercare Physicians, LLC

  • Internal Medicine Physician
  • Cranston, RI
  • NPI 1629493135
  Medicare reassignment
• Trucare Inc

  • Internal Medicine Physician
  • Cranston, RI
  • NPI 1538659081
  Medicare reassignment
• VMD Primary Providers of Rhode Island PC

  • Family Medicine Physician
  • Cumberland, RI
  • NPI 1598341067
  Medicare reassignment
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MA

  Medicare reassignment
• Bridgewater Pediatrics LLC

  • Pediatrics Physician
  • Bridgewater, MA
  • NPI 1255579975
  NPD (past)
• Caritas Medical Group, Inc.

  • Specialist
  • Brighton, MA
  • NPI 1174513204
  NPD (past)
• Good Samaritan Medical Practice Corp

  • Specialist
  • Brockton, MA
  • NPI 1285625137
  NPD (past)

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601251200000",
    "number": "1730177502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "799 HOPE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063635",
            "telephone_number": "508-479-1632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "799 HOPE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029063635",
            "telephone_number": "508-479-1632"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "830 Oak St",
            "address_2": "Suite 105W",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023011168",
            "country_code": "US",
            "telephone_number": "508-897-4764",
            "fax_number": "508-427-2610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "725 Reservoir Ave Ste 6A",
            "address_purpose": "LOCATION",
            "city": "Cranston",
            "state": "RI",
            "postal_code": "029104450",
            "country_code": "US",
            "telephone_number": "401-829-4446",
            "fax_number": "401-829-4434",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAHEY",
        "first_name": "CYNTHIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2020-09-28",
        "certification_date": "2020-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00575",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1563",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "FERRIS",
            "middle_name": "ANN",
            "prefix": "MS.",
            "credential": "PAC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tootles Faccenda
• Paul D. Fadale, M.D.
• Christa N Fadden, OTR
• Misty April Faella, MA
• Mark J Fagan, MD
• Sydney Elizabeth Fahey, MA
• Faith Fahnbulleh
• Momoh Bai Fahnbulleh
• Kiley Elizabeth Fair, AGACNP
• Alexander M Fairhurst, PHARMD

• Physician Assistant in Providence, RI
• Providers in Providence, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.