Individual provider Active NPI

Janice Marion Kizirian, MD

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1770685646
Registry record updated Jan 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD6335 Issued in RI
Practice address
148 W River St
1D
Providence, RI 02904-2615
Phone
(401) 334-1133
Fax
(401) 334-1136
NPI assigned
Sep 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD6335 RI Primary

Addresses

Primary practice location

148 W River St
1D
Providence, RI 02904-2615

Mailing address

148 W River St
1D
Providence, RI 02904-2615
Phone (401) 334-1133

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
I20190502001357 RI Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 3072655422

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD6335RIMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264377600000",
    "number": "1770685646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 W RIVER ST",
            "address_2": "1D",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042615",
            "telephone_number": "401-334-1133",
            "fax_number": "401-334-1136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 W RIVER ST",
            "address_2": "1D",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029042615",
            "telephone_number": "401-334-1133",
            "fax_number": "401-334-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIZIRIAN",
        "first_name": "JANICE",
        "middle_name": "MARION",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2010-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD6335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.