Active NPI
Anthony R Potenza, MD
- Diagnostic Radiology Physician
- Woonsocket, RI
National Provider Identifier
1780687400
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- MD04445
- Practice address
- 38 Hamlet Ave
Woonsocket, RI 02895-4423 - Phone
- (401) 762-0020
- Fax
- (401) 762-1819
- NPI assigned
- May 27, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | MD04445 | RI | Primary |
| Diagnostic Ultrasound Physician | 2085U0001X | MD04445 | RI |
Addresses
Primary practice location
38 Hamlet Ave
Woonsocket, RI 02895-4423
Mailing address
38 Hamlet Ave
Woonsocket, RI 02895-4423
Phone (401) 762-0020
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3122409 | Medicaid | MA | |
| 37750 | Other | MA | MA LICENSE |
| MD04445 | Other | RI | RI LICENSE |
| 7000164 | Medicaid | RI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Radiology Associates Inc | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Diagnostic Radiology Physician
- East Providence, RI
- NPI 1073516654
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317168000000",
"number": "1780687400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38 HAMLET AVE",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028954423",
"telephone_number": "401-762-0020"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38 HAMLET AVE",
"city": "WOONSOCKET",
"state": "RI",
"postal_code": "028954423",
"telephone_number": "401-762-0020",
"fax_number": "401-762-1819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTENZA",
"first_name": "ANTHONY",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2011-09-28",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "RI",
"license": "MD04445",
"primary": true
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "RI",
"license": "MD04445",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3122409",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MA LICENSE",
"identifier": "37750",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RI LICENSE",
"identifier": "MD04445",
"state": "RI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7000164",
"state": "RI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woonsocket, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.