NPIMap

Individual provider Active NPI

Matthew Raymond Hall, DO

  • Internal Medicine Physician
  • Coventry, RI
National Provider Identifier
1790245553
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO01157 Issued in RI
Practice address
595 Washington St
Coventry, RI 02816-5476
Phone
(401) 822-2772
Fax
(401) 821-5260
NPI assigned
Mar 20, 2019
Last updated
Dec 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

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 DO01157 RI Primary

Addresses

Primary practice location

595 Washington St
Coventry, RI 02816-5476

Mailing address

455 Toll Gate Rd
Warwick, RI 02886-2759

Other practice location 1

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010 ext. 35640

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mrhall@kent.cernerdirect.carene.org Health Information Exchange (HIE)

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
I20220526001984 RI Practitioner - Internal Medicine 6305172164 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New England, College of Osteo Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO01157RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Jul 10, 2022 Accepting new patients
Affinity Physicians LLC. Internal Medicine CurrentSince Jul 10, 2022 Accepting new patients
Duane T Golomb MD Inc CurrentSince Dec 3, 2023 Accepting new patients
Hematology & Oncology Associates of Rhode Island, Inc. PastSince Dec 3, 2023 Accepting new patients

Locations

595 Washington St
Coventry, RI 02816
Phone (401) 822-2772

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: mrhall@direct.carene.org

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 9

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": "1553040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701993600000",
    "number": "1790245553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 WASHINGTON ST",
            "city": "COVENTRY",
            "state": "RI",
            "postal_code": "028165476",
            "telephone_number": "401-822-2772",
            "fax_number": "401-821-5260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7010 x35640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HALL",
        "first_name": "MATTHEW",
        "middle_name": "RAYMOND",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-20",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "DO01157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mrhall@kent.cernerdirect.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "455 Toll Gate Rd",
            "city": "Warwick",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028862759",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coventry, RI

Sources for this page

Verify at the official NPI Registry.