Individual provider Active NPI

David Robert Cloutier, MD

  • Surgery Physician
  • Providence, RI
National Provider Identifier
1801835939
Registry record updated Jan 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD11212 Issued in RI
Practice address
195 Collyer St
Suite 302
Providence, RI 02904-1869
Phone
(401) 793-5702
Fax
(401) 793-5181
NPI assigned
Jun 5, 2006
Last updated
Jan 29, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD11212 RI Primary

Addresses

Primary practice location

195 Collyer St
Suite 302
Providence, RI 02904-1869

Mailing address

PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625

Other identifiers 1

IdentifierTypeStateIssuer
50565MedicaidRI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address David.Cloutier.usasurg@direct-address.net Direct

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
I20031112000220 RI Practitioner - General Surgery 1557274842 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Geisel School of Medicine at Dartmouth, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
University Surgical Associates, Inc.Group PAC ID 4082503032, 105 clinicians

Practice addresses (Care Compare)

195 Collyer St
Suite 302
Providence, RI 02904-1869
Phone (401) 272-1800

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.78 of 100Reported as individual
Quality
32.15
Promoting interoperability
70
Improvement activities
30
Cost
74.6

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)19
Hernia repair (minimally invasive)17
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Current Accepting new patients
University Surgical Associates, Inc. Surgery CurrentSince Feb 1, 2008 Accepting new patients
Lifespan Physician Group, Inc. Surgery CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

950 Warren Ave
Ste 103
East Providence, RI 02914
Phone (401) 606-4325

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

195 Collyer St
Ste 302
Providence, RI 02904
Phone (401) 793-5140

2 Dudley St
Ste 470
Providence, RI 02905
Phone (401) 274-7546

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

Interoperability endpoints

  • Direct secure messaging: david.cloutier.usasurg@direct-address.net

Organizations & group practices 6

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 1

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": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1801835939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16149",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029160697",
            "telephone_number": "401-453-9625",
            "fax_number": "401-435-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 COLLYER ST",
            "address_2": "SUITE 302",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041869",
            "telephone_number": "401-793-5702",
            "fax_number": "401-793-5181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOUTIER",
        "first_name": "DAVID",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "RI",
            "license": "MD11212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "50565",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "David.Cloutier.usasurg@direct-address.net",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "195 Collyer St",
            "address_2": "Suite 302",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029041869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.