Individual provider Active NPI

Matthew David Ethier, MD

  • Diagnostic Radiology Physician
  • Warwick, RI
National Provider Identifier
1821290644
Registry record updated Mar 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD14120 Issued in RI
Practice address
125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1768
Phone
(401) 432-2520
Fax
(401) 453-8220
NPI assigned
Jun 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LP01168 RI
Diagnostic Radiology Physician 2085R0202X 254498 MA
Diagnostic Radiology Physician 2085R0202X MD14120 RI Primary

Addresses

Primary practice location

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1768

Mailing address

125 Metro Center Blvd
Suite 2000
Warwick, RI 02886-1768
Phone (401) 432-2520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20130128000029 RI Practitioner - Diagnostic Radiology 1254585318 Reassigns benefits to 1 organization
I20130823000868 MA Practitioner - Diagnostic Radiology 1254585318 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Massachusetts Medical School, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern New England Radiology IncGroup PAC ID 9931404084, 22 clinicians

Practice addresses (Care Compare)

37 Antonio Dr
Seekonk, MA 02771-5345
Phone (508) 961-5856

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.59 of 100Reported as group
Quality
82.73
Improvement activities
40
Cost
81.43

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP01168RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern New England Radiology Inc Diagnostic Radiology CurrentSince Dec 31, 2019 Accepting new patients

Locations

363 Highland Ave
Fall River, MA 02720
Phone (508) 679-7052

300B Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 973-1020

672 Aquidneck Ave
Middletown, RI 02842
Phone (401) 847-0519

Interoperability endpoints

  • Direct secure messaging: methier38929@direct.southcoast.org

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.

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1821290644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD",
            "address_2": "SUITE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861768",
            "telephone_number": "401-432-2520",
            "fax_number": "401-453-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861768",
            "telephone_number": "401-432-2520",
            "fax_number": "401-453-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETHIER",
        "first_name": "MATTHEW",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP01168",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "254498",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "RI",
            "license": "MD14120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.