Individual provider Active NPI

Preston W Douglas, M.D.

  • Neurology Physician
  • Newport, RI
National Provider Identifier
1821416637
Registry record updated Jun 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD16188 Issued in RI
Practice address
19 Friendship St
Newport, RI 02840-2272
Phone
(401) 845-3800
NPI assigned
Mar 31, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X MD16188 RI Primary

Addresses

Primary practice location

19 Friendship St
Newport, RI 02840-2272

Mailing address

19 Friendship St
Newport, RI 02840-2272
Phone (401) 845-3800

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
I20190130002777 RI Practitioner - NeurologyPractitioner - Internal Medicine 0244531820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
NeurologyAlso: Internal Medicine
Education
University of Texas Medical School at San Antonio, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

19 Friendship St
Suite 150 160
Newport, RI 02840-2272
Phone (401) 845-3800

Hospital & facility affiliations

  • Visiting Nurse Home and Hospice Home health agency, Middleton, RI, CCN 417000
  • Newport Hospital Hospital, Newport, RI, CCN 410006
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16188RIMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Jul 14, 2019 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 14, 2019 Accepting new patients

Locations

19 Friendship St
Ste 150160
Newport, RI 02840
Phone (401) 845-3800

19 Friendship St
Newport, RI 02840
Phone (401) 845-4340

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

77 Turnpike Ave
Portsmouth, RI 02871
Phone (401) 683-2290

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

Organizations & group practices 2

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 8

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": "1396224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561593600000",
    "number": "1821416637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 FRIENDSHIP ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402272",
            "telephone_number": "401-845-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 FRIENDSHIP ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402272",
            "telephone_number": "401-845-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLAS",
        "first_name": "PRESTON",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-31",
        "last_updated": "2019-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "RI",
            "license": "MD16188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, RI

Sources for this page

Verify at the official NPI Registry.