NPIMap

Organization Active NPI

East Bay Community Action Program

  • Dental Clinic/Center
  • Newport, RI
National Provider Identifier
1861439705
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
EAST BAY COMMUNITY ACTION PROGRAM
Practice address
19 Broadway
Newport, RI 02840-2937
Phone
(401) 848-6697
Fax
(401) 847-6220
NPI assigned
May 31, 2006
Last updated
Mar 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Authorized official

Name
Mr. Rilwan Feyisitan
Title
Ceo
Phone
(401) 848-6697

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X Primary
Federally Qualified Health Center (FQHC) 261QF0400X 01520 RI

Addresses

Primary practice location

19 Broadway
Newport, RI 02840-2937

Mailing address

19 Broadway
Newport, RI 02840-2937
Phone (401) 848-6697

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040301000102 RI Part B Supplier - Clinic/Group Practice 1951298595 Receives reassigned benefits from 68 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Barrington, RI; East Providence, RI; Middletown, RI; Newport, RI; Riverside, RI
O20040407001561 RI Part A Provider - Federally Qualified Health Center (FQHC) 1951298595 2 other NPIs on this enrollment
Practice locations: Newport, RI
O20040623000437 RI Part A Provider - Federally Qualified Health Center (FQHC) 1951298595 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Riverside, RI
O20140829000799 RI Part A Provider - Federally Qualified Health Center (FQHC) 1951298595 2 other NPIs on this enrollment
Practice locations: Newport, RI

NPI to CCN mapping 3

The Medicare certification numbers (CCNs) connected to NPI 1861439705. Details of each certification follow.

Federally qualified health center certification: CCN 411813

Legal name
EAST BAY COMMUNITY ACTION PROGRAM
Doing business as
NEW VISIONS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 22, 2001
Last certification
Jan 22, 2001
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 12, 1965 in RI
Enrollment address
19 Broadway
Newport, RI 28402937

Federally qualified health center certification: CCN 411803

Legal name
EAST BAY COMMUNITY ACTION PROGRAM
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 1, 1993
Last certification
Jan 1, 1993
Ownership / control type
For profit – corporation
Most recent change of ownership
Nov 1, 2003 (1 total)
Organization structure
CorporationNon-profit
Incorporated
Apr 12, 1965 in RI
Enrollment address
100 Bullocks Point
Riverside, RI 29155351

Federally qualified health center certification: CCN 411846

Legal name
EAST BAY COMMUNITY ACTION PROGRAM
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 2, 2014
Last certification
Sep 2, 2014
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 12, 1965 in RI
Enrollment address
6 John H Chafee Blvd
Newport, RI 28401034

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
New Visions for Newport5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kathleen Ann Charbonneau Individual Corporate DirectorBoard Member Apr 22, 2014
Linda Dipalma Individual Corporate DirectorBoard Member Apr 24, 2012
Anne Richardson Individual Corporate Director Jan 1, 2019
Corporate DirectorBoard Member Feb 23, 2016
Barbara Haskell Individual Corporate Officer Jan 1, 2019
Corporate Director Jun 27, 2006
Corporate DirectorBoard Member Jun 27, 2006
Edward Carusi Individual Corporate DirectorBoard Member Jun 26, 2007
Karen C Ferrara Individual Corporate DirectorBoard Member Feb 26, 2013
Rilwan Feyisitan Individual Contracted Managing EmployeeCeo Feb 1, 2023
Corporate Officer Feb 1, 2023
Corporate OfficerCeo Feb 1, 2023
Corporate OfficerChief Executive Officer Jan 16, 2023
W-2 Managing Employee Jan 16, 2023
Jane Koster Individual Corporate DirectorBoard Secretary Jul 27, 2004
David Bebyn Individual Corporate Officer Jan 1, 2019
Corporate DirectorBoard Member Jul 28, 2015
Lori Silveira Individual Corporate Officer Jan 1, 2019
Corporate Director Jan 1, 2019
Julianne McCarthy Individual Corporate Officer Jan 1, 2019
Corporate Director Jan 1, 2019
Corporate DirectorBoard Member Feb 23, 2016
Jeyson Galvez Individual Corporate Officer Jan 1, 2019
Corporate Director Jan 1, 2019
Julie Chalue Individual Corporate DirectorBoard Member Nov 22, 2011
Laurie Simonds Individual Corporate DirectorBoard Member Jul 27, 2004
James Vincent Individual Corporate DirectorBoard President Jul 27, 2004
Gregory Dias Individual Corporate DirectorBoard Member Jan 23, 2007
Tracy Cooper-Ramos Individual Corporate Director May 31, 2022
Justine Cordeiro Individual Corporate OfficerChief Financial Officer Apr 28, 2023
John Taylor Individual Corporate Director Mar 29, 2022
Jessica Calvino Individual Corporate DirectorBoard Member Feb 23, 2021

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 35

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1861439705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 BROADWAY",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402937",
            "telephone_number": "401-848-6697",
            "fax_number": "401-847-6220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 BROADWAY",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402937",
            "telephone_number": "401-848-6697",
            "fax_number": "401-847-6220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST BAY COMMUNITY ACTION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-31",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "FEYISITAN",
        "authorized_official_first_name": "RILWAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "401-848-6697",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "RI",
            "license": "01520",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, RI

Sources for this page

Verify at the official NPI Registry.