Individual provider Active NPI

Matthew Kluge

  • Cardiovascular Disease Physician
  • Providence, RI
National Provider Identifier
1861887663
Registry record updated Jun 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD18350 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-5891
NPI assigned
Mar 30, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 273198 MA
Cardiovascular Disease Physician 207RC0000X MD18350 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

Other practice location 1

330 Brookline Ave # Span2
Boston, MA 02215
Phone (617) 754-4777

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
I20220728001180 RI Practitioner - Cardiovascular Disease (Cardiology) 3577878719 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Boston University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-4102

950 Warren Ave
FL 2
East Providence, RI 02914-1432
Phone (401) 606-1004

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
273198MAMDInternal Medicine Physician
MD18350RIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital CurrentSince Jan 2, 2024 Accepting new patients
Rhode Island Hospital Cardiovascular Disease CurrentSince Jan 2, 2024 Accepting new patients
The Miriam Hospital CurrentSince Aug 1, 2022 Accepting new patients
The Miriam Hospital Cardiovascular Disease CurrentSince Aug 1, 2022 Accepting new patients
The Miriam Hospital Current Accepting new patients
The Miriam Hospital Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Aug 1, 2022 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Aug 1, 2022 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 201
East Providence, RI 02914
Phone (855) 332-8474

950 Warren Ave
Fl 2
East Providence, RI 02914

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

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

593 Eddy St
Bldg 1ST
Providence, RI 02903

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

593 Eddy St
Providence, RI 02903

146 W River St
#11A
Providence, RI 02904
Phone (401) 606-8250

208 Collyer St
Ste 100
Providence, RI 02904
Phone (401) 793-7191

Organizations & group practices 9

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 7

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655251200000",
    "number": "1861887663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5891"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Brookline Ave # Span2",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02215",
            "country_code": "US",
            "telephone_number": "617-754-4777",
            "fax_number": "617-732-0215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLUGE",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-03-30",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "273198",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "MD18350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.