Individual provider Active NPI

Jeffrey Cumplido, MD

  • Internal Medicine Physician
  • East Providence, RI
National Provider Identifier
1881008480
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD15811 Issued in RI
Practice address
900 Warren Ave Ste 400
East Providence, RI 02914-1430
Phone
(401) 331-1221
Fax
(401) 751-8003
NPI assigned
Jun 12, 2014
Last updated
Apr 2, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD15811 RI Primary

Addresses

Primary practice location

900 Warren Ave Ste 400
East Providence, RI 02914-1430

Mailing address

10 Davol SQ Ste 400
Providence, RI 02903-4760
Phone (401) 421-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jcumplido11373@direct.lifespan.org

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
I20170622002727 RI Practitioner - Internal Medicine 5991922262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Tufts University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

900 Warren Ave
Suite 400
East Providence, RI 02914-1430
Phone (800) 508-4908

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Apr 25, 2021 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2020 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2020 Accepting new patients
Coastal Medical Physicians, Inc. Internal Medicine CurrentSince Apr 25, 2021 Accepting new patients
Lifespan Corporation Current Accepting new patients
Coastal Medical, Inc. Past Accepting new patients

Locations

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

900 Warren Ave
Ste 400
East Providence, RI 02914
Phone (401) 331-1221

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

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

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

245 Chapman St
Ste 300
Providence, RI 02905
Phone (401) 444-4741

593 Eddy St
Providence, RI 02903

375 Wampanoag Trl
Riverside, RI 02915
Phone (401) 649-4010

Interoperability endpoints

  • Direct secure messaging: jcumplido11373@brownhealth.medalliesdirect.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 10

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712016000000",
    "number": "1881008480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 DAVOL SQ STE 400",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034760",
            "telephone_number": "401-421-4000",
            "fax_number": "401-272-1456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WARREN AVE STE 400",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141430",
            "telephone_number": "401-331-1221",
            "fax_number": "401-751-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUMPLIDO",
        "first_name": "JEFFREY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-12",
        "last_updated": "2024-04-02",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD15811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jcumplido11373@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "900 Warren Ave Ste 400",
            "city": "East Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029141430",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.