NPIMap

Individual provider Active NPI

Faridah T Rodriguez, MD

  • Family Medicine Physician
  • West Warwick, RI
National Provider Identifier
1902050503
Registry record updated Jan 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD13379 Issued in RI
Practice address
186 Providence St
West Warwick, RI 02893-2508
Phone
(401) 615-2800
Fax
(401) 615-2805
NPI assigned
Nov 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD13379 RI Primary

Addresses

Primary practice location

186 Providence St
West Warwick, RI 02893-2508

Mailing address

450 Clinton St
Woonsocket, RI 02895-3207
Phone (401) 767-4100

Other identifiers 1

IdentifierTypeStateIssuer
FR82330MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100921001511 RI Practitioner - Family Practice 9931225448 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2003
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)

711 Main Rd
Tiverton, RI 02878-1352
Phone (401) 624-1400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD13379RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Family Medicine CurrentSince Feb 1, 2024 Accepting new patients
Lifespan Corporation Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jan 1, 2016 Accepting new patients
Coastal Medical Physicians, Inc. CurrentSince Feb 1, 2024 Accepting new patients
Coastal Medical, Inc. Past Accepting new patients

Locations

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

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

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

711 Main Rd
Tiverton, RI 02878
Phone (401) 624-1400

Interoperability endpoints

  • Direct secure messaging: frodriguez162285@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 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": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325721600000",
    "number": "1902050503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 CLINTON ST",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953207",
            "telephone_number": "401-767-4100",
            "fax_number": "401-235-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 PROVIDENCE ST",
            "city": "WEST WARWICK",
            "state": "RI",
            "postal_code": "028932508",
            "telephone_number": "401-615-2800",
            "fax_number": "401-615-2805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODRIGUEZ",
        "first_name": "FARIDAH",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2012-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD13379",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "FR82330",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Warwick, RI

Sources for this page

Verify at the official NPI Registry.