Individual provider Active NPI

Archana Lingannan, M.D

  • Pediatric Gastroenterology Physician
  • Providence, RI
National Provider Identifier
1902272644
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
A171378 Issued in CA
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-8306
NPI assigned
Aug 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2080P0206X 1902272644 RI
Pediatric Gastroenterology Physician 2080P0206X A171378 CA Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-8306

Other practice location 1

9300 Valley Childrens Pl
Madera, CA 93636-8761
Phone (559) 353-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210709002755 CA Practitioner - GastroenterologyPractitioner - Pediatric Medicine 4082016274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Pediatric Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Childrens Medical GroupGroup PAC ID 9032439336, 50 clinicians

Practice addresses (Care Compare)

1524 McHenry Ave
Modesto, CA 95350-4500
Phone (209) 572-3880

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A171378CAMDPediatric Gastroenterology Physician
1902272644RIMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Confermed of California PC Single Specialty CurrentSince Dec 13, 2024 Accepting new patients
Valley Children'S Medical Group Single Specialty CurrentSince Jun 1, 2021 Accepting new patients
Confermed PC Single Specialty Past Accepting new patients
Valley Children'S Hospital Past Accepting new patients

Locations

215 N Fresno St
Ste 370B
Fresno, CA 93701

101 Academy
Ste 100
Irvine, CA 92617
Phone (860) 323-0172

9300 Valley Childrens Pl
Madera, CA 93636
Phone (559) 353-5700

1524 McHenry Ave
Ste 550570
Modesto, CA 95350
Phone (209) 572-3880

11 Silver St
Unit 856
Middletown, CT 06457

Interoperability endpoints

  • Direct secure messaging: alingannan56462@valleychildrens-prd.direct-ci.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1439769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623974400000",
    "number": "1902272644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8306",
            "fax_number": "401-444-8748"
        },
        {
            "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": "401-444-8306"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9300 Valley Childrens Pl",
            "address_purpose": "LOCATION",
            "city": "Madera",
            "state": "CA",
            "postal_code": "936368761",
            "country_code": "US",
            "telephone_number": "559-353-5700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINGANNAN",
        "first_name": "ARCHANA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-17",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "RI",
            "license": "1902272644",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "CA",
            "license": "A171378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.