Individual provider Active NPI

Robert G McRae, MD

  • Otolaryngology Physician
  • Providence, RI
National Provider Identifier
1912015033
Registry record updated Apr 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
5604 Issued in RI
Practice address
118 Dudley St
Providence, RI 02905-2403
Phone
(401) 274-2300
Fax
(401) 272-1302
NPI assigned
Aug 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 5604 RI Primary

Addresses

Primary practice location

118 Dudley St
Providence, RI 02905-2403

Mailing address

118 Dudley St
Providence, RI 02905-2403
Phone (401) 274-2300

Other identifiers 1

IdentifierTypeStateIssuer
9000111MedicaidRI

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
I20040810000922 RI Practitioner - Otolaryngology 1951373927 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Tufts University School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Otolaryngology-Head and Neck Surgery, Inc.Group PAC ID 3274613930, 19 clinicians

Practice addresses (Care Compare)

830 Eddy St
Providence, RI 02905-4810
Phone (401) 885-8484

Hospital & facility affiliations

  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5604RIMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Otolaryngology-Head and Neck Surgery, Inc. Otolaryngology CurrentSince Dec 1, 2007 Accepting new patients
University Otolaryngology Head & Neck Surgery Inc. PastSince Dec 1, 2007 Accepting new patients

Locations

1351 S County Trl
Ste 303
East Greenwich, RI 02818
Phone (401) 885-8484

1351 S County Trl
Ste 303305
East Greenwich, RI 02818
Phone (401) 885-8484

1351 S County Trl
Ste 304
East Greenwich, RI 02818
Phone (401) 626-3708

118 Dudley St
Providence, RI 02905
Phone (401) 273-4155

830 Eddy St
Providence, RI 02905
Phone (401) 274-2300

Interoperability endpoints

  • Direct secure messaging: rmcrae@univoto.emadirect.md

Organizations & group practices 2

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 4

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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1912015033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052403",
            "telephone_number": "401-274-2300",
            "fax_number": "401-272-1302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052403",
            "telephone_number": "401-274-2300",
            "fax_number": "401-272-1302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCRAE",
        "first_name": "ROBERT",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-28",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "RI",
            "license": "5604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000111",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.