Miguel A Fuentes, M.D.

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

MD 8499 Issued in RI

Practice address

967 Mineral Spring Ave
North Providence, RI 02904-4934

Phone

(401) 312-0444

Fax

(401) 312-0446

NPI assigned

Sep 28, 2006

Last updated

Feb 15, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Santiago Medical Group, Inc.

  • Pediatric Adolescent Medicine Physician
  • North Providence, RI
  • NPI 1790830339
  NPD (past) Authorized official

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1912098336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "967 MINERAL SPRING AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044934",
            "telephone_number": "401-312-0444",
            "fax_number": "401-312-0446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "967 MINERAL SPRING AVE",
            "city": "NORTH PROVIDENCE",
            "state": "RI",
            "postal_code": "029044934",
            "telephone_number": "401-312-0444",
            "fax_number": "401-312-0446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUENTES",
        "first_name": "MIGUEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "RI",
            "license": "MD 8499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MS47209",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "004777",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "1680",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BS",
            "identifier": "22699-4",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH PLAN",
            "identifier": "12-02799",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "406110",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chelsea Elizabeth Frade, LCSW
• Randi Vera Frankl, OD
• Jason Lawrence Franklin, LCSW
• Alyssa Natale Friedman, PA-C
• Fruit Hill Day Services for Elderly
• Full Circle Behavioral Health
• Eric B. Gaboriault, LMHC
• Daphnay Laura Gabriel
• Galaxy Connections Counseling LLC
• Edward T Gallucci, DC

• Pediatric Adolescent Medicine Physician in North Providence, RI
• Providers in North Providence, RI by specialty
• Pediatric Adolescent Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.