Individual provider Active NPI

Meghan Elizabeth Fredette, MD

  • Pediatric Endocrinology Physician
  • Providence, RI
National Provider Identifier
1912249335
Registry record updated Apr 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
MD15403 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 793-8100
Fax
(401) 793-8101
NPI assigned
Mar 24, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X 280888 MA
Pediatric Endocrinology Physician 2080P0205X MD15403 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

593 Eddy St
Providence, RI 02903-4923
Phone (401) 793-8100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190619000069 RI Practitioner - EndocrinologyPractitioner - Pediatric Medicine 1759676091 Reassigns benefits to 2 organizations
I20190827003521 MA Practitioner - Endocrinology 1759676091 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
280888MAMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Rhode Island Hospital CurrentSince Aug 1, 2019 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Rhode Island Hospital CurrentSince Aug 1, 2019 Accepting new patients
Rhode Island Hospital Past Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

152 Emory St
Attleboro, MA 02703
Phone (508) 222-6409

10 N Main St
Fall River, MA 02720
Phone (508) 646-3923

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

701 George Washington Hwy
Ste 104
Lincoln, RI 02865
Phone (401) 444-8311

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

111 Plain St
Fl 3
Providence, RI 02903
Phone (401) 444-3355

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

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

593 Eddy St
Providence, RI 02903

593 Eddy St
Lowr
Providence, RI 02903
Phone (401) 444-4471

Organizations & group practices 7

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": "1364083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618358400000",
    "number": "1912249335",
    "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": "401-793-8100",
            "fax_number": "401-793-8101"
        },
        {
            "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": "401-793-8100",
            "fax_number": "401-793-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDETTE",
        "first_name": "MEGHAN",
        "middle_name": "ELIZABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-24",
        "last_updated": "2021-04-14",
        "certification_date": "2021-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MA",
            "license": "280888",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "RI",
            "license": "MD15403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.