Individual provider Active NPI

Kristina Marie Duarte, MD

  • Family Medicine Physician
  • Providence, RI
National Provider Identifier
1922076736
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD09763 Issued in RI
Practice address
1 Randall SQ
Providence, RI 02904
Phone
(401) 274-6339
Fax
(401) 456-6290
NPI assigned
Mar 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD09763 RI Primary
Family Medicine Physician 207Q00000X 204590 MA

Addresses

Primary practice location

1 Randall SQ
Providence, RI 02904

Mailing address

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

Other identifiers 2

IdentifierTypeStateIssuer
007059638OtherRIMEDICARE PTAN
9022202MedicaidRI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kduarte59326@HCNetwork.direct-ci.com

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
I20071022000349 RI Practitioner - Family Practice 1355303736 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Geisel School of Medicine at Dartmouth, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Providence Community Health Centers Inc.Group PAC ID 9335050962, 90 clinicians

Practice addresses (Care Compare)

1 Randall SQ
Providence, RI 02904-2709
Phone (401) 274-6339

375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
204590MAMDFamily Medicine Physician
MD09763RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Providence Community Health Centers, Inc CurrentSince Sep 10, 2018 Accepting new patients
The Providence Community Health Centers Inc. Past Accepting new patients

Locations

375 Allens Ave
Providence, RI 02905
Phone (401) 444-0400

1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500

Interoperability endpoints

  • Direct secure messaging: kduarte59326@hcnetwork.direct-ci.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702598400000",
    "number": "1922076736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400",
            "fax_number": "401-444-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RANDALL SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02904",
            "telephone_number": "401-274-6339",
            "fax_number": "401-456-6290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUARTE",
        "first_name": "KRISTINA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-08",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD09763",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "204590",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "007059638",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9022202",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kduarte59326@HCNetwork.direct-ci.com",
            "affiliation": "N",
            "address_1": "1 Randall Sq",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "02904",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.