Individual provider Active NPI

Marc Jonathan Perkel, PSYD

  • Clinical Psychologist
  • Riverside, RI
National Provider Identifier
1932337748
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PS01723 Issued in RI
Practice address
1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone
(401) 432-1000
Fax
(401) 432-1500
NPI assigned
Jun 30, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PS01723 RI Primary

Addresses

Primary practice location

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4513
Phone (401) 444-6779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20181019000353 RI Practitioner - Clinical Psychologist 2769735802 Reassigns benefits to 3 organizations
I20250805001327 CA Practitioner - Clinical Psychologist 2769735802 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Clinical CurrentSince Feb 6, 2019 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Nov 1, 2018 Accepting new patients
Rhode Island Hospital CurrentSince Feb 6, 2019 Accepting new patients
Lifespan Physician Group, Inc. Clinical CurrentSince Nov 1, 2018 Accepting new patients
Children'S Hospital Los Angeles Medical Group, Inc. CurrentSince Jun 22, 2025 Accepting new patients
Emma Pendleton Bradley Hospital CurrentSince Nov 1, 2018 Accepting new patients
Emma Pendleton Bradley Hospital CurrentSince Nov 1, 2018 Accepting new patients

Locations

4650 W Sunset Blvd
Los Angeles, CA 90027
Phone (323) 361-2122

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

900 Warren Ave
Ste 201
East Providence, RI 02914
Phone (401) 444-3575

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

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

593 Eddy St
Providence, RI 02903

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

1011 Veterans Memorial Pkwy
Riverside, RI 02915
Phone (401) 432-1000

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": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1932337748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054513",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "RIVERSIDE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-432-1000",
            "fax_number": "401-432-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKEL",
        "first_name": "MARC",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-30",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "RI",
            "license": "PS01723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, RI

Sources for this page

Verify at the official NPI Registry.