NPIMap

Individual provider Active NPI

Jesse Luke Hart, D.O.

  • Anatomic Pathology & Clinical Pathology Physician
  • Providence, RI
National Provider Identifier
1942409461
Registry record updated Oct 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
DO00766 Issued in RI
Practice address
593 Eddy St
Apc 12
Providence, RI 02903-4923
Phone
(401) 444-5151
Fax
(401) 444-8514
NPI assigned
Jul 13, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X DO00766 RI Primary

Addresses

Primary practice location

593 Eddy St
Apc 12
Providence, RI 02903-4923

Mailing address

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140922000023 RI Practitioner - Pathology 1850510033 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of New England, College of Osteo Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Newport HospitalGroup PAC ID 0042111437, 42 clinicians
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

11 Friendship St
Newport, RI 02840-2209
Phone (401) 845-1110

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-7245

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-3777

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO00766RIMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Miriam Hospital Current Accepting new patients
Newport Hospital CurrentSince Aug 4, 2014 Accepting new patients
Newport Hospital Anatomic Pathology & Clinical Pathology CurrentSince Aug 4, 2014 Accepting new patients
The Miriam Hospital Anatomic Pathology & Clinical Pathology CurrentSince Mar 1, 2017 Accepting new patients

Locations

950 Warren Ave
Ste 103
East Providence, RI 02914
Phone (401) 606-4325

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

593 Eddy St
Providence, RI 02903

593 Eddy St
#12
Providence, RI 02903
Phone (401) 444-5057

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

164 Summit Ave
Ste C
Providence, RI 02906
Phone (401) 793-2931

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

Organizations & group practices 5

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 7

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446076800000",
    "number": "1942409461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST",
            "address_2": "SUITE 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": "593 EDDY ST",
            "address_2": "APC 12",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5151",
            "fax_number": "401-444-8514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HART",
        "first_name": "JESSE",
        "middle_name": "LUKE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2015-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "RI",
            "license": "DO00766",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.