Individual provider Active NPI

Jamil Chaudhry, MD

  • Psychiatry Physician
  • Providence, RI
National Provider Identifier
1952337511
Registry record updated Mar 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD10418 Issued in RI
Practice address
520 Hope St
Providence, RI 02906-2532
Phone
(401) 276-4155
NPI assigned
Jun 24, 2006
Last updated
Mar 27, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD10418 RI Primary

Addresses

Primary practice location

520 Hope St
Providence, RI 02906-2532

Mailing address

528 N Main St
Providence, RI 02904-5757

Other identifiers 8

IdentifierTypeStateIssuer
1093831646OtherBUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
007059459OtherRIMEDICARE ID-TYPE UNSPECIFIED
408013OtherRIBLUE CHIP
1104801349OtherRIBUTLER HOSPITAL NPI
15-31228OtherRIUNITED BEHAVIORAL HEALTH
1104847946OtherRITHE PROVIDENCE CENTER NPI
30422-1OtherRIBLUE CROSS
7008555MedicaidRI

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
I20040817000041 RI Practitioner - Psychiatry 4789657909 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD10418RIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Providence Center Inc Psychiatry CurrentSince Aug 15, 2005 Accepting new patients
Affinity Physicians LLC. Psychiatry Current Accepting new patients
The Providence Center Psychiatry Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

520 Hope St
Providence, RI 02906
Phone (401) 276-4000

528 N Main St
Providence, RI 02904
Phone (401) 276-4020

530 N Main St
Providence, RI 02904
Phone (401) 274-2500

593 Eddy St
#970
Providence, RI 02903
Phone (401) 444-2128

593 Eddy St
Rm 38
Providence, RI 02903
Phone (401) 444-4779

171 Service Ave
Warwick, RI 02886
Phone (401) 222-9157

Interoperability endpoints

  • Direct secure messaging: jchaudhry@direct.carene.org

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1151107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238112000000",
    "number": "1952337511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 HOPE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062532",
            "telephone_number": "401-276-4155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUDHRY",
        "first_name": "JAMIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-24",
        "last_updated": "2009-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD10418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE",
            "identifier": "1093831646",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-TYPE UNSPECIFIED",
            "identifier": "007059459",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP",
            "identifier": "408013",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUTLER HOSPITAL NPI",
            "identifier": "1104801349",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED BEHAVIORAL HEALTH",
            "identifier": "15-31228",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE PROVIDENCE CENTER NPI",
            "identifier": "1104847946",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "30422-1",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7008555",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.