NPIMap

Individual provider Active NPI

Douglas M Burtt, M.D.

  • Interventional Cardiology Physician
  • Providence, RI
National Provider Identifier
1962449900
Registry record updated Nov 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
MD13236 Issued in RI
Practice address
208 Collyer St
Providence, RI 02904-1560
Phone
(401) 793-7191
Fax
(401) 793-7200
NPI assigned
May 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 54366 MA
Interventional Cardiology Physician 207RI0011X MD13236 RI Primary

Addresses

Primary practice location

208 Collyer St
Providence, RI 02904-1560

Mailing address

208 Collyer St
Providence, RI 02904-1560
Phone (401) 793-7191

Other identifiers 1

IdentifierTypeStateIssuer
9006434MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040430000657 RI Practitioner - Cardiovascular Disease (Cardiology) 9133116080 Reassigns benefits to 2 organizations
I20050211000802 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 9133116080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
New York University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians

Practice addresses (Care Compare)

11 Friendship St
Newport, RI 02840-2209
Phone (401) 846-6400

152 Emory St
Attleboro, MA 02703-2499
Phone (508) 226-7515

164 Summit Ave
Providence, RI 02906-2853

185 A High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

185 High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

208 Collyer St
Suite 100
Providence, RI 02904-1560
Phone (401) 793-7191

593 Eddy St
Providence, RI 02903-4923

593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172

593 Eddy St George BLDG 1St Floor
Providence, RI 02903-4923
Phone (401) 793-9166

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008
  • Landmark Medical Center Hospital, Woonsocket, RI, CCN 410011

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting15

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Sep 1, 2012 Accepting new patients
The Miriam Hospital CurrentSince Jan 1, 2012 Accepting new patients
The Miriam Hospital Cardiovascular Disease CurrentSince Jan 1, 2012 Accepting new patients
The Miriam Hospital Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Sep 1, 2012 Accepting new patients
The Miriam Hospital Current Accepting new patients
Lifespan Corporation Current Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients
Miriam Cardiology, Inc. Cardiovascular Disease Past Accepting new patients

Locations

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

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

593 Eddy St
Providence, RI 02903

208 Collyer St
Ste 100
Providence, RI 02904
Phone (401) 793-7191

2 Dudley St
Ste 360
Providence, RI 02905
Phone (401) 274-7546

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

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

208 Collyer St
Providence, RI 02904
Phone (401) 421-4200

Interoperability endpoints

  • Direct secure messaging: dburtt9346@brownhealth.medalliesdirect.net

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 8

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353024000000",
    "number": "1962449900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 COLLYER ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041560",
            "telephone_number": "401-793-7191",
            "fax_number": "401-793-7200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLLYER ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041560",
            "telephone_number": "401-793-7191",
            "fax_number": "401-793-7200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURTT",
        "first_name": "DOUGLAS",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-31",
        "last_updated": "2012-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "54366",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "RI",
            "license": "MD13236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9006434",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.