Individual provider Active NPI

Mary Beth Sutter, M.D.

  • Family Medicine Physician
  • Pawtucket, RI
National Provider Identifier
1962723205
Registry record updated Jul 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD16669 Issued in RI
Practice address
111 Brewster St
Pawtucket, RI 02860-4400
Phone
(401) 729-2238
Fax
(401) 729-2923
NPI assigned
Jun 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) Physician 207QA0401X MD16669 RI
Family Medicine Physician 207Q00000X MD16669 RI Primary

Addresses

Primary practice location

111 Brewster St
Pawtucket, RI 02860-4400

Mailing address

111 Brewster St
Pawtucket, RI 02860-4400
Phone (401) 729-2238

Other practice location 1

101 Dudley St
Providence, RI 02905-2401
Phone (401) 729-2238

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msutter@direct.carene.org Health Information Exchange (HIE)

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
I20190813000525 RI Practitioner - Family PracticePractitioner - Addiction Medicine 9436392545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Addiction Medicine
Education
Warren Alpert Medical School of Brown University, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Affinity Physicians LLC.Group PAC ID 0244413391, 723 clinicians

Practice addresses (Care Compare)

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Hospital & facility affiliations

  • Kent County Memorial Hospital Hospital, Warwick, RI, CCN 410009

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC. Family Medicine CurrentSince Sep 30, 2019 Accepting new patients
Affinity Physicians LLC CurrentSince Sep 30, 2019 Accepting new patients

Locations

111 Brewster St
Pawtucket, RI 02860
Phone (401) 729-2000

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

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

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.

Hospital & facility affiliations 2

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": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720742400000",
    "number": "1962723205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BREWSTER ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604400",
            "telephone_number": "401-729-2238",
            "fax_number": "401-729-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 BREWSTER ST",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028604400",
            "telephone_number": "401-729-2238",
            "fax_number": "401-729-2923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-729-2238",
            "fax_number": "401-729-2923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTTER",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2024-07-12",
        "certification_date": "2024-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "RI",
            "license": "MD16669",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD16669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msutter@direct.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "111 Brewster St",
            "city": "Pawtucket",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028604400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.