Individual provider Active NPI

Lionel McIntosh, M.D.

  • Sports Medicine (Family Medicine) Physician
  • East Providence, RI
National Provider Identifier
1972899896
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
MD19950 Issued in RI
Practice address
900 Warren Ave Ste 401
East Providence, RI 02914-1430
Phone
(401) 330-2480
Fax
(401) 808-6329
NPI assigned
Jun 20, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X MD19950 RI Primary

Addresses

Primary practice location

900 Warren Ave Ste 401
East Providence, RI 02914-1430

Mailing address

900 Warren Ave Ste 401
East Providence, RI 02914-1430
Phone (401) 330-2480

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
I20240611001857 RI Practitioner - Sports Medicine 9335453034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

900 Warren Ave
Suite 401
East Providence, RI 02914-1430
Phone (401) 330-2480

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Newport Hospital Hospital, Newport, RI, CCN 410006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD19950RIMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Coastal Medical Physicians, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Lifespan Corporation Current Accepting new patients
Coastal Medical, Inc. Past Accepting new patients

Locations

1598 S County Trl
Ste 201
East Greenwich, RI 02818
Phone (401) 884-0333

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

78 Baker St
Providence, RI 02905
Phone (401) 781-2400

10 Davol Sq
Ste 300
Providence, RI 02903

Interoperability endpoints

  • Direct secure messaging: lmcintosh225933@brownhealth.medalliesdirect.net

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1308528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1972899896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 WARREN AVE STE 401",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141430",
            "telephone_number": "401-330-2480",
            "fax_number": "401-808-6329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WARREN AVE STE 401",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141430",
            "telephone_number": "401-330-2480",
            "fax_number": "401-808-6329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "LIONEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-20",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "RI",
            "license": "MD19950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.