Individual provider Active NPI

Liza Cantor, M.D.

  • Pediatrics Physician
  • Warwick, RI
National Provider Identifier
1992152219
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD16709 Issued in RI
Practice address
300 Centerville Rd # 110
Warwick, RI 02886-0200
Phone
(401) 615-2299
NPI assigned
May 17, 2016
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X MD16709 RI Primary

Addresses

Primary practice location

300 Centerville Rd # 110
Warwick, RI 02886-0200

Mailing address

300 Centerville Rd # 110
Warwick, RI 02886-0200
Phone (401) 615-2299

Other practice location 1

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4471

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lcantor164118@direct.lifespan.org

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
I20190627001507 RI Practitioner - Pediatric Medicine 5496040669 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

300 Centerville Rd
Warwick, RI 02886-0200
Phone (401) 615-2299

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD16709RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. CurrentSince Apr 28, 2021 Accepting new patients
Coastal Medical Physicians, Inc. Pediatrics CurrentSince Apr 28, 2021 Accepting new patients
Lifespan Corporation Current Accepting new patients
Coastal Medical, Inc. Past Accepting new patients

Locations

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

593 Eddy St
Providence, RI 02903

300 Centerville Rd
Warwick, RI 02886
Phone (401) 615-2299

300 Centerville Rd
#110
Warwick, RI 02886
Phone (401) 615-2299

Interoperability endpoints

  • Direct secure messaging: lcantor164118@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, 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": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1992152219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CENTERVILLE RD # 110",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028860200",
            "telephone_number": "401-615-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CENTERVILLE RD # 110",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028860200",
            "telephone_number": "401-615-2299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "593 Eddy St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029034923",
            "country_code": "US",
            "telephone_number": "401-444-4471",
            "fax_number": "401-444-7574",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANTOR",
        "first_name": "LIZA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "MD16709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lcantor164118@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "300 Centerville Rd # 110",
            "city": "Warwick",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028860200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.