Individual provider Active NPI

Gloria Y. Sun, M.D.

  • Internal Medicine Physician
  • Wakefield, RI
National Provider Identifier
1992745350
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD10727 Issued in RI
Practice address
481 Kingstown Rd
Wakefield, RI 02879-3626
Phone
(401) 789-0283
Fax
(401) 789-0314
NPI assigned
Jun 7, 2006
Last updated
Jun 15, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD10727 RI Primary

Addresses

Primary practice location

481 Kingstown Rd
Wakefield, RI 02879-3626

Mailing address

481 Kingstown Rd
Wakefield, RI 02879-3626
Phone (401) 789-0283

Other identifiers 5

IdentifierTypeStateIssuer
RI10727OtherRIBLUE CROSS LICENSE RI
0405647OtherRIUNITEDHEALTHCARE
408881OtherRIBLUE CHIP HMORI OF RI
7009265MedicaidRI
MD10727OtherRISTATE LICENSE

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
I20100908000407 RI Practitioner - Internal Medicine 8022132406 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Spring Health Care Management, Inc. Internal Medicine CurrentSince Jan 1, 2018 Accepting new patients
Seacoast Eye Associates Inc Past Accepting new patients
State of Rhode Island Past Accepting new patients
John Jefferys Bandola, M.D. Internal Medicine PastSince Feb 1, 2010 Accepting new patients
Atlantic Professional Services of Rhode Island Incorporated Past Accepting new patients

Locations

3461 S County Trl
East Greenwich, RI 02818
Phone (401) 471-6740

70 Kenyon Ave
#211
Wakefield, RI 02879
Phone (401) 471-6285

70 Kenyon Ave
Unit 211
Wakefield, RI 02879
Phone (401) 789-8543

268 Post Rd
Ste 203
Westerly, RI 02891
Phone (401) 604-2530

Organizations & group practices 5

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1992745350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "481 KINGSTOWN RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793626",
            "telephone_number": "401-789-0283",
            "fax_number": "401-789-0314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "481 KINGSTOWN RD",
            "city": "WAKEFIELD",
            "state": "RI",
            "postal_code": "028793626",
            "telephone_number": "401-789-0283",
            "fax_number": "401-789-0314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "GLORIA",
        "middle_name": "Y.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD10727",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS LICENSE RI",
            "identifier": "RI10727",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE",
            "identifier": "0405647",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHIP HMORI OF RI",
            "identifier": "408881",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7009265",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD10727",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wakefield, RI

Sources for this page

Verify at the official NPI Registry.