Individual provider Active NPI

Ara Sadaniantz, MD

  • Cardiovascular Disease Physician
  • Providence, RI
National Provider Identifier
1992766679
Registry record updated Feb 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD06890 Issued in RI
Practice address
One Randall Square
Suite 305
Providence, RI 02940-7405
Phone
(401) 223-0223
Fax
(401) 312-2099
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X MD06890 RI Primary

Addresses

Primary practice location

One Randall Square
Suite 305
Providence, RI 02940-7405

Mailing address

333 School Street
Suite 112
Pawtucket, RI 02860-5335
Phone (401) 723-1210

Other identifiers 1

IdentifierTypeStateIssuer
9006307MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040304000136 RI Practitioner - Cardiovascular Disease (Cardiology) 8123915014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD06890RIMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Blackstone Cardiology Associates Cardiovascular Disease Past Accepting new patients
Cardiovascular Institute of New England PC Cardiovascular Disease PastSince Jan 1, 2009 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Organizations & group practices 3

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": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1992766679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SCHOOL STREET",
            "address_2": "SUITE 112",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605335",
            "telephone_number": "401-723-1210",
            "fax_number": "401-312-2099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE RANDALL SQUARE",
            "address_2": "SUITE 305",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029407405",
            "telephone_number": "401-223-0223",
            "fax_number": "401-312-2099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SADANIANTZ",
        "first_name": "ARA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "MD06890",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9006307",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.