MEMORIAL HOSPITAL (NPI# 1518176874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518176874 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL |
| Other Organization Name | MEMORIAL HOSPITAL OF RHODE ISLAND |
| Practice Address |
111 Brewster Street Pawtucket RI 02860 |
| Practice Telephone | 4017292000 |
| Mailing Telephone | 4017292000 |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2007-12-31 |
| Authorized Official Name | FRANCIS R DIETZ (PRESIDENT-CEO) |
| Authorized Official Telephone | 4017292000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | MH11562 | 05 |
| Other Name | Type Code |
|---|---|
| Memorial Hospital of Rhode Island | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528447992 | Memorial Hospital | General Acute Care Hospital | 1400 E. Boulder St. #3138, Colorado Springs, CO 80045 | 2015-05-19 |
| 1629469002 | Memorial Hospital | Family Medicine | 2319 Old Plank Road, Chester, IL 62233-1116 | 2015-02-06 |
| 1609073709 | Memorial Hospital | Nurse Practitioner | 9099 E Lansing Rd Ste B, Durand, MI 48429-1083 | 2007-07-02 |
| 1003025883 | Memorial Hospital | Psychiatric Residential Treatment Facility | 806 Central Ave Se, Albuquerque, NM 87102-3606 | 2007-05-21 |
| 1376759563 | Memorial Hospital | Family Medicine | 86 Savannah Lane, Bulan, KY 41722 | 2007-05-15 |
| 1598977787 | Memorial Hospital | Family Medicine | 3337 W Britton Rd, Perry, MI 48872 | 2007-05-03 |
| 1639209232 | Memorial Hospital | Internal Medicine | 1480 N M 52, Owosso, MI 48867-1235 | 2007-03-06 |
| 1306973805 | Memorial Hospital | Physician Assistant | 207 Shirlwood Dr, Schenectady, NY 12306-3417 | 2007-02-28 |
| 1851338149 | Memorial Hospital | General Acute Care Hospital | 715 South Taft Avenue, Fremont, OH 43420-3200 | 2006-06-02 |
| 1316923485 | Memorial Hospital | Hospice Care, Community Based | 1412 6th Ave, York, PA 17403-2648 | 2005-12-20 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL | 224 E 2nd St, Dumas, TX 79029-3808 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL & HEALTH CARE CENTER | 800 W 9th St, Jasper, IN 47546-2514 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND COMMUNITY HEALTH FOUNDATION INC | 112 East Fifth Avenue, Antigo, WI 54409-2710 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND HOMES ASSOCIATION, INC. | 415 8th Ave Sw, Perham, MN 56573-1156 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND MANOR | 1500 E Shotwell St, Bainbridge, GA 39819-4256 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AND MEDICAL CENTER | 400 Rosalind Redfern Grover Parkway, Midland, TX 79701-5846 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL AT GULFPORT | 4500 13th St, Gulfport, MS 39501-2515 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL CENTRAL | 1400 E Boulder St, Colorado Springs, CO 80909-5533 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL EAST | 1404 Cross St, Shiloh, IL 62269-2988 |
| System for Award Management (SAM) Entities | MEMORIAL HOSPITAL FOR CANCER & ALLIED DISEASES | 1275 York Ave, New York, NY 10065-6007 |
| Street Address |
111 BREWSTER STREET |
| City | PAWTUCKET |
| State | RI |
| Zip Code | 02860 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407854797 | Alice Yang-hee Kim | Internal Medicine | 111 Brewster Street, Pawtucket, RI 02860-4400 | 2005-07-11 |
| 1063939007 | Abraham Walusimbi | Internal Medicine | 111 Brewster Street, Pawtucket, RI 02860 | 2017-08-29 |
| 1265952576 | Ali Alkhayat | Internal Medicine | 111 Brewster Street, Pawtucket, RI 02860 | 2017-06-27 |
| 1740700780 | Melissa Ochoa-trochez | Family Medicine | 111 Brewster Street, Fcc B, Pawtucket, RI 02860 | 2017-06-21 |
| 1063883270 | Jennifer Derossi-dacosta | Registered Nurse | 111 Brewster Street, Cnemg Primary Care and Specialty Services, Pawtucket, RI 02860-4474 | 2015-10-14 |
| 1528368354 | Bethany S Snow | Physician Assistant | 111 Brewster Street, Pawtucket, RI 02860-4400 | 2010-10-27 |
| 1720260805 | Laura Lynnette Frakey | Clinical Neuropsychologist | 111 Brewster Street, Pawtucket, RI 02860-4400 | 2007-11-30 |
| 1740483742 | Linda Coren Hanley | Pathology | 111 Brewster Street, Department of Pathology, Pawtucket, RI 02860-4400 | 2007-06-07 |
| 1396954640 | Memorial Hospital | Family Medicine | 111 Brewster Street, Memorial Hospital of Rhode Island, Pawtucket, RI 02860 | 2007-05-22 |
| 1679798292 | Eric Gartman | Internal Medicine | 111 Brewster Street, Pawtucket, RI 02860 | 2007-04-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972096923 | Lmb Medical LLC | Internal Medicine | 127 School St, Pawtucket, RI 02860 | 2018-06-13 |
| 1215420435 | Tyla Jackson | Behavior Technician | 70 Wood St Apt 22, Pawtucket, RI 02860 | 2018-06-12 |
| 1376048637 | Michael A Iadevaia | Family Medicine | 111 Brewster St Fl 3, Pawtucket, RI 02860 | 2018-03-28 |
| 1730690488 | Anthony Edwin Ramicone | Physician Assistant | 407 East Ave Ste 120, Pawtucket, RI 02860 | 2017-10-21 |
| 1669991352 | Kathleen K. Kroessler, Md; Neurology & Acupuncture, Inc. PC | Clinic/Center | 407 East Ave; Suite 110, Pawtucket, RI 02860 | 2017-09-13 |
| 1841716230 | Ri Alternative Academy Management, LLC | Local Education Agency (LEA) | 249 Roosevelt Avenue, Pawtucket, RI 02860 | 2017-08-17 |
| 1396265724 | Hannah R Stoops | Family Medicine | 111 Brewster St Fcc A, Pawtucket, RI 02860 | 2017-06-27 |
| 1427578400 | Shaun Michael Flynn | Family Medicine | 111 Brewster St, Fcc A, Pawtucket, RI 02860 | 2017-06-21 |
| 1073051843 | Laura Jane Amaral | Counselor | 750 East Ave Unit 1e, Pawtucket, RI 02860 | 2017-02-01 |
| 1063862027 | Stephanie Shoppell | Counselor | 105 Bacon Street, Pawtucket, RI 02860 | 2016-06-20 |
| Find all providers in zip 02860 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972096923 | Lmb Medical LLC | Internal Medicine | 127 School St, Pawtucket, RI 02860 | 2018-06-13 |
| 1104315258 | Pawtucket Primary Care Inc. | Internal Medicine | 333 School St Ste 107, Pawtucket, RI 02860-5335 | 2018-05-04 |
| 1043635717 | Alton Jules Curran | Internal Medicine | 588 East Ave, Pawtucket, RI 02860 | 2014-03-04 |
| 1386815892 | Coppola Medical Associates, Ltd. | Internal Medicine | 174 Armistice Blvd Ste C, Pawtucket, RI 02860-3269 | 2008-03-13 |
| 1215024963 | Omeed Sani | Internal Medicine | Memorial Hospital of Rhode Isand, 111 Brewster Street, Pawtucket, RI 02860-4499 | 2006-10-06 |
| 1083638282 | Jeffrey Fredric Baron | Internal Medicine | 101 Ferris St, Pawtucket, RI 02861-3454 | 2006-07-27 |
| 1154363695 | Levis M Guzman | Internal Medicine | 139 Benefit St, Pawtucket, RI 02861 | 2006-06-11 |
| 1275570921 | Jiaying Wen | Internal Medicine | 174 Armstice Blvd, Coppola Medical Associate, Pawtucket, RI 02860 | 2006-06-01 |
| 1497743330 | John P Miskovsky | Internal Medicine | 131 Beechwood Avenue, Pawtucket, RI 02860 | 2005-10-13 |
| 1235125808 | Steven George Mccloy | Internal Medicine | 100 Smithfield Ave, Axiom Occupational Health LLC, Pawtucket, RI 02860-3474 | 2005-09-20 |
| Find all providers in PAWTUCKET | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.