LANDMARK MEDICAL CENTER (NPI# 1629055751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629055751 |
| Entity Type | Organization |
| Organization Name | LANDMARK MEDICAL CENTER |
| Other Organization Name | LANDMARK MC PATHOLOGY DEPT. |
| Practice Address |
115 Cass Ave Woonsocket RI 02895-4705 |
| Mailing Address |
196 Cass Ave Woonsocket RI 02895-4712 |
| Practice Telephone | 4017694100 |
| Practice Fax Number | 4017691744 |
| Mailing Telephone | 4017694100 |
| Mailing Fax Number | 4017656024 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MARY MACINTOSH (SVP/CFO) |
| Authorized Official Telephone | 4017694100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ZP0105X |
Pathology Specialization: Clinical Pathology/Laboratory Medicine |
00117 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | TUFTS HEALTH PLAN (IP) | 903289 | 01 |
| RI | 9006490 | 05 | |
| MA | TUFTS HEALTH PLAN (OP) | 903288 | 01 |
| Other Name | Type Code |
|---|---|
| Landmark MC Pathology Dept. | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073722005 | Landmark Medical Center | Psychiatric Residential Treatment Facility | 2030 N Garey Ave, Pomona, CA 91767-2722 | 2007-05-22 |
| 1942412002 | Landmark Medical Center | Clinical Neuropsychologist | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2007-05-03 |
| 1043297112 | Landmark Medical Center | Internal Medicine | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2005-12-29 |
| 1982681060 | Landmark Medical Center | Nuclear Medicine | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2005-12-29 |
| 1619954724 | Landmark Medical Center | Preventive Medicine | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2005-12-29 |
| 1285611392 | Landmark Medical Center | Nurse Practitioner | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2005-12-29 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | LANDMARK MEDICAL CENTER | 115 Cass Ave, Woonsocket, RI 02895-4705 |
| Street Address |
115 CASS AVE |
| City | WOONSOCKET |
| State | RI |
| Zip Code | 02895-4705 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114900024 | Glenn G. Fort | Internal Medicine | 115 Cass Ave, Landmark Medical Center, Woonsocket, RI 02895 | 2005-11-23 |
| 1407462955 | Alexandra Leigh Cataldo | Registered Nurse | 115 Cass Ave, Woonsocket, RI 02895-4731 | 2020-09-21 |
| 1568078434 | Abdessamad El Adnani | Student in an Organized Health Care Education/Training Program | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2020-09-16 |
| 1366078206 | Ethan Richard Manos | Physician Assistant | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2020-03-22 |
| 1972148047 | Leanne Benson | Advanced Practice Midwife | 115 Cass Ave, Woonsocket, RI 02895-4731 | 2019-11-13 |
| 1962055004 | Prime Healthcare Services - Landmark,llc | Pharmacy | 115 Cass Ave, Woonsocket, RI 02895-4731 | 2019-07-18 |
| 1992367734 | Sean Mitchell Conger | Physician Assistant | 115 Cass Ave, Woonsocket, RI 02895-4731 | 2019-07-02 |
| 1811457583 | Kenneth Charles Baris Jr. | Physician Assistant | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2019-03-20 |
| 1366920217 | Carla Angela Salvadore | Nurse Practitioner | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2018-08-02 |
| 1578097143 | Jennifer Fix | Nurse Practitioner | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2017-04-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730732017 | Karissa Cardoso | Behavior Technician | 36 Cleveland Street, Apt 1, Woonsocket, RI 02895 | 2019-07-16 |
| 1841714177 | Richard Keith Polacek | Behavioral Analyst | 30 Cumberland St., Woonsocket, RI 02895 | 2017-07-28 |
| 1912353335 | Muria Irine Nisbett | Social Worker | 4 Gaulin Ave., Floor 4, Woonsocket, RI 02895 | 2016-05-05 |
| 1083046833 | Shaylyn Kathleen Mcteague | Podiatrist | 20 Cumberland Hill Rd Unit 210, Woonsocket, RI 02895 | 2013-08-04 |
| 1902243165 | David J. Ward Dmd, PC | Dentist | 460 S. Main St., Woonsocket, RI 02895 | 2013-05-29 |
| 1073876256 | Patricia J Corbett | Social Worker | 181 Cumberland St # 301, Woonsocket, RI 02895 | 2012-06-21 |
| 1114206521 | Patricia Nievez Alvarez | Social Worker | 181 Cumberland St Ste 301, Woonsocket, RI 02895 | 2011-08-16 |
| 1891082970 | Ann Katherine Maccarone | Speech-Language Pathologist | 1 Cumberland St., Woonoscket, RI 02895 | 2011-07-08 |
| 1043507734 | Infectious Diseases Associates of Rhode Island | Internal Medicine | 115 Cass Avenue - 3rd Floor, C/o Landmark Medical, Woonsocket, RI 02895 | 2011-07-01 |
| 1740577543 | Michelle Marie Durand Straube | Optometrist | 385 Mendon Road, Woonsocket, RI 02895 | 2011-06-30 |
| Find all providers in zip 02895 | ||||
| Taxonomy Code | 207ZP0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Clinical Pathology/Laboratory Medicine |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/. American Osteopathic Board of Pathology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pathology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275733511 | James M Barbeau | Pathology | 593 Eddy St, Apc 12, Providence, RI 02903-4923 | 2007-07-24 |
| 1871799676 | Jeffrey A Bailey | Pathology | 593 Eddy St, Providence, RI 02903 | 2007-06-27 |
| 1194945980 | Memorial Hospital | Pathology | 111 Brewster St, Pawtucket, RI 02860-4400 | 2007-04-26 |
| 1487771861 | Women & Infants Hospital of Ri | Pathology | 101 Dudley St, Providence, RI 02905-2401 | 2007-03-23 |
| 1114060670 | John Dominic Romo | Pathology | 525 Broad St, Cumberland, RI 02864-6919 | 2007-02-15 |
| 1285611285 | Northern Ri Rehab Management Associates Lp | Pathology | 116 Eddie Dowling Hwy, North Smithfield, RI 02896-7327 | 2005-12-30 |
| City | WOONSOCKET |
| Zip Code | 02895 |
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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.