BLACKSTONE MEDICAL CENTER, INC. (NPI# 1992073308) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992073308 |
| Entity Type | Organization |
| Organization Name | BLACKSTONE MEDICAL CENTER, INC. |
| Other Organization Name | LANDMARK MEDICAL CENTER, INC. |
| Practice Address |
115 Cass Ave Woonsocket RI 02895-4705 |
| Practice Telephone | 4017694100 |
| Mailing Telephone | 4017694100 |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |
| Authorized Official Name | MR. JAMES RENNA (CFO) |
| Authorized Official Telephone | 6174194772 |
| Is Organization Subpart | Y |
| Parent Organization Name | STEWARD MEDICAL HOLDINGS, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 00117 | RI | Hospital Units |
| Other Name | Type Code |
|---|---|
| Landmark Medical Center, Inc. | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396090536 | Blackstone Medical Center, Inc. | Internal Medicine | 219 Cass Avenue, Woonsocket, RI 02895-4741 | 2012-07-13 |
| 1033464276 | Blackstone Medical Center, Inc. | Clinical Neuropsychologist | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2012-07-13 |
| 1881949014 | Blackstone Medical Center, Inc. | Nurse Practitioner | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2012-07-13 |
| 1447528856 | Blackstone Medical Center, Inc. | Internal Medicine | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2011-12-13 |
| 1538437942 | Blackstone Medical Center, Inc. | General Acute Care Hospital | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2011-12-13 |
| 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 | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396722666 | Prime Healthcare Services-landmark LLC | Psychiatric Unit | 115 Cass Ave, Woonsocket, RI 02895-4705 | 2005-12-28 |
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|---|---|---|---|---|
| 1528239621 | Veterans Administration Medical Center | Psychiatric Unit | 2 Heathman Road, White Hall, Rm 309, Kingston, RI 02881 | 2008-03-17 |
| 1710534961 | Lmw Healthcare Inc. | Psychiatric Unit | 25 Wells St, Westerly, RI 02891-2922 | 2019-08-22 |
| 1396160396 | Prospect Chartercare Sjhsri, LLC | Psychiatric Unit | 200 High Service Ave, North Providence, RI 02904-5113 | 2014-02-27 |
| 1477978476 | Prospect Chartercare Rwmc, LLC | Psychiatric Unit | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2014-02-27 |
| 1669561528 | Newport Hospital | Psychiatric Unit | 11 Friendship St, Newport, RI 02840-2209 | 2006-10-11 |
| 1083709109 | Rhode Island Hospital | Psychiatric Unit | 593 Eddy St, Providence, RI 02903-4923 | 2006-10-04 |
| 1689658791 | Roger Williams Hospital | Psychiatric Unit | 825 Chalkstone Ave, Providence, RI 02908-4728 | 2005-12-01 |
| 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.