THE MIRIAM HOSPITAL (NPI# 1952328569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952328569 |
| Entity Type | Organization |
| Organization Name | THE MIRIAM HOSPITAL |
| Other Organization Name | DEPARTMENT OF PATHOLOGY |
| Practice Address |
164 Summit Ave Department of Pathology Providence RI 02906-2853 |
| Mailing Address |
164 Summit Ave Patient Financial Services Providence RI 02906-2853 |
| Practice Telephone | 4017934200 |
| Practice Fax Number | 4012745154 |
| Mailing Telephone | 4017934200 |
| Mailing Fax Number | 4012745154 |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2013-12-16 |
| Authorized Official Name | MRS. MARY A WAKEFIELD (EXECUTIVE VICE PRESIDENT & CFO) |
| Authorized Official Telephone | 4014447914 |
| Is Organization Subpart | Y |
| Parent Organization Name | THE MIRIAM HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 282NC0060X |
General Acute Care Hospital Specialization: Critical Access |
122 | RI | Hospitals |
| Y | 207ZP0101X |
Pathology Specialization: Anatomic Pathology |
122 | RI | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Department of Pathology | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518482389 | The Miriam Hospital | Clinic/Center | 1454 S County Trl Ste 1100, East Greenwich, RI 02818-1750 | 2017-08-14 |
| 1902027808 | The Miriam Hospital | Clinic/Center | 11 Summit Ave, Providence, RI 02906-2506 | 2007-05-01 |
| 1568567790 | The Miriam Hospital | Nurse Practitioner | 14 Third Street, Providence, RI 02906-2738 | 2006-09-13 |
| 1225073638 | The Miriam Hospital | Clinical Nurse Specialist | 146 W River St Ste 11a, Providence, RI 02904-2609 | 2006-06-19 |
| 1588088850 | The Miriam Hospital | Internal Medicine | 164 Summit Ave, Fain Bldg, Providence, RI 02906-2853 | 2014-02-07 |
| 1740615277 | The Miriam Hospital | General Acute Care Hospital | 164 Summit Ave, Providence, RI 02906-2853 | 2013-09-03 |
| 1669726451 | The Miriam Hospital | Clinic/Center | 164 Summit Ave, 2rd Floor Fain Building, Providence, RI 02906-2853 | 2012-11-01 |
| 1649538323 | The Miriam Hospital | Clinic/Center | 146 W River St, Providence, RI 02904-2609 | 2012-05-01 |
| 1275810434 | The Miriam Hospital | Psychiatry & Neurology | 1125 N Main St, Providence, RI 02904-5739 | 2011-11-15 |
| 1851677470 | The Miriam Hospital | Internal Medicine | 208 Collyer St, Suite 100, Providence, RI 02904-1560 | 2011-10-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | THE MIRIAM HOSPITAL | 164 Summit Ave, Providence, RI 02906-2894 |
| Street Address |
164 SUMMIT AVE DEPARTMENT OF PATHOLOGY |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02906-2853 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558369512 | Josephine Salhab | Physician Assistant | 164 Summit Ave, Rm C70, Providence, RI 02906-2853 | 2005-07-13 |
| 1619519865 | Sarah Mcnerney | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2853 | 2019-10-09 |
| 1831743095 | Tracy Lynn Carraggi | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906-2853 | 2019-07-26 |
| 1689233975 | Nicole Parascandolo | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906-2894 | 2019-06-10 |
| 1164992558 | Lisha Andrew | Dietitian, Registered | 164 Summit Ave, Providence, RI 02906-2894 | 2018-11-28 |
| 1689156242 | Monique Coley | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2894 | 2018-08-30 |
| 1235615006 | Sameh Mohamed | Internal Medicine | 164 Summit Ave, Providence, RI 02906-2894 | 2018-07-16 |
| 1578058087 | Noor N Safadi | Physician Assistant | 164 Summit Ave, Providence, RI 02906-2853 | 2018-06-27 |
| 1356847172 | Heidi Jimenez | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906 | 2018-04-02 |
| 1831694439 | Laura Canavan | Nurse Practitioner | 164 Summit Ave, Providence, RI 02906 | 2018-03-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285245175 | Birdsong Traditional Medicine, LLC | Acupuncturist | 148 Waterman St. Ground Level, Providence, RI 02906 | 2020-08-13 |
| 1881218071 | Madison Pomerantz | Psychiatry & Neurology | 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 | 2020-06-03 |
| 1316453855 | Ellen Van Ingen Darling | Psychologist | 285 Governor St Ste 250, Providence, RI 02906 | 2017-12-20 |
| 1275063919 | Marissa Martz | Psychiatry & Neurology | 345 Blackstone Blvd., Providence, RI 02906 | 2017-06-15 |
| 1235663220 | Alena Haltzman | Counselor | 223 Summit Ave, Providence, RI 02906 | 2017-04-17 |
| 1669823399 | Kathryn Fleming-ives LLC | Psychiatry & Neurology | 355 Hope St Unit 1, Providence, RI 02906 | 2016-06-23 |
| 1134573389 | Sarah E. Kramer | Psychiatry & Neurology | Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 | 2016-04-13 |
| 1538534201 | Laura Anne Buss | Social Worker | 55 Hope St., Providence, RI 02906 | 2015-12-07 |
| 1700289360 | Tinatin Surguladze | Counselor | 205 Waterman St Suite 106, Providence, RI 02906 | 2014-09-26 |
| 1467851519 | Jamila Allouane | Social Worker | 120 Wayland Avenue Suite 2, Providence, RI 02906 | 2014-08-14 |
| Find all providers in zip 02906 | ||||
| Taxonomy Code | 207ZP0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology |
| 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. [7/1/2007: definition added, source added, 7/1/2009: defintion reformatted; 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 (note: this taxonomy code identifies the "anatomic pathology only" route). To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588032486 | Liz Edmund | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2015-09-09 |
| 1508249392 | Mara Banks | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2015-06-30 |
| 1558781260 | Katelyn Dannheim Drew | Pathology | 593 Eddy Street, Apc 12, Providence, RI 02903-4923 | 2014-04-21 |
| 1790072296 | Calvin E Oyer | Pathology | 101 Dudley St, Providence, RI 02905-2401 | 2011-07-05 |
| 1952544264 | Ali Amin | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2009-04-16 |
| 1770756819 | Christopher Pope Elco | Pathology | 593 Eddy Street, Apc 12, Providence, RI 02903 | 2008-04-09 |
| 1528285467 | Evgeny Yakirevich | Pathology | 593 Eddy St, Department of Pathology Rih Apc 12, Providence, RI 02903-4923 | 2007-04-20 |
| 1780703173 | Alexander M Chirkov | Pathology | 48 Orms St, Providence, RI 02904-2222 | 2007-03-28 |
| 1487770129 | University Pathology | Pathology | 825 Chalkstone Ave, Roger Williams Med Ctr, Pathology Dept., Providence, RI 02908-4728 | 2007-03-22 |
| 1245332642 | Paul Ferbend | Pathology | 825 Chalkstone Ave, Roger Williams Medical Center/pathology Dept., Providence, RI 02908-4728 | 2006-09-05 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02906 |
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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.