| Wayland Medical Associates | |
|
160 Wayland Ave Providence RI 02906-4304 | |
| (401) 521-1221 | |
| (401) 454-4189 |
| Full Name | Wayland Medical Associates |
|---|---|
| Speciality | Internal Medicine |
| Location | 160 Wayland Ave, Providence, Rhode Island |
| Authorized Official Name and Position | Richard J Ruggieri (PHYSICIAN OWNER) |
| Authorized Official Contact | 4015211221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wayland Medical Associates 160 Wayland Ave Providence RI 02906-4304 Ph: (401) 521-1221 | Wayland Medical Associates 160 Wayland Ave Providence RI 02906-4304 Ph: (401) 521-1221 |
| NPI Number | 1558480434 |
|---|---|
| Provider Enumeration Date | 03/29/2007 |
| Last Update Date | 10/12/2021 |
| Medicare PECOS PAC ID | 9638159676 |
|---|---|
| Medicare Enrollment ID | O20040721001092 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558480434 | NPI | - | NPPES |
| 9021123 | Medicaid | RI | |
| DD2464 | Other | RAILROAD MEDICARE GROUP # | |
| 404203 | Other | MA | TUFTS GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 07821 (Rhode Island) | Primary |
| Provider Name | Richard J Ruggieri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700883055 PECOS PAC ID: 5698755643 Enrollment ID: I20040726000055 |
| Provider Name | Geoffrey H Berg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902804313 PECOS PAC ID: 0345220703 Enrollment ID: I20040726000083 |
| Provider Name | Shandrea Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629278379 PECOS PAC ID: 0840553723 Enrollment ID: I20180405001185 |
| Provider Name | Abbey E Barkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568179547 PECOS PAC ID: 0547634131 Enrollment ID: I20230322001292 |
| Provider Name | Morgan-jean Hiraldo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215700216 PECOS PAC ID: 4183076474 Enrollment ID: I20240123001902 |
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