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Physician Compare National (NPI:1114348505)

HEALTHCARE PROVIDER: AMANDA RAPOSO MS, RD, LDN

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1114348505
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1052533957
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20150706000236
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name RAPOSO
Individual professional last name
Provider First Name AMANDA
Individual professional first name
Provider Middle Name J
Individual professional middle name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2009
Individual professional's medical school graduation year
Primary Specialty REGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name HEALTHWAYRI INC
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 9638273618
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 3
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 1145 RESERVOIR AVE
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 126
Group Practice or individual's line 2 address
City CRANSTON
Group Practice or individual's city
State RI
Group Practice or individual's state
Zip Code 029206000
Group Practice or individual's zip code (9 digits when available)
Phone Number 4012286010
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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