Blackstone Valley Foot and Ankle Inc.
NPI 1720482193ActiveOrganization· Podiatrist, Foot & Ankle Surgery· Pawtucket, RI
Podiatrist, Foot & Ankle Surgery in Pawtucket, Rhode Island, registered in NPPES in October 2014. The authorized official on file is Joseph Kevin Domenico, DPM, Owner. Enrolled in Medicare as dme supplier - physician - podiatry and part b supplier - clinic/group practice.
Overview
| NPI | 1720482193 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 14, 2014 |
| Last updated in NPPES | Apr 24, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Podiatrist, Foot & Ankle Surgery Primary | 213ES0103X | DPM00327 | RI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Podiatry (RI); Part B Supplier - Clinic/Group Practice (RI) |
|---|
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