DR. DENIS E JR. MOONAN (M.D.) – Geriatric Medicine (Internal Medicine) Physician, NPI 1386626174

DR. DENIS E JR. MOONAN (M.D.) is a healthcare provider. based in North providence, Rhode Island. specializing in Geriatric Medicine (Internal Medicine) Physician. They hold the professional credentials M.D.. They hold a License No. MD05654 (RI). The NPI Number for DR. DENIS E JR. MOONAN (M.D.) is 1386626174

Main info

Male
Sole Proprietor
52 Years Of Experience
Accepts Medicare Assignment
Name
DR. DENIS E JR. MOONAN (M.D.)
NPI
1386626174
Phone
(401) 353-0555
Address
1515 SMITH ST
Enumeration Date
16 November 2005
Last Update Date
9 September 2016

Doctor Profile

Medical School Name
CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Secondary Phone
-
Graduation Year
1974 (52 years ago)
PAC ID
2264597319
Professional Enrollment ID
I20090224000586
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for DR. DENIS E JR. MOONAN (M.D.)

  • 1515, Smith Street, Centerdale, Fruit Hill, North Providence, Providence County, Rhode Island, 02911, United States

    SUITE N

    NORTH PROVIDENCE, RI 029112947

    Phone: (401) 353-0555

    Fax: (401) 353-7079

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-02-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20090224000586IInternal MedicineRITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02911)

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Reviews

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Frequently asked questions

What is the standard ID for DR. DENIS E JR. MOONAN (M.D.) in the U.S.?
In the U.S., DR. DENIS E JR. MOONAN (M.D.) is identified by NPI 1386626174.
Does the public listing show DR. DENIS E JR. MOONAN (M.D.) as active?
DR. DENIS E JR. MOONAN (M.D.)'s NPI record reflects an active status in NPPES.
What type of care does DR. DENIS E JR. MOONAN (M.D.) provide?
DR. DENIS E JR. MOONAN (M.D.)'s profile centers on Geriatric Medicine (Internal Medicine) Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. DENIS E JR. MOONAN (M.D.)?
DR. DENIS E JR. MOONAN (M.D.) is associated with North Providence, Rhode Island in the same public data insurers reference.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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