SCMG Urology – Urology Physician, NPI 1477052256
Urology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for SCMG Urology
3461 S County Trl Ste 201
East Greenwich, RI 028181463
Phone: (401) 788-8780
Fax: (401) 788-8787
Type: Location
120 Centerville Rd Ste 3
Warwick, RI 028864336
Phone: (401) 788-8780
Fax: (401) 788-8787
Type: Location
70 KENYON AVE UNIT 324
WAKEFIELD, RI 02879
Phone: (401) 788-8757
Fax: (401) 782-9867
Type: Location
38 Powel Ave
Newport, RI 028402655
Phone: (401) 788-8780
Fax: (401) 788-8787
Type: Location
950 Warren Ave Ste 303
East Providence, RI 029141432
Phone: (401) 788-8780
Type: Location
70 Kenyon Ave Unit 324
Wakefield, RI 02879
Phone: (401) 788-8757
Fax: (401) 782-9867
Type: Location
70 KENYON AVE UNIT 210
WAKEFIELD, RI 028794241
Phone: (401) 788-8780
Fax: (401) 788-8787
Type: Location
PO BOX 229
WAKEFIELD, RI 028800229
Phone: (401) 788-8757
Fax: (401) 782-9867
Type: Mailing
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: 2018-03-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-06-30 (711 days ago).
Enrollment records
1
Earliest due date
2024-06-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20180326000869 | O | Clinic/Group Practice | RI | 2024-06-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 02818)
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