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BLUEWATER PSYCHIATRY, LLC
NPI 1205709136
Psychiatry & Neurology - Psychiatry in East Providence, RI

Active since September 26, 2025
450 VETERANS MEMORIAL PKWY STE 9A, EAST PROVIDENCE, RI 02914(401) 285-6040(401) 922-5407 Get Directions Write a Review

NPPES record last updated: April 17, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Bluewater Psychiatry, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BLUEWATER PSYCHIATRY, LLC (NPI 1205709136) is a healthcare organization registered as a psychiatry in East Providence, Rhode Island and active in the NPI registry since September 2025. The organization lists Randy Freeman, Medical Director, as its authorized official.

NPPES Registry Identity

NPI1205709136
Entity TypeOrganization
Primary Taxonomy2084P0800X
Legal Business NameBLUEWATER PSYCHIATRY, LLC
Location Address450 VETERANS MEMORIAL PKWY STE 9AEast Providence, RI 02914-5300
Mailing Address450 Veterans Memorial Pkwy Ste 9aEast Providence, RI 02914-5300 · (401) 285-6040 · Fax (401) 922-5407
Phone(401) 285-6040
Fax(401) 922-5407
Organization SubpartNo
Authorized OfficialRandy FreemanMedical Director · (401) 285-6040
Enumeration DateSeptember 26, 2025
Last NPPES UpdateApril 17, 2026
NPPES CertifiedApril 17, 2026
✔ NPI 1205709136 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
450 VETERANS MEMORIAL PKWY STE 9A, East Providence, RI 02914
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Bluewater Psychiatry, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to Bluewater Psychiatry, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (2)

Brittany Ambrose
Nurse Practitioner
NPI 1902749088
450 VETERANS MEMORIAL PKWY STE 9A
East Providence, RI 02914
(401) 285-6040
✔ PECOSSame address
Randy Freeman, D.O.
Psychiatry
NPI 1700273166
197 WARREN AVE STE 203
East Providence, RI 02914
(401) 285-6040
✔ PECOS✔ Accepts Medicare0.7 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bluewater Psychiatry, LLC's NPI number?

The NPI number for Bluewater Psychiatry, LLC is 1205709136. It was assigned to this organization in the NPPES registry on September 26, 2025.

Where is Bluewater Psychiatry, LLC located?

Bluewater Psychiatry, LLC is located at 450 Veterans Memorial Pkwy Ste 9A, East Providence, RI 02914. The listed phone number is (401) 285-6040.

What is Bluewater Psychiatry, LLC's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Bluewater Psychiatry, LLC enrolled in Medicare?

Yes. Bluewater Psychiatry, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Bluewater Psychiatry, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians reassign their Medicare billing to Bluewater Psychiatry, LLC, in Nurse Practitioner and Psychiatry. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Bluewater Psychiatry, LLC was last updated on April 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.