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PHILOMENE FORTES
NPI 1235568171
Nurse Practitioner - Family in Pawtucket, RI

Active since November 01, 2013PECOS EnrolledAccepts Medicare Assignment
39 EAST AVE, PAWTUCKET, RI 02860(401) 722-0081(401) 312-0318 Get Directions Write a Review

NPPES record last updated: September 30, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 30, 2024, Oct 18, 2021 (2 updates tracked since 2021).

About Philomene Fortes NPPES

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

PHILOMENE FORTES (NPI 1235568171) is an individual family provider in Pawtucket, Rhode Island, licensed in Rhode Island (APRN01560) and active in the NPI registry since November 2013. She is enrolled in Medicare PECOS, is affiliated with Women & Infants Hospital Of Rhode Island, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1235568171
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NamePHILOMENE FORTES
Location Address39 EAST AVEPawtucket, RI 02860-4003
Mailing Address4404 Queensbury RdRiverdale, MD 20737-1068
Phone(401) 722-0081
Fax(401) 312-0318
Sole ProprietorYes
Medical School CMSOtherGraduated 2013
Enumeration DateNovember 1, 2013
Last NPPES UpdateSeptember 30, 20242 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2024
✔ NPI 1235568171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in RI · APRN01560
39 EAST AVE, Pawtucket, RI 02860
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Philomene Fortes is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8426368978
PECOS Enrollment IDI20170801002407, I20170803001267
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Blood glucose (sugar) test performed by hand-held instrument 82962
A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.
19 services15 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
19 services15 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Women & Infants Hospital Of Rhode Island

Acute Care Hospitals · Providence, RI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number410010
Location101 Dudley StreetProvidence, RI 02905 · Providence County
Emergency services Birthing friendly

The Miriam Hospital

Acute Care Hospitals · Providence, RI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number410012
Location164 Summit AvenueProvidence, RI 02906 · Providence County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02860 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%186 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PRISCILLA K CUNHA RN
Registered Nurse (Case Management)
39 EAST AVE
PAWTUCKET, RI 02860
Providence County (401) 312-0502
CARDINAL HEALTH 132, LLC
Pharmacy (Community/Retail Pharmacy)
39 EAST AVE, SUITE 100
PAWTUCKET, RI 02860
Providence County (401) 642-2093
BLACKSTONE VALLEY COMMUNITY HEALTH CARE, INC.
Clinic/Center (Federally Qualified Health Center (FQHC))
39 EAST AVE
PAWTUCKET, RI 02860
Providence County (401) 312-9892
KELSEY OKOLOWITCZ MA, LMHC
Counselor (Mental Health)
39 EAST AVE
PAWTUCKET, RI 02860
Providence County (401) 312-9843
RODOLFO M GALINATTI PA-C
Physician Assistant (Medical)
39 EAST AVE
PAWTUCKET, RI 02860
Providence County (401) 729-0080
NICOLE SNAPPER
Nurse Practitioner (Family)
39 EAST AVE
PAWTUCKET, RI 02860
Providence County (401) 722-0081
MS. ANNE BARYLICK FNP-BC
Nurse Practitioner (Family)
39 EAST AVE
PAWTUCKET, RI 02860
Providence County (401) 722-0081
JANINE MARY MEDEIROS FNP-BC
Nurse Practitioner (Family)
39 EAST AVE
PAWTUCKET, RI 02860
Providence County (401) 722-0081

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 Philomene Fortes's NPI number?

The NPI number for Philomene Fortes is 1235568171. It was assigned to this individual provider in the NPPES registry on November 1, 2013.

Where is Philomene Fortes located?

Philomene Fortes practices at 39 East Ave, Pawtucket, RI 02860. The listed phone number is (401) 722-0081.

What is Philomene Fortes's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Philomene Fortes enrolled in Medicare?

Yes. Philomene Fortes is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Is Philomene Fortes affiliated with any hospitals?

According to CMS data, Philomene Fortes is affiliated with Women & Infants Hospital Of Rhode Island and The Miriam Hospital.

When was this NPI record last updated?

The NPPES record for Philomene Fortes was last updated on September 30, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.