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PROVIDENCE INTERVENTIONAL ASSOCIATES II LLC
NPI 1306123476
Radiology - Vascular & Interventional Radiology in Providence, RI

Active since November 03, 2011CLIA 41D2154673 · Waiver
100 HIGHLAND AVE STE 100, PROVIDENCE, RI 02906(401) 277-9729(401) 277-9730 Get Directions Write a Review

NPPES record last updated: June 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 13, 2025, Jul 11, 2023, May 9, 2023 and 4 more (7 updates tracked since 2018).

About Providence Interventional Associates Ii Llc NPPES

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

PROVIDENCE INTERVENTIONAL ASSOCIATES II LLC (NPI 1306123476) is a healthcare organization registered as a vascular & interventional radiology in Providence, Rhode Island and active in the NPI registry since November 2011. The organization holds a CLIA Waiver certificate valid through September 17, 2026 and lists Jonah Licht, Owner, as its authorized official.

NPPES Registry Identity

NPI1306123476
Entity TypeOrganization
Primary Taxonomy2085R0204X
Legal Business NamePROVIDENCE INTERVENTIONAL ASSOCIATES II LLC
Location Address100 HIGHLAND AVE STE 100Providence, RI 02906-2740
Mailing Address100 Highland Ave Ste 100Providence, RI 02906-2740 · (401) 277-9729 · Fax (401) 277-9730
Phone(401) 277-9729
Fax(401) 277-9730
Organization SubpartNo
Authorized OfficialJonah LichtOwner · (401) 277-9729
Enumeration DateNovember 3, 2011
Last NPPES UpdateJune 13, 20257 updates tracked since enumeration
NPPES CertifiedJune 13, 2025
✔ NPI 1306123476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Vascular & Interventional RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0204X
Definition
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X
100 HIGHLAND AVE STE 100, Providence, RI 02906
Open in Google Maps ↗

Other Identifiers 1

MedicaidPR86788RI

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 41D2154673

Providence Interventional Associates II, LLC · Providence, RI
Active · expires Sep 17, 2026
CLIA Number41D2154673
Laboratory TypePhysician Office
Certificate Effective DateSeptember 18, 2024
Certificate Expiration DateSeptember 17, 2026
Laboratory DirectorJonah M. Licht MD
Laboratory Phone(401) 277-9729
Laboratory LocationProvidence Interventional Associates II, LLC100 Highland Ave Ste 100, Providence, RI 02906
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

PROVIDENCE INTERVENTIONAL ASSOCIATES II LLC
Clinic/Center (Ambulatory Surgical)
100 HIGHLAND AVE STE 100
PROVIDENCE, RI 02906
Providence County (401) 277-9729

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 Providence Interventional Associates II LLC's NPI number?

The NPI number for Providence Interventional Associates II LLC is 1306123476. It was assigned to this organization in the NPPES registry on November 3, 2011.

Where is Providence Interventional Associates II LLC located?

Providence Interventional Associates II LLC is located at 100 Highland Ave Ste 100, Providence, RI 02906. The listed phone number is (401) 277-9729.

What is Providence Interventional Associates II LLC's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.

Does Providence Interventional Associates II LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 41D2154673) is associated with this NPI, valid through September 17, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Providence Interventional Associates II LLC was last updated on June 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.