Provider Demographics
NPI:1376531269
Name:HAAS, RICHARD A (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:A
Last Name:HAAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 METRO CENTER BOULEVARD SUITE 2000
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886
Mailing Address - Country:US
Mailing Address - Phone:401-432-2520
Mailing Address - Fax:401-921-9212
Practice Address - Street 1:125 METRO CENTER BOULEVARD SUITE 2000
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886
Practice Address - Country:US
Practice Address - Phone:401-432-2520
Practice Address - Fax:401-921-9212
Is Sole Proprietor?:No
Enumeration Date:2005-10-13
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI66142085R0202X
RIMD066142085R0202X, 2085R0204X
RI066142085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
006614OtherBLUESHIELD
006614OtherTUFTS
00700608OtherHOSPITAL PIN
000000001988OtherNHPRI
003790OtherBLUECHIP
050318025OtherUNICARE
240169OtherW AND I PILGRIM
RI7000608OtherMEDICAL ASSISTANCE
720052801OtherCIGNA
CT003117307OtherMED ASSISTANCE
003790OtherBLUECHIP SENIORS
0108651OtherHEALTHY START
240079OtherRIH PILGRIM
0600203OtherUNITED HEALTH PLANS
MA0108651Medicaid
6614OtherFEP BLUECROSS
RI7000608OtherMEDICAL ASSISTANCE
003790OtherBLUECHIP
0600203OtherUNITED HEALTH PLANS