Provider Directory - Blue Cross & Blue Shield of Rhode Island

Provider Directory

Group BlueCHiP for Medicare

Group BlueCHiP for Medicare

Provider Directory

This directory provides a list of Group BlueCHiP for Medicare's network providers. This directory is for the service area which includes the following Rhode Island counties: Bristol, Kent, Newport, Providence and Washington. In Massachusetts, the service area includes all of Bristol County. In Connecticut, the service area includes the following ZIP codes in New London County: 06340, 06339, 06355, 06320, 06359, 06378, 06385, 06388. This directory is current as of September 2013. Some network providers may have been added or removed from our network after this directory was printed. We do not guarantee that each provider is still accepting new members. To get the most up-to-date information about Group BlueCHiP for Medicare's network providers in your area, you can visit or call our Customer Service Department at 1-800-267-0439, October 1 February 14, seven days a week, 8:00 a.m. to 8:00 p.m.; February 15 - September 30, Monday through Friday, 8:00 a.m. to 8.00 p.m. An automated answering system is available outside of these hours. TTY/TDD users should call 711. Blue Cross & Blue Shield of Rhode Island is an HMO plan with a Medicare contract. Enrollment in Blue Cross & Blue Shield of Rhode Island depends on contract renewal. This information is available for free in other languages. Please contact our Customer Service number at 1-800-267-0439 (TTY/TDD users should call 711). Hours are October 1 ? February 14, seven days a week, 8:00 a.m. to 8:00 p.m.; February 15 ? September 30, Monday through Friday, 8:00 a.m. to 8:00 p.m. An automated answering system is available outside of these hours. Esta informaci?n est? disponible gratis en otros idiomas. Si desea obtener informaci?n adicional, llame a Servicio al cliente al 1-800-267-0439. (Los usuarios de TTY/TDD deben llamar al 711). El horario es, del 1 de octubre al 14 de febrero, los siete d?as de la semana de 8:00 a.m. a 8:00 p.m. Del 15 de febrero al 30 de septiembre, de lunes a viernes de 8:00 a.m. a 8:00 p.m. Fuera de estos horarios, hay un sistema automatizado de respuesta de llamadas disponible. El Servicio al cliente tambi?n tiene servicios de int?rprete de idiomas gratis disponibles para las personas que no hablan ingl?s. This information is also available in large print English and large print Spanish.

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Section 1 ? Introduction

This directory provides a list of Group BlueCHiP for Medicare's network providers. To get detailed information about your health care coverage, please see your Evidence of Coverage.

You will have to choose one of our network providers who are listed in this directory to be your Primary Care Physician (PCP). The term "PCP" will be used throughout this directory. Generally, you must get your health care coverage from your PCP. A PCP is an internal medicine physician, family practice physician or an OB/GYN, who meets state requirements and is trained to give you basic medical care. When you become a member of our plan, you must choose a PCP. As we explain in the following sections, you will get your routine or basic care from your PCP. You do not need a referral from your PCP to see a specialist. Your PCP will work with you in coordinating care for covered services.

The "network providers" listed in this directory have agreed to provide you with your health care coverage. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue going to that same provider. In some cases, you may get covered services from non-network providers.

If you need care when you are outside the service area, your health care coverage is limited. The only services we cover when you are outside of our service area are care of a medical emergency and post-stabilization care; urgently needed care; renal dialysis (kidney) services; and care that Group BlueCHiP for Medicare, or a Plan contracted partner, has approved in advance. These services will be covered at your in-network cost sharing levels. If you obtain routine care from out-of-network providers, neither Medicare nor Blue Cross & Blue Shield of Rhode Island will be responsible for the costs.

In addition, members who have the Point-of-Service option may use non-network providers for specified covered services at an additional cost. Please refer to your Evidence of Coverage for more information on the Point-of-Service benefit.

If a non-contracting provider submits a bill directly to you, you should not pay the bill. You should submit it to us for processing and determination of your liability.

Please submit the bill to:

Blue Cross & Blue Shield of Rhode Island Attn: Claims Department 500 Exchange Street Providence, RI 02903

Or call us at 1-800-267-0439, October 1 - February 14, seven days a week, 8:00 a.m. to 8:00 p.m.; February 15 - September 30, Monday through Friday, 8:00 a.m. to 8.00 p.m. An automated answering system is available outside of these hours. TTY/TDD users should call 711.

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What is the service area for Group BlueCHiP for Medicare? The counties in our service area are listed below. The following Rhode Island counties: Bristol, Kent, Newport, Providence, and Washington. In Massachusetts, the service area includes all of Bristol County. In Connecticut, the service area includes the following ZIP codes in New London County: 06340, 06339, 06355, 06320, 06359, 06378, 06385, 06388. How do you find Group BlueCHiP for Medicare providers in your area? You may look up a provider by category or by last name in the alphabetical physician/ provider listing at the front of this directory. Following the alphabetic list are listings by location and specialty, and by the type of provider. You can also use the Find a Doctor tool at for the most current listing of providers in the Group BlueCHiP for Medicare network and to locate a provider near you. If you have questions about Group BlueCHiP for Medicare or require assistance in selecting a PCP, please call our Customer Service Department at 1-800-267-0439, October 1 - February 14, seven days a week, 8:00 a.m. to 8:00 p.m.; February 15 - September 30, Monday through Friday, 8:00 a.m. to 8.00 p.m. An automated answering system is available outside of these hours. TTY/TDD users should call 711. Or, visit .

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Section 2 ? List of Network Providers

When looking for a provider by name, you can use the alphabetical physician/provider listing located in the index. If you are doing a general search for a physician/provider, the directory is organized by: State City (Listed alphabetically) Type of Provider There are approximately 1,359 Primary Care Physicians (PCP), 5,489 Specialists, 15 Hospitals, 22 Urgent Care Facilities, 2,787 Behavioral Health Providers and Substance Abuse Providers, 120 Laboratory Facilities, 1,597 Other Providers and Services, 75 Skilled Nursing Facilities, and 88 Durable Medical Equipment/Prosthetic & Orthotic Supplies in our network. Specialty (Listed alphabetically) Provider Name (Listed alphabetically) Address Phone Number Language Spoken

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TABLE OF CONTENTS

ALPHABETICAL PHYSICIAN/PROVIDER LISTING ................................ 1 RHODE ISLAND PHYSICIAN/PROVIDER NETWORK .......................... 56 MASSACHUSETTS PHYSICIAN/PROVIDER NETWORK ............................................................................................. 271 HOSPITALS ........................................................................................... 327 URGENT CARE FACILITIES................................................................. 328 RHODE ISLAND BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES ........................................................ 329 MASSACHUSETTS BEHAVIORAL HEALTH AND SUBSTANCE ABUSE SERVICES ........................................................ 396 LABORATORY FACILITIES.................................................................. 406 OTHER PROVIDERS AND SERVICES ................................................. 409 SKILLED NURSING FACILITIES .......................................................... 451 DURABLE MEDICAL EQUIPMENT/PROSTHETIC & ORTHOTIC SUPPLIERS ....................................................................... 454

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