Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edward Bae, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1447749031

Edward Bae, MD is a Dermatology in Providence, Rhode Island. Graduated from Boston University School of Medicine in 2018, 8 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
8
Trained at
Boston University School of Medicine
Licensed in
RI
In the registry since
2018
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-7139
Fax: (401) 444-7105
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence LP04750 (RI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1447749031
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 9, 2018
Last updated in NPPESOctober 15, 2024
Certification dateJuly 31, 2020
Mailing address81 Highland Ave, Salem, MA 01970-2714

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Also practisesMICROGRAPHIC DERMATOLOGIC SURGERY (MDS)
Medical schoolBOSTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Providence