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

Individual provider Psychiatry Physician · NPI 1366718090

Jose M Rengifo, MD is a Psychiatry in Providence, Rhode Island. Qualified in 2012, 14 years ago. Practices with Nystrom and Associates Ltd, a 617-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Rhode Island.

Years since qualifying
14
Licensed in
RI
In the registry since
2012
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

345 Blackstone Blvd Butler Hospital
Providence, RI 02906-4800
Phone: (401) 455-6655
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence CMD15380 (RI)

Record details

NPI number1366718090
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 27, 2012
Last updated in NPPESJanuary 18, 2017

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Nystrom And Associates Ltd — 617 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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