Lifespan Physician Group, Inc. - Medicare Dental Clinic in Providence, RI

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Lifespan Physician Group, Inc. is a medicare enrolled dental clinic (General Practice) in Providence, Rhode Island. The current practice location for Lifespan Physician Group, Inc. is 593 Eddy St, Providence, Rhode Island. For appointments, you can reach them via phone at (401) 444-6779. The mailing address for Lifespan Physician Group, Inc. is 117 Ellenfield St, Suite 101, Providence, Rhode Island and phone number is (401) 444-6779.

Lifespan Physician Group, Inc. is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1407116643. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (401) 444-6779.

Contact Information

Lifespan Physician Group, Inc.
593 Eddy St
Providence
RI 02903-4923
(401) 444-6779
(401) 444-6912

Map and Direction


Dental Care Clinic Profile

Full NameLifespan Physician Group, Inc.
SpecialityGeneral Practice
Location593 Eddy St, Providence, Rhode Island
Authorized Official Name and PositionPeter K Markell (EVP & CFO)
Authorized Official Contact4014447914
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Lifespan Physician Group, Inc.
117 Ellenfield St
Suite 101
Providence
RI 02905-4513

Ph: (401) 444-6779		Lifespan Physician Group, Inc.
593 Eddy St
Providence
RI 02903-4923

Ph: (401) 444-6779

NPI Details:

NPI Number1407116643
Provider Enumeration Date05/22/2012
Last Update Date11/06/2023

Medicare PECOS Information:

Medicare PECOS PAC ID2567455082
Medicare Enrollment IDO20121026000023

Medical Identifiers

Medical identifiers for Lifespan Physician Group, Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1407116643NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
122300000XDentist (* (Not Available))Secondary
133V00000XDietitian, Registered (* (Not Available))Secondary
152W00000XOptometrist (* (Not Available))Secondary
207LC0200XAnesthesiology - Critical Care Medicine (* (Not Available))Secondary
208D00000XGeneral Practice (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Lifespan Physician Group, Inc. acts as a billing entity for following providers:
Provider NameMaureen M Morrow
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1992718233
PECOS PAC ID: 9537060751
Enrollment ID: I20040120000213
Provider NameJami A Star
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1821079856
PECOS PAC ID: 5991797797
Enrollment ID: I20040401000400
Provider NameDouglas M Burtt
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1962449900
PECOS PAC ID: 9133116080
Enrollment ID: I20050211000802
Provider NamePaul Y Liu
Provider TypePractitioner - Plastic And Reconstructive Surgery
Provider IdentifiersNPI Number: 1649237058
PECOS PAC ID: 1052358249
Enrollment ID: I20050408001023
Provider NameJames W Ziegler
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1346209459
PECOS PAC ID: 4385685437
Enrollment ID: I20050518001085
Provider NameRobin A Kremsdorf
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1902001431
PECOS PAC ID: 4587730932
Enrollment ID: I20080909000088
Provider NameLisa Swartz Topor
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1215197355
PECOS PAC ID: 6901952092
Enrollment ID: I20090915000033
Provider NameTanya Booker
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1407054679
PECOS PAC ID: 5799841029
Enrollment ID: I20091124000482
Provider NameRosa H Bermudez-emmanuelli
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1043405863
PECOS PAC ID: 2769543883
Enrollment ID: I20100209000535
Provider NameRebecca W Randall
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1912955188
PECOS PAC ID: 5395721609
Enrollment ID: I20120112000783
Provider NameAdrienne J Perry
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1336169333
PECOS PAC ID: 6002977410
Enrollment ID: I20120913000423
Provider NameLloyd R Feit
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1720050313
PECOS PAC ID: 6608852926
Enrollment ID: I20130712000036
Provider NameSara R Ford
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1013989425
PECOS PAC ID: 8921077462
Enrollment ID: I20130712000053
Provider NameAugusto Martinez
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1639407679
PECOS PAC ID: 7315189776
Enrollment ID: I20130814000463
Provider NameLinda B Shalon
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1366497679
PECOS PAC ID: 4385530146
Enrollment ID: I20140626001998
Provider NameCarolina S Cerezo
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1073596011
PECOS PAC ID: 3577545623
Enrollment ID: I20140724000847
Provider NameNico Vehse
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1437352952
PECOS PAC ID: 0143412254
Enrollment ID: I20150211000608
Provider NameJon K Lambrecht
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1902945058
PECOS PAC ID: 3678466612
Enrollment ID: I20150910001265
Provider NamePaula J Demello
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1790955391
PECOS PAC ID: 3072763671
Enrollment ID: I20160601000008
Provider NameValerie Hamel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457781619
PECOS PAC ID: 3173740073
Enrollment ID: I20160622001654
Provider NameKaren L Daigle
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1497727101
PECOS PAC ID: 9032299987
Enrollment ID: I20160901001024
Provider NameKerri Keselowsky
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1205282522
PECOS PAC ID: 6103111208
Enrollment ID: I20161207001699
Provider NameJohn B Dickey
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1023278371
PECOS PAC ID: 6103135439
Enrollment ID: I20170111001499
Provider NameMelissa Nelson
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1992164933
PECOS PAC ID: 2961791108
Enrollment ID: I20170404002669
Provider NameFrancois Luks
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1124025937
PECOS PAC ID: 7618937467
Enrollment ID: I20170725000057
Provider NameErin Elizabeth Kunkel
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1053759316
PECOS PAC ID: 8123392735
Enrollment ID: I20170920003230
Provider NameHillary Lorenco
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1427369032
PECOS PAC ID: 8729226154
Enrollment ID: I20171106000126
Provider NameWilliam Douglas Brown
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1588624647
PECOS PAC ID: 2860468345
Enrollment ID: I20180228001584
Provider NameMegan Elizabeth Morris
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1538666409
PECOS PAC ID: 5698030617
Enrollment ID: I20180522002866
Provider NameKate Millington
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1306263843
PECOS PAC ID: 1052676624
Enrollment ID: I20180531002532
Provider NameMichele Style
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1275946329
PECOS PAC ID: 4789933169
Enrollment ID: I20181116000943
Provider NameShova Subedi
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1801102470
PECOS PAC ID: 1052539616
Enrollment ID: I20190124002883
Provider NameLeah R Battista
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1063560969
PECOS PAC ID: 1052329232
Enrollment ID: I20190827003223
Provider NameMeghan E Fredette
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1912249335
PECOS PAC ID: 1759676091
Enrollment ID: I20190827003521
Provider NameKatie Anne Lester
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1962745208
PECOS PAC ID: 6800035080
Enrollment ID: I20190924002025
Provider NameMelissa Russo
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1205034519
PECOS PAC ID: 4981852811
Enrollment ID: I20200324000761
Provider NameMartha B Kole-white
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1477993160
PECOS PAC ID: 1153626965
Enrollment ID: I20200529000331
Provider NameSusan Mcilvaine
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1770932386
PECOS PAC ID: 0648565580
Enrollment ID: I20201019002691
Provider NameMaria Teresa Perez Carballo
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1508277013
PECOS PAC ID: 8224449277
Enrollment ID: I20201123001211
Provider NameDuyu Nie
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1528473527
PECOS PAC ID: 3577980341
Enrollment ID: I20201127000015
Provider NameBrett Goudie
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1679627798
PECOS PAC ID: 4284736463
Enrollment ID: I20210305000574
Provider NameKathleen M Rotondo
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1972570422
PECOS PAC ID: 9638070758
Enrollment ID: I20210327000008
Provider NameKevin Scully
Provider TypePractitioner - Endocrinology
Provider IdentifiersNPI Number: 1770978363
PECOS PAC ID: 8123332640
Enrollment ID: I20210611000571
Provider NameElizabeth Anne Maranzano
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1285606418
PECOS PAC ID: 5991190464
Enrollment ID: I20220318001948
Provider NameAmanda Lee Azar
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1194065748
PECOS PAC ID: 2860887288
Enrollment ID: I20220322002747
Provider NameJennifer M Lafleur
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730314287
PECOS PAC ID: 0143616748
Enrollment ID: I20220407001845
Provider NameMarta S Sowa
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1891860029
PECOS PAC ID: 8820485717
Enrollment ID: I20220422001926
Provider NameThomas Patrick Hines
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1083789218
PECOS PAC ID: 7214324128
Enrollment ID: I20220425000037
Provider NameJonathan Nyce
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1093177008
PECOS PAC ID: 4880930247
Enrollment ID: I20220908001143
Provider NameSalley Pels
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1114100104
PECOS PAC ID: 8426182866
Enrollment ID: I20221021000998
Provider NameRachna Kataria
Provider TypePractitioner - Advanced Heart Failure And Transplant Cardiology
Provider IdentifiersNPI Number: 1134503766
PECOS PAC ID: 1759621428
Enrollment ID: I20221103001124
Provider NameCameron Lang
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1609286459
PECOS PAC ID: 7517182892
Enrollment ID: I20230215002985
Provider NamePei-chun Mcgregor
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1023231073
PECOS PAC ID: 5890919906
Enrollment ID: I20230307000597
Provider NameTiffany J Lee
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1417341736
PECOS PAC ID: 4587057138
Enrollment ID: I20230413001436
Provider NameAllison Cameron
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215663109
PECOS PAC ID: 6709242993
Enrollment ID: I20230512001644
Provider NameThomas J Seery
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1639198096
PECOS PAC ID: 3274719257
Enrollment ID: I20231116003437
Provider NameRajendrasinh Rathod
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1417159229
PECOS PAC ID: 2062699937
Enrollment ID: I20231223000282

Reviews and Comments


Dental Clinics in Providence, RI

Angell Street Dental Associates, Inc
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 425 Angell St, Providence, RI 02906
Phone: 401-272-2331    Fax: 401-272-2361
Sunnyside Family Dental
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 381 Angell St, Providence, RI 02906
Phone: 401-272-4900    Fax: 401-272-5989
Cityline Dental Inc.
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 400 Reservoir Ave, Suite 3d, Providence, RI 02907
Phone: 401-941-3353    Fax: 401-461-6558
Dentplus Dental Center
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 66 Kennedy Plz, Providence, RI 02903
Phone: 401-454-3000    Fax: 401-521-9004
Zumstein Family Dentistry, Llc
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 159 Governor St, Providence, RI 02906
Phone: 401-274-1140    
Celestial Smile Dental Associates Pc
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 10 Dorrance St Ste 700, Providence, RI 02903
Phone: 781-774-9885    
Wellrooted Dentistry Llc
Dental Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 111 Chestnut St Ste 1, Providence, RI 02903
Phone: 401-533-9632    Fax: 401-415-8608

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.