NPIMap

Organization Active NPI

Lifespan Physician Group, Inc.

Doing business as Brown Health Medical Group

  • Anesthesiology Physician
  • Providence, RI
National Provider Identifier
1053782466
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
LIFESPAN PHYSICIAN GROUP, INC.
Doing business as
Brown Health Medical Group
Practice address
593 Eddy St
Providence, RI 02903-4923
Phone
(401) 444-5172
Fax
(401) 444-5090
NPI assigned
Oct 12, 2015
Last updated
Mar 30, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Peter K Markell
Title
Evp & Cfo
Phone
(401) 444-7914

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207L00000X Primary
Certified Registered Nurse AnesthetistGroup: 193200000X MULTI-SPECIALTY GROUP 367500000X

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903-4923

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

Other practice location 1

62 Amaral St
Riverside, RI 02915-2205
Phone (401) 649-4970

Other practice location 2

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 444-5172

Other practice location 3

11 Friendship St
Newport, RI 02840-2209
Phone (401) 444-5172

Other practice location 4

101 Dudley St
Providence, RI 02905-2401
Phone (401) 444-5172

Other names 1

  • Brown Health Medical Group Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160121000235 RI Part B Supplier - Clinic/Group Practice 2567455082 Receives reassigned benefits from 107 practitioners
Practice locations: Newport, RI; Providence, RI; Riverside, RI

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 107

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 107

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1444608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774828800000",
    "number": "1053782466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5172",
            "fax_number": "401-444-5090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "62 Amaral St",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "RI",
            "postal_code": "029152205",
            "country_code": "US",
            "telephone_number": "401-649-4970",
            "fax_number": "401-649-4031",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "164 Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029062853",
            "country_code": "US",
            "telephone_number": "401-444-5172",
            "fax_number": "401-444-5090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11 Friendship St",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "RI",
            "postal_code": "028402209",
            "country_code": "US",
            "telephone_number": "401-444-5172",
            "fax_number": "401-444-5090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-444-5172",
            "fax_number": "401-444-5090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIFESPAN PHYSICIAN GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-12",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A",
        "authorized_official_last_name": "MARKELL",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EVP & CFO",
        "authorized_official_telephone_number": "401-444-7914",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brown Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.