Active NPI
Breanne Leigh St Martin, FNP-C
- Family Nurse Practitioner
- Providence, RI
National Provider Identifier
1053938886
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- APRN02363
- Practice address
- 33 Staniford St FL 2
Providence, RI 02905-3105 - Phone
- (401) 421-8800
- NPI assigned
- Jun 27, 2020
- Last updated
- Dec 23, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN02363 | RI | Primary |
Addresses
Primary practice location
33 Staniford St FL 2
Providence, RI 02905-3105
Mailing address
55 Deacon Ave
Warwick, RI 02886-5103
Other practice location 1
5670 Post Rd
East Greenwich, RI 02818-3461
Phone (401) 234-9080
Other practice location 2
1407 S County Trl Ste 410
East Greenwich, RI 02818-1679
Phone (401) 421-8800
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | bstmartin1@lifespan.org | Direct | Lifespan corporation |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
33 Staniford St
Providence, RI 02905-3105
Phone (401) 421-8800
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Gastroenterology, LLC | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Family | Past | Accepting new patients |
Locations
1407 S County Trl
Ste 410
East Greenwich, RI 02818
Phone (401) 886-4040
33 Staniford St
Providence, RI 02905
Phone (401) 274-1810
33 Staniford St
#2
Providence, RI 02905
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Gastroenterology Physician
- Providence, RI
- NPI 1386952612
-
dba Brown Health Medical Group
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
Family
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Providence, RI
- NPI 1588659528
-
- General Acute Care Hospital
- Providence, RI
- NPI 1972768174
-
- General Acute Care Hospital
- Providence, RI
- NPI 1487649430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640217600000",
"number": "1053938886",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 DEACON AVE",
"city": "WARWICK",
"state": "RI",
"postal_code": "028865103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "33 STANIFORD ST FL 2",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029053105",
"telephone_number": "401-421-8800"
}
],
"practiceLocations": [
{
"address_1": "5670 Post Rd",
"address_purpose": "LOCATION",
"city": "East Greenwich",
"state": "RI",
"postal_code": "028183461",
"country_code": "US",
"telephone_number": "401-234-9080",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1407 S County Trl Ste 410",
"address_purpose": "LOCATION",
"city": "East Greenwich",
"state": "RI",
"postal_code": "028181679",
"country_code": "US",
"telephone_number": "401-421-8800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ST MARTIN",
"first_name": "BREANNE",
"middle_name": "LEIGH",
"credential": "FNP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-27",
"last_updated": "2021-12-23",
"certification_date": "2020-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "RI",
"license": "APRN02363",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "bstmartin1@lifespan.org",
"affiliation": "Y",
"affiliationName": "Lifespan corporation",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "Email",
"address_1": "765 Allens Ave",
"city": "Providence",
"state": "RI",
"country_code": "US",
"postal_code": "029055443",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}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 Dec 23, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.