Individual provider Active NPI

Joseph Timothy Lifrak, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Swansea, MA
National Provider Identifier
1093700726
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
261943 Issued in MA
Practice address
479 Swansea Mall Dr
Swansea, MA 02777-4119
Phone
(508) 973-1550
Fax
(508) 973-0386
NPI assigned
Sep 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X 261943 MA Primary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X MD09929 RI

Addresses

Primary practice location

479 Swansea Mall Dr
Swansea, MA 02777-4119

Mailing address

200 Mill Rd Ste 180
Fairhaven, MA 02719-5255
Phone (508) 973-2000

Other identifiers 4

IdentifierTypeStateIssuer
1093700726OtherRIDURABLE
32172-3OtherRIRI BLUE CROSS
7006971MedicaidRI
405507OtherRICHIP

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jlifrak19829@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100225000773 RI Practitioner - Orthopedic Surgery 7416091673 Reassigns benefits to 1 organization
I20150908002329 MA Practitioner - Orthopedic Surgery 7416091673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Warren Alpert Medical School of Brown University, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

1076 N Main St
Southcoast Physicians Services Inc
Providence, RI 02904-5709
Phone (401) 273-2460

479 Swansea Mall Dr
Swansea, MA 02777-4119
Phone (508) 973-1570

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Knee replacement50
Lower limb (leg) arthroscopy (minimally invasive joint repair)24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
261943MAMDSports Medicine (Orthopaedic Surgery) Physician
MD09929RIMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. Orthopaedic Surgery CurrentSince Jul 6, 2015 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Jul 6, 2015 Accepting new patients
Jewett Orthopaedic Clinic LLC Orthopaedic Surgery Past Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

300C Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 973-2230

479 Swansea Mall Dr
Swansea, MA 02777
Phone (508) 672-5300

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

1076 N Main St
Providence, RI 02904
Phone (401) 273-2460

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1093700726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195255",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 SWANSEA MALL DR",
            "city": "SWANSEA",
            "state": "MA",
            "postal_code": "027774119",
            "telephone_number": "508-973-1550",
            "fax_number": "508-973-0386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIFRAK",
        "first_name": "JOSEPH",
        "middle_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MA",
            "license": "261943",
            "primary": true
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "RI",
            "license": "MD09929",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DURABLE",
            "identifier": "1093700726",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RI BLUE CROSS",
            "identifier": "32172-3",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7006971",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIP",
            "identifier": "405507",
            "state": "RI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlifrak19829@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "479 Swansea Mall Dr",
            "city": "Swansea",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027774119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Swansea, MA

Sources for this page

Verify at the official NPI Registry.