Individual provider Active NPI

Tanya Sanita Thomas, M.D.

  • Psychiatry Physician
  • Providence, RI
National Provider Identifier
1104021070
Registry record updated Aug 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD13358 Issued in RI
Practice address
845 N Main St Ste L1B
Providence, RI 02904-5775
Phone
(401) 863-3476
Fax
(401) 863-3607
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD13358 RI Primary
Psychiatry Physician 2084P0800X LP01246 RI

Addresses

Primary practice location

845 N Main St Ste L1B
Providence, RI 02904-5775

Mailing address

464 Pavilion Ave
Warwick, RI 02888-6021
Phone (401) 440-1012

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250912002558 RI Practitioner - Neuropsychiatry 4082897061 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neuropsychiatry
Education
Other, 2007
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

464 Pavilion Ave
Warwick, RI 02888-6021

845 N Main St
Providence, RI 02904-5700

PO Box
Suite 3085
Pawtucket, RI 02861

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP01246RIMDPsychiatry Physician
MD13358RIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Koann Therapeutic Services Inc CurrentSince Aug 1, 2025 Accepting new patients
Koann Therapeutic Services Inc CurrentSince Jun 3, 2025 Accepting new patients

Locations

845 N Main St
Providence, RI 02904
Phone (401) 421-7300

845 N Main St
Ste L1B
Providence, RI 02904
Phone (401) 648-7172

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756425600000",
    "number": "1104021070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "464 PAVILION AVE",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028886021",
            "telephone_number": "401-440-1012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 N MAIN ST STE L1B",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029045775",
            "telephone_number": "401-863-3476",
            "fax_number": "401-863-3607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "TANYA",
        "middle_name": "SANITA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2025-08-29",
        "certification_date": "2025-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "MD13358",
            "primary": true
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "RI",
            "license": "LP01246",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.