Individual provider Active NPI

Kendra Ryan Pimenta, PA-C

  • Physician Assistant
  • Middletown, RI
National Provider Identifier
1164916904
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
99 E Main Rd Ste 19a
Middletown, RI 02842-4957
Phone
(401) 846-0055
Fax
(401) 842-0963
NPI assigned
Jun 15, 2018
Last updated
Oct 29, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

99 E Main Rd Ste 19a
Middletown, RI 02842-4957

Mailing address

99 E Main Rd Ste 19a
Middletown, RI 02842-4957
Phone (401) 846-0055

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kpimenta172102@direct.lifespan.org

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180809000613 RI Practitioner - Physician Assistant 6800144783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Medical Physicians IncGroup PAC ID 0345658316, 222 clinicians

Practice addresses (Care Compare)

850 Aquidneck Ave
Middletown, RI 02842-7280
Phone (401) 606-4510

900 Warren Ave
East Providence, RI 02914-1430

99 E Main Rd
Suite 19a
Middletown, RI 02842-4957
Phone (401) 846-0055

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Medical Physicians, Inc. CurrentSince Apr 25, 2021 Accepting new patients
Lifespan Corporation Current Accepting new patients

Locations

900 Warren Ave
Ste 401
East Providence, RI 02914
Phone (401) 330-2480

850 Aquidneck Ave
Middletown, RI 02842
Phone (401) 846-0055

Interoperability endpoints

  • Direct secure messaging: kpimenta172102@brownhealth.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1164916904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 E MAIN RD STE 19A",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028424957",
            "telephone_number": "401-846-0055",
            "fax_number": "401-842-0963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 E MAIN RD STE 19A",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028424957",
            "telephone_number": "401-846-0055",
            "fax_number": "401-842-0963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMENTA",
        "first_name": "KENDRA",
        "middle_name": "RYAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-15",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kpimenta172102@direct.lifespan.org",
            "affiliation": "N",
            "address_1": "850 Aquidneck Ave",
            "city": "Middletown",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028427280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

Verify at the official NPI Registry.