Individual provider Active NPI

Phathsady Louangxay, P.A.

  • Medical Physician Assistant
  • Providence, RI
National Provider Identifier
1174586671
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
00356 Issued in RI
Practice address
164 Summit Ave # C70
Providence, RI 02906-2853
Phone
(401) 793-4545
Fax
(401) 793-7866
NPI assigned
Apr 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 00356 RI Primary

Addresses

Primary practice location

164 Summit Ave # C70
Providence, RI 02906-2853

Mailing address

PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625

Other practice location 1

455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010

Other identifiers 2

IdentifierTypeStateIssuer
1396864542OtherRINPI KENT HOSPITAL PBO
9004070MedicaidRI

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
I20050418000080 RI Practitioner - Physician Assistant 8729025184 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
VMD Primary Providers of Rhode Island PCGroup PAC ID 3072913714, 51 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
University Surgical Associates, Inc.Group PAC ID 4082503032, 105 clinicians

Practice addresses (Care Compare)

106 Nate Whipple Hwy
Suite 101
Cumberland, RI 02864-1403
Phone (401) 658-2020

164 Summit Ave
C70
Providence, RI 02906-2853
Phone (401) 793-4545

2 Dudley St
Providence, RI 02905-3248
Phone (401) 272-1800

400 Putnam Pike
Smithfield, RI 02917-2408
Phone (401) 757-6160

982 Tiogue Ave
Coventry, RI 02816-6116
Phone (401) 821-6800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
00356RIMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Current Accepting new patients
Ocean State Urgent Care Center of Woonsocket CurrentSince Oct 16, 2016 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. Medical CurrentSince Feb 15, 2022 Accepting new patients
Mdri LLC CurrentSince Jan 5, 2026 Accepting new patients
Rhode Island Hospital Past Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Past Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients
Nes Rhode Island, Inc. Past Accepting new patients

Locations

1407 S County Trl
Ste 431
East Greenwich, RI 02818
Phone (401) 398-0288

11 Commerce Way
Ste 5
Johnston, RI 02919
Phone (401) 606-2610

1360 W Main Rd
Middletown, RI 02842
Phone (401) 606-3110

200 High Service Ave
North Providence, RI 02904
Phone (401) 456-3000

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

2 Dudley St
Ste 470
Providence, RI 02905
Phone (401) 274-7546

164 Summit Ave
Ste C70
Providence, RI 02906

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

164 Summit Ave
#C70
Providence, RI 02906
Phone (401) 793-3922

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

25 John a Cummings Way
Woonsocket, RI 02895
Phone (401) 235-7310

Interoperability endpoints

  • Direct secure messaging: phathsady.louangxay.1@31278.direct.athenahealth.com

Organizations & group practices 12

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 1

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": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1174586671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16149",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029160697",
            "telephone_number": "401-453-9625",
            "fax_number": "401-435-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE # C70",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-4545",
            "fax_number": "401-793-7866"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Toll Gate Rd",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7010",
            "fax_number": "401-736-4546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOUANGXAY",
        "first_name": "PHATHSADY",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "RI",
            "license": "00356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI KENT HOSPITAL PBO",
            "identifier": "1396864542",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9004070",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.