Individual provider Active NPI

Christian Glardon, PA

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1184920928
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01449 Issued in RI
Practice address
593 Eddy Street
Claverick 2
Providence, RI 02903
Phone
(401) 444-4000
NPI assigned
Jan 26, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 028370 NY
Physician Assistant 363A00000X 1877 NH
Physician Assistant 363A00000X PA01449 RI Primary
Physician Assistant 363A00000X PA9105689 FL

Addresses

Primary practice location

593 Eddy Street
Claverick 2
Providence, RI 02903

Mailing address

125 Whipple St Ste 3
Providence, RI 02908-3258

Other practice location 1

2626 Capital Medical Blvd
Tallahassee, FL 32308-4402
Phone (904) 332-4316

Other practice location 2

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

Other practice location 3

200 High Service Ave
North Providence, RI 02904-5113
Phone (401) 456-3000

Other practice location 4

100 Kenyon Ave
Wakefield, RI 02879-4216
Phone (401) 782-8000

Other practice location 5

825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA, RI3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20120912000622 FL Practitioner - Physician Assistant 4284882440 Reassigns benefits to 1 organization
I20210106000709 GA Practitioner - Physician Assistant 4284882440 Reassigns benefits to 1 organization
I20220521000023 RI Practitioner - Physician Assistant 4284882440 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-7024

Hospital & facility affiliations

  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Newport Hospital Hospital, Newport, RI, CCN 410006

Merit-based Incentive Payment System (MIPS)

Final score
96.45 of 100Reported as group
Quality
85.46
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1877NHMDClinical Social Worker
PA01449RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Oliver Emergency Group, LLC Emergency Medical Services CurrentSince Jun 14, 2022 Accepting new patients
Affinity Physicians LLC CurrentSince Aug 31, 2025 Accepting new patients
Old Fields Emergency Physicians, LLC Past Accepting new patients
Vale of Paradise Emergency Physicians, LLC Past Accepting new patients
Quincy Creek Emergency Physicians LLC Past Accepting new patients

Locations

23186 Blue Star Hwy
Quincy, FL 32351
Phone (850) 875-5977

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

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

Interoperability endpoints

  • Direct secure messaging: cglardon36343@mvhealthsystem.direct-ci.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 5

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": "1296000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1184920928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WHIPPLE ST STE 3",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029083258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY STREET",
            "address_2": "CLAVERICK 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-444-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2626 Capital Medical Blvd",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323084402",
            "country_code": "US",
            "telephone_number": "904-332-4316",
            "fax_number": "904-332-4339",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "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"
        },
        {
            "address_1": "200 High Service Ave",
            "address_purpose": "LOCATION",
            "city": "North Providence",
            "state": "RI",
            "postal_code": "029045113",
            "country_code": "US",
            "telephone_number": "401-456-3000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Kenyon Ave",
            "address_purpose": "LOCATION",
            "city": "Wakefield",
            "state": "RI",
            "postal_code": "028794216",
            "country_code": "US",
            "telephone_number": "401-782-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "825 Chalkstone Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029084728",
            "country_code": "US",
            "telephone_number": "401-456-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLARDON",
        "first_name": "CHRISTIAN",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-26",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "028370",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1877",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01449",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9105689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.