NPIMap

Organization Active NPI

Emma Pendleton Bradley Hospital

  • Psychiatric Hospital
  • East Providence, RI
National Provider Identifier
1225017486
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
Legal business name
EMMA PENDLETON BRADLEY HOSPITAL
Practice address
1011 Veterans Memorial Pkwy
East Providence, RI 02915-5061
Phone
(401) 432-1000
NPI assigned
Jan 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Authorized official

Name
Peter K Markell
Title
Evp & Cfo
Phone
(401) 444-7914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X RI Primary

Addresses

Primary practice location

1011 Veterans Memorial Pkwy
East Providence, RI 02915-5061

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779

Other identifiers 2

IdentifierTypeStateIssuer
OP04003MedicaidRI
4104003MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080318000711 RI Part A Provider - Hospital 3870527526 Practice locations: Riverside, RI

Hospital certification: CCN 414003

Legal name
EMMA PENDLETON BRADLEY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Aug 6, 1974
Last certification
Dec 9, 2009
Beds
60
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Oct 10, 1957 in RI
Enrollment address
1011 Veterans Memorial Pkwy
Riverside, RI 29155061
Main/Primary Hospital Location
Hospital subgroups
Psychiatric

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Care Compare: Hospital

Medicare Care Compare
Listed as
Emma Pendleton Bradley HospitalCCN 414003
Type
Psychiatric
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Carol J Jensen Cisw6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

63 Fountain St
Ste 402
Framingham, MA 01702
Phone (508) 861-1150

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lifespan Corporation Organization, Providence, RI Operational/Managerial Control Aug 9, 1994
Paula McNamara Individual Corporate Officer Dec 12, 2023
Roger N Begin Individual Corporate Director Oct 23, 2012
Christine Rawnsley Individual W-2 Managing Employee May 13, 2016
Bernard Buonanno Individual Corporate DirectorDirector Dec 10, 2024
Janet Robinson Individual Corporate Director Dec 12, 2023
Angel Taveras Individual Corporate Director Dec 12, 2023
Henry T Sachs Individual Corporate Director Oct 1, 2019
W-2 Managing Employee Oct 1, 2019
Alan H Litwin Individual Corporate Director Apr 1, 2011
Shivan Subramaniam Individual Corporate Director Oct 23, 2012
Eva Greenwood Individual Corporate OfficerSr Vice President Aug 29, 2022
W-2 Managing EmployeeSr Vice President Aug 29, 2022
Martha Mainiero Individual Corporate Director Oct 16, 2019
Lawrence a Aubin Individual Corporate Director Apr 1, 1998
Samuel Mencoff Individual Corporate Officer Aug 1, 2024
John R Fernandez Individual Corporate Director Jan 30, 2023
W-2 Managing Employee Jan 30, 2023
Ziya Levent Gokaslan Individual Corporate Director Feb 12, 2019
Michael L Hanna Individual Corporate Director Oct 16, 2019
Emanuel Barrows Individual Corporate Director Oct 23, 2012
Peter K Markell Individual Corporate Director Jan 30, 2023
W-2 Managing Employee Jan 30, 2023
Christian Cocks Individual Corporate Officer Dec 1, 2023

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1137369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765324800000",
    "number": "1225017486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 VETERANS MEMORIAL PKWY",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029155061",
            "telephone_number": "401-432-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMMA PENDLETON BRADLEY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-16",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A",
        "authorized_official_last_name": "MARKELL",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EVP & CFO",
        "authorized_official_telephone_number": "401-444-7914"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "RI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "OP04003",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4104003",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.