Individual provider Active NPI

Thomas David Morin, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1285173021
Registry record updated Jan 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00941 Issued in RI
Practice address
164 Summit Ave
Providence, RI 02906-2853
Phone
(401) 793-2500
NPI assigned
Feb 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X PA00941 RI Primary

Addresses

Primary practice location

164 Summit Ave
Providence, RI 02906-2853

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

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
I20240222002026 RI Practitioner - Physician Assistant 5496199085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Miriam HospitalGroup PAC ID 6901796408, 178 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-7245

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Miriam Hospital CurrentSince Jan 9, 2024 Accepting new patients
The Miriam Hospital Current Accepting new patients
The Miriam Hospital Current Accepting new patients
The Miriam Hospital CurrentSince Jan 9, 2024 Accepting new patients
The Miriam Hospital Current Accepting new patients

Locations

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

164 Summit Ave
Ste C
Providence, RI 02906
Phone (401) 793-2931

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

Organizations & group practices 5

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": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706659200000",
    "number": "1285173021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORIN",
        "first_name": "THOMAS",
        "middle_name": "DAVID",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-13",
        "last_updated": "2024-01-31",
        "certification_date": "2024-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.