University Surgical Associates, Inc.
Organization Active NPI Surgery Physician · Providence, RI
NPI 1376589895 · NPPES record last updated Oct 16, 2025
Key facts
- NPI
- 1376589895
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgery Physician 208600000X
- Legal business name
- UNIVERSITY SURGICAL ASSOCIATES, INC.
- Practice address
- 2 Dudley St Ste 470
Providence, RI 02905-3248 - Phone
- (401) 272-1800
- Fax
- (401) 751-5124
- NPI assigned
- Jun 22, 2006
- Organization subpart
- No
Authorized official
- Name
- Donna Gordon
- Title
- Senior Director, Revenue Cycle
- Phone
- (401) 443-4983
Practitioners 139
-
Hana Ajouz, MEDICAL DOCTOR
-
Rachel Erin Beard, M.D.
-
Gretchen Carr, NP-C
-
Kristen Ann Chapian, CNP
-
Artur Chernoguz, MD
-
Joshua Cohen, M.D.
-
Dawn Melissa Drake, RNP
-
Sydney Formicola, NP
-
Andrew Fournier, NP
-
Kathleen Ann Greggerson, FNP-BC
-
Benjamin Hall, M.D
-
Nicole Halton, NP
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 41D2163991 | University Surgical Associates | Certificate of waiver | Mar 25, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040818001275 | RI | Part B Supplier - Clinic/Group Practice | 4082503032 |
Receives reassigned benefits from 130 practitioners Practice locations: Warwick, RI; Warren, RI; Smithfield, RI; Scituate, RI; Providence, RI; East Greenwich, RI; East Providence, RI; Johnston, RI… |
National Provider Directory
Locations
1454 S County Trl
Ste 201
East Greenwich, RI 02818
1672 S County Trl
East Greenwich, RI 02818
Phone (401) 885-7546
450 Veterans Memorial Pkwy
Bldg 9
East Providence, RI 02914
Phone (401) 435-5533
1524 Atwood Ave
Ste 335
Johnston, RI 02919
Phone (401) 553-8318
19 Friendship St
Ste 423
Newport, RI 02840
593 Eddy St
Fl 4
Providence, RI 02903
Phone (301) 444-6420
208 Collyer St
Ste 302
Providence, RI 02904
Phone (401) 725-4888
593 Eddy St
Apt 4
Providence, RI 02903
120 Dudley St
Ste 6
Providence, RI 02905
Phone (401) 274-4720
593 Eddy St
#435
Providence, RI 02903
164 Summit Ave
Rm C70
Providence, RI 02906
Phone (401) 793-3922
2 Dudley St
Ste 115
Providence, RI 02905
154 Waterman St
Ste 2
Providence, RI 02906
Phone (401) 223-0962
195 Collyer St
Ste 302
Providence, RI 02904
Phone (401) 793-5140
593 Eddy St
#456
Providence, RI 02903
Phone (401) 444-5545
195 Collyer St
#302
Providence, RI 02904
593 Eddy St
Ste 4
Providence, RI 02903
2 Dudley St
Ste 190
Providence, RI 02905
Phone (401) 228-0555
75 Newman Ave
Ste 2
Rumford, RI 02916
200 Metro Center Blvd
Ste 7
Warwick, RI 02886
115 Cass Ave
Woonsocket, RI 02895
Phone (401) 356-1701
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician |
208600000X | Yes |
Addresses
Primary practice location
2 Dudley St Ste 470
Providence, RI 02905-3248
Mailing address
PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625
Other practice location 1
1407 S County Trl Ste 423
East Greenwich, RI 02818-1761
Phone (401) 228-0590
Other practice location 2
593 Eddy St
Apc 4
Providence, RI 02903
Phone (401) 272-1800
Other practice location 3
562 Washington St
South Attleboro, MA 02703-6942
Phone (401) 272-1800
Other practice location 4
19 Friendship St Unit 240
Newport, RI 02840-2200
Phone (401) 619-3930
Other practice location 5
738 Washington St
Attleboro, MA 02703-6948
Phone (401) 272-1800
Other practice location 6
164 Summit Ave # C70
Providence, RI 02906-2853
Phone (401) 793-4545
Other practice location 7
208 Collyer St Ste 301A
Providence, RI 02904-1560
Phone (401) 725-4888
Other practice location 8
900 Douglas Pike Ste B1
Smithfield, RI 02917-1842
Phone (401) 272-1800
Other practice location 9
2 Dudley St Ste 370
Providence, RI 02905-3248
Phone (401) 272-1800
Other practice location 10
639 Metacom Ave
Warren, RI 02885-2348
Phone (401) 272-1800
Other practice location 11
1524 Atwood Ave
Johnston, RI 02919-3248
Phone (401) 272-1800
Other practice location 12
2 Dudley St Ste 190
Providence, RI 02905-3248
Phone (401) 272-1800
Other practice location 13
195 Collyer St Ste 302
Providence, RI 02904-1869
Phone (401) 793-3236
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RI04030 | Medicaid | RI |
Other names
- Brown Surgical Associates
Other providers in Providence, RI
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- University Plastic Surgeons Inc
- University Shuttle LLC
- University Urological Associates, Inc.
- University Urological Associates, Inc.
- University Urological Associates, Inc.
- Tamlin Unruh
- Uplift Behavioral Health Services LLC
All providers in Providence, RI · Surgery Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.