Individual provider Active NPI

Sara Jean Deasley, NNP-BC

  • Critical Care Neonatal Nurse Practitioner
  • Providence, RI
National Provider Identifier
1396164307
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X
License
APRN00790 Issued in RI
Practice address
101 Dudley St
Providence, RI 02905-2401
Phone
(401) 274-1122
Fax
(401) 453-7571
NPI assigned
Apr 8, 2014
Last updated
Jul 31, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Neonatal Nurse Practitioner 363LN0005X APRN00790 RI Primary

Addresses

Primary practice location

101 Dudley St
Providence, RI 02905-2401

Mailing address

455 Toll Gate Road
PRC and Credentiailng
Warwick, RI 02886-2759
Phone (401) 273-0641

Other practice location 1

455 Toll Gate Road
Warwick, RI 02886-2759
Phone (401) 737-7000

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
I20180113000013 RI Practitioner - Nurse Practitioner 8628294287 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5006841NCMDCritical Care Neonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Feb 1, 2018 Accepting new patients
Affinity Physicians LLC. CurrentSince Feb 1, 2018 Accepting new patients

Locations

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

345 Blackstone Blvd
Providence, RI 02906
Phone (401) 455-6375

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

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1396915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1396164307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE ROAD",
            "address_2": "PRC AND CREDENTIAILNG",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-273-0641",
            "fax_number": "401-273-2919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052401",
            "telephone_number": "401-274-1122",
            "fax_number": "401-453-7571"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Toll Gate Road",
            "address_purpose": "LOCATION",
            "city": "Warwick",
            "state": "RI",
            "postal_code": "028862759",
            "country_code": "US",
            "telephone_number": "401-737-7000",
            "fax_number": "401-736-4546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEASLEY",
        "first_name": "SARA",
        "middle_name": "JEAN",
        "name_prefix": "Miss",
        "credential": "NNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-08",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "RI",
            "license": "APRN00790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.