Individual provider Active NPI

Elyse Korn, PA-C

  • Physician Assistant
  • Cranston, RI
National Provider Identifier
1407791353
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01903 Issued in RI
Practice address
725 Reservoir Ave Ste 101
Cranston, RI 02910-4450
Phone
(401) 457-1500
NPI assigned
Apr 20, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01903 RI Primary

Addresses

Primary practice location

725 Reservoir Ave Ste 101
Cranston, RI 02910-4450

Mailing address

1 Kettle Point Ave
East Providence, RI 02914-5375

Other practice location 1

2 Dudley St Ste 200
Providence, RI 02905-3252
Phone (401) 457-1500

Other practice location 2

2138 Mendon Rd Ste 302
Cumberland, RI 02864-3836
Phone (401) 457-1500

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
I20260508000758 RI Practitioner - Physician Assistant 3375011216 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Orthopedics IncGroup PAC ID 9931000395, 185 clinicians

Practice addresses (Care Compare)

2 Dudley St
Suite 200
Providence, RI 02905-3248
Phone (401) 457-1500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA01903RIMDPhysician Assistant

Organizations & group practices 1

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": "1776643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1407791353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KETTLE POINT AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029145375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 RESERVOIR AVE STE 101",
            "city": "CRANSTON",
            "state": "RI",
            "postal_code": "029104450",
            "telephone_number": "401-457-1500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Dudley St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029053252",
            "country_code": "US",
            "telephone_number": "401-457-1500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2138 Mendon Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "RI",
            "postal_code": "028643836",
            "country_code": "US",
            "telephone_number": "401-457-1500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KORN",
        "first_name": "ELYSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-20",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cranston, RI

Sources for this page

Verify at the official NPI Registry.