Individual provider Active NPI

Gita Subramanian Pensa, MD

  • Emergency Medicine Physician
  • Newport, RI
National Provider Identifier
1447216379
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD10611 Issued in RI
Practice address
11 Friendship St
Newport, RI 02840-2271
Phone
(401) 845-1593
Fax
(401) 847-0650
NPI assigned
Apr 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD10611 RI Primary

Addresses

Primary practice location

11 Friendship St
Newport, RI 02840-2271

Mailing address

11 Friendship St
Newport, RI 02840-2271
Phone (401) 845-1593

Other identifiers 1

IdentifierTypeStateIssuer
7009049MedicaidRI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100610000186 RI Practitioner - Emergency Medicine 9739219254 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD10611RIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2020 Accepting new patients
Lifespan Physician Group, Inc. Emergency Medicine CurrentSince Dec 1, 2020 Accepting new patients

Locations

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

11 Friendship St
Ph
Newport, RI 02840
Phone (401) 845-1593

185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050

593 Eddy St
Providence, RI 02903

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419984000000",
    "number": "1447216379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 FRIENDSHIP ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402271",
            "telephone_number": "401-845-1593",
            "fax_number": "401-847-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 FRIENDSHIP ST",
            "city": "NEWPORT",
            "state": "RI",
            "postal_code": "028402271",
            "telephone_number": "401-845-1593",
            "fax_number": "401-847-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PENSA",
        "first_name": "GITA",
        "middle_name": "SUBRAMANIAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-20",
        "last_updated": "2014-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "MD10611",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7009049",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport, RI

Sources for this page

Verify at the official NPI Registry.