Active NPI
Cailyne Ghazarian, PA
- Physician Assistant
- Providence, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 593 Eddy St
Davol 141
Providence, RI 02903-4923 - Phone
- (401) 519-1604
- Fax
- (401) 272-0538
- NPI assigned
- Jan 18, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
593 Eddy St
Davol 141
Providence, RI 02903-4923
Mailing address
PO Box 9484
Providence, RI 02940-9484
Phone (401) 854-2500
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | cghazarian58547@HCNetwork.direct-ci.com |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
31 Atwood St
Providence, RI 02909-3410
Phone (401) 444-0590
355 Prairie Ave
Providence, RI 02905-1928
Phone (401) 444-0570
375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lifespan Corporation | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Current | Accepting new patients | |
| Lifespan Physician Group, Inc. | Physician Assistant | Current | Accepting new patients |
| The Providence Community Health Centers, Inc | Current | Accepting new patients | |
| The Providence Community Health Centers Inc. | Past | Accepting new patients |
Locations
185A High Service Ave
North Providence, RI 02904
Phone (401) 354-6050
375 Allens Ave
Providence, RI 02905
Phone (401) 444-0400
593 Eddy St
Providence, RI 02903
164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104
593 Eddy St
#141
Providence, RI 02903
Phone (401) 444-5120
31 Atwood St
Providence, RI 02909
Phone (401) 444-0590
455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000
Interoperability endpoints
- cghazarian8734@brownhealth.medalliesdirect.net
- cghazarian58547@hcnetwork.direct-ci.com
Organizations & group practices 7
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.
-
- Federally Qualified Health Center (FQHC)
- Providence, RI
- NPI 1053313593
-
- Emergency Medicine Physician
- Providence, RI
- NPI 1962455022
-
dba Brown Health Medical Group
- General Practice Physician
- Providence, RI
- NPI 1407116643
-
- Children's Rehabilitation Hospital
- Providence, RI
- NPI 1790221232
-
dba Brown Health Medical Group
- General Practice Physician
- Riverside, RI
- NPI 1215899869
-
dba Brown Health Medical Group
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
Physician Assistant
-
- Federally Qualified Health Center (FQHC)
- Providence, RI
- NPI 1558650986
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1326844800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702425600000",
"number": "1528339876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9484",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029409484",
"telephone_number": "401-854-2500",
"fax_number": "401-854-2519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "593 EDDY ST",
"address_2": "DAVOL 141",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034923",
"telephone_number": "401-519-1604",
"fax_number": "401-272-0538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHAZARIAN",
"first_name": "CAILYNE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-18",
"last_updated": "2023-12-13",
"certification_date": "2023-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "cghazarian58547@HCNetwork.direct-ci.com",
"affiliation": "N",
"address_1": "355 Prairie Ave",
"city": "Providence",
"state": "RI",
"country_code": "US",
"postal_code": "029051928",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.