Individual provider Active NPI

Cailyne Ghazarian, PA

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1528339876
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
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

Updated by the provider on Dec 13, 2023

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 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

TypeEndpointUseAffiliation
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120425000598 RI Practitioner - Physician Assistant 2264694983 Reassigns benefits to 3 organizations

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

OrganizationSpecialtyStatusNew patients
Lifespan Corporation Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Feb 1, 2026 Accepting new patients
Lifespan Physician Group, Inc. Physician Assistant CurrentSince Feb 1, 2026 Accepting new patients
The Providence Community Health Centers, Inc CurrentSince Mar 20, 2023 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

  • Direct secure messaging: cghazarian8734@brownhealth.medalliesdirect.net
  • Direct secure messaging: 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.

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

Verify at the official NPI Registry.