Individual provider Active NPI

Kimberly Ann Zeller, M.D.

  • Family Medicine Physician
  • East Providence, RI
National Provider Identifier
1578780060
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD12275 Issued in RI
Practice address
900 Warren Ave Ste 400
East Providence, RI 02914-1430
Phone
(401) 331-1221
Fax
(401) 751-8003
NPI assigned
Apr 19, 2007
Last updated
Aug 25, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD12275 RI Primary

Addresses

Primary practice location

900 Warren Ave Ste 400
East Providence, RI 02914-1430

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779

Other identifiers 2

IdentifierTypeStateIssuer
007061006OtherRIMEDICARE PTAN
KZ73014MedicaidRI

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
I20070920000734 RI Practitioner - Family PracticePractitioner - Obstetrics/Gynecology 6800980855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Obstetrics/Gynecology
Education
University of Texas Southwestern Medical School at Dallas, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osh - Ri Physicians Group PCGroup PAC ID 5193051936, 32 clinicians

Practice addresses (Care Compare)

300 Quaker LN
Warwick, RI 02886-0159
Phone (401) 233-5051

712 Broad St
Providence, RI 02907-1465
Phone (401) 536-9138

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
12275RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Osh - Ri Physicians Group, PC Family Medicine CurrentSince Mar 6, 2023 Accepting new patients
Memorial Hospital Past Accepting new patients
Southcoast Physicians Group, Inc. PastSince Sep 11, 2017 Accepting new patients

Locations

712 Broad St
Providence, RI 02907
Phone (401) 233-5060

300 Quaker Ln
Warwick, RI 02886
Phone (401) 233-5051

Organizations & group practices 3

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1578780060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 LA SALLE SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029031814",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WARREN AVE STE 400",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141430",
            "telephone_number": "401-331-1221",
            "fax_number": "401-751-8003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZELLER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD12275",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "007061006",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "KZ73014",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Providence, RI

Sources for this page

Verify at the official NPI Registry.