Individual provider Active NPI

Samantha Lynn Ahle, M.D.

  • Pediatric Surgery Physician
  • Providence, RI
National Provider Identifier
1649682956
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
MD Issued in RI
Practice address
2 Dudley St Ste 190
Providence, RI 02905-3248
Phone
(401) 421-1939
Fax
(401) 868-2319
NPI assigned
May 21, 2014
Last updated
Feb 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Surgery Physician 2086S0120X MD RI Primary

Addresses

Primary practice location

2 Dudley St Ste 190
Providence, RI 02905-3248

Mailing address

PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL samantha.ahle@northwestern.edu Direct

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
I20230808002766 RI Practitioner - Pediatric Medicine 4688994825 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
George Washington University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

2 Dudley St
Providence, RI 02905-3236
Phone (401) 453-4500

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MDRIMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Current Accepting new patients
University Surgical Associates, Inc. CurrentSince Sep 18, 2023 Accepting new patients
Lifespan Physician Group, Inc. Pediatric Surgery CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

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

2 Dudley St
Providence, RI 02905
Phone (401) 444-2299

2 Dudley St
Ste 190
Providence, RI 02905
Phone (401) 228-0555

2 Dudley St
Ste 470
Providence, RI 02905
Phone (401) 274-7546

Interoperability endpoints

  • Direct secure messaging: samantha.ahle@direct-address.net

Organizations & group practices 5

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": "1400630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1649682956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16149",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029160697",
            "telephone_number": "401-453-9625",
            "fax_number": "401-435-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST STE 190",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053248",
            "telephone_number": "401-421-1939",
            "fax_number": "401-868-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHLE",
        "first_name": "SAMANTHA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-21",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "RI",
            "license": "MD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "samantha.ahle@northwestern.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "225 E Chicago Ave # 63",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606112991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.