Individual provider Active NPI

Victoria Hartley, PA-C

  • Physician Assistant
  • Middletown, RI
National Provider Identifier
1689423410
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01697 Issued in RI
Practice address
1360 W Main Rd
Middletown, RI 02842-6301
Phone
(401) 606-3110
NPI assigned
May 14, 2024
Last updated
May 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01697 RI Primary
Physician Assistant 363A00000X PA101635 MA

Addresses

Primary practice location

1360 W Main Rd
Middletown, RI 02842-6301

Mailing address

6 Woodlake Dr
Johnston, RI 02919-3157

Other practice location 1

795 Middle St
Fall River, MA 02721-1733
Phone (508) 996-3991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240725001986 RI Practitioner - Physician Assistant 8921544040 Reassigns benefits to 1 organization
I20250627002146 MA Practitioner - Physician Assistant 8921544040 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
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)

1360 W Main Rd
Middletown, RI 02842-6301
Phone (401) 606-3110

17 Airport Rd
Warwick, RI 02889-1001
Phone (401) 606-2520

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Lifespan Physician Group, Inc. Physician Assistant CurrentSince Jul 1, 2024 Accepting new patients

Locations

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

1360 W Main Rd
Middletown, RI 02842
Phone (401) 606-3110

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1715644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1689423410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 WOODLAKE DR",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029193157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 W MAIN RD",
            "city": "MIDDLETOWN",
            "state": "RI",
            "postal_code": "028426301",
            "telephone_number": "401-606-3110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "795 Middle St",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027211733",
            "country_code": "US",
            "telephone_number": "508-996-3991",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "VICTORIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-14",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01697",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA101635",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, RI

Sources for this page

Verify at the official NPI Registry.