Individual provider Active NPI

Grace Faith Suttle, MD

  • Physical Medicine & Rehabilitation Physician
  • Providence, RI
National Provider Identifier
1699302158
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
MD20691 Issued in RI
Practice address
765 Allens Ave Ste 110
Providence, RI 02905-5443
Phone
(401) 432-6800
NPI assigned
Mar 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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 0
Physical Medicine & Rehabilitation Physician 208100000X MD20691 RI Primary

Addresses

Primary practice location

765 Allens Ave Ste 110
Providence, RI 02905-5443

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541

Other practice location 1

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-5000

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
I20250714003297 RI Practitioner - Physical Medicine and Rehabilitation 3173038650 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Rutgers New Jersey Medical School, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

765 Allens Ave
Suite 110
Providence, RI 02905-5443
Phone (401) 432-6800

Hospital & facility affiliations

  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Newport Hospital Hospital, Newport, RI, CCN 410006
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Aug 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Aug 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

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

765 Allens Ave
Ste 110
Providence, RI 02905
Phone (401) 432-6800

593 Eddy St
Ste 7A
Providence, RI 02903
Phone (401) 444-8732

164 Summit Ave
Providence, RI 02906
Phone (401) 793-2104

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1699302158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ALLENS AVE STE 110",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055443",
            "telephone_number": "401-432-6800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079606136",
            "country_code": "US",
            "telephone_number": "973-971-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUTTLE",
        "first_name": "GRACE",
        "middle_name": "FAITH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-25",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": "0",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "RI",
            "license": "MD20691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.