NPIMap

Individual provider Active NPI

Anne Elizabeth Dacosta, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1700372356
Registry record updated Nov 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01259 Issued in RI
Practice address
2 Dudley St Ste 470
Providence, RI 02905-3248
Phone
(401) 228-0602
Fax
(401) 868-2320
NPI assigned
Jul 6, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4157 CT
Physician Assistant 363A00000X PA7680 MA
Physician Assistant 363A00000X PA01259 RI Primary

Addresses

Primary practice location

2 Dudley St Ste 470
Providence, RI 02905-3248

Mailing address

47 Sunset Lake Rd
Warren, CT 06754-1701
Phone (860) 866-6938

Other practice location 1

67 Slades Ferry Ave
Somerset, MA 02726-1220
Phone (508) 678-5633

Other names 1

  • Anne Elizabeth Carlson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201119001950 MA Practitioner - Physician Assistant 7517216419 Reassigns benefits to 1 organization
I20220707000323 RI Practitioner - Physician Assistant 7517216419 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Surgical Associates, Inc.Group PAC ID 4082503032, 105 clinicians
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

2 Dudley St
Providence, RI 02905-3248
Phone (401) 272-1800

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA7680MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Current Accepting new patients
Lifespan Physician Group, Inc. Physician Assistant CurrentSince Dec 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Prima Care, PC CurrentSince Oct 1, 2020 Accepting new patients
Prima Care, PC CurrentSince Oct 1, 2020 Accepting new patients
Rhode Island Hospital Past Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

67 Slades Ferry Ave
Somerset, MA 02726
Phone (508) 673-9400

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

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

900 Douglas Pike
Ste B1
Smithfield, RI 02917
Phone (401) 725-4888

Interoperability endpoints

  • Direct secure messaging: anne.carlson.usasurg@direct-address.net

Organizations & group practices 8

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": "1530835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764028800000",
    "number": "1700372356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 SUNSET LAKE RD",
            "city": "WARREN",
            "state": "CT",
            "postal_code": "067541701",
            "telephone_number": "860-866-6938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST STE 470",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053248",
            "telephone_number": "401-228-0602",
            "fax_number": "401-868-2320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "67 Slades Ferry Ave",
            "address_purpose": "LOCATION",
            "city": "Somerset",
            "state": "MA",
            "postal_code": "027261220",
            "country_code": "US",
            "telephone_number": "508-678-5633",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DACOSTA",
        "first_name": "ANNE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-06",
        "last_updated": "2025-11-25",
        "certification_date": "2025-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "4157",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7680",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01259",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "CARLSON",
            "middle_name": "ELIZABETH",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.