Individual provider Active NPI

Laura Favicchio, PA

  • Physician Assistant
  • Warwick, RI
National Provider Identifier
1760717219
Registry record updated Sep 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA00737 Issued in RI
Practice address
125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone
(401) 432-2500
Fax
(401) 453-8220
NPI assigned
Oct 15, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA00737 RI
Physician Assistant 363A00000X PA3844 MA
Surgical Physician Assistant 363AS0400X PA3844 MA
Physician Assistant 363A00000X PA00737 RI Primary

Addresses

Primary practice location

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785

Mailing address

125 Metro Center Blvd Ste 2000
Warwick, RI 02886-1785
Phone (401) 432-2500

Other practice location 1

211 Park St
Attleboro, MA 02703-3137
Phone (508) 222-5200

Other names 1

  • Laura Sharp Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 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
I20120622000045 MA Practitioner - Physician Assistant 5799940896 Reassigns benefits to 1 organization
I20140422000896 RI Practitioner - Physician Assistant 5799940896 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rhode Island Medical Imaging IncGroup PAC ID 8022097815, 107 clinicians

Practice addresses (Care Compare)

1 Kettle Point Ave
East Providence, RI 02914-5375
Phone (401) 626-3900

200 High Service Ave
North Providence, RI 02904-5113
Phone (401) 456-3000

Hospital & facility affiliations

  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Newport Hospital Hospital, Newport, RI, CCN 410006
  • Roger Williams Medical Center Hospital, Providence, RI, CCN 410004
  • Women & Infants Hospital of Rhode Island Hospital, Providence, RI, CCN 410010
  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007

Merit-based Incentive Payment System (MIPS)

Final score
86.17 of 100Reported as group
Quality
82.44
Improvement activities
40
Cost
86.08

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA3844MAMDPhysician Assistant
PA00737RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Medical Imaging Inc CurrentSince Mar 15, 2014 Accepting new patients
Lifespan Corporation Current Accepting new patients

Locations

211 Park St
South Attleboro, MA 02703
Phone (508) 222-5200

593 Eddy St
Providence, RI 02903

1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500

125 Metro Center Blvd
Ste 2000
Warwick, RI 02886
Phone (401) 432-2520

Interoperability endpoints

  • Direct secure messaging: lsharp13793@brownhealth.medalliesdirect.net
  • Direct secure messaging: lfavicchio13793@brownhealth.medalliesdirect.net

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 8

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": "1255564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601424000000",
    "number": "1760717219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2500",
            "fax_number": "401-453-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 METRO CENTER BLVD STE 2000",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028861785",
            "telephone_number": "401-432-2500",
            "fax_number": "401-453-8220"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "211 Park St",
            "address_purpose": "LOCATION",
            "city": "Attleboro",
            "state": "MA",
            "postal_code": "027033137",
            "country_code": "US",
            "telephone_number": "508-222-5200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAVICCHIO",
        "first_name": "LAURA",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-15",
        "last_updated": "2020-09-30",
        "certification_date": "2020-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "RI",
            "license": "PA00737",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA3844",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA3844",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAURA",
            "last_name": "SHARP",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.