Active NPI
Mark Ryan Gauvin, MS, MSPAS, RD, PA-C
- Physician Assistant
- Providence, RI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA01375
- Practice address
- 593 Eddy St
Providence, RI 02903-4923 - Phone
- (401) 444-4000
- NPI assigned
- Jan 18, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA01375 | RI | Primary |
| Registered Dietitian | 133V00000X | LDN00892 | RI |
Addresses
Primary practice location
593 Eddy St
Providence, RI 02903-4923
Mailing address
15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 444-6779
Other practice location 1
200 High Service Ave
North Providence, RI 02904-5113
Phone (401) 456-3000
Other practice location 2
1360 W Main Rd
Middletown, RI 02842-6301
Phone (401) 606-3111
Other practice location 3
825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 456-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110178471A | Other | MA | MASSHEALTH |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-7024
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LDN00892 | RI | MD | Registered Dietitian |
| PA01375 | RI | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Physician Associates of New England PC | Physician Assistant | Current | Accepting new patients |
| Lifespan Physician Group, Inc. | Physician Assistant | Current | Accepting new patients |
Locations
1360 W Main Rd
Middletown, RI 02842
Phone (401) 606-3110
200 High Service Ave
North Providence, RI 02904
Phone (401) 456-3000
593 Eddy St
Providence, RI 02903
15 La Salle Sq
Providence, RI 02903
825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000
100 Kenyon Ave
Wakefield, RI 02879
Phone (401) 782-8000
Organizations & group practices 4
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.
-
- Urgent Care Clinic/Center
- Warwick, RI
- NPI 1285191163
-
- Emergency Medicine Physician
- Wakefield, RI
- NPI 1427381052
Physician Assistant
-
- Emergency Medicine Physician
- North Providence, RI
- NPI 1639537335
-
- Emergency Medicine Physician
- Providence, RI
- NPI 1568325678
Physician Assistant
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Providence, RI
- NPI 1487649430
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785801600000",
"number": "1801332507",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 LA SALLE SQ",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029031814",
"telephone_number": "401-444-6779",
"fax_number": "401-444-6912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "593 EDDY ST",
"city": "PROVIDENCE",
"state": "RI",
"postal_code": "029034923",
"telephone_number": "401-444-4000"
}
],
"practiceLocations": [
{
"address_1": "200 High Service Ave",
"address_purpose": "LOCATION",
"city": "North Providence",
"state": "RI",
"postal_code": "029045113",
"country_code": "US",
"telephone_number": "401-456-3000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1360 W Main Rd",
"address_purpose": "LOCATION",
"city": "Middletown",
"state": "RI",
"postal_code": "028426301",
"country_code": "US",
"telephone_number": "401-606-3111",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "825 Chalkstone Ave",
"address_purpose": "LOCATION",
"city": "Providence",
"state": "RI",
"postal_code": "029084728",
"country_code": "US",
"telephone_number": "401-456-2000",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAUVIN",
"first_name": "MARK",
"middle_name": "RYAN",
"name_prefix": "Mr.",
"credential": "MS, MSPAS, RD, PA-C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-18",
"last_updated": "2026-08-04",
"certification_date": "2026-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "RI",
"license": "PA01375",
"primary": true
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "RI",
"license": "LDN00892",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSHEALTH",
"identifier": "110178471A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Providence, RI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.