The Miriam Hospital
Organization Active NPI Adult Medicine Physician · Providence, RI
NPI 1831362813 · NPPES record last updated Mar 18, 2026
Key facts
- NPI
- 1831362813
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Adult Medicine Physician 207QA0505X
- Legal business name
- THE MIRIAM HOSPITAL
- Practice address
- 180 Corliss St Ste C
Providence, RI 02904-2602 - Phone
- (401) 793-4636
- Fax
- (401) 793-4639
- NPI assigned
- Apr 10, 2008
- Organization subpart
- No
Authorized official
- Name
- Peter K Markell
- Title
- E VP & Cfo
- Phone
- (401) 444-7914
Other NPIs with the same Medicare PAC ID 10
Practitioners 283
-
Jeffrey Lawrence, M.D.
-
Martin M. Miner, M.D.
-
Lauren Pillsbury, APRN
-
Kenneth Ralph Vieira, CNP
-
Mariepet Tabanas Ask, M.D.
-
Mary Margaret Flynn, PHD, RD
-
Vincent M. Harisaran, M.D.
-
Bethany Nelson, PA-C
-
Mark Sigman, MD
-
Brian G Abbott, MD
-
Christina Al Malouf, M.D.
-
Saud Alhusaini, MD, PHD
-
Karen E Aspry, MD
-
Lisa Anne Bonin, N.P.
-
Douglas M Burtt, M.D.
-
Mary V. Cabral, APRN-CNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20081016000420 | RI | Part B Supplier - Clinic/Group Practice | 6901796408 |
Receives reassigned benefits from 13 practitioners Practice locations: Providence, RI |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | |||
| Family Medicine Physician |
207Q00000X | |||
| Adult Medicine Physician |
207QA0505X | Yes | ||
| Urology Physician |
208800000X |
Addresses
Primary practice location
180 Corliss St Ste C
Providence, RI 02904-2602
Mailing address
15 La Salle SQ
Providence, RI 02903-1814
Other practice location 1
164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-4636
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| TM70395 | Medicaid | RI |
Other names
- The Men's Health Center
Other providers in Providence, RI
- The Miriam Hospital
- The Miriam Hospital
- The Miriam Hospital
- The Miriam Hospital
- The Miriam Hospital
- The Miriam Hospital
- The Miriam Hospital
- The Miriam Hospital Outpatient Rehabilitation
- The Orthopaedic Institute
- The Plum Psychology, LLC
All providers in Providence, RI · Adult Medicine Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.