Individual provider Active NPI

Anthony Joseph Spallino, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1831857531
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01434 Issued in RI
Practice address
593 Eddy Street
Apc 6
Providence, RI 02903
Phone
(401) 606-5891
Fax
(401) 606-4692
NPI assigned
Nov 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA01434 RI Primary

Addresses

Primary practice location

593 Eddy Street
Apc 6
Providence, RI 02903

Mailing address

593 Eddy Street
Apc 6
Providence, RI 02903
Phone (401) 606-5891

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220422000259 RI Practitioner - Physician Assistant 6800283854 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
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)

185 A High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

185 High Service Ave
North Providence, RI 02904-5114
Phone (401) 354-6050

593 Eddy St
Providence, RI 02903-4923

593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172

593 Eddy St George BLDG 1St Floor
Providence, RI 02903-4923
Phone (401) 793-9166

825 Chalkstone Ave
Providence, RI 02908-4728
Phone (401) 649-4000

Hospital & facility affiliations

  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Roger Williams Medical Center Hospital, Providence, RI, CCN 410004
  • Newport Hospital Hospital, Newport, RI, CCN 410006

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01434RIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. Physician Assistant CurrentSince Jul 1, 2023 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Lifespan Corporation Current Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients
Southcoast Physicians Group, Inc. PastSince Dec 1, 2021 Accepting new patients

Locations

1351 S County Trl
Ste 210
East Greenwich, RI 02818
Phone (401) 884-2008

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

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

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

690 Eddy St
#2
Providence, RI 02903
Phone (401) 793-9166

593 Eddy St
#7
Providence, RI 02903
Phone (401) 444-3565

593 Eddy St
Providence, RI 02903

593 Eddy St
#6
Providence, RI 02903
Phone (401) 793-9166

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

2 Dudley St
Ste 370
Providence, RI 02905
Phone (401) 444-3600

41 Sanderson Rd
Ste 202
Smithfield, RI 02917
Phone (401) 456-2316

Interoperability endpoints

  • Direct secure messaging: aspallino190164@brownhealth.medalliesdirect.net

Organizations & group practices 6

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 7

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": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695254400000",
    "number": "1831857531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY STREET",
            "address_2": "APC 6",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-606-5891",
            "fax_number": "401-606-4692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY STREET",
            "address_2": "APC 6",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-606-5891",
            "fax_number": "401-606-4692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPALLINO",
        "first_name": "ANTHONY",
        "middle_name": "JOSEPH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-30",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.