NPIMap

Organization Active NPI

The Miriam Hospital

  • Cardiovascular Disease Physician
  • Providence, RI
National Provider Identifier
1851677470
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
HOS00122 Issued in RI
Legal business name
THE MIRIAM HOSPITAL
Practice address
208 Collyer St
Suite 100
Providence, RI 02904-1560
Phone
(401) 793-7191
NPI assigned
Oct 27, 2011
Last updated
Mar 18, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFESPAN CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Authorized official

Name
Peter K Markell
Title
Evp & Cfo
Phone
(401) 444-7914

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X HOS00122 RI Primary

Addresses

Primary practice location

208 Collyer St
Suite 100
Providence, RI 02904-1560

Mailing address

15 La Salle SQ
Providence, RI 02903-1814
Phone (401) 793-2500

Other practice location 1

950 Warren Ave Ste 201
East Providence, RI 02914-1432
Phone (401) 606-1004

Other practice location 2

1454 S County Trl Ste 2
East Greenwich, RI 02818-1750
Phone (401) 606-1100

Other practice location 3

164 Summit Ave
Providence, RI 02906-2853
Phone (401) 793-4102

Other names 1

  • Cardiovascular Institute Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120416000473 RI Part B Supplier - Clinic/Group Practice 6901796408 Receives reassigned benefits from 113 practitioners
Practice locations: East Greenwich, RI; Providence, RI; East Providence, RI

Other NPIs with the same Medicare PAC ID 10

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Lifespan Corporation

Locations

1454 S County Trl
Ste 2
East Greenwich, RI 02818
Phone (401) 606-1100

1454 S County Trl
Ste 2000
East Greenwich, RI 02818
Phone (401) 606-1100

950 Warren Ave
Ste 201
East Providence, RI 02914
Phone (855) 332-8474

Practitioners & affiliated clinicians

Practitioners 183

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 183

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773792000000",
    "number": "1851677470",
    "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": "401-793-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 COLLYER ST",
            "address_2": "SUITE 100",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041560",
            "telephone_number": "401-793-7191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "950 Warren Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "East Providence",
            "state": "RI",
            "postal_code": "029141432",
            "country_code": "US",
            "telephone_number": "401-606-1004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1454 S County Trl Ste 2",
            "address_purpose": "LOCATION",
            "city": "East Greenwich",
            "state": "RI",
            "postal_code": "028181750",
            "country_code": "US",
            "telephone_number": "401-606-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "164 Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029062853",
            "country_code": "US",
            "telephone_number": "401-793-4102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "THE MIRIAM HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFESPAN CORPORATION",
        "enumeration_date": "2011-10-27",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A",
        "authorized_official_last_name": "MARKELL",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "EVP & CFO",
        "authorized_official_telephone_number": "401-444-7914"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "RI",
            "license": "HOS00122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cardiovascular Institute",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Cardiovascular Institute",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.