Audrey CMK Tin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA01729 Issued in RI

Practice address

132 Old River Rd.
Suite 108
Lincoln, RI 02865-1397

Phone

(401) 723-9250

Fax

(814) 339-6165

NPI assigned

Apr 2, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: audrey.tin.p1@direct.wrhsrhodeisland.nextgenshare.com

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.

• Core Clinicals LLC

  • Internal Medicine Physician
  • Lincoln, RI
  • NPI 1235704917
  Medicare reassignment
• Wood River Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Hope Valley, RI
  • NPI 1417947383
  Medicare reassignment

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

{
    "created_epoch": "1712016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1861244170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 OLD RIVER RD.",
            "address_2": "SUITE 108",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028651397",
            "telephone_number": "401-723-9250",
            "fax_number": "814-339-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 OLD RIVER RD.",
            "address_2": "SUITE 108",
            "city": "LINCOLN",
            "state": "RI",
            "postal_code": "028651397",
            "telephone_number": "401-723-9250",
            "fax_number": "814-339-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIN",
        "first_name": "AUDREY",
        "middle_name": "CMK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-02",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01729",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861244170",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Therapeutic Solutions, LLC
• Therapyworks, Inc.
• Megan Thompson
• Andrew Thomas Thorp Jr., MD, MBA
• Astarrian Timbo
• Anne M Tisdell, NP
• Daniela Tosta
• Town of Lincoln
• Town of Lincoln Public Schools
• Town of Lincoln Public Schools

• Physician Assistant in Lincoln, RI
• Providers in Lincoln, RI by specialty
• Physician Assistant in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.