Individual provider Active NPI

Elizabeth J Renaud, M.D.

  • Pediatric Surgery Physician
  • Providence, RI
National Provider Identifier
1881715944
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
MD16025 Issued in RI
Practice address
2 Dudley St Ste 190
Providence, RI 02905-3248
Phone
(401) 228-0555
Fax
(401) 868-2319
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X MD16025 RI Primary
Pediatric Surgery Physician 2086S0120X 262737 NY
Pediatric Surgery Physician 2086S0120X 216251 MA

Addresses

Primary practice location

2 Dudley St Ste 190
Providence, RI 02905-3248

Mailing address

PO Box 16149
Rumford, RI 02916-0697
Phone (401) 453-9625

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elizabeth.renaud.usasurg@direct-address.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20090914000400 MA Practitioner - Pediatric MedicinePractitioner - General Surgery 4082760236
I20171205000310 RI Practitioner - Pediatric Medicine 4082760236 Reassigns benefits to 2 organizations
I20250409001065 MA Practitioner - General SurgeryPractitioner - Pediatric Medicine 4082760236 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Pediatric Medicine
Education
University of Michigan Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

10 N Main St
Fall River, MA 02720-2130
Phone (508) 646-3923

2 Dudley St
Suite 190
Providence, RI 02905-3248
Phone (401) 272-1800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
216251MAMDPediatric Surgery Physician
MD16025RIMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jun 1, 2025 Accepting new patients
Lifespan Physician Group, Inc. Pediatric Surgery CurrentSince Jun 1, 2025 Accepting new patients
Rhode Island Hospital Past Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

152 Emory St
Attleboro, MA 02703
Phone (508) 222-6409

10 N Main St
Ste 2C
Fall River, MA 02720
Phone (508) 564-3923

10 N Main St
Fall River, MA 02720
Phone (508) 646-3923

562 Washington St
South Attleboro, MA 02703
Phone (401) 725-4888

1407 S County Trl
Ste 423
East Greenwich, RI 02818
Phone (401) 228-0590

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

2 Dudley St
Ste 190
Providence, RI 02905
Phone (401) 228-0555

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

2 Dudley St
Ste 470
Providence, RI 02905
Phone (401) 274-7546

Interoperability endpoints

  • Direct secure messaging: elizabeth.renaud.usasurg@direct-address.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.

NPI Registry JSON

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742256000000",
    "number": "1881715944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16149",
            "city": "RUMFORD",
            "state": "RI",
            "postal_code": "029160697",
            "telephone_number": "401-453-9625",
            "fax_number": "401-435-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST STE 190",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053248",
            "telephone_number": "401-228-0555",
            "fax_number": "401-868-2319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RENAUD",
        "first_name": "ELIZABETH",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "RI",
            "license": "MD16025",
            "primary": true
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "NY",
            "license": "262737",
            "primary": false
        },
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "MA",
            "license": "216251",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elizabeth.renaud.usasurg@direct-address.net",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2 Dudley St Ste 190",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029053248",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.