Individual provider Active NPI

Jill Alison O'Brien, M.D.

  • Internal Medicine Physician
  • Providence, RI
National Provider Identifier
1881896629
Registry record updated Mar 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD13193 Issued in RI
Practice address
164 Summit Ave
Providence, RI 02906-2853
Phone
(401) 793-2104
Fax
(401) 793-4741
NPI assigned
Jun 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X LP01180 RI
Internal Medicine Physician 207R00000X MD13193 RI Primary

Addresses

Primary practice location

164 Summit Ave
Providence, RI 02906-2853

Mailing address

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

Other names 1

  • Jill Alison Tremblay Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20100805000123 RI Practitioner - Internal Medicine 2365575701 Reassigns benefits to 1 organization
I20260305002395 MA Practitioner - Internal Medicine 2365575701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 2007
Medicare assignment
May accept Medicare assignment
Group practices
Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians
Lifespan Physician Group of Massachusetts IncGroup PAC ID 3870020399, 458 clinicians

Practice addresses (Care Compare)

164 Summit Ave
Providence, RI 02906-2853

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

88 Washington St
Taunton, MA 02780-2465
Phone (508) 828-7000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP01180RIMDInternal Medicine Physician
MD13193RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group of Massachusetts Inc Internal Medicine CurrentSince Jan 26, 2026 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Corporation Current Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Lifespan of Massachusetts - Taunton Inc Past Accepting new patients

Locations

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

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

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

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

Interoperability endpoints

  • Direct secure messaging: jobrien11956@brownhealth.medalliesdirect.net

Organizations & group practices 5

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 2

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": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331769600000",
    "number": "1881896629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVENUE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02906",
            "telephone_number": "401-793-2104",
            "fax_number": "401-793-4741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029062853",
            "telephone_number": "401-793-2104",
            "fax_number": "401-793-4741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'BRIEN",
        "first_name": "JILL",
        "middle_name": "ALISON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-04",
        "last_updated": "2012-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "LP01180",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD13193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "TREMBLAY",
            "middle_name": "ALISON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.