Individual provider Active NPI

Tianyi Niu, M.D.

  • Neurological Surgery Physician
  • Providence, RI
National Provider Identifier
1891051702
Registry record updated Mar 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
MD16544 Issued in RI
Practice address
593 Eddy St
Providence, RI 02903
Phone
(401) 793-9166
Fax
(401) 444-2788
NPI assigned
Apr 4, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X MD16544 RI Primary

Addresses

Primary practice location

593 Eddy St
Providence, RI 02903

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4513
Phone (401) 444-6779

Other practice location 1

757 Westwood Plz
Los Angeles, CA 90095-8358
Phone (310) 825-6643

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190627002630 RI Practitioner - Neurosurgery 5092067140 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Medical College of Wisconsin, 2012
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)

593 Eddy St
Providence, RI 02903-4923
Phone (401) 444-4000

Hospital & facility affiliations

  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • Newport Hospital Hospital, Newport, RI, CCN 410006

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion67
Laminectomy or laminotomy (partial removal of spine bones)11

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Jul 1, 2019 Accepting new patients
Lifespan Physician Group, Inc. Past Accepting new patients

Locations

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

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

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

593 Eddy St
Providence, RI 02903

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

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

Organizations & group practices 3

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 5

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": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1891051702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054513",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-793-9166",
            "fax_number": "401-444-2788"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "757 Westwood Plz",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900958358",
            "country_code": "US",
            "telephone_number": "310-825-6643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NIU",
        "first_name": "TIANYI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-04",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "RI",
            "license": "MD16544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.