Individual provider Active NPI

Alyssa Gellerman, NP

  • Acute Care Nurse Practitioner
  • Providence, RI
National Provider Identifier
1952720641
Registry record updated Oct 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
NPP37866 Issued in RI
Practice address
593 Eddy St
Bridge 6, App Office
Providence, RI 02903-4923
Phone
(401) 444-5633
Fax
(401) 444-5036
NPI assigned
Apr 10, 2014
Last updated
Oct 12, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X NPP37866 RI Primary

Addresses

Primary practice location

593 Eddy St
Bridge 6, App Office
Providence, RI 02903-4923

Mailing address

593 Eddy St
Bridge 6, App Office
Providence, RI 02903-4923
Phone (401) 444-5633

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923002576 RI Practitioner - Nurse Practitioner 4688981640 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
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)

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

593 Eddy St
Providence, RI 02903-4923

593 Eddy St Apc
Suite 6
Providence, RI 02903-4923
Phone (401) 793-9172

593 Eddy St George BLDG 1St Floor
Providence, RI 02903-4923
Phone (401) 793-9166

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 29, 2015 Accepting new patients
Lifespan Corporation Current Accepting new patients

Locations

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

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

593 Eddy St
Ofc
Providence, RI 02903
Phone (401) 444-4500

Interoperability endpoints

  • Direct secure messaging: agellerman7633@brownhealth.medalliesdirect.net
  • Direct secure messaging: alavallee7633@brownhealth.medalliesdirect.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1397088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444608000000",
    "number": "1952720641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "BRIDGE 6, APP OFFICE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5633",
            "fax_number": "401-444-5036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "BRIDGE 6, APP OFFICE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-5633",
            "fax_number": "401-444-5036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELLERMAN",
        "first_name": "ALYSSA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-10",
        "last_updated": "2015-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "RI",
            "license": "NPP37866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.