Andrew Mazur, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

150693 Issued in MA

Practice address

765 Allens Ave Ste 110
Providence, RI 02905-5443

Phone

(401) 432-6800

Fax

(401) 432-6832

NPI assigned

Feb 9, 2006

Sex

Male

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 MA, RI2 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

Specialty

Physical Medicine and Rehabilitation

Education

State University of New York Downstate Medical Center, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southeast Rehabilitation Associates, PCGroup PAC ID 2163419375, 3 clinicians

Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment Care Compare group NPD
• Southeast Rehabilitation Associates, P.C.

  • Physical Medicine & Rehabilitation Physician
  • Fall River, MA
  • NPI 1760564413
  Medicare reassignment Care Compare group NPD
• Southeast Management Services LLC

  • Physical Medicine & Rehabilitation Physician
  • Fall River, MA
  • NPI 1396163796
  NPD (past) Authorized official
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD
• Lifespan Physician Group, Inc.

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Southcoast Hospitals Group, Inc

  • General Acute Care Hospital
  • Wareham, MA
  • NPI 1922024835
  Care Compare affiliation

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783987200000",
    "number": "1972576007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 ALLENS AVE STE 104",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055443",
            "telephone_number": "401-606-4150",
            "fax_number": "401-270-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 ALLENS AVE STE 110",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055443",
            "telephone_number": "401-432-6800",
            "fax_number": "401-432-6832"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "277 Pleasant St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Fall River",
            "state": "MA",
            "postal_code": "027213005",
            "country_code": "US",
            "telephone_number": "508-676-3292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "164 Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029062853",
            "country_code": "US",
            "telephone_number": "401-845-1652",
            "fax_number": "401-845-1198",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAZUR",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-09",
        "last_updated": "2026-07-14",
        "certification_date": "2026-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "150693",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "RI",
            "license": "MD09581",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3152570",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sally L Mayo, PHD
• Kiran A Maypole
• Phina A Mayu, NP
• Aidan Mazagonwalla
• Nabila Kabir Mazumder, M.D.
• Lauren Mazur
• Cardia J. Mazyck
• Julie Mazza, DO
• Peter Joseph Mazzaglia, MD
• Sabrina Mazzilli, LICSW

• Physical Medicine & Rehabilitation Physician in Providence, RI
• Providers in Providence, RI by specialty
• Physical Medicine & Rehabilitation Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.