NPIMap

Individual provider Active NPI

Pamela Kusiak, APRN-CNP

  • Nurse Practitioner
  • Providence, RI
National Provider Identifier
1982130548
Registry record updated Jul 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN01587 Issued in RI
Practice address
164 Summit Avenue
Suite C Medicinie Clinic
Providence, RI 02906
Phone
(401) 793-2930
Fax
(401) 793-2953
NPI assigned
May 2, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN01587 RI Primary

Addresses

Primary practice location

164 Summit Avenue
Suite C Medicinie Clinic
Providence, RI 02906

Mailing address

117 Ellenfield St Ste 101
Providence, RI 02905-4541
Phone (401) 444-6779

Other practice location 1

245 Chapman St Ste 300
Providence, RI 02905-4539
Phone (401) 444-4741

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180123000134 RI Practitioner - Nurse Practitioner 7012276983 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Rhode Island HospitalGroup PAC ID 8921900044, 430 clinicians

Practice addresses (Care Compare)

245 Chapman St
Suite 300
Providence, RI 02905-4539
Phone (401) 444-5280

593 Eddy St
Providence, RI 02903-4923

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Physician Group, Inc. Nurse Practitioner CurrentSince Mar 27, 2020 Accepting new patients
The Miriam Hospital CurrentSince Jan 1, 2020 Accepting new patients
Rhode Island Hospital CurrentSince Mar 15, 2020 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Mar 27, 2020 Accepting new patients
The Miriam Hospital Nurse Practitioner CurrentSince Jan 1, 2020 Accepting new patients
Rhode Island Hospital CurrentSince Mar 15, 2020 Accepting new patients
The Miriam Hospital Current Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

1454 S County Trl
Ste 2100
East Greenwich, RI 02818
Phone (401) 606-2000

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

825 Chalkstone Ave
Providence, RI 02908
Phone (401) 456-2000

245 Chapman St
Ste 300
Providence, RI 02905
Phone (401) 444-4741

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

164 Summit Ave
Ste C
Providence, RI 02906
Phone (401) 793-2931

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

593 Eddy St
Ste 9B
Providence, RI 02903
Phone (401) 444-5280

Organizations & group practices 8

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": "1493683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751932800000",
    "number": "1982130548",
    "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": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 SUMMIT AVENUE",
            "address_2": "SUITE C MEDICINIE CLINIC",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02906",
            "telephone_number": "401-793-2930",
            "fax_number": "401-793-2953"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "245 Chapman St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029054539",
            "country_code": "US",
            "telephone_number": "401-444-4741",
            "fax_number": "401-444-4445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KUSIAK",
        "first_name": "PAMELA",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-02",
        "last_updated": "2025-07-08",
        "certification_date": "2025-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "RI",
            "license": "APRN01587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.