KATHLEEN FAVA ACNP-BC
NPI 1053682765
Nurse Practitioner - Acute Care in Providence, RI
About Kathleen Fava Acnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KATHLEEN FAVA ACNP-BC (NPI 1053682765) is an individual acute care provider in Providence, Rhode Island, licensed in Rhode Island (NPP37680) and active in the NPI registry since January 2012. She is enrolled in Medicare PECOS, is affiliated with Rhode Island Hospital, and maintains a secondary practice location in Providence.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Kathleen Fava Acnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Kathleen Fava reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Providence, RI 02903
- Reassigned Medicare billing, Rhode Island enrollment
- 1,372 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Rhode Island Hospital
Acute Care Hospitals · Providence, RIThe Miriam Hospital
Acute Care Hospitals · Providence, RIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 02903 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Kathleen Fava's NPI number?
The NPI number for Kathleen Fava is 1053682765. It was assigned to this individual provider in the NPPES registry on January 26, 2012.
Where is Kathleen Fava located?
Kathleen Fava practices at 593 Eddy Street, Jane Brown, 2 South, Providence, RI 02903. The listed phone number is (401) 444-5943.
What is Kathleen Fava's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Kathleen Fava enrolled in Medicare?
Yes. Kathleen Fava is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Kathleen Fava's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kathleen Fava reassigns Medicare benefits to Lifespan Physician Group, Inc. (Providence, RI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kathleen Fava's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Kathleen Fava affiliated with any hospitals?
According to CMS data, Kathleen Fava is affiliated with Rhode Island Hospital and The Miriam Hospital.
When was this NPI record last updated?
The NPPES record for Kathleen Fava was last updated on December 5, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Kathleen Fava, ACNP-BC · NPI 1053682765
Acute Care physician in Providence, Rhode Island. Individual provider, active in the CMS NPPES registry since January 26, 2012.
## Identity
- **NPI:** 1053682765 (Entity type: Individual)
- **Enumerated:** January 26, 2012
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** NPP37680 (Rhode Island)
- **Sole proprietor:** No
## Practice location
- **Address:** 593 EDDY STREET, JANE BROWN, 2 SOUTH, Providence, RI 02903-4923
- **Phone:** (401) 444-5943 · **Fax:** (401) 444-4216
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Lifespan Physician Group, Inc. (NPI 1407116643, Providence, RI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2011
## Record status
- **NPPES last updated:** December 5, 2018
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Source: [NPI Profile](https://npiprofile.com/npi/1053682765) · Data from the CMS NPPES public registry.