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SYDNEY SUMI MOON M.D.
NPI 1114954583
Psychiatry & Neurology - Psychosomatic Medicine in Providence, RI

Active since June 28, 2006PECOS EnrolledAccepts Medicare Assignment
593 EDDY ST, LIFESPAN PHYSCIAN GROUP, PROVIDENCE, RI 02903(401) 444-2128(401) 444-8836 Get Directions Write a Review

NPPES record last updated: March 31, 2017. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sydney Sumi Moon M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SYDNEY SUMI MOON M.D. (NPI 1114954583) is an individual psychosomatic medicine provider in Providence, Rhode Island, licensed in Rhode Island (14228) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS, is affiliated with Rhode Island Hospital, and is a graduate of Other (1996).

NPPES Registry Identity

NPI1114954583
Entity TypeIndividualFemale
Primary Taxonomy2084P0015X
Provider Legal NameSYDNEY SUMI MOONCredential: M.D.
Location Address593 EDDY ST, LIFESPAN PHYSCIAN GROUPProvidence, RI 02903-4923
Mailing Address593 Eddy St, Lifespan Physcian GroupProvidence, RI 02903-4923 · (401) 444-2128 · Fax (401) 444-8836
Phone(401) 444-2128
Fax(401) 444-8836
Sole ProprietorNo
Medical School CMSOtherGraduated 1996
Enumeration DateJune 28, 2006
Last NPPES UpdateMarch 31, 2017
✔ NPI 1114954583 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · Psychosomatic MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2084P0015X
License✔ Licensed in RI · 14228
Definition
Psychosomatic Medicine is subspecialty in the diagnosis and treatment of psychiatric disorders and symptoms in complex medically ill patients. This subspecialty includes treatment of patients with acute or chronic medical, neurological, obstetrical or surgical illness in which psychiatric illness is affecting their medical care and/or quality of life such as HIV infection, organ transplantation, heart disease, renal failure, cancer, stroke, traumatic brain injury, high-risk pregnancy and COPD, among others. Patients also may be those who have a psychiatric disorder that is the direct consequence of a primary medical condition, or a somatoform disorder or psychological factors affecting a general medical condition. Psychiatrists specializing in Psychosomatic Medicine provide consultation-liaison services in general medical hospitals, attend on medical psychiatry inpatient units, and provide collaborative care in primary care and other outpatient settings.
593 EDDY ST, Providence, RI 02903
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Other Names 1

Former Name (1)Sumi Moon M.d.

Other Identifiers 2

Medicare PINA40186MA
Medicaid110073955AMA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Harvard Pilgrim Health Care, Taro Health.Insurance ›

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

Sydney Sumi Moon M.d. 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.

PECOS PAC ID5890799712
PECOS Enrollment IDI20130820000301
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sydney Moon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lifespan Physician Group, Inc.
Same address
Psychiatry
593 EDDY STREET
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • 315 clinicians in this Medicare group
NPI 1548506793 (401) 444-7442

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
30 services12 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Rhode Island Hospital

Acute Care Hospitals · Providence, RI
3/5 CMS rating
OwnershipTribal
CMS Certification Number410007
Location593 Eddy StreetProvidence, RI 02903 · Providence County
Emergency services

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KEITH-AUSTIN SCARFO D.O.
Anesthesiology
593 EDDY ST, APC 6
PROVIDENCE, RI 02903
Providence County (401) 444-3777
AILEEN HSUEH
Surgery
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-8450
RHODE ISLAND HOSPITAL
General Acute Care Hospital
593 EDDY ST, MAIN 4
PROVIDENCE, RI 02903
Providence County (401) 444-7585
DR. GA HIE NAM M.D.
Pathology (Anatomic Pathology & Clinical Pathology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-5057
EUGENIE ATALLAH
Psychiatry & Neurology (Neurology)
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 606-2645
BRET CAULFIELD
Physician Assistant
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4000
JUNG HO GONG
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 793-2695
FANNY HUANG MD
Student in an Organized Health Care Education/Training Program
593 EDDY ST
PROVIDENCE, RI 02903
Providence County (401) 444-4741

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 Sydney Moon's NPI number?

The NPI number for Sydney Moon is 1114954583. It was assigned to this individual provider in the NPPES registry on June 28, 2006. The provider is also known as Sumi Moon M.D..

Where is Sydney Moon located?

Sydney Moon practices at 593 Eddy St Lifespan Physcian Group, Providence, RI 02903. The listed phone number is (401) 444-2128.

What is Sydney Moon's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychosomatic Medicine, with taxonomy code 2084P0015X.

Is Sydney Moon enrolled in Medicare?

Yes. Sydney Moon 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 Sydney Moon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sydney Moon 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 Sydney Moon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sydney Moon accept?

Health plans from Harvard Pilgrim Health Care and Taro Health list Sydney Moon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Sydney Moon affiliated with any hospitals?

According to CMS data, Sydney Moon is affiliated with Rhode Island Hospital.

When was this NPI record last updated?

The NPPES record for Sydney Moon was last updated on March 31, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.