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JOHN A PHILLIP MD
NPI 1285617696
Surgery in Johnston, RI

Active since November 21, 2005PECOS Enrolled
1524 ATWOOD AVE, SUITE 245, JOHNSTON, RI 02919(401) 443-5559(401) 443-5562 Get Directions Write a Review

NPPES record last updated: December 20, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About John A Phillip Md NPPES

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

JOHN A PHILLIP MD (NPI 1285617696) is an individual surgery provider in Johnston, Rhode Island, licensed in Rhode Island (RI08221) and active in the NPI registry since November 2005. He is enrolled in Medicare PECOS, is affiliated with Our Lady Of Fatima Hospital, and is a graduate of Other (1985).

NPPES Registry Identity

NPI1285617696
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameJOHN A PHILLIPCredential: MD
Location Address1524 ATWOOD AVE, SUITE 245Johnston, RI 02919-3228
Mailing Address1524 Atwood Ave Ste 245Johnston, RI 02919-3228 · (401) 443-5559 · Fax (401) 443-5562
Phone(401) 443-5559
Fax(401) 443-5562
Sole ProprietorNo
Medical School CMSOtherGraduated 1985
Enumeration DateNovember 21, 2005
Last NPPES UpdateDecember 20, 2023
NPPES CertifiedDecember 20, 2023
✔ NPI 1285617696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in RI · RI08221
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
1524 ATWOOD AVE, Johnston, RI 02919
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Other Identifiers 4

Medicaid7002899RI
OtherRI08221RI · State License #
Other1700281RI · United Healthcare #
Other004509RI · Blue Chip #

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

John A Phillip Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557362365
PECOS Enrollment IDI20070122000561
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 Reassignments

2

Medicare enrollment records show John Phillip reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Phillip Surgical LLC
Same address
Surgery
1524 ATWOOD AVE STE 245
Johnston, RI 02919
  • Reassigned Medicare billing, Rhode Island enrollment
NPI 1851098602 (401) 529-1731
Prospect Chartercare Physicians, LLC
3.5 mi
Internal Medicine
1681 CRANSTON ST
Cranston, RI 02920
  • Reassigned Medicare billing, Rhode Island enrollment
  • 146 clinicians in this Medicare group
NPI 1629493135 (401) 944-6889

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 4

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
89 services47 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
36 services22 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
33 services33 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

Our Lady Of Fatima Hospital

Acute Care Hospitals · North Providence, RI
3/5 CMS rating
OwnershipProprietary
CMS Certification Number410005
Location200 High Service AvenueNorth Providence, RI 02904 · Providence County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02919 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$72.93 typical visit price
range $18.92 – $144.38
Typical copayment $18.23 (range $4.73 – $36.09)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
95%224 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%441 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
37%1,064 patients2/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
98%1,064 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
2%1,064 patients1/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
8%1,064 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

JUDITH ADEWUYI
Nurse Practitioner (Psychiatric/Mental Health)
1524 ATWOOD AVE
JOHNSTON, RI 02919
Providence County (401) 259-0340
DR. WILLIAM J ANDREONI OPHTHALMOLOGIST
Ophthalmology
1524 ATWOOD AVE
JOHNSTON, RI 02919
Providence County (401) 272-2110
MS. LISA A MELLOW P.T.
Physical Therapist
1524 ATWOOD AVE, DBA/ROBERT BUONANNO
JOHNSTON, RI 02919
Providence County (401) 351-6200
DR. KILEY TODER M.D.
Internal Medicine
1524 ATWOOD AVE, SUITE 333
JOHNSTON, RI 02919
Providence County (401) 421-6011
ANTHONY F TESTA M.D.
Internal Medicine (Hematology & Oncology)
1524 ATWOOD AVE, SUITE340
JOHNSTON, RI 02919
Providence County (401) 273-0220
MRS. JESSICA MARIE DIROCCO APRN, FNP-BC
Nurse Practitioner (Family)
1524 ATWOOD AVE
JOHNSTON, RI 02919
Providence County (401) 274-2910
DR. TERRY WAYNE TSCHIRLEY MD
Internal Medicine (Cardiovascular Disease)
1524 ATWOOD AVE, SUITE 226
JOHNSTON, RI 02919
Providence County (401) 273-2730
DR. ROBERT ALEXANDER MARZILLI PHD
Psychologist (Clinical)
1524 ATWOOD AVE, STE. NO. 433
JOHNSTON, RI 02919
Providence County (401) 861-2190

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 John Phillip's NPI number?

The NPI number for John Phillip is 1285617696. It was assigned to this individual provider in the NPPES registry on November 21, 2005.

Where is John Phillip located?

John Phillip practices at 1524 Atwood Ave Suite 245, Johnston, RI 02919. The listed phone number is (401) 443-5559.

What is John Phillip's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is John Phillip enrolled in Medicare?

Yes. John Phillip is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for John Phillip's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Phillip reassigns Medicare benefits to 2 organizations: Phillip Surgical LLC (Johnston, RI) and Prospect Chartercare Physicians, LLC (Cranston, RI). Each 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 John Phillip's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is John Phillip affiliated with any hospitals?

According to CMS data, John Phillip is affiliated with Our Lady Of Fatima Hospital.

When was this NPI record last updated?

The NPPES record for John Phillip was last updated on December 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.