1. Home
  2. Directory
  3. Rhode Island
  4. Providence
  5. Pediatrics
  6. NPI Profile

LORETTA M. MARION DO
NPI 1285690313
Pediatrics in Providence, RI

Active since April 26, 2006PECOS Enrolled
355 PRAIRIE AVE, PROVIDENCE, RI 02905(401) 444-0570(401) 444-0427 Get Directions Write a Review

NPPES record last updated: December 14, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 14, 2023, Aug 1, 2022, Jun 4, 2021 (3 updates tracked since 2021).

About Loretta M. Marion Do NPPES

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

LORETTA M. MARION DO (NPI 1285690313) is an individual pediatrics provider in Providence, Rhode Island, licensed in Rhode Island (DO01075) and active in the NPI registry since April 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Providence.

NPPES Registry Identity

NPI1285690313
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameLORETTA M. MARIONCredential: DO
Location Address355 PRAIRIE AVEProvidence, RI 02905-1928
Mailing Address375 Allens AveProvidence, RI 02905-5010 · (401) 780-2511 · Fax (401) 780-2565
Phone(401) 444-0570
Fax(401) 444-0427
Sole ProprietorNo
Enumeration DateApril 26, 2006
Last NPPES UpdateDecember 14, 20233 updates tracked since enumeration
NPPES CertifiedDecember 14, 2023
✔ NPI 1285690313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Licenses✔ Licensed in RI · DO01075✔ Licensed in PA · OS007739L✔ Licensed in SC · DO37583
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
355 PRAIRIE AVE, Providence, RI 02905
Open in Google Maps ↗

Secondary Practice Location 1

Location 1101 Dudley StProvidence, RI 02905-2401 · Phone (401) 274-1122 · Fax (401) 453-7571

Other Identifiers 1

Medicaid001592004PA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include WellSense Health Plan.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Loretta M. Marion Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Loretta Marion reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Affinity Physicians LLC
0.5 mi
Anesthesiology
101 DUDLEY STREET, WIH DEPT OF ANESTHESIOLOGY
Providence, RI 02905
  • Reassigned Medicare billing, Rhode Island enrollment
  • 984 clinicians in this Medicare group
NPI 1053038471 (401) 274-1122
Geisinger Clinic
199 mi
Family Medicine
3306 LAKE ARIEL HWY
Honesdale, PA 18431
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 4,429 clinicians in this Medicare group
NPI 1720495393 (570) 253-0148

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02905 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
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

SORAYA S. P. DARWOOD MD
Family Medicine
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Providence County (401) 444-0570
PAMELA GONZALEZ MS
Counselor
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Providence County (401) 444-0570
LUIS DAVID RODRIGUEZ MA, LMHC
Counselor (Mental Health)
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Providence County (401) 276-4193
MS. ARLINE A CABRERA MSW
Counselor
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Providence County (401) 921-8662
GABRIELA GARZA M.S.
Counselor
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Providence County (401) 515-8844
ALIIA AGLIULLINA MD
Pediatrics
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Providence County (401) 444-0570
SUMI SINGH MD
Internal Medicine
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Providence County (401) 444-0570
ANDREW W. LEUKHARDT RN, CDOE
Registered Nurse (Diabetes Educator)
355 PRAIRIE AVE
PROVIDENCE, RI 02905
Providence County (401) 444-0570

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 Loretta Marion's NPI number?

The NPI number for Loretta Marion is 1285690313. It was assigned to this individual provider in the NPPES registry on April 26, 2006.

Where is Loretta Marion located?

Loretta Marion practices at 355 Prairie Ave, Providence, RI 02905. The listed phone number is (401) 444-0570.

What is Loretta Marion's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Loretta Marion enrolled in Medicare?

Yes. Loretta Marion is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Loretta Marion's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Loretta Marion reassigns Medicare benefits to 2 organizations: Affinity Physicians LLC (Providence, RI) and Geisinger Clinic (Honesdale, PA). 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 Loretta Marion's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Loretta Marion accept?

Health plans from WellSense Health Plan list Loretta Marion 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.

When was this NPI record last updated?

The NPPES record for Loretta Marion was last updated on December 14, 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.