LIFESPAN PHYSICIAN GROUP, INC.
NPI 1407116643
General Practice in Providence, RI

Q: What is Lifespan Physician Group, Inc.'s NPI number?

The NPI number for Lifespan Physician Group, Inc. is 1407116643. It was assigned to this organization in the NPPES registry on May 22, 2012. The provider is doing business as Brown Health Medical Group.

Q: What is Lifespan Physician Group, Inc.'s specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Active since May 22, 2012

593 EDDY ST, PROVIDENCE, RI 02903(401) 444-6779(401) 444-6912 Get Directions Write a Review

NPPES record last updated: October 7, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Oct 7, 2025, Sep 18, 2024, Nov 6, 2023 and 3 more (6 updates tracked since 2019).

On this page

About Lifespan Physician Group, Inc. NPPES

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

LIFESPAN PHYSICIAN GROUP, INC. (NPI 1407116643), doing business as Brown Health Medical Group, is a healthcare organization registered as a general practice in Providence, Rhode Island and active in the NPI registry since May 2012. The organization lists Peter K Markell, Evp & Cfo, as its authorized official.

NPPES Registry Identity

NPI1407116643

Entity TypeOrganization

Primary Taxonomy208D00000X

Legal Business NameLIFESPAN PHYSICIAN GROUP, INC.

Location Address593 EDDY STProvidence, RI 02903-4923

Mailing Address117 Ellenfield St, Suite 101Providence, RI 02905-4513 · (401) 444-6779 · Fax (401) 444-6912

Phone(401) 444-6779

Fax(401) 444-6912

Organization SubpartYesParent: Lifespan Corporation

Authorized OfficialPeter K MarkellEvp & Cfo · (401) 444-7914

Enumeration DateMay 22, 2012

Last NPPES UpdateOctober 7, 20256 updates tracked since enumeration

NPPES CertifiedOctober 7, 2025

✔ NPI 1407116643 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

Also ListedDietitian, RegisteredTaxonomy 133V00000X

Also ListedOptometristTaxonomy 152W00000X

Also ListedTransplant SurgeryTaxonomy 204F00000X

Also ListedAnesthesiology · Critical Care MedicineTaxonomy 207LC0200X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedPlastic SurgeryTaxonomy 208200000X

Also ListedSurgeryTaxonomy 208600000X

Also ListedSurgery · Surgical Critical CareTaxonomy 2086S0102X

Also ListedSurgery · Pediatric SurgeryTaxonomy 2086S0120X

Also ListedSurgery · Trauma SurgeryTaxonomy 2086S0127X

Also ListedSurgery · Vascular SurgeryTaxonomy 2086S0129X

Also ListedSurgery · Surgical OncologyTaxonomy 2086X0206X

Also ListedColon & Rectal SurgeryTaxonomy 208C00000X

Also ListedThoracic Surgery (Cardiothoracic Vascular Surgery)Taxonomy 208G00000X

593 EDDY ST, Providence, RI 02903

Open in Google Maps ↗

Other Names 1

Doing Business AsBrown Health Medical Group

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lifespan Physician Group, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

1,384

Medicare enrollment records show 1,384 clinicians reassign Medicare billing to Lifespan Physician Group, Inc., which bills Medicare for the services they deliver. Of these, 465 practice at this address and 1,083 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 54

Internal Medicine240

Nurse Practitioner234

Emergency Medicine144

Pediatric Medicine77

Cardiovascular Disease (Cardiology)61

Obstetrics/Gynecology61

General Surgery38

Ophthalmology38

46 other specialties491

Nearest to this location (20)

See all 1,384

Geeta Abraham, PMHNP

Nurse Practitioner

NPI 1134772437

593 EDDY ST
Providence, RI 02903

(401) 444-4000

✔ PECOS✔ Accepts MedicareSame address

Anna Acidera, MD

Internal Medicine

NPI 1659547271

593 EDDY ST
Providence, RI 02903

(401) 444-3985

✔ PECOS✔ Accepts MedicareSame address

Christina Al Malouf, M.D.

Cardiovascular Disease (Cardiology)

NPI 1346692779

593 EDDY ST
Providence, RI 02903

(401) 444-5891

✔ PECOS✔ Accepts MedicareSame address

Ana Albuja Ponce, MD

Neurology

NPI 1336581347

593 EDDY ST
Providence, RI 02903

(401) 444-6195

✔ PECOS✔ Accepts MedicareSame address

Fahad Ali, MD

Emergency Medicine

NPI 1790308393

593 EDDY ST
Providence, RI 02903

(401) 444-6489

✔ PECOS✔ Accepts MedicareSame address

Jason Aliotta, MD

Pulmonary Disease

NPI 1558314757

593 EDDY STREET APC 7
Providence, RI 02903

(401) 444-3565

✔ PECOS✔ Accepts MedicareSame address

Khaled Alkhateeb, M.B.B.S.

Pathology

NPI 1295265478

593 EDDY STREET APC 12
Providence, RI 02903

(401) 444-5057

✔ PECOS✔ Accepts MedicareSame address

Lauren Allister, MD

Pediatric Medicine

NPI 1326002288

593 EDDY ST
Providence, RI 02903

(401) 444-4000

✔ PECOSSame address

Marcella Aquino, MD

Allergy/Immunology

NPI 1356563670

593 EDDY ST
Providence, RI 02903

(401) 444-6195

✔ PECOS✔ Accepts MedicareSame address

Wael Asaad, MD, PHD

Neurosurgery

NPI 1770619165

593 EDDY ST FL 6 RIH DEPARTMENT OF NEUROSURGERY
Providence, RI 02903

(401) 793-9166

✔ PECOS✔ Accepts MedicareSame address

Rupa Bala, MD

Cardiac Electrophysiology

NPI 1417983123

593 EDDY ST
Providence, RI 02903

(401) 444-5891

✔ PECOS✔ Accepts MedicareSame address

Dardan Beqiri, MD

Plastic and Reconstructive Surgery

NPI 1467982082

593 EDDY STREET
Providence, RI 02903

(401) 444-4188

✔ PECOS✔ Accepts MedicareSame address

Lionel Bercovitch, M.D.

Dermatology

NPI 1962473314

593 EDDY STREET, APC-10
Providence, RI 02903

(401) 444-7959

✔ PECOS✔ Accepts MedicareSame address

Reena Bhatt

Hand Surgery

NPI 1578781316

593 EDDY ST
Providence, RI 02903

(401) 444-8450

✔ PECOS✔ Accepts MedicareSame address

Rebecca Burns, MD

Infectious Disease

NPI 1740748268

593 EDDY ST
Providence, RI 02903

(401) 444-7793

✔ PECOS✔ Accepts MedicareSame address

Katharine Darland, M.D.

Family Practice

NPI 1093247660

593 EDDY ST
Providence, RI 02903

(401) 444-3985

✔ PECOS✔ Accepts MedicareSame address

Brijal Desai, MD

Radiation Oncology

NPI 1811282767

593 EDDY ST
Providence, RI 02903

(401) 444-3600

✔ PECOSSame address

Ryan Desrochers, MD

General Surgery

NPI 1649809179

593 EDDY ST
Providence, RI 02903

(401) 444-2695

✔ PECOSSame address

Yannick D'silva, M.D.

Hospitalist

NPI 1730672536

593 EDDY ST
Providence, RI 02903

(401) 444-4000

✔ PECOS✔ Accepts MedicareSame address

Ahmed Elkaryoni, M.D.

Interventional Cardiology

NPI 1851829410

593 EDDY ST
Providence, RI 02903

(401) 444-5328

✔ PECOS✔ Accepts MedicareSame address

See all 1,384 clinicians

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

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 Lifespan Physician Group, Inc.'s NPI number?

The NPI number for Lifespan Physician Group, Inc. is 1407116643. It was assigned to this organization in the NPPES registry on May 22, 2012. The provider is doing business as Brown Health Medical Group.

Where is Lifespan Physician Group, Inc. located?

Lifespan Physician Group, Inc. is located at 593 Eddy St, Providence, RI 02903. The listed phone number is (401) 444-6779.

What is Lifespan Physician Group, Inc.'s specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Lifespan Physician Group, Inc. enrolled in Medicare?

Yes. Lifespan Physician Group, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lifespan Physician Group, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1,384 clinicians in 54 Medicare specialties reassign their Medicare billing to Lifespan Physician Group, Inc.. A 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 the clinician's services. The largest specialties are Internal Medicine (240), Nurse Practitioner (234) and Emergency Medicine (144). Of these, 465 practice at this address and 1,083 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Lifespan Physician Group, Inc. was last updated on October 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.