JACK RICHARD
NPI 1730926940
Physician Assistant in Providence, RI

Q: What is Jack Richard's NPI number?

The NPI number for Jack Richard is 1730926940. It was assigned to this individual provider in the NPPES registry on July 15, 2024.

Q: What is Jack Richard's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Jack Richard was last updated on October 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.

Active since July 15, 2024PECOS EnrolledAccepts Medicare Assignment

33 STANIFORD ST, PROVIDENCE, RI 02905(401) 421-8800(401) 421-2492 Get Directions Write a Review

NPPES record last updated: October 28, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Jack Richard NPPES

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

JACK RICHARD (NPI 1730926940) is an individual physician assistant in Providence, Rhode Island, licensed in Rhode Island (PA01719) and active in the NPI registry since July 2024. He is enrolled in Medicare PECOS, is affiliated with Rhode Island Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1730926940

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameJACK RICHARD

Location Address33 STANIFORD STProvidence, RI 02905-3105

Mailing Address36 Whetstone StWest Newbury, MA 01985-1432 · (978) 914-4086

Phone(401) 421-8800

Fax(401) 421-2492

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateJuly 15, 2024

Last NPPES UpdateOctober 28, 2024

NPPES CertifiedOctober 28, 2024

✔ NPI 1730926940 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in RI · PA01719

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

33 STANIFORD ST, Providence, RI 02905

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jack Richard 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 ID7810426129

PECOS Enrollment IDI20250130002448

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.

Hospital Affiliations CMS Care Compare 3

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

Kent County Memorial Hospital

Acute Care Hospitals · Warwick, RI

3/5 CMS rating

OwnershipProprietary

CMS Certification Number410009

Location455 Toll Gate RdWarwick, RI 02886 · Kent County

Emergency services Birthing friendly

The Miriam Hospital

Acute Care Hospitals · Providence, RI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410012

Location164 Summit AvenueProvidence, RI 02906 · Providence County

Emergency services

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

$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.

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.

THEODORE C. PALUMBO, MD, INC.

Internal Medicine (Gastroenterology)