ALEXANDRA TETREAULT PA-C
NPI 1972318673
Physician Assistant in Providence, RI

Q: What is Alexandra Tetreault's NPI number?

The NPI number for Alexandra Tetreault is 1972318673. It was assigned to this individual provider in the NPPES registry on February 10, 2025.

Q: What is Alexandra Tetreault's specialty?

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

Active since February 10, 2025PECOS EnrolledAccepts Medicare Assignment

66 BRANCH AVE STE 150, PROVIDENCE, RI 02904(401) 606-2590(401) 606-2591 Get Directions Write a Review

NPPES record last updated: March 18, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 18, 2025, Feb 10, 2025 (2 updates tracked since 2025).

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About Alexandra Tetreault Pa-c NPPES

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

ALEXANDRA TETREAULT PA-C (NPI 1972318673) is an individual physician assistant in Providence, Rhode Island, licensed in Rhode Island (PA01765) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS, is affiliated with Newport Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1972318673

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameALEXANDRA TETREAULTCredential: PA-C

Location Address66 BRANCH AVE STE 150Providence, RI 02904-2756

Mailing Address66 Branch Ave Ste 150Providence, RI 02904-2756 · (401) 606-2590 · Fax (401) 606-2591

Phone(401) 606-2590

Fax(401) 606-2591

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateFebruary 10, 2025

Last NPPES UpdateMarch 18, 20252 updates tracked since enumeration

NPPES CertifiedMarch 18, 2025

✔ NPI 1972318673 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 · PA01765

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.

66 BRANCH AVE STE 150, Providence, RI 02904

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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

Alexandra Tetreault Pa-c 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 ID2961925359

PECOS Enrollment IDI20250326002155

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 2

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

Newport Hospital

Acute Care Hospitals · Newport, RI

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number410006

Location11 Friendship StreetNewport, RI 02840 · Newport 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 02904 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 10

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

ELIZABETH Z SMITH FNP

Nurse Practitioner