Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1730926940 Individual Practitioner Male Practitioner

Jack Richard

Physician Assistant • Providence, RI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Jack Richard is a certified Physician Assistant practicing in Providence, RI. With approximately 2 years of clinical experience since completing medical education in 2024, Jack Richard delivers high-quality medical care to the local community at 33 STANIFORD ST.

Jack Richard is affiliated with University Gastroenterology, Llc and accepts Medicare assignment.

Practice Location & Contact Primary Location

Practice Address

33 Staniford St

Providence, RI 029053105

Telephone 4014218800
Fax 4014212492
Associated Practice Facility / Clinic
🏢 Bayside Endoscopy Center, Llc Facility NPI 1720085657

Medicare Profile & Education

Medical School

Other

Graduation Year

2024

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Providence, RI

Rising Specialist (<5 Yrs)
Practitioner Clinical Experience
2 Yrs -8.6 yrs vs City Avg
City Avg: 10.6 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
267 Specialists

Practicing in Providence, RI (687 Statewide)

Telehealth Adoption Rate
16.5% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Richard (2 Years) 2 Yrs
Providence Specialty Average (10.6 Years) 10.6 Yrs

Medical Specialties & State Licenses

CMS Verified: 2024-10-28
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License RI PA01719

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.

Hospital & Practice Group Affiliations

University Gastroenterology, Llc

33 Staniford St, Providence, RI 029053105

Phone: 4014218800

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

26 Associated Practitioners
Breanne St Martin , FNP-C

Nurse Practitioner - Family

NPI 1053938886

Family Nurse Practitioner (Certified)

Dr. Lisa Mueller , MD

Internal Medicine - Gastroenterology

NPI 1063583383

Doctor of Medicine (M.D.)

Dr. Paul Vanzuiden , MD

Internal Medicine - Gastroenterology

NPI 1194896480

Doctor of Medicine (M.D.)

Dr. Breton Roussel , MD

Internal Medicine - Gastroenterology

NPI 1215385661

Doctor of Medicine (M.D.)

Sandra Ferraz

Nurse Practitioner - Gerontology

NPI 1265026272
Mary Fortuna-Silva , NP

Nurse Practitioner - Family

NPI 1306917521

Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 28, 2024

Physician Assistant (License #PA01719 in RI)

NPI Profile Active July 15, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location July 15, 2024

Registered at 33 STANIFORD ST, PROVIDENCE, RI 029053105 (Tel: 4014218800)

📍
Updated Business Mailing Address July 15, 2024

Registered at 36 WHETSTONE ST, WEST NEWBURY, MA 019851432 (Tel: 9789144086)

👤
Provider Name / Credentials Updated July 15, 2024

Recorded as JACK RICHARD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 15, 2024

Physician Assistant

🟢
Initial NPI Registration & Enumeration July 15, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730926940
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 15, 2024
Last Update: October 28, 2024
Sole Proprietor: No

Mailing Address

36 Whetstone St

West Newbury, MA 019851432

Phone: 9789144086

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.