Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alexandra Tetreault, PA-C

Individual provider Physician Assistant · NPI 1972318673

Alexandra Tetreault, PA-C is a Physician Assistant in Providence, Rhode Island. Qualified in 2024, 2 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
2
Licensed in
RI
In the registry since
2025
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

66 Branch Ave Ste 150
Providence, RI 02904-2756
Phone: (401) 606-2590
Fax: (401) 606-2591
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA01765 (RI)

Record details

NPI number1972318673
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 10, 2025
Last updated in NPPESMarch 18, 2025
Certification dateMarch 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

Other providers in Providence