Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Michael Elliot Whalen, PA

Individual provider Physician Assistant · NPI 1922470533

Mr. Michael Elliot Whalen, PA is a Physician Assistant in Providence, Rhode Island. Qualified in 2015, 11 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group and accepts Medicare assignment. Licensed in Massachusetts and Rhode Island.

Years since qualifying
11
Licensed in
MA, RI
In the registry since
2015
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

164 Summit Ave
Providence, RI 02906-2853
Phone: (401) 793-4102
Fax: (401) 793-4049
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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 PA01153 (RI)
Physician Assistant Taxonomy 363A00000X · Licence PA5543 (MA)

Record details

NPI number1922470533
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 21, 2015
Last updated in NPPESMarch 25, 2024
Certification dateMarch 25, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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