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

Nicole Elizabeth Authelet, PA

Individual provider Physician Assistant · NPI 1487174447

Nicole Elizabeth Authelet, PA is a Physician Assistant in Providence, Rhode Island. Qualified in 2017, 9 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group, works from 3 locations and accepts Medicare assignment.

Years since qualifying
9
In the registry since
2017
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) 793-2500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 593 Eddy St, Providence, RI 02903-4923 — (401) 444-4000
  • 94 Fairway Ln, Warwick, RI 02889-2231 — (401) 450-8135

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1487174447
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJune 21, 2017
Last updated in NPPESJuly 21, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 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

Other providers in Providence