Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Pieter Storm De Klerk, MD

Individual provider Cardiovascular Disease Physician · NPI 1730612490

Pieter Storm De Klerk, MD is a Cardiovascular Disease (Cardiology) in Providence, Rhode Island. Qualified in 2011, 15 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group and accepts Medicare assignment. Licensed in Rhode Island.

Years since qualifying
15
Licensed in
RI
In the registry since
2017
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

593 Eddy St
Providence, RI 02903-4923
Phone: (401) 444-5891
Fax: (401) 444-8158
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence MD17152 (RI)
Cardiovascular Disease Physician Taxonomy 207RC0000X · Licence MD17152 (RI)

Record details

NPI number1730612490
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedApril 9, 2017
Last updated in NPPESApril 16, 2024
Certification dateApril 16, 2024

Medicare enrollment

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

Medicare specialtyCARDIOVASCULAR DISEASE (CARDIOLOGY)
Also practisesINTERVENTIONAL CARDIOLOGY
Medical schoolOTHER
Graduated 2011 (15 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Providence