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

Sydney Sumi Moon, MD

Individual provider Psychosomatic Medicine Physician · NPI 1114954583

Sydney Sumi Moon, MD is a Psychiatry in Providence, Rhode Island. Qualified in 1996, 30 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Rhode Island.

Years since qualifying
30
Licensed in
RI
In the registry since
2006
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 Lifespan Physcian Group
Providence, RI 02903-4923
Phone: (401) 444-2128
Fax: (401) 444-8836
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychosomatic Medicine Physician (primary) Taxonomy 2084P0015X · Licence 14228 (RI)

Record details

NPI number1114954583
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 28, 2006
Last updated in NPPESMarch 31, 2017

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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