Jennifer Detrisac, M.D.
Pediatrics Physician · Providence, RI
Jennifer Detrisac, M.D. is a pediatrics physician with a practice address in Providence, Rhode Island, and NPI 1891132916, issued on May 30, 2013. Check the license (Rhode Island LP02788, as entered in NPPES) on the Rhode Island Board of Medical Licensure and Discipline; the Medicare figures below come from public CMS files.
- Name
- Jennifer Detrisac
- Credential
- M.D.
- Primary taxonomy
- Pediatrics Physician 208000000X
- License number
- LP02788 RI
Self-reported in NPPES; status is on the state search - Practice location
- 593 Eddy St, Providence, RI 02903
- Phone
- (401) 444-4471
- Enumerated
- May 30, 2013
- Record last updated
- Feb 22, 2016 (not updated in 10 years: call before relying on the address or phone)
- Fax
- (401) 444-7574
- Entity
- Type 1 · individual
Also registered at 593 Eddy St
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Farah AbazaStudent in an Organized Health Care Education/Training Program1598437477
- Nilofar Abdul ShukurPhysician Assistant1336010529
- Hael Abdulrazeq, MDNeurological Surgery Physician1659934289
- James Abernathy, MDAnesthesiology Physician1942257217
- Karen Abi Chebl, MDStudent in an Organized Health Care Education/Training Program1255179552
- Georges Abi Roustom, MDAnesthesiology Physician1548871908
Verify Jennifer Detrisac in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersRhode Island Board of Medical Licensure and Discipline
Search for license LP02788Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Industry payments in 2024: $275.62
17 payments; by number, the most common kind was food and beverage; the largest payer was Cranial Technologies, Inc. The 21,580 providers of this specialty with any payment received $842.05 on average. Payments are reported by manufacturers, not by the provider, and are not a sign of wrongdoing.
Source: CMS Open Payments, program year 2024 (openpaymentsdata.cms.gov); average among providers of this specialty with at least one payment.
160 pediatrics physician records list a practice address in Providence
They are 160 of the 9,647 NPPES records with a practice address in Providence, and 330 pediatrics physician records in Rhode Island.
All 160 in Providence → All 330 in Rhode Island → Every provider in Providence →
Other pediatrics physician records in Rhode Island
- Nicole Abrunzo, M.D.Providence, RI1336194794
- Dianne Abuelo, MDProvidence, RI1205889367
- Olulayole AdedejiProvidence, RI1497688188
- Aliia Agliullina, MDProvidence, RI1063116416
- Anthony Alario, MDWarwick, RI1386697357
- Byron AlexProvidence, RI1114212404
- Zaid Alhinai, M.D.Providence, RI1467755637
- Emily Allen, M.D.Providence, RI1457610198
- Anthony Amaio, M.D.Newport, RI1376518084
- Maha Ammar, MDWarwick, RI1962570648
Common questions
What is Jennifer Detrisac, M.D.'s NPI number?
Jennifer Detrisac, M.D.'s National Provider Identifier (NPI) is 1891132916, issued on May 30, 2013. An NPI identifies a provider in billing; it is not a license.
Where is Jennifer Detrisac, M.D. located?
The NPPES record lists a practice address at 593 Eddy St, Providence, RI, 02903. Phone: (401) 444-4471. Providers update this record themselves, so call before visiting.
How can I verify Jennifer Detrisac, M.D.'s license?
NPPES lists Rhode Island license number LP02788, as entered by the provider. Search the Rhode Island Board of Medical Licensure and Discipline at https://healthri.mylicense.com/Verification/. The NPPES record confirms identity only; the state search shows license status, expiration and public orders.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.