JULIE MAZZA (DO) – Internal Medicine Physician, NPI 1104454883

JULIE MAZZA (DO) is a healthcare provider. based in Warwick, Rhode Island. specializing in INTERNAL MEDICINE. They hold the professional credentials DO. They hold a License No. DO01466 (RI). The NPI Number for JULIE MAZZA (DO) is 1104454883

Main info

Female
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
JULIE MAZZA (DO)
NPI
1104454883
Phone
Not provided
Address
455 TOLL GATE RD
Enumeration Date
30 March 2020
Last Update Date
24 June 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4014154275
Graduation Year
2020 (6 years ago)
PAC ID
6204250061
Group Practice PAC ID
4587659255
Professional Enrollment ID
I20250814003906
Address ID
RI029045719PR1085XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience55
Completeness85
Years active:6State licenses:2Digital endpointsOther names

1,155 INTERNAL MEDICINE in RI

Provider Addresses for JULIE MAZZA (DO)

  • 455 TOLL GATE RD

    WARWICK, RI 028862759

    Phone:

    Type: Mailing

  • 1085 N MAIN ST

    PROVIDENCE, RI 029045719

    Phone: (401) 415-4200

    Type: Location

  • 10 Emory St

    Attleboro, MA 027033089

    Phone: (508) 222-0118

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250814003636IInternal MedicineMATBD
I20250814003906IInternal MedicineRITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02886)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4587659255View full group profile
NameSpecialtyState
Internal Medicine, Hospice/Palliative CareRI
Family PracticeRI
Nurse PractitionerRI
Nurse PractitionerMA
-RI
-RI
-MA
Hospice/Palliative CareRI
Hospice/Palliative CareNY
Nurse PractitionerRI

Reviews

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Frequently asked questions

What is the 10-digit NPI for JULIE MAZZA (DO)?
JULIE MAZZA (DO) — NPI 1104454883 — is the standard way to identify this listing.
Does the file indicate JULIE MAZZA (DO) is practicing under active NPI?
Directory data currently reports JULIE MAZZA (DO) as active.
What is JULIE MAZZA (DO)'s primary classification?
Internal Medicine Physician is the headline specialty for JULIE MAZZA (DO) here. Clinical services aligned with this taxonomy classification.
What address line appears for JULIE MAZZA (DO)?
JULIE MAZZA (DO)'s geographic hint is Warwick, Rhode Island in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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