| |
593 Eddy St Providence RI 02903-4923 | |
(401) 444-6779 | |
(401) 444-6912 |
Full Name | |
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Speciality | General Practice |
Location | 593 Eddy St, Providence, Rhode Island |
Authorized Official Name and Position | Peter K Markell (EVP & CFO) |
Authorized Official Contact | 4014447914 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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117 Ellenfield St Suite 101 Providence RI 02905-4513 Ph: (401) 444-6779 | 593 Eddy St Providence RI 02903-4923 Ph: (401) 444-6779 |
NPI Number | 1407116643 |
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Provider Enumeration Date | 05/22/2012 |
Last Update Date | 09/18/2024 |
Medicare PECOS PAC ID | 2567455082 |
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Medicare Enrollment ID | O20121026000023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407116643 | NPI | - | NPPES |
Provider Name | Maureen M Morrow |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1992718233 PECOS PAC ID: 9537060751 Enrollment ID: I20040120000213 |
Provider Name | Jami A Star |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1821079856 PECOS PAC ID: 5991797797 Enrollment ID: I20040401000400 |
Provider Name | Douglas M Burtt |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1962449900 PECOS PAC ID: 9133116080 Enrollment ID: I20050211000802 |
Provider Name | Paul Y Liu |
---|---|
Provider Type | Practitioner - Plastic And Reconstructive Surgery |
Provider Identifiers | NPI Number: 1649237058 PECOS PAC ID: 1052358249 Enrollment ID: I20050408001023 |
Provider Name | James W Ziegler |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1346209459 PECOS PAC ID: 4385685437 Enrollment ID: I20050518001085 |
Provider Name | Robin A Kremsdorf |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1902001431 PECOS PAC ID: 4587730932 Enrollment ID: I20080909000088 |
Provider Name | Lisa Swartz Topor |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1215197355 PECOS PAC ID: 6901952092 Enrollment ID: I20090915000033 |
Provider Name | Tanya Booker |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1407054679 PECOS PAC ID: 5799841029 Enrollment ID: I20091124000482 |
Provider Name | Rosa H Bermudez-emmanuelli |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1043405863 PECOS PAC ID: 2769543883 Enrollment ID: I20100209000535 |
Provider Name | Rebecca W Randall |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1912955188 PECOS PAC ID: 5395721609 Enrollment ID: I20120112000783 |
Provider Name | Adrienne J Perry |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1336169333 PECOS PAC ID: 6002977410 Enrollment ID: I20120913000423 |
Provider Name | Marcella Calhoun Radano |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1689893349 PECOS PAC ID: 7618135435 Enrollment ID: I20130325000354 |
Provider Name | Lloyd R Feit |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1720050313 PECOS PAC ID: 6608852926 Enrollment ID: I20130712000036 |
Provider Name | Sara R Ford |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1013989425 PECOS PAC ID: 8921077462 Enrollment ID: I20130712000053 |
Provider Name | Augusto Martinez |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1639407679 PECOS PAC ID: 7315189776 Enrollment ID: I20130814000463 |
Provider Name | Christopher Song |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1043453624 PECOS PAC ID: 1355574617 Enrollment ID: I20140513000145 |
Provider Name | Linda B Shalon |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1366497679 PECOS PAC ID: 4385530146 Enrollment ID: I20140626001998 |
Provider Name | Carolina S Cerezo |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1073596011 PECOS PAC ID: 3577545623 Enrollment ID: I20140724000847 |
Provider Name | Nico Vehse |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1437352952 PECOS PAC ID: 0143412254 Enrollment ID: I20150211000608 |
Provider Name | Jon K Lambrecht |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1902945058 PECOS PAC ID: 3678466612 Enrollment ID: I20150910001265 |
Provider Name | Yash Rameshbhai Patel |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1548550585 PECOS PAC ID: 4183862139 Enrollment ID: I20151022002513 |
Provider Name | Paula J Demello |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790955391 PECOS PAC ID: 3072763671 Enrollment ID: I20160601000008 |
Provider Name | Valerie Hamel |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1457781619 PECOS PAC ID: 3173740073 Enrollment ID: I20160622001654 |
Provider Name | Karen L Daigle |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1497727101 PECOS PAC ID: 9032299987 Enrollment ID: I20160901001024 |
Provider Name | Kerri Keselowsky |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1205282522 PECOS PAC ID: 6103111208 Enrollment ID: I20161207001699 |
Provider Name | John B Dickey |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1023278371 PECOS PAC ID: 6103135439 Enrollment ID: I20170111001499 |
Provider Name | Melissa Nelson |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1992164933 PECOS PAC ID: 2961791108 Enrollment ID: I20170404002669 |
Provider Name | Francois Luks |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1124025937 PECOS PAC ID: 7618937467 Enrollment ID: I20170725000057 |
Provider Name | Erin Elizabeth Kunkel |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1053759316 PECOS PAC ID: 8123392735 Enrollment ID: I20170920003230 |
Provider Name | Hillary Lorenco |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427369032 PECOS PAC ID: 8729226154 Enrollment ID: I20171106000126 |
Provider Name | William Douglas Brown |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1588624647 PECOS PAC ID: 2860468345 Enrollment ID: I20180228001584 |
Provider Name | Megan Elizabeth Morris |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1538666409 PECOS PAC ID: 5698030617 Enrollment ID: I20180522002866 |
Provider Name | Kate Millington |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1306263843 PECOS PAC ID: 1052676624 Enrollment ID: I20180531002532 |
Provider Name | Niharika D Mehta |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1558394833 PECOS PAC ID: 3274511001 Enrollment ID: I20181003001602 |
Provider Name | Michele Style |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1275946329 PECOS PAC ID: 4789933169 Enrollment ID: I20181116000943 |
Provider Name | Shova Subedi |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1801102470 PECOS PAC ID: 1052539616 Enrollment ID: I20190124002883 |
Provider Name | Leah R Battista |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1063560969 PECOS PAC ID: 1052329232 Enrollment ID: I20190827003223 |
Provider Name | Meghan E Fredette |
---|---|
Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1912249335 PECOS PAC ID: 1759676091 Enrollment ID: I20190827003521 |
Provider Name | Katie Anne Lester |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1962745208 PECOS PAC ID: 6800035080 Enrollment ID: I20190924002025 |
Provider Name | Melissa Russo |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1205034519 PECOS PAC ID: 4981852811 Enrollment ID: I20200324000761 |
Provider Name | Martha B Kole-white |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1477993160 PECOS PAC ID: 1153626965 Enrollment ID: I20200529000331 |
Provider Name | Maria Teresa Perez Carballo |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1508277013 PECOS PAC ID: 8224449277 Enrollment ID: I20201123001211 |
Provider Name | Duyu Nie |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1528473527 PECOS PAC ID: 3577980341 Enrollment ID: I20201127000015 |
Provider Name | Brett Goudie |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1679627798 PECOS PAC ID: 4284736463 Enrollment ID: I20210305000574 |
Provider Name | Kathleen M Rotondo |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1972570422 PECOS PAC ID: 9638070758 Enrollment ID: I20210327000008 |
Provider Name | Kevin Scully |
---|---|
Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1770978363 PECOS PAC ID: 8123332640 Enrollment ID: I20210611000571 |
Provider Name | Elizabeth Anne Maranzano |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1285606418 PECOS PAC ID: 5991190464 Enrollment ID: I20220318001948 |
Provider Name | Amanda Lee Azar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1194065748 PECOS PAC ID: 2860887288 Enrollment ID: I20220322002747 |
Provider Name | Jennifer M Lafleur |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1730314287 PECOS PAC ID: 0143616748 Enrollment ID: I20220407001845 |
Provider Name | Marta S Sowa |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1891860029 PECOS PAC ID: 8820485717 Enrollment ID: I20220422001926 |
Provider Name | Thomas Patrick Hines |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1083789218 PECOS PAC ID: 7214324128 Enrollment ID: I20220425000037 |
Provider Name | Jonathan Nyce |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1093177008 PECOS PAC ID: 4880930247 Enrollment ID: I20220908001143 |
Provider Name | Salley Pels |
---|---|
Provider Type | Practitioner - Hematology/oncology |
Provider Identifiers | NPI Number: 1114100104 PECOS PAC ID: 8426182866 Enrollment ID: I20221021000998 |
Provider Name | Rachna Kataria |
---|---|
Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
Provider Identifiers | NPI Number: 1134503766 PECOS PAC ID: 1759621428 Enrollment ID: I20221103001124 |
Provider Name | Cameron Lang |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1609286459 PECOS PAC ID: 7517182892 Enrollment ID: I20230215002985 |
Provider Name | Pei-chun Mcgregor |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1023231073 PECOS PAC ID: 5890919906 Enrollment ID: I20230307000597 |
Provider Name | Tiffany Lee |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1417341736 PECOS PAC ID: 4587057138 Enrollment ID: I20230413001436 |
Provider Name | Allison Cameron |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215663109 PECOS PAC ID: 6709242993 Enrollment ID: I20230512001644 |
Provider Name | Thomas J Seery |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1639198096 PECOS PAC ID: 3274719257 Enrollment ID: I20231116003437 |
Provider Name | Rajendrasinh Rathod |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1417159229 PECOS PAC ID: 2062699937 Enrollment ID: I20231223000282 |
Provider Name | Mallory Mccabe |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1730765462 PECOS PAC ID: 8729526413 Enrollment ID: I20240826001033 |
Provider Name | Christina Kang |
---|---|
Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
Provider Identifiers | NPI Number: 1417197161 PECOS PAC ID: 0143454264 Enrollment ID: I20241114002043 |
Provider Name | Christine B Andrews |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1295255198 PECOS PAC ID: 5991075319 Enrollment ID: I20241126004124 |
Angell Street Dental Associates, Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 425 Angell St, Providence, RI 02906 Phone: 401-272-2331 Fax: 401-272-2361 | |
Sunnyside Family Dental Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 381 Angell St, Providence, RI 02906 Phone: 401-272-4900 Fax: 401-272-5989 | |
Cityline Dental Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Reservoir Ave, Suite 3d, Providence, RI 02907 Phone: 401-941-3353 Fax: 401-461-6558 | |
Zumstein Family Dentistry, Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 159 Governor St, Providence, RI 02906 Phone: 401-274-1140 | |
Boustani Periodontics Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Elmgrove Ave, Providence, RI 02906 Phone: 401-421-1717 Fax: 401-421-0066 | |
Celestial Smile Dental Associates Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Dorrance St Ste 700, Providence, RI 02903 Phone: 781-774-9885 |