| Blackstone Valley Community Health Care, Inc. | |
|
39 East Ave Pawtucket RI 02860-4003 | |
| (401) 312-9892 | |
| Not Available |
| Full Name | Blackstone Valley Community Health Care, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 39 East Ave, Pawtucket, Rhode Island |
| Authorized Official Name and Position | Raymond J Lavoie (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4013129892 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Blackstone Valley Community Health Care, Inc. 39 East Ave Pawtucket RI 02860-4003 Ph: (401) 312-9892 | Blackstone Valley Community Health Care, Inc. 39 East Ave Pawtucket RI 02860-4003 Ph: (401) 312-9892 |
| NPI Number | 1063574135 |
|---|---|
| Provider Enumeration Date | 12/15/2006 |
| Last Update Date | 03/04/2024 |
| Certification Date | 03/04/2024 |
| Medicare PECOS PAC ID | 8628045762 |
|---|---|
| Medicare Enrollment ID | O20040916000775 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063574135 | NPI | - | NPPES |
| BV01759 | Medicaid | RI |
| Provider Name | Dawn M Borschel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124002365 PECOS PAC ID: 9931095932 Enrollment ID: I20040226000140 |
| Provider Name | Michael S Siclari |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033226444 PECOS PAC ID: 9830086917 Enrollment ID: I20040303000191 |
| Provider Name | Maria F Ferreira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932196953 PECOS PAC ID: 7416931803 Enrollment ID: I20040615000004 |
| Provider Name | David W Ashley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477523488 PECOS PAC ID: 2769466903 Enrollment ID: I20040616000019 |
| Provider Name | Ian M Jacobson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013057900 PECOS PAC ID: 6103803150 Enrollment ID: I20040707000720 |
| Provider Name | Rabin F Chandran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477536415 PECOS PAC ID: 9436125283 Enrollment ID: I20040903000011 |
| Provider Name | Carla Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376528794 PECOS PAC ID: 0648231175 Enrollment ID: I20041019000818 |
| Provider Name | David A Sam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710962055 PECOS PAC ID: 1658338850 Enrollment ID: I20041220000062 |
| Provider Name | Karen Walser |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1235246323 PECOS PAC ID: 9032168943 Enrollment ID: I20050118000912 |
| Provider Name | Beata Felicia Nelken |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518922095 PECOS PAC ID: 7113970369 Enrollment ID: I20050228000626 |
| Provider Name | Joshua D Gutman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902908023 PECOS PAC ID: 7214821206 Enrollment ID: I20070806000409 |
| Provider Name | Cristina Pacheco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386757656 PECOS PAC ID: 8628166105 Enrollment ID: I20071116000277 |
| Provider Name | Joanna Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720059025 PECOS PAC ID: 0345322418 Enrollment ID: I20080128000783 |
| Provider Name | Maria P Sampalis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1740470566 PECOS PAC ID: 3678656923 Enrollment ID: I20080211000421 |
| Provider Name | Carol Cancro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477561348 PECOS PAC ID: 0244235430 Enrollment ID: I20081029000367 |
| Provider Name | Grace E Cook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235370016 PECOS PAC ID: 4587717244 Enrollment ID: I20090729000265 |
| Provider Name | Kunjbala B Sharma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477618528 PECOS PAC ID: 8628007796 Enrollment ID: I20100119000470 |
| Provider Name | America Foster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942230990 PECOS PAC ID: 9436292349 Enrollment ID: I20100201000343 |
| Provider Name | Janine M Stello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275813248 PECOS PAC ID: 1658544705 Enrollment ID: I20120523000314 |
| Provider Name | Tirza Goncalves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477894715 PECOS PAC ID: 9931340346 Enrollment ID: I20130729000085 |
| Provider Name | Elizabeth Gomes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730498171 PECOS PAC ID: 0446402838 Enrollment ID: I20140520000519 |
| Provider Name | Rosa H Bermudez-emmanuelli |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043405863 PECOS PAC ID: 2769543883 Enrollment ID: I20141013001716 |
| Provider Name | Deirdre O Couture |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871645341 PECOS PAC ID: 1759604960 Enrollment ID: I20141219000237 |
| Provider Name | Charlie Imonah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659770642 PECOS PAC ID: 3577884683 Enrollment ID: I20150602000145 |
| Provider Name | Mohamad Hamdi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750570172 PECOS PAC ID: 7315125606 Enrollment ID: I20150811005250 |
| Provider Name | Jennifer L Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003213257 PECOS PAC ID: 6901112473 Enrollment ID: I20150828000361 |
| Provider Name | Katherene R Hofstetter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518398320 PECOS PAC ID: 6002113966 Enrollment ID: I20160322000012 |
| Provider Name | Michael D Fine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659460442 PECOS PAC ID: 2062574775 Enrollment ID: I20160407000365 |
| Provider Name | Catherine H Veaco |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891751095 PECOS PAC ID: 0042372690 Enrollment ID: I20160519000111 |
| Provider Name | Mofoluso O Agbelese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194178558 PECOS PAC ID: 3779870076 Enrollment ID: I20160930000866 |
| Provider Name | Alicia Paquin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770822678 PECOS PAC ID: 9739464405 Enrollment ID: I20170320001490 |
| Provider Name | Kelly A Cunningham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659739522 PECOS PAC ID: 4688956360 Enrollment ID: I20170501000612 |
| Provider Name | Mary Blanchet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194745208 PECOS PAC ID: 2466434212 Enrollment ID: I20170612000020 |
| Provider Name | Mary R Dias-regus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326015496 PECOS PAC ID: 3577508282 Enrollment ID: I20170629000180 |
| Provider Name | Anne Barylick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275064933 PECOS PAC ID: 6901176379 Enrollment ID: I20170718000275 |
| Provider Name | Morgan Motia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578975215 PECOS PAC ID: 3870882608 Enrollment ID: I20170728001909 |
| Provider Name | Philomene Fortes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235568171 PECOS PAC ID: 8426368978 Enrollment ID: I20170803001267 |
| Provider Name | Justin Dowlatshahi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811317407 PECOS PAC ID: 6709185630 Enrollment ID: I20170929000017 |
| Provider Name | Mia P Phan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245761931 PECOS PAC ID: 0446525125 Enrollment ID: I20171005001402 |
| Provider Name | Yuli Y Paula |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487038584 PECOS PAC ID: 2769743418 Enrollment ID: I20180221001192 |
| Provider Name | Meena Theva |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033524624 PECOS PAC ID: 7113222910 Enrollment ID: I20180725000525 |
| Provider Name | Patricia J Doolin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942796339 PECOS PAC ID: 0244580595 Enrollment ID: I20180906002068 |
| Provider Name | Daijsia Melena Bubb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023595725 PECOS PAC ID: 9830440247 Enrollment ID: I20180925001124 |
| Provider Name | Alice Omerhi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760969869 PECOS PAC ID: 2062763345 Enrollment ID: I20180926000377 |
| Provider Name | Elana Schwam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265911556 PECOS PAC ID: 2860743184 Enrollment ID: I20180926001982 |
| Provider Name | Rose Tarsio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063995611 PECOS PAC ID: 3971841040 Enrollment ID: I20190214002855 |
| Provider Name | Mariza M. G. Lopes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548601347 PECOS PAC ID: 7911247549 Enrollment ID: I20190319001139 |
| Provider Name | Nicole Snapper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114498995 PECOS PAC ID: 8022359025 Enrollment ID: I20190401000100 |
| Provider Name | Katharine Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548749682 PECOS PAC ID: 1456787068 Enrollment ID: I20200130000235 |
| Provider Name | Carolyn Pearce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578057311 PECOS PAC ID: 0345642385 Enrollment ID: I20210713001854 |
| Provider Name | Mckinzie Eggers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922504604 PECOS PAC ID: 5193073484 Enrollment ID: I20210917002545 |
| Provider Name | Sara Taveras |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184005456 PECOS PAC ID: 8729486774 Enrollment ID: I20211006001533 |
| Provider Name | Corissa A Pond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578996625 PECOS PAC ID: 4082840640 Enrollment ID: I20220331000681 |
| Provider Name | Kathryn Melissa Bergen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669969267 PECOS PAC ID: 4385998921 Enrollment ID: I20220824000233 |
| Provider Name | Vilma N Guevara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831137561 PECOS PAC ID: 6800270844 Enrollment ID: I20220825001001 |
Cynthia M Barte Licsw, Lcdp, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Lafayette St, Suite 206, Pawtucket, RI 02860 Phone: 401-965-6699 Fax: 401-568-9050 | |
Wendy V., Lmhc, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 126 Prospect St Ste 206, Pawtucket, RI 02860 Phone: 401-400-2135 Fax: 401-272-4361 | |
Archer Mental Wellness, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 63 Bristol Ave, Pawtucket, RI 02861 Phone: 401-572-8052 | |
Addiction Recovery Institute Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 31 N Union St, Pawtucket, RI 02860 Phone: 401-725-2520 Fax: 401-723-9595 | |
Gateway Healthcare, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 - 105 Bacon Street, Pawtucket, RI 02860 Phone: 401-722-3560 Fax: 401-722-3593 | |
Peerpoint Recovery Residences Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Coyle Ave, Pawtucket, RI 02860 Phone: 401-516-8958 |