| Meditelecare Of Rhode Island Llc | |
|
222 Jefferson Blvd Ste 200 Warwick RI 02888-3855 | |
| (860) 788-6404 | |
| (860) 829-0495 |
| Full Name | Meditelecare Of Rhode Island Llc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 222 Jefferson Blvd Ste 200, Warwick, Rhode Island |
| Authorized Official Name and Position | Andrea Godfrey (CREDENTIALING & ENROLLMENT MANAGER) |
| Authorized Official Contact | 8607886404 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Meditelecare Of Rhode Island Llc Po Box 1595 Middletown CT 06457-8095 Ph: (860) 788-6404 | Meditelecare Of Rhode Island Llc 222 Jefferson Blvd Ste 200 Warwick RI 02888-3855 Ph: (860) 788-6404 |
| NPI Number | 1801477963 |
|---|---|
| Provider Enumeration Date | 04/19/2021 |
| Last Update Date | 09/04/2024 |
| Certification Date | 09/04/2024 |
| Medicare PECOS PAC ID | 4385053131 |
|---|---|
| Medicare Enrollment ID | O20210506001621 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801477963 | NPI | - | NPPES |
| Provider Name | Donald L Round |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598704132 PECOS PAC ID: 6709926835 Enrollment ID: I20091221000283 |
| Provider Name | Virginia Ann Rockhill |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528097383 PECOS PAC ID: 8426071002 Enrollment ID: I20121004000559 |
| Provider Name | Marielle Pitts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518215490 PECOS PAC ID: 0840441879 Enrollment ID: I20151124001377 |
| Provider Name | Cynthia Jean Ruggiero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215482831 PECOS PAC ID: 1153609185 Enrollment ID: I20161026002344 |
| Provider Name | Veenu Thakur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275901514 PECOS PAC ID: 4082906383 Enrollment ID: I20170410001879 |
| Provider Name | Doreen M Braz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114406006 PECOS PAC ID: 2163773839 Enrollment ID: I20180919000393 |
| Provider Name | Michelle Rowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164474813 PECOS PAC ID: 2860405412 Enrollment ID: I20200730002474 |
| Provider Name | Mary Beth Boyce |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821608936 PECOS PAC ID: 6305257486 Enrollment ID: I20201120001099 |
| Provider Name | Belarmina Montoya |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356952477 PECOS PAC ID: 9931510807 Enrollment ID: I20201125000373 |
| Provider Name | Tiffany Nickie-hull |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457503534 PECOS PAC ID: 7719268374 Enrollment ID: I20211101000612 |
| Provider Name | Jennifer Glidewell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588199970 PECOS PAC ID: 8325428907 Enrollment ID: I20220805002991 |
| Provider Name | Shirley Bakker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588932461 PECOS PAC ID: 7416100177 Enrollment ID: I20220927001287 |
| Provider Name | John Dixon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023256930 PECOS PAC ID: 7416986781 Enrollment ID: I20221201001436 |
| Provider Name | Leona Nobles-harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285280529 PECOS PAC ID: 5193159861 Enrollment ID: I20230215000469 |
| Provider Name | Timothy Davis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740346253 PECOS PAC ID: 7810218658 Enrollment ID: I20230221002147 |
| Provider Name | Michelle Segerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134554132 PECOS PAC ID: 2769614882 Enrollment ID: I20230320002317 |
| Provider Name | Sarah Bione-dunn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356579395 PECOS PAC ID: 9032438171 Enrollment ID: I20230607002777 |
| Provider Name | Naomie Robert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841902970 PECOS PAC ID: 7618341256 Enrollment ID: I20231116002485 |
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