| The Miriam Hospital | |
|
146 W River St Ste 11a Providence RI 02904-2609 | |
| (401) 793-8770 | |
| (401) 793-8709 |
| Full Name | The Miriam Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 146 W River St Ste 11a, Providence, Rhode Island |
| Authorized Official Name and Position | Peter M 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 |
|---|---|
| The Miriam Hospital 117 Ellenfield St Suite 101, Credentialing Department Providence RI 02905-4513 Ph: (401) 444-6779 | The Miriam Hospital 146 W River St Ste 11a Providence RI 02904-2609 Ph: (401) 793-8770 |
| NPI Number | 1225073638 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 04/20/2023 |
| Certification Date | 04/20/2023 |
| Medicare PECOS PAC ID | 6901796408 |
|---|---|
| Medicare Enrollment ID | O20040625000150 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225073638 | NPI | - | NPPES |
| 1225073638 | Medicaid | RI | |
| MI72815 - PSYCH | Medicaid | RI |
| Provider Name | Maria L Buckley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487632634 PECOS PAC ID: 3375520513 Enrollment ID: I20040706000622 |
| Provider Name | Jeffrey M Burock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023096278 PECOS PAC ID: 4486616588 Enrollment ID: I20041101000761 |
| Provider Name | Laura J Henseler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073575049 PECOS PAC ID: 0143272245 Enrollment ID: I20050304000118 |
| Provider Name | Debbie Mendelsohn |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1215915228 PECOS PAC ID: 2466499611 Enrollment ID: I20050411000195 |
| Provider Name | Catherine Noble Heart |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1831134469 PECOS PAC ID: 2769482603 Enrollment ID: I20061228000084 |
| Provider Name | Romina P Smulever |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407918121 PECOS PAC ID: 4688768799 Enrollment ID: I20070920000300 |
| Provider Name | Heather M Hall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407918030 PECOS PAC ID: 7416042593 Enrollment ID: I20071004000294 |
| Provider Name | Kristy L Dalrymple |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750579355 PECOS PAC ID: 1153411665 Enrollment ID: I20071220000649 |
| Provider Name | Theresa Jerominek |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1992877393 PECOS PAC ID: 2567526957 Enrollment ID: I20090129000544 |
| Provider Name | Purva Agarwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750495271 PECOS PAC ID: 4183779432 Enrollment ID: I20090910000068 |
| Provider Name | Brankica Lazic Mazlagic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184774200 PECOS PAC ID: 4688710593 Enrollment ID: I20091007000256 |
| Provider Name | Richard V Morgera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801934310 PECOS PAC ID: 9133266455 Enrollment ID: I20110217000163 |
| Provider Name | Megan Pinkston Camp |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447560487 PECOS PAC ID: 7113100389 Enrollment ID: I20110325000010 |
| Provider Name | Laura A Stanton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851596712 PECOS PAC ID: 1456508936 Enrollment ID: I20120906000443 |
| Provider Name | Maria Barros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700135316 PECOS PAC ID: 4284867698 Enrollment ID: I20140508001360 |
| Provider Name | Emily E Murphy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659501377 PECOS PAC ID: 5395965099 Enrollment ID: I20141001000180 |
| Provider Name | Ernestine G Jennings |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154731743 PECOS PAC ID: 9830412790 Enrollment ID: I20141229001306 |
| Provider Name | Selvi Kuppuswamy Kumar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841693611 PECOS PAC ID: 1759609175 Enrollment ID: I20150415002089 |
| Provider Name | Julie Morris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003172586 PECOS PAC ID: 9234445974 Enrollment ID: I20150826001701 |
| Provider Name | Cerena Reid-maynard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053759258 PECOS PAC ID: 9436448438 Enrollment ID: I20160513002052 |
| Provider Name | Nabila K Mazumder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033509567 PECOS PAC ID: 4880986579 Enrollment ID: I20160718001162 |
| Provider Name | Anna E Schierberl Scherr |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235594797 PECOS PAC ID: 0547554131 Enrollment ID: I20160804000585 |
| Provider Name | Kalin Burkhardt Clark |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629446927 PECOS PAC ID: 8527349836 Enrollment ID: I20161228001877 |
| Provider Name | Angela M Simpson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699723700 PECOS PAC ID: 4486670114 Enrollment ID: I20170113001878 |
| Provider Name | Sarah E Ouellette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225468267 PECOS PAC ID: 4385905819 Enrollment ID: I20180327002597 |
| Provider Name | Brittney Boykin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316289754 PECOS PAC ID: 5991004905 Enrollment ID: I20180712001176 |
| Provider Name | Barbara M Ruf |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093129330 PECOS PAC ID: 7113222860 Enrollment ID: I20180802000545 |
| Provider Name | Camille Gregorian |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578037958 PECOS PAC ID: 0143569723 Enrollment ID: I20190226000727 |
| Provider Name | Caitlin S Lawrence |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629458047 PECOS PAC ID: 1153626809 Enrollment ID: I20190424002716 |
| Provider Name | Cerissa Blaney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528433489 PECOS PAC ID: 2163777418 Enrollment ID: I20191108000940 |
| Provider Name | Lora Wu |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982254215 PECOS PAC ID: 8729415815 Enrollment ID: I20200302002542 |
| Provider Name | Kate Wilson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1417616616 PECOS PAC ID: 9931592433 Enrollment ID: I20220204001309 |
| Provider Name | Jyllian Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649862863 PECOS PAC ID: 0446633689 Enrollment ID: I20220819002325 |
| Provider Name | Amanda S. Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619590726 PECOS PAC ID: 9537588827 Enrollment ID: I20221104000323 |
| Provider Name | Emily Federo Hungria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184120073 PECOS PAC ID: 9234488206 Enrollment ID: I20230731000561 |
One Step At A Time Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 Kinfield St, Providence, RI 02909 Phone: 401-871-2379 | |
Aba Centers Of Rhode Island Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 235 Georgia Ave Ste 110, Providence, RI 02905 Phone: 844-982-4222 | |
Because I Matter Wellness Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 Wayland Ave, Suite 4b, Providence, RI 02906 Phone: 401-431-2953 | |
Providence Behavioral Health Associates Inc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1075 Smith St, Providence, RI 02908 Phone: 401-369-9224 Fax: 401-369-9275 | |
The Wellness Center Ri, Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Reservoir Ave, Suite 2k, Providence, RI 02907 Phone: 401-461-9355 Fax: 401-784-9609 |