| Rhode Island Health Group Primacare Pc | |
|
63 Eddie Dowling Hwy Ste 1 North Smithfield RI 02896-7322 | |
| (401) 769-2222 | |
| (401) 769-4555 |
| Full Name | Rhode Island Health Group Primacare Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 63 Eddie Dowling Hwy Ste 1, North Smithfield, Rhode Island |
| Authorized Official Name and Position | Nasir Alam Bhatti (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4015975353 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rhode Island Health Group Primacare Pc 63 Eddie Dowling Hwy Ste 1 North Smithfield RI 02896-7322 Ph: (401) 769-2222 | Rhode Island Health Group Primacare Pc 63 Eddie Dowling Hwy Ste 1 North Smithfield RI 02896-7322 Ph: (401) 769-2222 |
| NPI Number | 1174295406 |
|---|---|
| Provider Enumeration Date | 10/05/2021 |
| Last Update Date | 03/07/2022 |
| Medicare PECOS PAC ID | 6800275843 |
|---|---|
| Medicare Enrollment ID | O20220621002853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174295406 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Phina A Mayu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003383795 PECOS PAC ID: 3779829817 Enrollment ID: I20190110003389 |
| Provider Name | Kaneisha Rae Deburgo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952955023 PECOS PAC ID: 9436481843 Enrollment ID: I20210507001089 |
| Provider Name | Nasir A Bhatti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326012576 PECOS PAC ID: 2567450513 Enrollment ID: I20220726001974 |
| Provider Name | Habiba H. Kure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275263329 PECOS PAC ID: 0941679542 Enrollment ID: I20221202001580 |
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