| Simone Thavaseelan, | |
|
2 Dudley St Ste 185, Providence, RI 02905-3247 | |
| (401) 444-5795 | |
| Not Available |
| Full Name | Simone Thavaseelan |
|---|---|
| Gender | Female |
| Speciality | Urology |
| Experience | 20 Years |
| Location | 2 Dudley St Ste 185, Providence, Rhode Island |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053530782 | NPI | - | NPPES |
| 349005986 | Other | RI | MEDICARE GROUP PTAN |
| 1659463230 | Other | GROUP NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208800000X | Urology | MD13391 (Rhode Island) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Rhode Island Hospital | Providence, RI | Hospital |
| The Miriam Hospital | Providence, RI | Hospital |
| Newport Hospital | Newport, RI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Brown Urology, Inc. | 7810254513 | 29 |
| Entity Name | The Miriam Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669726451 PECOS PAC ID: 6901796408 Enrollment ID: O20130430000334 |
| Entity Name | Brown Urology, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1467973099 PECOS PAC ID: 7810254513 Enrollment ID: O20171206000082 |
| Mailing Address | Practice Location Address |
|---|---|
| Simone Thavaseelan, 195 Collyer St Ste 201, Providence, RI 02904-1869 Ph: (401) 272-7799 | Simone Thavaseelan, 2 Dudley St Ste 185, Providence, RI 02905-3247 Ph: (401) 444-5795 |
Boris Gershman, M.D. Urology Medicare: Accepting Medicare Assignments Practice Location: 195 Collyer St, Suite 201, Providence, RI 02904 Phone: 401-272-7799 Fax: 401-453-9078 | |
Daniel Isaac Sanford, MD Urology Medicare: Medicare Enrolled Practice Location: 593 Eddy St, Providence, RI 02903 Phone: 401-444-5795 | |
Prof. Stephen N. Rous, M.D. Urology Medicare: Medicare Enrolled Practice Location: 830 Chalkstone Ave, Providence, RI 02908 Phone: 401-273-7100 | |
Mark Sigman, MD Urology Medicare: Medicare Enrolled Practice Location: 2 Dudley St, Suite 185, Providence, RI 02905 Phone: 401-421-0710 Fax: 401-421-0796 | |
Harry Michael Iannotti, MD Urology Medicare: Medicare Enrolled Practice Location: 1165 N Main St, Ste. 200, Providence, RI 02904 Phone: 401-521-4333 Fax: 401-521-4377 | |
Dr. Barry Stephen Stein, MD Urology Medicare: Medicare Enrolled Practice Location: 2 Dudley St, Suite 174, Providence, RI 02905 Phone: 401-444-8577 |