| Primary Medical Center and Walk-in LLC | |
|
684 Warren Ave East Providence RI 02914-1405 | |
| (401) 434-0022 | |
| (401) 434-6111 |
| Full Name | Primary Medical Center and Walk-in LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 684 Warren Ave, East Providence, Rhode Island |
| Authorized Official Name and Position | Constantine Vafidis (OWNER) |
| Authorized Official Contact | 4014340022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Medical Center and Walk-in LLC 684 Warren Ave East Providence RI 02914-1405 Ph: (401) 434-0022 | Primary Medical Center and Walk-in LLC 684 Warren Ave East Providence RI 02914-1405 Ph: (401) 434-0022 |
| NPI Number | 1225444243 |
|---|---|
| Provider Enumeration Date | 07/10/2014 |
| Last Update Date | 06/29/2016 |
| Medicare PECOS PAC ID | 1951521079 |
|---|---|
| Medicare Enrollment ID | O20141013000467 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225444243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Primary |
| 261QU0200X | Clinic/center - Urgent Care | () | Secondary |
| Provider Name | Angelo Carpethos |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518056795 PECOS PAC ID: 4284661281 Enrollment ID: I20071010000861 |
| Provider Name | Walter M Deluca |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962598516 PECOS PAC ID: 0042259715 Enrollment ID: I20080514000345 |
| Provider Name | Constantine Vafidis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467683227 PECOS PAC ID: 7618136466 Enrollment ID: I20120314000204 |
| Provider Name | Michelle M Lamoureux |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1760574099 PECOS PAC ID: 2062672306 Enrollment ID: I20120324000035 |
| Provider Name | Andrew F Moody |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720426646 PECOS PAC ID: 6709020498 Enrollment ID: I20141202000214 |
| Provider Name | Shane Mcnamara Gazzo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396425427 PECOS PAC ID: 3971958950 Enrollment ID: I20231127000504 |
| Provider Name | Marisa Kane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639851785 PECOS PAC ID: 5193162170 Enrollment ID: I20240326003007 |
| Provider Name | Joshua Gaumond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831901172 PECOS PAC ID: 5092231506 Enrollment ID: I20250428003832 |
| Provider Name | Emma Dallaire |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174410989 PECOS PAC ID: 5193204865 Enrollment ID: I20260212001503 |
| Provider Name | Yiannis Koutsofavas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164317194 PECOS PAC ID: 8729555339 Enrollment ID: I20260430002407 |
Alex Mandel, M.D. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 Massasoit Ave, Suite 300, East Providence, RI 02914 Phone: 401-434-8226 Fax: 401-434-4178 |
East Providence Senior Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 Waterman Ave, East Providence, RI 02914 Phone: 401-435-7800 Fax: 401-435-7803 |
Broadway Medical Treatment Center, LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1053 S Broadway, East Providence, RI 02914 Phone: 401-438-5551 Fax: 401-438-7272 |
Dr Michael C Souza, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2761 Pawtucket Ave, East Providence, RI 02914 Phone: 401-434-3350 Fax: 401-434-5230 |
Daniela Turacova MD Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 525 Taunton Avenue, Suite 100, East Providence, RI 02914 Phone: 401-438-0888 |
Dsmt at East Providence Senior Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 Waterman Ave, East Providence, RI 02914 Phone: 401-435-7800 Fax: 401-435-7803 |