| The Providence Community Health Centers, Inc | |
|
375 Allens Ave Providence RI 02905-5010 | |
| (401) 444-0400 | |
| (401) 444-0468 |
| Full Name | The Providence Community Health Centers, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 375 Allens Ave, Providence, Rhode Island |
| Authorized Official Name and Position | Brenda Charpentier (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 4017802511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Providence Community Health Centers, Inc 375 Allens Ave Providence RI 02905-5010 Ph: (401) 444-0400 | The Providence Community Health Centers, Inc 375 Allens Ave Providence RI 02905-5010 Ph: (401) 444-0400 |
| NPI Number | 1053313593 |
|---|---|
| Provider Enumeration Date | 08/15/2005 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 9335050962 |
|---|---|
| Medicare Enrollment ID | O20040608000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053313593 | NPI | - | NPPES |
| 7001361 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Rhode Island) | Primary |
| Provider Name | Katherine Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154385979 PECOS PAC ID: 4284526955 Enrollment ID: I20040326001142 |
| Provider Name | Jennifer Hosmer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972596575 PECOS PAC ID: 7618956228 Enrollment ID: I20040716001025 |
| Provider Name | Donna M Lafontaine |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407887706 PECOS PAC ID: 3870572340 Enrollment ID: I20040717000369 |
| Provider Name | Jacqueline M Joubert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447221668 PECOS PAC ID: 2466421672 Enrollment ID: I20040924000801 |
| Provider Name | Carolyn D Howard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689774473 PECOS PAC ID: 5597724195 Enrollment ID: I20041008000478 |
| Provider Name | Carla Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376528794 PECOS PAC ID: 0648231175 Enrollment ID: I20041019000818 |
| Provider Name | Stephanie J Avila |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1184643363 PECOS PAC ID: 4082677422 Enrollment ID: I20041108000387 |
| Provider Name | Cathy J Schoorens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588646632 PECOS PAC ID: 3072597616 Enrollment ID: I20050726001233 |
| Provider Name | Hua Zhou |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1770538563 PECOS PAC ID: 6709810633 Enrollment ID: I20050921000117 |
| Provider Name | Kathleen A O'heelan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174513451 PECOS PAC ID: 7810921285 Enrollment ID: I20050924000274 |
| Provider Name | Ivan Wolfson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841358587 PECOS PAC ID: 4587679394 Enrollment ID: I20060215000705 |
| Provider Name | Michael A. Thursby |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1669455192 PECOS PAC ID: 3476560368 Enrollment ID: I20060317000375 |
| Provider Name | Daniel Dragomire |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1134192206 PECOS PAC ID: 2961484209 Enrollment ID: I20060608000313 |
| Provider Name | Altug Koymen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336170893 PECOS PAC ID: 7012910201 Enrollment ID: I20060808000283 |
| Provider Name | Edith P Mcconaughey |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1558391979 PECOS PAC ID: 5496758005 Enrollment ID: I20060822000265 |
| Provider Name | Jennifer J Raney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225084064 PECOS PAC ID: 3274425491 Enrollment ID: I20061002000580 |
| Provider Name | Anne L Murray |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770788218 PECOS PAC ID: 1254426380 Enrollment ID: I20071003000672 |
| Provider Name | Kristina M Duarte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922076736 PECOS PAC ID: 1355303736 Enrollment ID: I20071022000349 |
| Provider Name | Pervez A Khatib |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881687481 PECOS PAC ID: 9234211723 Enrollment ID: I20080123000250 |
| Provider Name | Tara A Capuano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992834253 PECOS PAC ID: 1456438175 Enrollment ID: I20080404000713 |
| Provider Name | Megan Gaynor-charette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609992197 PECOS PAC ID: 2961572953 Enrollment ID: I20080603000262 |
| Provider Name | Magdi L Salmon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700957164 PECOS PAC ID: 2769548296 Enrollment ID: I20090306000369 |
| Provider Name | Sarah Gaines |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790880169 PECOS PAC ID: 9537193495 Enrollment ID: I20090707000043 |
| Provider Name | Stanley Block |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1013900638 PECOS PAC ID: 5496891699 Enrollment ID: I20091001000150 |
| Provider Name | Emily M White |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255533931 PECOS PAC ID: 7719071570 Enrollment ID: I20091012000182 |
| Provider Name | Jessica Salak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871778936 PECOS PAC ID: 4688741440 Enrollment ID: I20091109000006 |
| Provider Name | David Mills |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1891796819 PECOS PAC ID: 8921012105 Enrollment ID: I20100220000040 |
| Provider Name | Jennifer M Etue |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639320013 PECOS PAC ID: 9335276484 Enrollment ID: I20100421000197 |
| Provider Name | Boris Skurkovich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558343467 PECOS PAC ID: 6103718523 Enrollment ID: I20101012000044 |
| Provider Name | Beth Toolan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750360236 PECOS PAC ID: 0941492755 Enrollment ID: I20101012001151 |
| Provider Name | Karen Ng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508859109 PECOS PAC ID: 0446442123 Enrollment ID: I20101013000763 |
| Provider Name | Lonice Thomas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114909017 PECOS PAC ID: 4486847068 Enrollment ID: I20101015000689 |
| Provider Name | Judith Ann Nudelman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396701249 PECOS PAC ID: 7012197742 Enrollment ID: I20110211000587 |
| Provider Name | Timothy N. Fornaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952563645 PECOS PAC ID: 2365628187 Enrollment ID: I20110512000201 |
| Provider Name | Anh-tai V Dang |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487846648 PECOS PAC ID: 4183895659 Enrollment ID: I20110914000596 |
| Provider Name | Jennifer R Sunderland |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1265624274 PECOS PAC ID: 1254427172 Enrollment ID: I20120123000232 |
| Provider Name | Greg Waldorf |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1386709947 PECOS PAC ID: 1759355845 Enrollment ID: I20120330000065 |
| Provider Name | Beth Cronin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417126251 PECOS PAC ID: 4284898552 Enrollment ID: I20120618000363 |
| Provider Name | Rebecca M Ray |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1750678884 PECOS PAC ID: 6709034507 Enrollment ID: I20120920000419 |
| Provider Name | John Paul A Abroguena |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235361080 PECOS PAC ID: 9931358389 Enrollment ID: I20121001000065 |
| Provider Name | Willy A Salas Sanchez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932455946 PECOS PAC ID: 0547411357 Enrollment ID: I20121102000409 |
| Provider Name | Erin E Dana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417208802 PECOS PAC ID: 6204088321 Enrollment ID: I20121218000133 |
| Provider Name | Nicole J Saquet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528393345 PECOS PAC ID: 8527212661 Enrollment ID: I20130125000304 |
| Provider Name | Heidi N Kurrus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427343128 PECOS PAC ID: 3779737937 Enrollment ID: I20130218000080 |
| Provider Name | Desirae Heys |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316381205 PECOS PAC ID: 7810137940 Enrollment ID: I20130712000179 |
| Provider Name | Erick R Soria Galvarro Duran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093026700 PECOS PAC ID: 0547496796 Enrollment ID: I20131119000562 |
| Provider Name | Andrew Saal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326013913 PECOS PAC ID: 1052599818 Enrollment ID: I20140626001225 |
| Provider Name | Vinod Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598995045 PECOS PAC ID: 8729204326 Enrollment ID: I20140716001549 |
| Provider Name | Prerna Ganjoo |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1083843155 PECOS PAC ID: 2264659838 Enrollment ID: I20140806001107 |
| Provider Name | Nicole Siegert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750678082 PECOS PAC ID: 1759510506 Enrollment ID: I20140818000913 |
| Provider Name | Michael J Monsour |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1528052677 PECOS PAC ID: 6406095256 Enrollment ID: I20141013001065 |
| Provider Name | Cesar A Mora Jaramillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629341813 PECOS PAC ID: 0840412664 Enrollment ID: I20141112000170 |
| Provider Name | Karen L Saal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568501377 PECOS PAC ID: 0042225591 Enrollment ID: I20150202000116 |
| Provider Name | Sandy Chai |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1902035330 PECOS PAC ID: 5092932582 Enrollment ID: I20150818003882 |
| Provider Name | Susan H Buckner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790101525 PECOS PAC ID: 4183930290 Enrollment ID: I20150904000381 |
| Provider Name | Suvekchha Devkota |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316294929 PECOS PAC ID: 2062729718 Enrollment ID: I20150914001822 |
| Provider Name | Kristin Gianelis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447303912 PECOS PAC ID: 0547362980 Enrollment ID: I20160125002211 |
| Provider Name | Nicole D. Burns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235597139 PECOS PAC ID: 4385942259 Enrollment ID: I20160408000651 |
| Provider Name | Elaine K Parker Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366540718 PECOS PAC ID: 8820286990 Enrollment ID: I20160429000633 |
| Provider Name | Jennifer A Morin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114381225 PECOS PAC ID: 0749572824 Enrollment ID: I20160711000973 |
| Provider Name | Sheldon D.e. Malcolm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104054261 PECOS PAC ID: 1052553989 Enrollment ID: I20160811002541 |
| Provider Name | Nadine S Hewamudalige |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184966608 PECOS PAC ID: 2466748660 Enrollment ID: I20160915000156 |
| Provider Name | Mofoluso O Agbelese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194178558 PECOS PAC ID: 3779870076 Enrollment ID: I20160930000866 |
| Provider Name | Kristin L Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649622184 PECOS PAC ID: 9335427855 Enrollment ID: I20161103000054 |
| Provider Name | Kathleen P O'leary |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1790072650 PECOS PAC ID: 8325216112 Enrollment ID: I20161220000140 |
| Provider Name | Shideh Shafie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1871796243 PECOS PAC ID: 9931355401 Enrollment ID: I20170505000591 |
| Provider Name | Erin E. Rawson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487815452 PECOS PAC ID: 4082863196 Enrollment ID: I20170524001918 |
| Provider Name | Lily M Pike |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467719088 PECOS PAC ID: 6800102054 Enrollment ID: I20170630001325 |
| Provider Name | Mark D Pfeiffer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447433016 PECOS PAC ID: 4385789064 Enrollment ID: I20170921000878 |
| Provider Name | Michael T Neary |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1750357679 PECOS PAC ID: 4587889324 Enrollment ID: I20171220000748 |
| Provider Name | Therese M Zink |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497709398 PECOS PAC ID: 6305731415 Enrollment ID: I20180321000012 |
| Provider Name | Libertad Flores |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437564028 PECOS PAC ID: 2567717176 Enrollment ID: I20180622002148 |
| Provider Name | Tenesha R Lisbon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356779458 PECOS PAC ID: 5092061929 Enrollment ID: I20180709001403 |
| Provider Name | Takeysha A Duarte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982185526 PECOS PAC ID: 5092068932 Enrollment ID: I20181023003195 |
| Provider Name | Phina A Mayu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003383795 PECOS PAC ID: 3779829817 Enrollment ID: I20190110003389 |
| Provider Name | John Edward Yeomans |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720164106 PECOS PAC ID: 5294992145 Enrollment ID: I20190507002215 |
| Provider Name | Lauren Nicole Waterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295298677 PECOS PAC ID: 8224371430 Enrollment ID: I20190509002157 |
| Provider Name | Clarissa D. Lewis |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558845669 PECOS PAC ID: 6406181692 Enrollment ID: I20190710002232 |
| Provider Name | Ursulina L Bencosme |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639195480 PECOS PAC ID: 7012193964 Enrollment ID: I20190722002819 |
| Provider Name | Zein A Farhat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871955369 PECOS PAC ID: 4981999679 Enrollment ID: I20190724000114 |
| Provider Name | Angela Langley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871147553 PECOS PAC ID: 4082944129 Enrollment ID: I20191002002922 |
| Provider Name | Courtney L Jusino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235606526 PECOS PAC ID: 5193056976 Enrollment ID: I20191009000194 |
| Provider Name | Christine Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861677023 PECOS PAC ID: 8022189224 Enrollment ID: I20191010002242 |
| Provider Name | Jenny R David |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275916702 PECOS PAC ID: 3971809724 Enrollment ID: I20191018000339 |
| Provider Name | Nelsy Robles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902456270 PECOS PAC ID: 2163754458 Enrollment ID: I20191106002028 |
| Provider Name | Joseph B Singer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346293016 PECOS PAC ID: 6901023282 Enrollment ID: I20191118000693 |
| Provider Name | Jill A. Gabrielsen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699894360 PECOS PAC ID: 9032542105 Enrollment ID: I20191203001864 |
| Provider Name | Elizabeth Carol Bogus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174174825 PECOS PAC ID: 9739516485 Enrollment ID: I20200219001632 |
| Provider Name | Amanda M Hunter |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1114368164 PECOS PAC ID: 3375772106 Enrollment ID: I20200319001112 |
| Provider Name | Kristen J Hylan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164767604 PECOS PAC ID: 4880849124 Enrollment ID: I20200626000135 |
| Provider Name | Yvette Oliveira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336509413 PECOS PAC ID: 0840614947 Enrollment ID: I20200722002043 |
| Provider Name | Rama P. Nagireddi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891177093 PECOS PAC ID: 1557676574 Enrollment ID: I20200904001085 |
| Provider Name | Jaai Deshpande |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679095947 PECOS PAC ID: 4981023405 Enrollment ID: I20201002001332 |
| Provider Name | Megan E Nappi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598380610 PECOS PAC ID: 2466871850 Enrollment ID: I20201005001427 |
| Provider Name | Ambreen Allana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790167161 PECOS PAC ID: 3072828094 Enrollment ID: I20201005001825 |
| Provider Name | Briana J. Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134744659 PECOS PAC ID: 0143630467 Enrollment ID: I20201027002953 |
| Provider Name | Kaleena Crooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639717408 PECOS PAC ID: 0941610968 Enrollment ID: I20201103001582 |
| Provider Name | Mansi K James |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1982099834 PECOS PAC ID: 8123332384 Enrollment ID: I20201120002181 |
| Provider Name | Aaron Scheinman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801240999 PECOS PAC ID: 7012326846 Enrollment ID: I20210507001698 |
| Provider Name | Marianela Dougal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427247444 PECOS PAC ID: 5496154122 Enrollment ID: I20210528000591 |
| Provider Name | Loretta M Marion |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285690313 PECOS PAC ID: 1254325046 Enrollment ID: I20210622001458 |
| Provider Name | Janet R. Encarnacion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144244963 PECOS PAC ID: 3476554288 Enrollment ID: I20210714000602 |
| Provider Name | Sirin O. Tapan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548601230 PECOS PAC ID: 7416248307 Enrollment ID: I20210727000466 |
| Provider Name | Bridget M. Wieczkowski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194083386 PECOS PAC ID: 5799099453 Enrollment ID: I20210730000694 |
| Provider Name | Levi A. Diaz Menjivar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063907780 PECOS PAC ID: 0749685683 Enrollment ID: I20210816002950 |
| Provider Name | Vrishali Suman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194202705 PECOS PAC ID: 1759632466 Enrollment ID: I20211005003218 |
| Provider Name | Chinedu Oluchi Ogwurike |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689166720 PECOS PAC ID: 5092113795 Enrollment ID: I20211011002333 |
| Provider Name | Susan A. Haupt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730678509 PECOS PAC ID: 7113261181 Enrollment ID: I20211026001344 |
| Provider Name | Miriam R. Okero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518629070 PECOS PAC ID: 4385032978 Enrollment ID: I20211101002803 |
| Provider Name | Suzelle S. Luc |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1770765505 PECOS PAC ID: 7315135464 Enrollment ID: I20211109000474 |
| Provider Name | Fatima M Jibrel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386171973 PECOS PAC ID: 2365711629 Enrollment ID: I20211210001786 |
| Provider Name | Courtney R. Dowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023536232 PECOS PAC ID: 5496013286 Enrollment ID: I20211215002750 |
| Provider Name | Jon Dooley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619472339 PECOS PAC ID: 1951645472 Enrollment ID: I20220125000843 |
| Provider Name | Lilizita Monteiro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811440506 PECOS PAC ID: 6103173984 Enrollment ID: I20220616000920 |
| Provider Name | Katrina L Mahood |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821733718 PECOS PAC ID: 1658753280 Enrollment ID: I20220729000309 |
| Provider Name | Perola Lamba |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1679929814 PECOS PAC ID: 0749527778 Enrollment ID: I20220812000711 |
| Provider Name | Neilakash Beharry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194386276 PECOS PAC ID: 3577995109 Enrollment ID: I20220822002892 |
| Provider Name | Leslia F. Gonzalez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861059727 PECOS PAC ID: 1759615354 Enrollment ID: I20220906001629 |
| Provider Name | Pavinarmatha Ketheeswaran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962066878 PECOS PAC ID: 9830574136 Enrollment ID: I20220922003675 |
| Provider Name | Maria Fam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871155440 PECOS PAC ID: 3274869904 Enrollment ID: I20220929000975 |
| Provider Name | Mayelin Pacheco Nunez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013638584 PECOS PAC ID: 8820464365 Enrollment ID: I20221025000345 |
| Provider Name | Isabela C Saba Osta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891358214 PECOS PAC ID: 6305213729 Enrollment ID: I20221027002088 |
| Provider Name | Matthew B. Perry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962965905 PECOS PAC ID: 8325376528 Enrollment ID: I20221104001829 |
| Provider Name | Hannah J. Raymond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346848082 PECOS PAC ID: 3577931815 Enrollment ID: I20221117002757 |
| Provider Name | Diego A. Tecun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962122754 PECOS PAC ID: 2860860871 Enrollment ID: I20221123000860 |
| Provider Name | Courtney L. Scanlon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932635562 PECOS PAC ID: 7113294109 Enrollment ID: I20221215002531 |
| Provider Name | Konstantin Ravvin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851851901 PECOS PAC ID: 7113256207 Enrollment ID: I20230214001372 |
| Provider Name | Uchenna T. Amaoma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316464092 PECOS PAC ID: 3173988680 Enrollment ID: I20230504001802 |
| Provider Name | Jasmine I. Humphrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184144073 PECOS PAC ID: 2769745934 Enrollment ID: I20230519000362 |
| Provider Name | Diana Arredondo |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821782913 PECOS PAC ID: 5597125872 Enrollment ID: I20230718003227 |
| Provider Name | Soraya S. P. Darwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003432212 PECOS PAC ID: 2668890666 Enrollment ID: I20230802003023 |
| Provider Name | Rudiger C. Ramlal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033672134 PECOS PAC ID: 0840651162 Enrollment ID: I20230803000854 |
| Provider Name | Chhavi Karir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114554144 PECOS PAC ID: 8820416100 Enrollment ID: I20230815002147 |
| Provider Name | Margaret G. Robinson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235767567 PECOS PAC ID: 4587088349 Enrollment ID: I20230907003925 |
| Provider Name | Ifeoma C. Odukwe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477180545 PECOS PAC ID: 1456715051 Enrollment ID: I20230915000510 |
| Provider Name | Long Yang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821740358 PECOS PAC ID: 1759735152 Enrollment ID: I20231003001913 |
| Provider Name | Elyse V. Trinh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174055636 PECOS PAC ID: 8022357276 Enrollment ID: I20231009000409 |
| Provider Name | Wesley Smyth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831976794 PECOS PAC ID: 8729433222 Enrollment ID: I20231018000505 |
| Provider Name | Allison J. Sciallis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063992469 PECOS PAC ID: 5496009243 Enrollment ID: I20231114001801 |
| Provider Name | Nichole Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881186120 PECOS PAC ID: 4688903057 Enrollment ID: I20240118000644 |
| Provider Name | Stacy L. Silva |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1861758484 PECOS PAC ID: 1456704758 Enrollment ID: I20240201003657 |
| Provider Name | Nozomi Sakai |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205399615 PECOS PAC ID: 3870828833 Enrollment ID: I20240220004116 |
| Provider Name | Gourav V Patil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609339423 PECOS PAC ID: 8325483993 Enrollment ID: I20240305002962 |
Kevin E. Baill Md & Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 345 Blackstone Blvd, Providence, RI 02906 Phone: 917-447-2138 | |
Ocean State Urgent Care At St Joseph Health Center Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 21 Peace St, Providence, RI 02907 Phone: 301-314-3999 Fax: 401-808-6294 | |
Theodore C. Palumbo, Md, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 33 Staniford St, Providence, RI 02905 Phone: 401-421-8800 Fax: 401-273-6510 | |
The Providence Community Health Centers, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 145 Beaufort St, Providence, RI 02908 Phone: 888-612-7242 Fax: 401-444-0421 | |
Concentra Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 290 Branch Ave, Providence, RI 02904 Phone: 401-722-8880 Fax: 401-723-9320 | |
Barrington Urgent Care Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 381 Wickenden St, Providence, RI 02903 Phone: 401-433-7550 Fax: 401-490-0905 | |
Hallworth House Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 66 Benefit St, Providence, RI 02904 Phone: 401-274-4505 |