1043234792 NPI number — ACHYUT KAMAT MD

Table of content: ACHYUT KAMAT MD (NPI 1043234792)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043234792 NPI number — ACHYUT KAMAT MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAMAT
Provider First Name:
ACHYUT
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043234792
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
125 WHIPPLE ST STE 3
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PROVIDENCE
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02908-3258
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-519-0337
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
164 SUMMIT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02906-2853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-444-5175
Provider Business Practice Location Address Fax Number:
401-272-0538
Provider Enumeration Date:
07/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  MD10314 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 939025129 . This is a "RI MEDICARE GROUP NUMBER" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 1043234792 . This is a "NPI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 3208923 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7008245 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 930091305 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 04/15/2009 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 408826 . This is a "BCBSRI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 01/27/2009 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 12/14/2006 . This is a "NHPRI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com