MRS. MICHELLE L. TAUTKUS (NPI# 1053319038) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053319038 |
| Entity Type | Individual |
| Full Name | MRS. MICHELLE L. TAUTKUS |
| Credential | P.A.-C |
| Practice Address |
475 Kilvert Street Suite 310 Warwick RI 02886 |
| Practice Telephone | 7814728650 |
| Mailing Telephone | 7814728650 |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2008-04-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | 1856 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA00464 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | RHODE ISLAND LICENSE | PA00464 | 01 |
| Street Address |
475 KILVERT STREET SUITE 310 |
| City | WARWICK |
| State | RI |
| Zip Code | 02886 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528694445 | Sheri Lynn Sklarz | Specialist | 300 Quaker Lane, Miracle Ear Suite C15, Warwick, RI 02886 | 2020-03-23 |
| 1316581424 | Dr. Degiulio & Associates Inc | Optometrist | 400 Bald Hill Road Ste 163, Warwick Mall, Warwick, RI 02886 | 2019-10-31 |
| 1255813291 | Samantha Pena Moore | Behavioral Analyst | 3446 Post Road, Warwick, RI 02886 | 2018-09-06 |
| 1912496209 | Martin Jude Cotti | Internal Medicine | 455 Toll Gate Rd., Warwick, RI 02886 | 2018-05-02 |
| 1447764261 | Cynthia A Lessard | Nurse Practitioner | 15 Health Lane, Warwick, RI 02886 | 2017-12-01 |
| 1538687520 | David A. Bennett | Registered Nurse | 2756 Post Road, Warwick, RI 02886 | 2017-08-30 |
| 1427585223 | Brittany Teixeira | Counselor | 85 Earl Street, Warwick, RI 02886 | 2017-05-11 |
| 1497125199 | Aiden Philip Cwynar | Optometrist | 1050 Centerville Road, Warwick, RI 02886 | 2015-10-07 |
| 1104221738 | Wilfredo L Sancianco Dmd Inc | Preferred Provider Organization | 3411 W Shiore Rd, Warwick, RI 02886 | 2014-10-24 |
| 1831508662 | Matthew Bryant Mitchell | Physical Therapist | 400 Bald Hill Rd #511, Warwick, RI 02886 | 2014-08-06 |
| Find all providers in zip 02886 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154807717 | Ocean State Primary, LLC | Physician Assistant | 300 Toll Gate Rd Ste 101b, Warwick, RI 02886-4447 | 2018-07-17 |
| 1174083794 | Peter Basilios | Physician Assistant | 120 Centerville Rd, Warwick, RI 02886-4336 | 2019-03-20 |
| 1518435015 | Britiany Alicia Browning | Physician Assistant | 17 Airport Rd, Warwick, RI 02889-1001 | 2018-11-02 |
| 1356865620 | Megan Ashley Giec | Physician Assistant | 1131 Warwick Ave, Warwick, RI 02888-6337 | 2017-07-28 |
| 1619400116 | Heather M Barone | Physician Assistant | 455 Toll Gate Rd, Warwick, RI 02886-2759 | 2017-04-11 |
| 1700338407 | Krystal Coutcher | Physician Assistant | 535 Centerville Rd, Warwick, RI 02886-4486 | 2016-10-28 |
| 1598157422 | Shannon M Doran | Physician Assistant | 400 Bald Hill Rd, Suite 520, Warwick, RI 02886-1617 | 2015-03-02 |
| 1972933406 | Erica Grace Mayer | Physician Assistant | 455 Toll Gate Road, Asp Building Suite Peach, Warwick, RI 02886-2759 | 2013-11-19 |
| 1558632851 | James D Kramarz | Physician Assistant | 455 Toll Gate Rd, Warwick, RI 02886-2759 | 2012-01-18 |
| 1033342399 | Jessica Lavoie | Physician Assistant | 475 Kilvert St, Warwick, RI 02886-1379 | 2009-09-02 |
| Find all providers in WARWICK | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.