DAVID M BOURASSA (NPI# 1215992870) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215992870 |
| Entity Type | Individual |
| Full Name | DAVID M BOURASSA |
| Credential | M.D. |
| Practice Address |
450 Clinton Street Woonsocket RI 02895 |
| Mailing Address |
171 Service Avenue Warwick RI 02886 |
| Practice Telephone | 4017674100 |
| Practice Fax Number | 4012356894 |
| Mailing Telephone | 4017674100 |
| Mailing Fax Number | 4012356899 |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2018-03-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD09354 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | 7005698 | 05 |
| Street Address |
450 CLINTON STREET |
| City | WOONSOCKET |
| State | RI |
| Zip Code | 02895 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962439786 | Syed R Mehdi | Family Medicine | 450 Clinton Street, Thundermist Health Center, Woonsocket, RI 02895 | 2006-06-27 |
| 1588604490 | Cheryl M Donovan | Midwife | 450 Clinton Street, Thundermist Health Center, Woonsocket, RI 02895 | 2006-06-08 |
| 1720031859 | Paula J Antonellis | Pharmacist | 450 Clinton Street, Woonsocket, RI 02895 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730732017 | Karissa Cardoso | Behavior Technician | 36 Cleveland Street, Apt 1, Woonsocket, RI 02895 | 2019-07-16 |
| 1841714177 | Richard Keith Polacek | Behavioral Analyst | 30 Cumberland St., Woonsocket, RI 02895 | 2017-07-28 |
| 1912353335 | Muria Irine Nisbett | Social Worker | 4 Gaulin Ave., Floor 4, Woonsocket, RI 02895 | 2016-05-05 |
| 1083046833 | Shaylyn Kathleen Mcteague | Podiatrist | 20 Cumberland Hill Rd Unit 210, Woonsocket, RI 02895 | 2013-08-04 |
| 1902243165 | David J. Ward Dmd, PC | Dentist | 460 S. Main St., Woonsocket, RI 02895 | 2013-05-29 |
| 1073876256 | Patricia J Corbett | Social Worker | 181 Cumberland St # 301, Woonsocket, RI 02895 | 2012-06-21 |
| 1114206521 | Patricia Nievez Alvarez | Social Worker | 181 Cumberland St Ste 301, Woonsocket, RI 02895 | 2011-08-16 |
| 1891082970 | Ann Katherine Maccarone | Speech-Language Pathologist | 1 Cumberland St., Woonoscket, RI 02895 | 2011-07-08 |
| 1043507734 | Infectious Diseases Associates of Rhode Island | Internal Medicine | 115 Cass Avenue - 3rd Floor, C/o Landmark Medical, Woonsocket, RI 02895 | 2011-07-01 |
| 1740577543 | Michelle Marie Durand Straube | Optometrist | 385 Mendon Road, Woonsocket, RI 02895 | 2011-06-30 |
| Find all providers in zip 02895 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104186089 | Jason Rafferty | Pediatrics | 450 Clinton St, Woonsocket, RI 02895-3207 | 2012-05-24 |
| 1154500585 | Marina N Korneeva | Pediatrics | 450 Clinton St, Woonsocket, RI 02895-3207 | 2007-11-01 |
| 1144372640 | Sarah Elizabeth Davenport | Pediatrics | 219 Cass Ave, Suite G, Woonsocket, RI 02895-4736 | 2007-01-17 |
| 1518922095 | Beata Felicia Nelken | Pediatrics | 450 Clinton St, Thundermist Health Center, Woonsocket, RI 02895-3207 | 2006-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679116214 | Jenks Park Pediatrics, Inc. | Pediatrics | 577 Broad St Fl 1, Central Falls, RI 02863-2837 | 2019-10-28 |
| 1760049522 | Daniel Steven Alanko | Pediatrics | 293 Eddy Street, Providence, RI 02903 | 2019-05-28 |
| 1629509112 | Kelly Fitzgerald Cohen | Pediatrics | 900 Warren Ave Ste 200, East Providence, RI 02914-1430 | 2017-03-25 |
| 1992152219 | Liza Cantor | Pediatrics | 300 Centerville Rd # 110, Warwick, RI 02886-0200 | 2016-05-17 |
| 1508264060 | Cecile Ibrahim | Pediatrics | 11 Magazine St, Cranston, RI 02920-8123 | 2014-12-16 |
| 1275949984 | Jessica Brett Farrell | Pediatrics | 285 Governor St Ste 3, Providence, RI 02906 | 2014-07-02 |
| 1447697552 | Michelle Beller | Pediatrics | 334 County Rd, Barrington, RI 02806-2497 | 2013-05-30 |
| 1063765196 | Kathleen Ann Calenda | Pediatrics | 185 Joseph Ct, Warwick, RI 02886 | 2012-10-26 |
| 1154680007 | Yvonne Stuy Weiss | Pediatrics | 23 Nayatt Rd, Barrington, RI 02806-3317 | 2012-05-14 |
| 1336408723 | Emad Awa | Pediatrics | 1 Randall Sq Ste 404, Providence, RI 02904 | 2012-05-07 |
| Find all providers with the same taxonomy | ||||
| City | WOONSOCKET |
| Zip Code | 02895 |
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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.