MARYKATE DUNLEAVY (NPI# 1396800520) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396800520 |
| Entity Type | Individual |
| Full Name | MARYKATE DUNLEAVY |
| Credential | MSPAS, PA-C |
| Practice Address |
593 Eddy St Providence RI 02903-4923 |
| Mailing Address |
Po Box 9484 Providence RI 02940-9484 |
| Practice Telephone | 4015191604 |
| Practice Fax Number | 4012720538 |
| Mailing Telephone | 4018542500 |
| Mailing Fax Number | 4018542519 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2010-02-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA00489 | RI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
001873 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | RI MEDICARE | 979006382 | 01 |
| RI | NHPRI | 05/14/2009 | 01 |
| RI | BCBS | 05/29/2009 | 01 |
| RI | NPI | 1396800520 | 01 |
| RI | RI MEDICARE GROUP NUMBER | 939025129 | 01 |
| RI | MD74353 | 05 |
| Street Address |
593 EDDY ST |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02903-4923 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952306185 | Mitchel A Sklar | Internal Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2005-06-15 |
| 1376140707 | Kristen Marie Czekanski | Student in an Organized Health Care Education/Training Program | 593 Eddy St, Providence, RI 02903-4923 | 2020-10-08 |
| 1326645300 | Elizabeth Stefanilo | Nurse Practitioner | 593 Eddy St, Providence, RI 02903-4923 | 2020-10-03 |
| 1841807633 | Julie Walden | Student in an Organized Health Care Education/Training Program | 593 Eddy St, Providence, RI 02903-4923 | 2020-09-26 |
| 1417567751 | Yigit Baykara | Pathology | 593 Eddy St, Providence, RI 02903-4923 | 2020-08-02 |
| 1588273064 | Cassandra Pagnotta | Dietitian, Registered | 593 Eddy St, Providence, RI 02903-4923 | 2020-07-30 |
| 1982213294 | Sabitha Sasidharan Pillai | Pediatrics | 593 Eddy St, Providence, RI 02903-4923 | 2020-07-23 |
| 1861019481 | Courtney Pedersen | Emergency Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-30 |
| 1508483496 | Mohammad Hisham Hout | Urology | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-26 |
| 1639796642 | Benjamin Hagan | Emergency Medicine | 593 Eddy St, Providence, RI 02903-4923 | 2020-06-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609475755 | Sarah Fellows | Student in an Organized Health Care Education/Training Program | 350 Eddy Street, Uri Nursing Education Center, Providence, RI 02903 | 2020-10-20 |
| 1093328262 | Esther Robbins | Social Worker | 290 West Exchange St., Suite 100, Providence, RI 02903 | 2020-08-27 |
| 1720619489 | Ivy Marie Mcdonald | Behavioral Analyst | 290 W Exchange St #101, Providence, RI 02903 | 2020-01-31 |
| 1447802707 | Natalie Monaghan, LLC | Social Worker | 545 South Water Street, Providence, RI 02903 | 2019-07-16 |
| 1760049522 | Daniel Steven Alanko | Pediatrics | 293 Eddy Street, Providence, RI 02903 | 2019-05-28 |
| 1154894368 | Margaret Emily Dyson | Behavior Technician | 290 W. Exchange St, Providence, RI 02903 | 2019-01-10 |
| 1497235014 | Yao Zhou Liu | Surgery | 593 Eddy St - Rhode Island Hospital, Providence, RI 02903 | 2018-08-14 |
| 1558840645 | Tamara Gore | Behavior Technician | 290 W Exchange Street Suite 101, Providence, RI 02903 | 2018-08-09 |
| 1437642709 | Adrian Cotarelo | Student in an Organized Health Care Education/Training Program | 174 Wickenden St, Apt. 3rd Floor, Providence, RI 02903 | 2018-06-12 |
| 1356833024 | Natalie Rita Noonan | Clinical Neuropsychologist | 593 Eddy St Ste 430, Providence, RI 02903 | 2018-05-30 |
| Find all providers in zip 02903 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962962589 | Delaney Horsley | Physician Assistant | 472 W Fountain St Apt 1, Providence, RI 02903-3570 | 2019-03-20 |
| 1346698024 | Samantha Lea Colli | Physician Assistant | 100 Dudley St Fl 3, Providence, RI 02905 | 2016-06-02 |
| 1548204399 | Jeannette Mary Doyle-gay | Physician Assistant | 164 Summitt Ave, Room C70, The Miriam Hospital, Providence, RI 02906 | 2006-06-15 |
| 1790744381 | Ian Paul Krouson | Physician Assistant | 1195 N Main St, Providence, RI 02904-1824 | 2006-03-22 |
| 1457328221 | Richard A. Hernandez | Physician Assistant | 164 Summit Ave # C70, Providence, RI 02906-2853 | 2006-03-01 |
| 1801889787 | Paul Mallari | Physician Assistant | 49 Seekonk St, Suite 3, Providence, RI 02906-5176 | 2005-08-25 |
| 1558369512 | Josephine Salhab | Physician Assistant | 164 Summit Ave, Rm C70, Providence, RI 02906-2853 | 2005-07-13 |
| 1528065430 | Sandra M Jamieson | Physician Assistant | 593 Eddy Street, Grad Dorms, Providence, RI 02903 | 2005-07-07 |
| 1518962034 | Patricia A Trafford | Physician Assistant | 790 N Main St, Providence, RI 02904-5706 | 2005-06-21 |
| 1336144856 | Arya Biswas | Physician Assistant | 280 Melrose St, Providence, RI 02907-2152 | 2005-06-21 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02903 |
Please comment or provide details below to improve the information on MARYKATE DUNLEAVY.
| 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.