Jack R Bevivino


Address: 120 Dudley St, Suite 201, Providence, RI 02905-2431
Phone: 4015219290

Jack R Bevivino (NPI# 1780705707, PAC ID# 1759576929) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PLASTIC AND RECONSTRUCTIVE SURGERY.

Physician Overview

Nation Provider ID (NPI) 1780705707
PAC ID by PECOS 1759576929
Professional Enrollment ID I20101112000952
Full Name Jack R Bevivino
Address 120 Dudley St
Suite 201
Providence
RI 02905-2431
Phone Number 4015219290
Gender M
Medical School GEORGETOWN UNIVERSITY OF MEDICINE
Graduation Year 1976
Primary Specialty PLASTIC AND RECONSTRUCTIVE SURGERY
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
410007 RHODE ISLAND HOSPITAL

Other Locations

Address Phone Organization
120 Dudley St, Suite 201, Providence, RI 02905-2431 4015219290

Organization Information

Office Location

Street Address 120 DUDLEY ST
SUITE 201
City PROVIDENCE
State RI
Zip 02905-2431

Physicians in the same location

Name Specialty Organization Address
Yoash R Enzer Ophthalmology 120 Dudley St, Suite 104, Providence, RI 02905-2431
Philip R Rizzuto Ophthalmology 120 Dudley St, Suite 301, Providence, RI 02905-2429
Robert Janigian Jr. Ophthalmology Robert H. Janigian Jr. Md LLC 120 Dudley St, Suite 303, Providence, RI 02905-2429

Physicians in the same zip code

Name Specialty Organization Address
Clarissa D. Lewis Optometry The Providence Community Health Centers Inc. 335 Prairie Ave, Fl 2, Providence, RI 02905-1924
Angel M. Eads Family Medicine The Providence Community Health Centers Inc. 355 Prairie Ave, Providence, RI 02905-1928
Sandrine O Guilherme Clinical Social Worker The Providence Center Inc 355 Prairie Ave, Providence, RI 02905-1928
Katherine Williams Family Medicine The Providence Community Health Centers Inc. 355 Prairie Ave, Providence, RI 02905-1928
Luis A Ferreira Clinical Social Worker The Providence Center Inc 355 Prairie Ave, Providence, RI 02905-1928
Andrew Saal Family Medicine The Providence Community Health Centers Inc. 355 Prairie Ave, Providence, RI 02905-1928
Lauren E Stewart Obstetrics/gynecology The Providence Community Health Centers Inc. 355 Prairie Ave, Providence, RI 02905-1928
Tenesha R Lisbon Nurse Practitioner The Providence Community Health Centers Inc. 355 Prairie Ave, Providence, RI 02905-1928
Elaine K Parker Williams Nurse Practitioner The Providence Community Health Centers Inc. 355 Prairie Ave, Providence, RI 02905-1928
Carla Martin Internal Medicine The Providence Community Health Centers Inc. 355 Prairie Ave, Providence, RI 02905-1928
Find all physicians in zip 02905

Competitor

Search similar physicians

City PROVIDENCE
Zip Code 02905
Specialty PLASTIC AND RECONSTRUCTIVE SURGERY
City + Specialty PROVIDENCE + PLASTIC AND RECONSTRUCTIVE SURGERY

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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