Simone Thavaseelan (NPI# 1053530782, PAC ID# 2668641945) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1053530782 |
| PAC ID by PECOS | 2668641945 |
| Professional Enrollment ID | I20110802000527 |
| Full Name | Simone Thavaseelan |
| Organization Legal Name | BROWN UROLOGY, INC. |
| Address |
827 N Main St Suite 4 Providence RI 02904-5751 |
| Phone Number | 4012762060 |
| Gender | F |
| Medical School | GEORGETOWN UNIVERSITY OF MEDICINE |
| Graduation Year | 2005 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 7810254513 |
| Number of Group Practice Members | 23 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 410007 | RHODE ISLAND HOSPITAL |
| 410012 | THE MIRIAM HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 2 Dudley St, Suite 175, Providence, RI 02905-3246 | 4014210710 | BROWN UROLOGY, INC. |
| 827 N Main St, Suite 4, Providence, RI 02904-5751 | 4012762060 | BROWN UROLOGY, INC. |
| Organization Legal Name | BROWN UROLOGY, INC. |
| Physicians | 17 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jo Ann M Moore | Nurse Practitioner | Brown Urology, Inc. | 195 Collyer St, Providence, RI 02904-1869 |
| Harry M Iannotti | Urology | Brown Urology, Inc. | 195 Collyer St, Suite 104, Providence, RI 02904-1869 |
| Rashmi Licht | Urology | Brown Urology, Inc. | 827 N Main St, Suite 4, Providence, RI 02904-5751 |
| Ahmed Aziz Chaudhary | Radiation Oncology | Brown Urology, Inc. | 827 N Main St, Suite 4, Providence, RI 02904-5751 |
| Steven C Lane | Radiation Oncology | Brown Urology, Inc. | 827 N Main St, Suite 4, Providence, RI 02904-5751 |
| Jacqueline M Joubert | Nurse Practitioner | Brown Urology, Inc. | 195 Collyer St, Suite 201, Providence, RI 02904-1869 |
| Kennon S Miller | Urology | Brown Urology, Inc. | 2 Dudley St, Suite 175, Providence, RI 02905-3246 |
| Gabriella Juliet Avellino | Urology | Brown Urology, Inc. | 2 Dudley St, Suite 175, Providence, RI 02905-3246 |
| Arthur Wang-yan Wong | Urology | Brown Urology, Inc. | 195 Collyer St, Suite 201, Providence, RI 02904-1869 |
| Dragan Golijanin | Urology | Brown Urology, Inc. | 195 Collyer St, Suite 104, Providence, RI 02904-1869 |
| Street Address |
827 N MAIN ST SUITE 4 |
| City | PROVIDENCE |
| State | RI |
| Zip | 02904-5751 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rashmi Licht | Urology | Brown Urology, Inc. | 827 N Main St, Suite 4, Providence, RI 02904-5751 |
| Ahmed Aziz Chaudhary | Radiation Oncology | Brown Urology, Inc. | 827 N Main St, Suite 4, Providence, RI 02904-5751 |
| Steven C Lane | Radiation Oncology | Brown Urology, Inc. | 827 N Main St, Suite 4, Providence, RI 02904-5751 |
| Kathy Radie Keane | Radiation Oncology | Brown Urology, Inc. | 827 N Main St, Suite 4, Providence, RI 02904-5751 |
| Scott A Triedman | Radiation Oncology | Brown Urology, Inc. | 827 N Main St, Suite 4, Providence, RI 02904-5751 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert B Patterson | Vascular Surgery | 486 Silver Spring St, Providence, RI 02904-1556 | |
| Nishit Shah | Colorectal Surgery (proctology) | University Surgical Associates, Inc. | 208 Collyer St, Suite 302, Providence, RI 02904-1560 |
| Laurel A Gay | Physician Assistant | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Adam Klipfel | Colorectal Surgery (proctology) | University Surgical Associates, Inc. | 208 Collyer St, Suite 302, Providence, RI 02904-1560 |
| Fredric V Christian | Cardiovascular Disease (cardiology) | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Roger D Raymond | Cardiovascular Disease (cardiology) | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Michelle Kristen Finkelman | Nurse Practitioner | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Olivia Macaskill | Nurse Practitioner | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Susan P Emaus | Physician Assistant | The Miriam Hospital | 208 Collyer St, Suite 100, Providence, RI 02904-1560 |
| Kenneth S Korr | Cardiovascular Disease (cardiology) | The Miriam Hospital | 208 Collyer St, Providence, RI 02904-1560 |
| Find all physicians in zip 02904 | |||
| City | PROVIDENCE |
| Zip Code | 02904 |
| Specialty | UROLOGY |
| City + Specialty | PROVIDENCE + UROLOGY |
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| 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.