MARYKATE DUNLEAVY MSPAS PA-C NPI 1396800520

NPI Information

NPI: 1396800520
Provider Name: MARYKATE DUNLEAVY, MSPAS, PA-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
593 EDDY ST
PROVIDENCE, RI
ZIP 02903
Phone: (401) 519-1604
Get Directions

Marykate Dunleavy, MSPAS, PA-C is a medical physician assistant in Providence, RI. Marykate Dunleavy, MSPAS, PA-C NPI is 1396800520. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

593 EDDY ST
PROVIDENCE, RI
ZIP 02903-923
Phone: (401) 519-1604
Fax: (401) 272-0538

The NPI 1396800520 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/27/2006 and was last updated on 2/5/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	001873	CONNECTICUT	No
2	363AM0700X	Physician Assistant	Medical	PA00489	RHODE ISLAND	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	05/14/2009	OTHER	RHODE ISLAND	NHPRI
2	979006382	OTHER	RHODE ISLAND	RI MEDICARE
3	939025129	OTHER	RHODE ISLAND	RI MEDICARE GROUP NUMBER
4	MD74353	MEDICAID	RHODE ISLAND
5	1396800520	OTHER	RHODE ISLAND	NPI
6	05/29/2009	OTHER	RHODE ISLAND	BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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