WALTER DELUCA PAC NPI 1962598516

NPI Information

NPI: 1962598516
Provider Name: WALTER DELUCA, PAC
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
684 WARREN AVE
EAST PROVIDENCE, RI
ZIP 02914
Phone: (401) 434-0022
Get Directions

Walter Deluca, PAC is a medical physician assistant in East Providence, RI. Walter Deluca, PAC NPI is 1962598516. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

684 WARREN AVE
EAST PROVIDENCE, RI
ZIP 02914-405
Phone: (401) 434-0022
Fax: (401) 434-6111

The NPI 1962598516 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 10/4/2006 and was last updated on 9/18/2018.

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	289	MONTANA	No
2	363AM0700X	Physician Assistant	Medical	PA00002	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	0438260	MEDICAID	MONTANA
2	289	OTHER	MONTANA	STATE LIC NUMBER
3	000096303	OTHER	MONTANA	BLUE CROSS NUMBER
4	979006386	OTHER	RHODE ISLAND	MEDICARE PTAN
5	7005920	MEDICAID	RHODE ISLAND

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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