RICHARD A PELOQUIN


Address: 100 Butler Dr, Providence, RI 02906-4862
Phone: 4012770790

RICHARD A PELOQUIN (NPI# 1164464772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1164464772
Entity Type Individual
Full Name RICHARD A PELOQUIN
Credential PA-C
Practice Address 100 Butler Dr
Providence
RI 02906-4862
Mailing Address 16 Arlington Dr
Lincoln
RI 02865-1636
Practice Telephone 4012770790
Enumeration Date 2006-06-11
Last Update Date 2010-05-17
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA00096 RI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
RI 7006485 05
RI MEDICARE PTAN 979006370 01

Office Location

Street Address 100 BUTLER DR
City PROVIDENCE
State RI
Zip Code 02906-4862

Providers in the same location

NPI Name Taxonomy Address Enumeration
1447254479 Thomas Francis Bliss Jr. Orthopaedic Surgery 100 Butler Dr, Providence, RI 02906-4862 2005-06-08
1760917207 Tyler Ashley Rosa Physician Assistant 100 Butler Dr, Providence, RI 02906-4862 2017-04-21
1376955575 Karyn A. Roda Physical Therapist 100 Butler Dr, Providence, RI 02906-4862 2014-05-22
1417293432 Christopher Paul Gomes Physical Therapist 100 Butler Dr, Providence, RI 02906-4862 2012-12-19
1356615124 University Orthopedics, Inc. Physical Therapist 100 Butler Dr, Providence, RI 02906-4862 2012-02-27
1821251950 Caitlyn Cuthbertson Specialist 100 Butler Dr, Providence, RI 02906-4862 2008-07-09
1396854162 Todd Allen Fellars Orthopaedic Surgery 100 Butler Dr, Providence, RI 02906-4862 2006-08-29
1578582086 Edward J Wojciechowski Physical Therapist 100 Butler Dr, Providence, RI 02906-4862 2006-07-18
1699715920 Christopher W Digiovanni Orthopaedic Surgery 100 Butler Dr, Providence, RI 02906-4862 2006-06-07
1154368926 Robert M Shalvoy Orthopaedic Surgery 100 Butler Dr, Providence, RI 02906-4862 2006-06-01
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NPI Name Taxonomy Address Enumeration
1285245175 Birdsong Traditional Medicine, LLC Acupuncturist 148 Waterman St. Ground Level, Providence, RI 02906 2020-08-13
1881218071 Madison Pomerantz Psychiatry & Neurology 345 Blackstone Boulevard, Box G-bh, Providence, RI 02906 2020-06-03
1316453855 Ellen Van Ingen Darling Psychologist 285 Governor St Ste 250, Providence, RI 02906 2017-12-20
1275063919 Marissa Martz Psychiatry & Neurology 345 Blackstone Blvd., Providence, RI 02906 2017-06-15
1235663220 Alena Haltzman Counselor 223 Summit Ave, Providence, RI 02906 2017-04-17
1669823399 Kathryn Fleming-ives LLC Psychiatry & Neurology 355 Hope St Unit 1, Providence, RI 02906 2016-06-23
1134573389 Sarah E. Kramer Psychiatry & Neurology Butler Hospital, Adult Psychiatry Residency, 345 Blackstone Blvd, Providence, RI 02906 2016-04-13
1538534201 Laura Anne Buss Social Worker 55 Hope St., Providence, RI 02906 2015-12-07
1700289360 Tinatin Surguladze Counselor 205 Waterman St Suite 106, Providence, RI 02906 2014-09-26
1467851519 Jamila Allouane Social Worker 120 Wayland Avenue Suite 2, Providence, RI 02906 2014-08-14
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City PROVIDENCE
Zip Code 02906

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Dataset Information

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.

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