PETER JOSEPH MAZZAGLIA (NPI# 1639103617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639103617 |
| Entity Type | Individual |
| Full Name | PETER JOSEPH MAZZAGLIA |
| Credential | MD |
| Practice Address |
2 Dudley St Suite 470 Providence RI 02905-3236 |
| Mailing Address |
Po Box 16149 Rumford RI 02916-0697 |
| Practice Telephone | 4012230962 |
| Practice Fax Number | 4018611272 |
| Mailing Telephone | 4014539625 |
| Mailing Fax Number | 4014357069 |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-01-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | MD12186 | RI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | RHODE ISLAND BCBS | 31703-4 | 01 |
| RI | 7058687 | 05 |
| Street Address |
2 DUDLEY ST SUITE 470 |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02905-3236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356343651 | Northeast Orthotics and Prosthetics Inc | Prosthetic/Orthotic Supplier | 2 Dudley St, Ste 161, Providence, RI 02905-3236 | 2005-06-01 |
| 1366935231 | Christy Gandhi | Obstetrics & Gynecology | 2 Dudley St, Providence, RI 02905-3236 | 2018-06-14 |
| 1295274215 | Nora Kinslow | Occupational Therapist | 2 Dudley St, Suite 200, Providence, RI 02905-3236 | 2017-02-23 |
| 1578008082 | Laura Nelson | Occupational Therapist | 2 Dudley St, Suite 200, Providence, RI 02905-3236 | 2016-12-20 |
| 1619328127 | Bryan Jon Berlin | Physician Assistant | 2 Dudley St, Suite 200, Providence, RI 02905-3236 | 2016-06-27 |
| 1245600238 | Kristin Wedel | Social Worker | 2 Dudley St, Providence, RI 02905-3236 | 2015-10-02 |
| 1497155378 | Michael Platz | Occupational Therapist | 2 Dudley St, Ste 200, Providence, RI 02905-3236 | 2014-08-28 |
| 1164831160 | Nicholas Bruno | Physical Therapist | 2 Dudley St, Suite 200, Providence, RI 02905-3236 | 2014-08-05 |
| 1619389160 | Laurie J Deruosi | Nurse Practitioner | 2 Dudley St, Suite G 85, Providence, RI 02905-3236 | 2014-06-02 |
| 1851729511 | Rhode Island Hospital | Surgery | 2 Dudley St, Suite 180, Providence, RI 02905-3236 | 2013-10-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477100808 | Raisa Emilia Garcia-diaz | Counselor | 66 Pavilion Avenue, Providence, RI 02905 | 2019-08-21 |
| 1962976571 | Nike A. Kendall | Social Worker | Program In Women's Oncology, 101 Dudley Street, Providence, RI 02905 | 2019-01-16 |
| 1891265443 | Carolyn Te Young | Pathology | 1320 Narragansett Blvd, Cranston, RI 02905 | 2018-11-27 |
| 1417427071 | Julianne Elizabeth Houtchens | Dietitian, Registered | Adult Primary Care 245 Chapman Street, Providence, RI 02905 | 2018-11-27 |
| 1922577394 | Dilenia C Cruz | Health Educator | 335r Prairie Ave., Suite 2b, Providence, RI 02905 | 2018-11-15 |
| 1639653116 | Varina S. Gunn | Health Educator | 335r Prarie Ave., Suite 2b, Providence, RI 02905 | 2018-09-20 |
| 1427590421 | Cardea Healthcare LLC | In Home Supportive Care | 100 Pavilion Avenue, Suite 101, Providence, RI 02905 | 2016-11-08 |
| 1265884597 | Maxwell King | Physical Therapy Assistant | 48 Moorland Avenue, Cranston, RI 02905 | 2016-07-11 |
| 1346698024 | Samantha Lea Colli | Physician Assistant | 100 Dudley St Fl 3, Providence, RI 02905 | 2016-06-02 |
| 1346697448 | Amy Jean Simpson | Marriage & Family Therapist | 1981 Broad Street, Cranston, RI 02905 | 2016-05-18 |
| Find all providers in zip 02905 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497235014 | Yao Zhou Liu | Surgery | 593 Eddy St - Rhode Island Hospital, Providence, RI 02903 | 2018-08-14 |
| 1801389713 | Aparna Ashok | Surgery | 2 Dudley St Ste 174, Providence, RI 02905-3246 | 2018-06-14 |
| 1174845606 | Vahey M. Pahigian M.d., Ltd. | Surgery | 323 Angell Street, Providence, RI 02906-3293 | 2010-02-25 |
| 1477885424 | Remo Moomiaie | Surgery | 137 Doyle Ave, Providence, RI 02906-1609 | 2010-02-02 |
| 1962639690 | Rachel Erin Beard | Surgery | 2 Dudley St Ste 370, Providence, RI 02905-3248 | 2009-06-21 |
| 1407019490 | Hannah Alice Bansil | Surgery | 668 Eddy St, Providence, RI 02903-4942 | 2008-07-09 |
| 1487748729 | Christine M. Emmick | Surgery | 100 Highland Ave Ste 308, Providence, RI 02906-2753 | 2006-10-03 |
| 1376589895 | University Surgical Associates, Inc. | Surgery | 2 Dudley St Ste 470, Providence, RI 02905-3248 | 2006-06-22 |
| 1881683985 | Arnold Harvey Herman | Surgery | 528 N Main St, Suite 3, Providence, RI 02904-5762 | 2005-10-20 |
| 1790783744 | Beth Ann Ryder | Surgery | 195 Collyer St, Suite 302, Providence, RI 02904-1869 | 2005-07-13 |
| Find all providers in PROVIDENCE | ||||
| City | PROVIDENCE |
| Zip Code | 02905 |
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| 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.