IAN PAUL KROUSON


Address: 1195 N Main St, Providence, RI 02904-1824
Phone: 4018613782

IAN PAUL KROUSON (NPI# 1790744381) 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) 1790744381
Entity Type Individual
Full Name IAN PAUL KROUSON
Credential PA
Practice Address 1195 N Main St
Providence
RI 02904-1824
Mailing Address 70 S Bay Dr
Unit A2
Narragansett
RI 02882-2870
Practice Telephone 4018613782
Practice Fax Number 4013835846
Mailing Telephone 8604607361
Enumeration Date 2006-03-22
Last Update Date 2019-09-16
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
00398 RI Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
RI RI LICENSE PA# PA00398 01

Office Location

Street Address 1195 N MAIN ST
City PROVIDENCE
State RI
Zip Code 02904-1824

Providers in the same location

NPI Name Taxonomy Address Enumeration
1730663287 Lisa S Bailey Physician Assistant 1195 N Main St, Providence, RI 02904-1824 2018-09-20
1700323490 Sean Bennett Eden Physician Assistant 1195 N Main St, Fl 2, Providence, RI 02904-1824 2017-01-19
1558816330 East Side Primary Care Providence LLC Internal Medicine 1195 N Main St, Providence, RI 02904-1824 2016-08-22
1235305871 Agape Primary Care and Laser Center LLC Dermatology 1195 N Main St, Providence, RI 02904-1824 2008-05-04
1558531467 East Side Urgent Care LLC Clinic/Center 1195 N Main St, Providence, RI 02904-1824 2008-03-06
1952501942 Jason Charles Xynellis Physician Assistant 1195 N Main St, Providence, RI 02904-1824 2007-07-19
1437224763 Michael Stempek Physician Assistant 1195 N Main St, Providence, RI 02904-1824 2006-11-21
1639168198 Frederick Salvatore Crisafulli Internal Medicine 1195 N Main St, Providence, RI 02904-1824 2005-10-18

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1144792383 Lifespan Pharmacy LLC Durable Medical Equipment & Medical Supplies 180 Corliss Street, Suite A, Providence, RI 02904 2018-12-28
1780168229 Beth M. Kalunian Social Worker 480 Charles Street, Providence, RI 02904 2018-09-20
1588161608 Michael P. Johnson, Md, Inc Internal Medicine 148 W River St Ste 22b, Providence, RI 02904 2018-04-06
1780045948 Fred Saccoccio Pharmacist 15 Smithfield Road, No Providence, RI 02904 2016-03-16
1699148999 Latin Adult Day Health Care Center Clinic/Center 665 Charles Street, Providence, RI 02904 2015-11-09
1144639956 Dina P Toolin Occupational Therapist 195 Collyer St. 3rd Floor, University Medical Center/miriam Hospital Outpatient, Providence, RI 02904 2014-08-06
1801208798 Seth Clark Internal Medicine 200 Corliss St, Providence, RI 02904 2014-05-27
1134554645 Molly Elizabeth Smith Physical Therapist 1405 Douglas Ave, North Providence, RI 02904 2013-09-04
1336408723 Emad Awa Pediatrics 1 Randall Sq Ste 404, Providence, RI 02904 2012-05-07
1598036790 Joseph F. Osmanski, Od, Inc Optometrist 1971 Mineral Spring Avenue, N. Providence, RI 02904 2012-01-19
Find all providers in zip 02904

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
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
1649762071 Ethan Robert Walsh Physician Assistant 593 Eddy St, Providence, RI 02903-4923 2018-06-01
Find all providers in PROVIDENCE

Competitor

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City PROVIDENCE
Zip Code 02904

Improve Information

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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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