Simone Thavaseelan

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

MD13391 Issued in RI

Practice address

2 Dudley St Ste 185
Providence, RI 02905-3247

Phone

(401) 444-5795

NPI assigned

Apr 24, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in RI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Urology

Education

Georgetown University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lifespan Physician Group IncGroup PAC ID 2567455082, 1,151 clinicians

Brown Urology, Inc.Group PAC ID 7810254513, 32 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rhode Island Hospital Hospital, Providence, RI, CCN 410007
• The Miriam Hospital Hospital, Providence, RI, CCN 410012
• Newport Hospital Hospital, Newport, RI, CCN 410006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Brown Urology, Inc.

  • Urology Physician
  • Providence, RI
  • NPI 1467973099
  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment Care Compare group NPD
• The Miriam Hospital

  • Multi-Specialty Clinic/Center
  • Providence, RI
  • NPI 1669726451
  Medicare reassignment NPD
• Brown Urology, Inc.

  • Radiation Oncology Physician
  • Providence, RI
  • NPI 1184303984
  NPD
• Brown Urology, Inc.

  • Ambulatory Surgical Clinic/Center
  • Providence, RI
  • NPI 1336658145

  Urology

  NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD
• The Miriam Hospital

  • Cardiac Rehabilitation Clinic/Center
  • East Greenwich, RI
  • NPI 1518482389
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Newport Hospital

  • General Acute Care Hospital
  • Newport, RI
  • NPI 1457346413
  Care Compare affiliation
• Rhode Island Hospital

  • Ambulance
  • Providence, RI
  • NPI 1053552299

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • Clinic/Center
  • Providence, RI
  • NPI 1154663383

  Hospital

  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1588659528
  Care Compare affiliation
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  Care Compare affiliation
• The Miriam Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1487649430
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318550400000",
    "number": "1053530782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 COLLYER ST STE 201",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041869",
            "telephone_number": "401-272-7799",
            "fax_number": "401-272-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 DUDLEY ST STE 185",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029053247",
            "telephone_number": "401-444-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAVASEELAN",
        "first_name": "SIMONE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-24",
        "last_updated": "2011-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "RI",
            "license": "MD13391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "349005986",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1659463230",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kishan Thakkar
• Rupal H Thakor, MD
• Sweta Thakur, DDS
• Pranjal Thakuria, MD
• Mihika Thapliyal
• David Thayer, LICSW
• Denise Charlene Thayer
• Erika Lane Thayer, DO
• Pamela Thayer, PT
• The Capable Cottage LLC

• Urology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Urology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.