Primary Medical Center and Walk-in LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PRIMARY MEDICAL CENTER AND WALK-IN LLC

Practice address

684 Warren Ave
East Providence, RI 02914-1405

Phone

(401) 434-0022

Fax

(401) 434-6111

NPI assigned

Jul 10, 2014

Organization subpart

No

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

Authorized official

Name

Constantine Vafidis, MDNPI 1467683227

Title

Owner

Phone

(401) 434-0022

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in RI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Constantine Vafidis, MD

  • Family Medicine Physician
  • Johnston, RI
  • NPI 1467683227
  Medicare reassignment Care Compare group NPD Authorized official
• Emma Elizabeth Dallaire, PA-C

  • Physician Assistant
  • East Providence, RI
  • NPI 1174410989
  Medicare reassignment Care Compare group NPD
• Joshua Gaumond, FNP, DNP

  • Family Nurse Practitioner
  • East Providence, RI
  • NPI 1831901172
  Medicare reassignment Care Compare group NPD
• Michelle Marie Lamoureux, RD, LDN

  • Registered Dietitian
  • Providence, RI
  • NPI 1760574099
  Medicare reassignment Care Compare group NPD
• Angelo Carpethos, PA

  • Medical Physician Assistant
  • East Providence, RI
  • NPI 1518056795
  Medicare reassignment Care Compare group
• Andrew Francis Moody, PA-C

  • Physician Assistant
  • East Providence, RI
  • NPI 1720426646
  Medicare reassignment Care Compare group
• Marisa Nicole Kane, APRN

  • Family Nurse Practitioner
  • East Providence, RI
  • NPI 1639851785
  Medicare reassignment NPD
• Yiannis Koutsofavas, PA-C

  • Physician Assistant
  • East Providence, RI
  • NPI 1164317194
  Medicare reassignment NPD
• Walter Deluca, PAC

  • Medical Physician Assistant
  • East Providence, RI
  • NPI 1962598516
  Medicare reassignment
• Shane McNamara Gazzo, PA-C

  • Physician Assistant
  • Newport, RI
  • NPI 1396425427
  Medicare reassignment
• Kelsey A Hayes, PA-C

  • Physician Assistant
  • East Providence, RI
  • NPI 1427786474
  NPD
• Kirsten Theresa Shinde, PA-C

  • Physician Assistant
  • East Providence, RI
  • NPI 1578029955
  NPD

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

{
    "created_epoch": "1404950400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467158400000",
    "number": "1225444243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 WARREN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141405",
            "telephone_number": "401-434-0022",
            "fax_number": "401-434-6111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "684 WARREN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029141405",
            "telephone_number": "401-434-0022",
            "fax_number": "401-434-6111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY MEDICAL CENTER AND WALK-IN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-10",
        "last_updated": "2016-06-29",
        "status": "A",
        "authorized_official_last_name": "VAFIDIS",
        "authorized_official_first_name": "CONSTANTINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-434-0022",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Medical Group, Professional Corporation
• Mitchell Pressman, MD
• Prestige ABA Therapy Services, Inc
• Caren Prideaux, LICSW
• Cheryl Prignano, ACNP-BC
• Primary Walk-in Medical Urgent Care LLC
• Prism Health & Medical Equipment LLC
• Mary Catherine Proietta, R.D., L.D.N.
• Nate Pseekos, PHD
• Kerry Puniello, LMHCA

• Family Medicine Physician in East Providence, RI
• Providers in East Providence, RI by specialty
• Family Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.