Tatiana Bakaeva, M.D., PH.D.

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MD16734 Issued in RI

Practice address

1 Hoppin Street
Corowest Suite 202
Providence, RI 02903

Phone

(401) 444-6551

Fax

(401) 444-6587

NPI assigned

Jun 25, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Neurology

Education

Other, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

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

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Miriam Hospital Hospital, Providence, RI, CCN 410012
• Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074
• Rhode Island Hospital Hospital, Providence, RI, CCN 410007

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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.

• Lifespan Physician Group, Inc.

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment Care Compare group NPD
• Lifespan Physician Group, Inc.

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD

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

• 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
• Southcoast Hospitals Group, Inc

  • General Acute Care Hospital
  • Wareham, MA
  • NPI 1922024835
  Care Compare affiliation

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

{
    "created_epoch": "1403654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1275948572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "401-444-6912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 HOPPIN STREET",
            "address_2": "COROWEST SUITE 202",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-444-6551",
            "fax_number": "401-444-6587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAKAEVA",
        "first_name": "TATIANA",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-25",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "272919",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "RI",
            "license": "MD16734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Baillargeon, NP
• Theresa Bainbridge, CNM
• Kori Elizabeth Bainton, PA-C
• Gurdev Bajwa, M.D.
• Muhammad Ali Haider Bajwa, M.D.
• Leen Bakdash
• Sarah Rose Baker-Carroll
• Abigail D Baker, CRNA
• Bethany W Baker, NURSR PRACTITIONER
• Elizabeth P Baker, NP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.