Kethelyne Beauvais, MD
Individual provider Active NPI Family Medicine Physician · Warwick, RI
NPI 1306307368 · NPPES record last updated Jul 14, 2025
Key facts
- NPI
- 1306307368
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- LP04629 (RI)
- Practice address
- 455 Toll Gate Rd
Warwick, RI 02886-2759 - Phone
- (401) 737-7010
- NPI assigned
- Mar 30, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 8
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Eastern Virginia Medical School, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- University Primary Care Practices Inc
Practice addresses (Care Compare)
11100 Euclid Ave
Cleveland, OH 44106-1716
158 W Main Rd
Conneaut, OH 44030-2039
Hospital & facility affiliations
- University Hospitals Portage Medical Center
- Genesis Hospital
- Tamarack Ridge Health and Rehabilitation
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220919001498 | OH | Practitioner - Family Practice | 1557697455 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Primary Care Practices Inc | Current |
Accepting new patients | |
| University Primary Care Practices Inc | Current |
Accepting new patients | |
| University Primary Care Practices Inc | Current | Accepting new patients | |
| FHS Brimfield, Inc. | Past | Accepting new patients |
Locations
158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | LP04629 | RI | Yes |
Addresses
Primary practice location
455 Toll Gate Rd
Warwick, RI 02886-2759
Mailing address
455 Toll Gate Rd
Warwick, RI 02886-2759
Phone (401) 737-7010
Other providers in Warwick, RI
- Tasha Beaudin
- Danielle Marie Beaudoin-Parsons
- Jessica Beaupre
- Laurie M Beauregard
- Beautiful Days Ahead LLC
- Lauren M Bedard
- Alexa Beer
- Matthew Behrens
- Andrew Belcher
- Richard P. Belhumeur
All providers in Warwick, RI · Family Medicine Physician in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 14, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.