Mohamedyakub A Puthawala, M.D

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

MD07818 Issued in RI

Practice address

593 Eddy St
Dept of Radiation Oncology
Providence, RI 02903-4923

Phone

(401) 444-8311

Fax

(401) 444-5335

NPI assigned

Apr 17, 2006

Sex

Male

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 3

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

Radiation Oncology

Education

Other, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Radiosurgery Center of Rhode Island LLCGroup PAC ID 0345393559, 9 clinicians

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

Practice addresses (Care Compare)

Hospital & facility affiliations

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mputhawala@wih.cernerdirect.carene.org
• Direct secure messaging: mputhawala17722@brownhealth.medalliesdirect.net

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.

  dba Brown Health Medical Group

  • General Practice Physician
  • Providence, RI
  • NPI 1407116643
  Medicare reassignment Care Compare group NPD
• Radiosurgery Center of Rhode Island LLC

  • Radiation Oncology Physician
  • Providence, RI
  • NPI 1578726261
  Medicare reassignment Care Compare group NPD
• Rhode Island Hospital

  • Hematology & Oncology Physician
  • Providence, RI
  • NPI 1396849782
  Medicare reassignment NPD
• Lifespan Corporation

  • Children's Rehabilitation Hospital
  • Providence, RI
  • NPI 1790221232
  NPD
• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • Emergency Medicine Physician
  • Providence, RI
  • NPI 1568325678
  NPD
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1972768174
  NPD
• Lifespan Physician Group, Inc.

  dba Brown Health Medical Group

  • Psychiatry Physician
  • Providence, RI
  • NPI 1548506793
  NPD (past)
• Rhode Island Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1588659528
  NPD (past)

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

• Rhode Island Hospital

  dba LifePact

  • 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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254873600000",
    "number": "1508821364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "DEPT OF RADIATION ONCOLOGY",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8311",
            "fax_number": "401-444-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "DEPT OF RADIATION ONCOLOGY",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-8311",
            "fax_number": "401-444-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PUTHAWALA",
        "first_name": "MOHAMEDYAKUB",
        "middle_name": "A",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2009-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "RI",
            "license": "MD07818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "2400030",
            "state": "RI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7002082",
            "state": "RI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4804-8",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aayush Purohit, MD
• Jo Ann Purvis
• Warren L Purvis, M.D.
• Elena T. Puscasiu, M.D.
• Mohamedtauqir M Puthawala, M.D.
• Rachel Kate Putman, MD
• Heather Putnam
• Sharath Ponnappa Puttichanda
• Pvdchiro LLC
• Raaj Pyada, MD

• Radiation Oncology Physician in Providence, RI
• Providers in Providence, RI by specialty
• Radiation Oncology Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2009; 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.