Marisa Dasilva, DNP
Individual provider Active NPI Family Nurse Practitioner · Providence, RI
NPI 1871298703 · NPPES record last updated Sep 13, 2024
Key facts
- NPI
- 1871298703
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- APRN04088 (RI)
- Practice address
- 1 Randall SQ
Providence, RI 02904-2709 - Phone
- (401) 274-6339
- Fax
- (401) 453-6290
- NPI assigned
- Mar 31, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 9
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Providence Community Health Centers Inc.
Practice addresses (Care Compare)
1 Randall SQ
Providence, RI 02904-2709
Phone (401) 274-6339
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in RI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241008001484 | RI | Practitioner - Nurse Practitioner | 0749711273 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN2358392 | MA | MD | Family Nurse Practitioner |
| APRN04088 | RI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Providence Community Health Centers, Inc | Current |
Accepting new patients | |
| The Providence Community Health Centers Inc. | Past | Accepting new patients |
Locations
1 Randall Sq
Ste 205
Providence, RI 02904
Phone (401) 323-8109
1 Randall Sq
Providence, RI 02904
Phone (401) 272-5500
375 Allens Ave
Providence, RI 02905
Phone (401) 444-0400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | APRN04088 | RI | Yes |
| Registered Nurse | 163W00000X | RN2358392 | MA | |
| Family Nurse Practitioner | 363LF0000X | RN2358392 | MA |
Addresses
Primary practice location
1 Randall SQ
Providence, RI 02904-2709
Mailing address
375 Allens Ave
Providence, RI 02905-5010
Phone (401) 444-0400
Other providers in Providence, RI
- Yamilet M Dasilva Montesdeoca
- Elizabeth Anne Dasilva
- Erin Kelli Dasilva
- Hollie Dasilva
- Malissa Dasilva
- Melissa R Dasilva
- Nicole Cristina Dasilva
- Zoila Dasilva
- Shaelyn Dasilveira
- Lindsay Dimeo Daskalopoulos
All providers in Providence, RI · Family Nurse Practitioner 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 Sep 13, 2024. 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.