Pavinarmatha Ketheeswaran, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME179335 Issued in FL

Practice address

40 Candace St
Providence, RI 02908-3747

Phone

(401) 444-0550

Fax

(401) 444-0425

NPI assigned

Apr 25, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in RI, FL2 enrollments

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 2

Specialty

Family Practice

Education

Florida International Univ, College of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

The Providence Community Health Centers Inc.Group PAC ID 9335050962, 90 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pketheeswaran60002@hcnetwork.direct-ci.com

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.

• The Providence Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Providence, RI
  • NPI 1053313593
  Medicare reassignment Care Compare group NPD
• Tampa Family Health Centers Inc

  • Multi-Specialty Clinic/Center
  • Tampa, FL
  • NPI 1356347413
  Medicare reassignment
• The Providence Community Health Centers Inc.

  • Federally Qualified Health Center (FQHC)
  • Providence, RI
  • NPI 1558650986
  NPD (past)

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

{
    "created_epoch": "1556150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783468800000",
    "number": "1962066878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 ALLENS AVE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029055010",
            "telephone_number": "401-444-0400",
            "fax_number": "401-444-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CANDACE ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029083747",
            "telephone_number": "401-444-0550",
            "fax_number": "401-444-0425"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7814 N Dale Mabry Hwy",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336143220",
            "country_code": "US",
            "telephone_number": "813-397-5300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETHEESWARAN",
        "first_name": "PAVINARMATHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-25",
        "last_updated": "2026-07-08",
        "certification_date": "2026-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "LP04636",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME179335",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD18615",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "pketheeswaran60002@HCNetwork.direct-ci.com",
            "affiliation": "N",
            "address_1": "40 Candace St",
            "city": "Providence",
            "state": "RI",
            "country_code": "US",
            "postal_code": "029083747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jillian Taylor Kern, PA-C
• Kate Taylor Kernochan, CNM
• Marianna Isabel Kessimian, M.D.
• Anita Susan Kestin, M.P.H
• Martin Keszler, M.D.
• Yvonne Antoinette Kettels
• Elizabeth Pressly Kettyle, CNM
• Kevin E Baill, MD and Associates, LLC
• Kevin E. Baill MD & Associates, LLC
• Kevin S. Palumbo, MD, Inc.

• Family Medicine Physician in Providence, RI
• Providers in 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 Jul 8, 2026; 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.