Basic Information
| Provider Information | |||||||||
| NPI: | 1043234792 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KAMAT | ||||||||
| FirstName: | ACHYUT | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 125 WHIPPLE ST STE 3 | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029083258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4015190337 | ||||||||
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| Practice Location | |||||||||
| Address1: | 164 SUMMIT AVE | ||||||||
| Address2: | |||||||||
| City: | PROVIDENCE | ||||||||
| State: | RI | ||||||||
| PostalCode: | 029062853 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4014445175 | ||||||||
| FaxNumber: | 4012720538 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2006 | ||||||||
| LastUpdateDate: | 01/27/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MD10314 | RI | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
ID Information
| ID | Type | State | Issuer | Description | 939025129 | 01 | RI | RI MEDICARE GROUP NUMBER | OTHER | 1043234792 | 01 | RI | NPI | OTHER | 3208923 | 05 | MA | MEDICAID | 7008245 | 05 | RI | MEDICAID | 930091305 | 01 | RAILROAD MEDICARE | OTHER | 04/15/2009 | 01 | RI | UNITED HEALTH CARE | OTHER | 408826 | 01 | RI | BCBSRI | OTHER | 01/27/2009 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 12/14/2006 | 01 | RI | NHPRI | OTHER |