Provider Demographics
NPI:1043234792
Name:KAMAT, ACHYUT (MD)
Entity Type:Individual
Prefix:
First Name:ACHYUT
Middle Name:
Last Name:KAMAT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 WHIPPLE ST STE 3
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02908-3258
Mailing Address - Country:US
Mailing Address - Phone:401-519-0337
Mailing Address - Fax:
Practice Address - Street 1:164 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906-2853
Practice Address - Country:US
Practice Address - Phone:401-444-5175
Practice Address - Fax:401-272-0538
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD10314207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI939025129OtherRI MEDICARE GROUP NUMBER
RI1043234792OtherNPI
MA3208923Medicaid
RI7008245Medicaid
930091305OtherRAILROAD MEDICARE
RI04/15/2009OtherUNITED HEALTH CARE
RI408826OtherBCBSRI
MA01/27/2009OtherTUFTS HEALTH PLAN
RI12/14/2006OtherNHPRI
RI12/14/2006OtherNHPRI
RI04/15/2009OtherUNITED HEALTH CARE