Provider Demographics
NPI:1285634535
Name:CHACE, PATRICIA ANN (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:CHACE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 KILVERT ST
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1379
Mailing Address - Country:US
Mailing Address - Phone:401-732-7105
Mailing Address - Fax:855-205-4737
Practice Address - Street 1:475 KILVERT ST
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1379
Practice Address - Country:US
Practice Address - Phone:401-732-7105
Practice Address - Fax:855-205-4737
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2014-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD05448207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI004025OtherRI BCHIP
RI406132OtherTUFTS HEALTH PLAN
RI6000288OtherHARVARD PILGRIM HEALTHCAR
RI9000605Medicaid
RI050340866OtherUNITEDHEALTHCARE
RI110090082OtherRAILROAD MEDICARE
RI0000000605OtherRI B/S
RI3821OtherNEIGHBORHOOD HEALTH PLAN
RI007001654Medicare PIN
RI119000605Medicare PIN
RI004025OtherRI BCHIP