Provider Demographics
NPI:1508089871
Name:CARTAGENA, CLAUDIA JANET (PA-C)
Entity Type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:JANET
Last Name:CARTAGENA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:588 PAWTUCKET AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02860-6057
Mailing Address - Country:US
Mailing Address - Phone:401-722-2400
Mailing Address - Fax:401-728-3920
Practice Address - Street 1:588 PAWTUCKET AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02860-6057
Practice Address - Country:US
Practice Address - Phone:401-722-2400
Practice Address - Fax:401-728-3920
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIPA00400363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI1508089Medicaid
RI32716-3OtherBLUECHIP
RI979005394OtherRI MEDICARE
RI939025129OtherRI MEDICARE GROUP NUMBER
RI01/15/2008OtherNHPRI
RI1508089871OtherNPI
RI414115OtherBCBSRI
RI04-15-2009OtherUNITED HEALTH CARE