Provider Demographics
NPI:1629456371
Name:BAIMA, CAASI (RNP)
Entity Type:Individual
Prefix:
First Name:CAASI
Middle Name:
Last Name:BAIMA
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 DAVOL SQ
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02903-4754
Mailing Address - Country:US
Mailing Address - Phone:401-421-4000
Mailing Address - Fax:401-272-1456
Practice Address - Street 1:41 SANDERSON RD
Practice Address - Street 2:SUITE 201
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-2602
Practice Address - Country:US
Practice Address - Phone:401-949-0300
Practice Address - Fax:401-349-3387
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN00619363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI05-0483739OtherTAX ID #
RI709004048OtherMEDICARE GROUP PTAN
RI1629456371Medicaid
RIU400230075Medicare PIN