Provider Demographics
NPI:1477544948
Name:CASSESE, JOHN A (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:A
Last Name:CASSESE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:125 METRO CENTER BOULEVARD
Mailing Address - Street 2:SUITE 2000
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-1768
Mailing Address - Country:US
Mailing Address - Phone:401-432-2520
Mailing Address - Fax:401-453-8220
Practice Address - Street 1:125 METRO CENTER BOULEVARD
Practice Address - Street 2:SUITE 2000
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-1768
Practice Address - Country:US
Practice Address - Phone:401-432-2520
Practice Address - Fax:401-453-8220
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2024-08-28
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Provider Licenses
StateLicense IDTaxonomies
RI102862085R0202X
MA2042372085R0202X
RIMD102862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
300010864OtherRAILROAD MEDICARE
003117125OtherCT MED ASSISTANCE
050318025OtherUNICARE
3207056OtherMASSMEDICAID
16 00025OtherUNITED HEALTH PLANS
7008227OtherRI MEDICAL ASSISTANCE
720099001OtherCIGNA
406967OtherBLUE CHIP
007008227OtherHOSPITAL PIN
406967OtherBLUE CHIP SENIORS
010286OtherBLUE SHIELD
010286OtherFEP BLUE CROSS
241360OtherRIH PILGRIM
409791OtherTUFTS
000000001988OtherNHPRI
3207056OtherHEALTHY START