MARYKATE DUNLEAVY MSPAS, PA-C
NPI 1396800520
Physician Assistant - Medical in Providence, RI

Q: What is Marykate Dunleavy's NPI number?

The NPI number for Marykate Dunleavy is 1396800520. It was assigned to this individual provider in the NPPES registry on December 27, 2006.

Q: What is Marykate Dunleavy's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Marykate Dunleavy was last updated on March 5, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since December 27, 2006PECOS Enrolled

593 EDDY ST, PROVIDENCE, RI 02903(401) 519-1604(401) 272-0538 Get Directions Write a Review

NPPES record last updated: March 5, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Marykate Dunleavy Mspas, Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARYKATE DUNLEAVY MSPAS, PA-C (NPI 1396800520) is an individual medical provider in Providence, Rhode Island, licensed in Rhode Island (PA00489) and active in the NPI registry since December 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1396800520

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMARYKATE DUNLEAVYCredential: MSPAS, PA-C

Location Address593 EDDY STProvidence, RI 02903-4923

Mailing AddressPo Box 9484Providence, RI 02940-9484 · (401) 854-2500 · Fax (401) 854-2519

Phone(401) 519-1604

Fax(401) 272-0538

Sole ProprietorNo

Enumeration DateDecember 27, 2006

Last NPPES UpdateMarch 5, 2026

NPPES CertifiedMarch 5, 2026

✔ NPI 1396800520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

Licenses✔ Licensed in RI · PA00489✔ Licensed in NY · 029700✔ Licensed in FL · 9116904

593 EDDY ST, Providence, RI 02903

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Other Identifiers 6

Other05/29/2009RI · Bcbs

MedicaidMD74353RI

Other1396800520RI · Npi

Other939025129RI · Ri Medicare Group Number

Other05/14/2009RI · Nhpri

Other979006382RI · Ri Medicare

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Marykate Dunleavy Mspas, Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.