WALTER DELUCA PAC
NPI 1962598516
Physician Assistant - Medical in East Providence, RI

Q: What is Walter Deluca's NPI number?

The NPI number for Walter Deluca is 1962598516. It was assigned to this individual provider in the NPPES registry on October 4, 2006.

Q: What is Walter Deluca'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 Walter Deluca was last updated on September 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 04, 2006PECOS Enrolled

684 WARREN AVE, EAST PROVIDENCE, RI 02914(401) 434-0022(401) 434-6111 Get Directions Write a Review

NPPES record last updated: September 18, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Walter Deluca Pac NPPES

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

WALTER DELUCA PAC (NPI 1962598516) is an individual medical provider in East Providence, Rhode Island, licensed in Rhode Island (PA00002) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1962598516

Entity TypeIndividualMale

Primary Taxonomy363AM0700X

Provider Legal NameWALTER DELUCACredential: PAC

Location Address684 WARREN AVEEast Providence, RI 02914-1405

Mailing Address684 Warren AveEast Providence, RI 02914-1405 · (401) 434-0022 · Fax (401) 434-6111

Phone(401) 434-0022

Fax(401) 434-6111

Sole ProprietorNo

Enumeration DateOctober 4, 2006

Last NPPES UpdateSeptember 18, 2018

✔ NPI 1962598516 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 · PA00002✔ Licensed in MT · 289

684 WARREN AVE, East Providence, RI 02914

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Other Identifiers 5

Medicaid0438260MT

Other289MT · State Lic Number

Other000096303MT · Blue Cross Number

Other979006386RI · Medicare Ptan

Medicaid7005920RI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Walter Deluca Pac 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.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YIANNIS KOUTSOFAVAS PA-C

Physician Assistant