MEDICARE: DR. ASHISH RAMESH THAKKAR MD

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	32876	WV
2	207R00000X	Internal Medicine Physician	275377	NY
3	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	MD19443	RI
4	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	245377	NY
5	207R00000X	Internal Medicine Physician	32876	WV
6	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	32876	WV
7	208M00000X	Hospitalist Physician	275377	NY
8	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	ME141113	FL
9	207RP1001X	Pulmonary Disease Physician	55570	TN

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	UB659	OTHER	FL	MEDICARE HF

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1538456124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHISH RAMESH THAKKAR MD

Provider Business Mailing Address
First Line	:	1324 LAKELAND HILLS BLVD
Second Line	:
City	:	LAKELAND
State	:	FL
Zip	:	33805-4543
Country	:	US
Telephone Number	:	863-687-1100
Fax Number	:

Provider Business Practice Location Address
First Line	:	455 TOLL GATE RD
Second Line	:
City	:	WARWICK
State	:	RI
Zip	:	02886-2759
Country	:	US
Telephone Number	:	401-737-7010
Fax Number	:	401-736-4546

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2011
Last Update Date	:	02/06/2026

2871 POST RD , PREHAB SPORTS MEDICARE SERVICES INC.
WARWICK, RI
02886-0076

Practice Phone: 401-463-3060
Practice Fax: 401-732-1045