Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kenneth Cushing Botelho, PA-C

Individual provider Physician Assistant · NPI 1184977514

Kenneth Cushing Botelho, PA-C is a Physician Assistant in East Providence, Rhode Island. Qualified in 2012, 14 years ago. Practices with The Duluth Clinic Ltd, a 1,127-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota and Rhode Island.

Years since qualifying
14
Licensed in
MN, RI
In the registry since
2012
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

450 Veterans Memorial Pkwy Bldg 9
East Providence, RI 02914-5300
Phone: (401) 435-5533
Fax: (401) 435-3586
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 4855 W Arrowhead Rd, Hermantown, MN 55811-3936 — (218) 786-3540

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA00716 (RI)
Physician Assistant Taxonomy 363A00000X · Licence 15285 (MN)

Record details

NPI number1184977514
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedOctober 23, 2012
Last updated in NPPESMay 16, 2025
Certification dateMay 16, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice The Duluth Clinic Ltd — 1127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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