Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Simone Thavaseelan

Individual provider Urology Physician · NPI 1053530782

Simone Thavaseelan is an Urology in Providence, Rhode Island. Graduated from Georgetown University School of Medicine in 2005, 21 years ago. Practices with Lifespan Physician Group Inc, a 1,125-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Rhode Island.

Years since qualifying
21
Trained at
Georgetown University School of Medicine
Licensed in
RI
In the registry since
2007
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Practice location Address checks out

2 Dudley St Ste 185
Providence, RI 02905-3247
Phone: (401) 444-5795
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence MD13391 (RI)

Record details

NPI number1053530782
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 24, 2007
Last updated in NPPESOctober 14, 2011
Mailing address195 Collyer St Ste 201, Providence, RI 02904-1869

Medicare enrollment

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

Medicare specialtyUROLOGY
Medical schoolGEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Graduated 2005 (21 years in practice)
Group practice Lifespan Physician Group Inc — 1125 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations7 on file with Medicare

Other providers in Providence