| Dhhs, Phs, Naihs, Shiprock Hospital | |
|
Us Highway 491 North Shiprock NM 87420-0160 | |
| (505) 368-6401 | |
| (505) 368-6431 |
| Full Name | Dhhs, Phs, Naihs, Shiprock Hospital |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | Us Highway 491 North, Shiprock, New Mexico |
| Authorized Official Name and Position | Fannessa Comer (CEO) |
| Authorized Official Contact | 5053686006 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dhhs, Phs, Naihs, Shiprock Hospital Po Box 160 Us Highway 491 North Shiprock NM 87420-0160 Ph: (505) 368-6401 | Dhhs, Phs, Naihs, Shiprock Hospital Us Highway 491 North Shiprock NM 87420-0160 Ph: (505) 368-6401 |
| NPI Number | 1780639971 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 12/23/2008 |
| Medicare PECOS PAC ID | 0749193837 |
|---|---|
| Medicare Enrollment ID | O20031105000809 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780639971 | NPI | - | NPPES |
| 020503 | Medicaid | AZ | |
| H6785 | Medicaid | NM | |
| 7000000092 | Medicaid | UT | |
| 7000000084 | Medicaid | UT | |
| PENDING | Medicaid | CO | |
| 95017950 | Medicaid | CO | |
| 80796 | Medicaid | NM |
| Provider Name | Allen W Mcculloch |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1881778215 PECOS PAC ID: 7113830969 Enrollment ID: I20031107000702 |
| Provider Name | William J Bufkin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285616045 PECOS PAC ID: 8325952609 Enrollment ID: I20031119000656 |
| Provider Name | Christian Y Herrera |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740243971 PECOS PAC ID: 4486559333 Enrollment ID: I20031203000723 |
| Provider Name | Mark F Bevan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720185788 PECOS PAC ID: 4284544560 Enrollment ID: I20040116000883 |
| Provider Name | Sandra Dodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558399113 PECOS PAC ID: 3476455296 Enrollment ID: I20040122000901 |
| Provider Name | Paul R Dewitt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1366474207 PECOS PAC ID: 2567447170 Enrollment ID: I20040618001214 |
| Provider Name | Jerome Lee |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1336241256 PECOS PAC ID: 9830176064 Enrollment ID: I20040706000615 |
| Provider Name | Linda K Knedler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679557581 PECOS PAC ID: 6800866930 Enrollment ID: I20040727001446 |
| Provider Name | David Michael Greenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003896408 PECOS PAC ID: 9133193477 Enrollment ID: I20040823001353 |
| Provider Name | Randall A Heidenreich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295709913 PECOS PAC ID: 7810988318 Enrollment ID: I20040907000927 |
| Provider Name | Dawn M Clary |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649288028 PECOS PAC ID: 4082676309 Enrollment ID: I20041029000355 |
| Provider Name | Amber N Redhouse |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275519431 PECOS PAC ID: 9335104678 Enrollment ID: I20041129000109 |
| Provider Name | Sara A Michaels |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790774552 PECOS PAC ID: 5991762734 Enrollment ID: I20041214000474 |
| Provider Name | Alice F Hatch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740336700 PECOS PAC ID: 1658338090 Enrollment ID: I20041216000819 |
| Provider Name | John W Randall |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982695524 PECOS PAC ID: 8820074156 Enrollment ID: I20050107000114 |
| Provider Name | Ikaehota Nyowheoma |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1417975368 PECOS PAC ID: 9931159746 Enrollment ID: I20050129000112 |
| Provider Name | Joy G Harrison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366432486 PECOS PAC ID: 6800848821 Enrollment ID: I20050217000364 |
| Provider Name | Nancy Kitson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174543664 PECOS PAC ID: 2062466022 Enrollment ID: I20050311000716 |
| Provider Name | David Lynn Doss |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598751778 PECOS PAC ID: 3072568708 Enrollment ID: I20050316000174 |
| Provider Name | Nathan Tillotson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770670473 PECOS PAC ID: 3274589064 Enrollment ID: I20050324000552 |
| Provider Name | Jennifer M Aucoin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629187893 PECOS PAC ID: 6800843293 Enrollment ID: I20050407000607 |
| Provider Name | Susie A John |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194714956 PECOS PAC ID: 7911815261 Enrollment ID: I20050616000589 |
| Provider Name | Katherine Zang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720077563 PECOS PAC ID: 3577531094 Enrollment ID: I20050628001025 |
| Provider Name | Eileen Barrett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972592723 PECOS PAC ID: 9739104399 Enrollment ID: I20051012000772 |
| Provider Name | Catherine Elizabeth Foster Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811198559 PECOS PAC ID: 9032154752 Enrollment ID: I20051026000710 |
| Provider Name | Allan Edward Crandell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376595454 PECOS PAC ID: 2365354701 Enrollment ID: I20051116000134 |
| Provider Name | Mark B Horton |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1376556985 PECOS PAC ID: 8426070988 Enrollment ID: I20051227000352 |
| Provider Name | Thomas B Burnison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922039643 PECOS PAC ID: 6608817762 Enrollment ID: I20060112000094 |
| Provider Name | Stephen Malcolm Bowers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962472019 PECOS PAC ID: 2264474550 Enrollment ID: I20060126000852 |
| Provider Name | Colette M Robertson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962476572 PECOS PAC ID: 6800799313 Enrollment ID: I20060222000577 |
| Provider Name | Joseph B Strunce |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194759407 PECOS PAC ID: 1052328283 Enrollment ID: I20060314000245 |
| Provider Name | Lawrence E Chance |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952452492 PECOS PAC ID: 9133138464 Enrollment ID: I20060414000096 |
| Provider Name | Frank M Wolf |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447211388 PECOS PAC ID: 3971490954 Enrollment ID: I20060421000206 |
| Provider Name | Barbara A Massey |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558361766 PECOS PAC ID: 5799795951 Enrollment ID: I20060502000756 |
| Provider Name | Gwendolyn Grant |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1841395357 PECOS PAC ID: 5597762633 Enrollment ID: I20061106000579 |
| Provider Name | Joann Lameman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1780777185 PECOS PAC ID: 4789683574 Enrollment ID: I20061205000128 |
| Provider Name | Erin A Giles |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1912087727 PECOS PAC ID: 4587663323 Enrollment ID: I20061205000555 |
| Provider Name | Matthew G Hudkins |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356331136 PECOS PAC ID: 3274538319 Enrollment ID: I20070112000202 |
| Provider Name | Sari Miettinen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790896355 PECOS PAC ID: 2365544319 Enrollment ID: I20070222000589 |
| Provider Name | Esther E Arnette |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851408942 PECOS PAC ID: 7113957135 Enrollment ID: I20070227000133 |
| Provider Name | Joan P Zinkawich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770626335 PECOS PAC ID: 7517063910 Enrollment ID: I20070501000584 |
| Provider Name | Mark Hauswald |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881600443 PECOS PAC ID: 5991801748 Enrollment ID: I20070510000605 |
| Provider Name | Adrienne Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659588721 PECOS PAC ID: 4981696556 Enrollment ID: I20070727000124 |
| Provider Name | Maxine J Ain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447450382 PECOS PAC ID: 9133212087 Enrollment ID: I20070907000700 |
| Provider Name | John K Kosik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568532562 PECOS PAC ID: 7113010067 Enrollment ID: I20070907000714 |
| Provider Name | Stephen A Savoia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346259496 PECOS PAC ID: 2668567645 Enrollment ID: I20071005000277 |
| Provider Name | Erica L Markovitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457410375 PECOS PAC ID: 1254434939 Enrollment ID: I20071009000962 |
| Provider Name | Stephens R Triplett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669421103 PECOS PAC ID: 5991762015 Enrollment ID: I20071018000771 |
| Provider Name | Kathleen J Wilder |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861609521 PECOS PAC ID: 6608964655 Enrollment ID: I20071108000748 |
| Provider Name | April R Nabahe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639147937 PECOS PAC ID: 4688763766 Enrollment ID: I20071128000282 |
| Provider Name | Guy P Fiocco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700881695 PECOS PAC ID: 0941199863 Enrollment ID: I20071129000333 |
| Provider Name | Marilynn Ann Prince-fiocco |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407858699 PECOS PAC ID: 6800985763 Enrollment ID: I20071130000365 |
| Provider Name | Jon C Stucki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235236126 PECOS PAC ID: 5890876841 Enrollment ID: I20080115000738 |
| Provider Name | Oluyemisi J Fatunde |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457359663 PECOS PAC ID: 4688663966 Enrollment ID: I20080225000662 |
| Provider Name | Charles G Silas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245431121 PECOS PAC ID: 7416930086 Enrollment ID: I20080317000582 |
| Provider Name | Manish Pandya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326145392 PECOS PAC ID: 6002848900 Enrollment ID: I20080327000764 |
| Provider Name | George C Baacke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366432775 PECOS PAC ID: 9436161114 Enrollment ID: I20080416000418 |
| Provider Name | Mark E Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689634479 PECOS PAC ID: 4183643372 Enrollment ID: I20080430000375 |
| Provider Name | Bowen C Tzeng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952591760 PECOS PAC ID: 5294807079 Enrollment ID: I20080710000757 |
| Provider Name | John Balintona |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104813583 PECOS PAC ID: 9537232764 Enrollment ID: I20080722000493 |
| Provider Name | Ann Marie Vaughn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992792170 PECOS PAC ID: 6002980646 Enrollment ID: I20080731000144 |
| Provider Name | Angelique Pflueger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043255524 PECOS PAC ID: 9335175793 Enrollment ID: I20080924000671 |
| Provider Name | John Christopher Mohs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184614570 PECOS PAC ID: 1052479805 Enrollment ID: I20081022000572 |
| Provider Name | Christian Ingui |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407893894 PECOS PAC ID: 0042213431 Enrollment ID: I20081203000324 |
| Provider Name | Ari Plosker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639141682 PECOS PAC ID: 4587693320 Enrollment ID: I20081203000368 |
| Provider Name | Iris D Bazing |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982756730 PECOS PAC ID: 5294793311 Enrollment ID: I20090126000634 |
| Provider Name | Christian M Gomez-castro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518141498 PECOS PAC ID: 4587738455 Enrollment ID: I20090212000427 |
| Provider Name | David A Jones |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1952339327 PECOS PAC ID: 9436169588 Enrollment ID: I20090327000461 |
| Provider Name | Ann Marie Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588653323 PECOS PAC ID: 1254489016 Enrollment ID: I20090505000133 |
| Provider Name | Marilisa Mancao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912982455 PECOS PAC ID: 8921171539 Enrollment ID: I20090616000715 |
| Provider Name | Steven L Spoonemore |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548496656 PECOS PAC ID: 0941351894 Enrollment ID: I20090706000539 |
| Provider Name | Rosemary A Johnston |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558350397 PECOS PAC ID: 9335291079 Enrollment ID: I20090710000300 |
| Provider Name | Vivian A Godwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255592317 PECOS PAC ID: 4385797786 Enrollment ID: I20090803000389 |
| Provider Name | Travis J Mellon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932366382 PECOS PAC ID: 8527111756 Enrollment ID: I20090805000157 |
| Provider Name | Ruby K Osterloh |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1689722928 PECOS PAC ID: 9133275266 Enrollment ID: I20090915000475 |
| Provider Name | Heather Kovich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972615912 PECOS PAC ID: 9032265624 Enrollment ID: I20090923000499 |
| Provider Name | Jean E Howe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487776639 PECOS PAC ID: 0648316984 Enrollment ID: I20090930000256 |
| Provider Name | Joyanna M Wendt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215111265 PECOS PAC ID: 1153467402 Enrollment ID: I20090930000399 |
| Provider Name | William M Finn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982616470 PECOS PAC ID: 0840337622 Enrollment ID: I20091027000793 |
| Provider Name | Sandra D Beirne |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033125877 PECOS PAC ID: 5597802314 Enrollment ID: I20091028000277 |
| Provider Name | Elaine L Shiang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699754978 PECOS PAC ID: 8729121637 Enrollment ID: I20100201000330 |
| Provider Name | Kristal Elizabeth Dye |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114258985 PECOS PAC ID: 0244375178 Enrollment ID: I20100303000894 |
| Provider Name | Pearl Kloac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427143593 PECOS PAC ID: 0648372722 Enrollment ID: I20100317000742 |
| Provider Name | Ira Salom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124027750 PECOS PAC ID: 8527193192 Enrollment ID: I20100322000284 |
| Provider Name | Lorrie L Murdoch |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932197753 PECOS PAC ID: 6002942265 Enrollment ID: I20100327000278 |
| Provider Name | R Michael Harding |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780616243 PECOS PAC ID: 6709885056 Enrollment ID: I20100512000300 |
| Provider Name | Reymundo M Torres |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245290246 PECOS PAC ID: 7113056615 Enrollment ID: I20100521000132 |
| Provider Name | Paul F Dellaripa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093727950 PECOS PAC ID: 3678477312 Enrollment ID: I20100630000776 |
| Provider Name | Emily Jane Tatum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760565279 PECOS PAC ID: 3274614383 Enrollment ID: I20100709000084 |
| Provider Name | Christian M Hull |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710080379 PECOS PAC ID: 4789718883 Enrollment ID: I20100811000455 |
| Provider Name | Christopher A Percy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992786727 PECOS PAC ID: 4981738028 Enrollment ID: I20100811000946 |
| Provider Name | Michael M Steele |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497770788 PECOS PAC ID: 4880718709 Enrollment ID: I20100830000911 |
| Provider Name | Tracey A Milligan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487635504 PECOS PAC ID: 6507844859 Enrollment ID: I20100830000938 |
| Provider Name | Denise Bartley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952390619 PECOS PAC ID: 6800814195 Enrollment ID: I20100830001004 |
| Provider Name | Thomas W Hurst |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1699766287 PECOS PAC ID: 1052436094 Enrollment ID: I20100915000280 |
| Provider Name | Donald Durwood Vasser |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952398331 PECOS PAC ID: 6709902760 Enrollment ID: I20100927001376 |
| Provider Name | Kimberly Sue Mohs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245220631 PECOS PAC ID: 3476679457 Enrollment ID: I20100928000075 |
| Provider Name | Caitlin A Hall |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386804250 PECOS PAC ID: 5698677755 Enrollment ID: I20100928001699 |
| Provider Name | Randall S King |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982680310 PECOS PAC ID: 0042280117 Enrollment ID: I20100928001717 |
| Provider Name | Christopher W Barrett |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790977031 PECOS PAC ID: 3476745761 Enrollment ID: I20101005000680 |
| Provider Name | Jeffrey C Powell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194700674 PECOS PAC ID: 9133312044 Enrollment ID: I20101025000247 |
| Provider Name | Ouida J Vincent |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558307769 PECOS PAC ID: 2860689395 Enrollment ID: I20101209001308 |
| Provider Name | Hope L Druckman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245287648 PECOS PAC ID: 3678465614 Enrollment ID: I20110124000334 |
| Provider Name | Daniel J Langsam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063679652 PECOS PAC ID: 4587843586 Enrollment ID: I20110124000362 |
| Provider Name | Eric C Haag |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659524643 PECOS PAC ID: 0345421137 Enrollment ID: I20110228000403 |
| Provider Name | Jennifer Michelle Manning |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609099290 PECOS PAC ID: 6002914777 Enrollment ID: I20110413001052 |
| Provider Name | Keri M Shafer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346407939 PECOS PAC ID: 8426226978 Enrollment ID: I20110727000646 |
| Provider Name | Aaisya Nabeehah Ansari |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326048752 PECOS PAC ID: 5294714564 Enrollment ID: I20110815000041 |
| Provider Name | Eric L Gold |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114033255 PECOS PAC ID: 6709886286 Enrollment ID: I20110901000635 |
| Provider Name | Leslie A Meyer |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1184903411 PECOS PAC ID: 0244401867 Enrollment ID: I20110912000364 |
| Provider Name | Laura Cottam Dewitt |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1407936578 PECOS PAC ID: 8022172501 Enrollment ID: I20110914000537 |
| Provider Name | Annicol Dorthee Marrocco |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699747642 PECOS PAC ID: 2163417288 Enrollment ID: I20110923000250 |
| Provider Name | Aubrey S Wong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073827663 PECOS PAC ID: 9133392228 Enrollment ID: I20111107000142 |
| Provider Name | Paulette L Foster-galbraith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215963723 PECOS PAC ID: 3678644705 Enrollment ID: I20111229000773 |
| Provider Name | Shail B Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124281647 PECOS PAC ID: 6901067594 Enrollment ID: I20120406000305 |
| Provider Name | Adrianne M Thomas |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629226022 PECOS PAC ID: 0244363372 Enrollment ID: I20120503000517 |
| Provider Name | Kinchen W Ballentine |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710046644 PECOS PAC ID: 5890701445 Enrollment ID: I20120718000642 |
| Provider Name | Martin C Price |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689884330 PECOS PAC ID: 8426206269 Enrollment ID: I20120919000634 |
| Provider Name | Sarah S Kim |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750575346 PECOS PAC ID: 1557412467 Enrollment ID: I20120919000859 |
| Provider Name | Milap Pokharel |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1336349463 PECOS PAC ID: 4587810767 Enrollment ID: I20120921000415 |
| Provider Name | Jaime J Rueda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013155050 PECOS PAC ID: 9537317169 Enrollment ID: I20120924000378 |
| Provider Name | Rotimi A Iluyomade |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043298615 PECOS PAC ID: 2466433966 Enrollment ID: I20121004000447 |
| Provider Name | Katherine Costello |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619104916 PECOS PAC ID: 3577714179 Enrollment ID: I20121107000647 |
| Provider Name | Richard Arthur Ferguson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568437556 PECOS PAC ID: 1759526197 Enrollment ID: I20130405000391 |
| Provider Name | Lawanda Jim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821256900 PECOS PAC ID: 9537305412 Enrollment ID: I20130419000193 |
| Provider Name | Chih-chen Luke Luan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326273277 PECOS PAC ID: 9638316656 Enrollment ID: I20130513000072 |
| Provider Name | Melissa Schossow |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942548961 PECOS PAC ID: 4284871179 Enrollment ID: I20130514000093 |
| Provider Name | Ashlee M Walls |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114253838 PECOS PAC ID: 6709023690 Enrollment ID: I20130514000127 |
| Provider Name | Venay Uecke |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649447327 PECOS PAC ID: 4385692003 Enrollment ID: I20130603000543 |
| Provider Name | Charleton M Charleston |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205176831 PECOS PAC ID: 1951540251 Enrollment ID: I20130618000293 |
| Provider Name | Virginia Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477746816 PECOS PAC ID: 6305009994 Enrollment ID: I20130702000743 |
| Provider Name | Tonya Marie Steinen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811922859 PECOS PAC ID: 6901873686 Enrollment ID: I20130705000492 |
| Provider Name | Linda A Mclaughlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659495661 PECOS PAC ID: 1052404258 Enrollment ID: I20131114001594 |
| Provider Name | Kristi Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972831857 PECOS PAC ID: 4082852363 Enrollment ID: I20140122001064 |
| Provider Name | Erin D Schmitt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568696441 PECOS PAC ID: 1254569197 Enrollment ID: I20140122001298 |
| Provider Name | Jeanne L Rittschof |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306075254 PECOS PAC ID: 9739317611 Enrollment ID: I20140123000579 |
| Provider Name | Melissa M Lester |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164864534 PECOS PAC ID: 7214165190 Enrollment ID: I20140128000075 |
| Provider Name | Samuel Salen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629073804 PECOS PAC ID: 1254231814 Enrollment ID: I20140131001658 |
| Provider Name | Robert S Rippner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932127602 PECOS PAC ID: 7315859428 Enrollment ID: I20140205001104 |
| Provider Name | Juan Carlos Gutierrez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194978932 PECOS PAC ID: 0749456101 Enrollment ID: I20140210000159 |
| Provider Name | Richard Mitchell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255368353 PECOS PAC ID: 9436045713 Enrollment ID: I20140210000640 |
| Provider Name | Huma Sarah Qureshi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568447357 PECOS PAC ID: 9335167733 Enrollment ID: I20140212000771 |
| Provider Name | Terence Hamel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649240334 PECOS PAC ID: 7113950999 Enrollment ID: I20140213000715 |
| Provider Name | Robert Martin Reuter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528279783 PECOS PAC ID: 8022199165 Enrollment ID: I20140227000092 |
| Provider Name | Alix Vincent |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003802265 PECOS PAC ID: 4789602194 Enrollment ID: I20140227000925 |
| Provider Name | Kathryn A Occhipinti |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194703819 PECOS PAC ID: 0244139129 Enrollment ID: I20140227001031 |
| Provider Name | Atul Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528045374 PECOS PAC ID: 6103844774 Enrollment ID: I20140228000080 |
| Provider Name | Nicolaus Joseph Kuehn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518946649 PECOS PAC ID: 6507858651 Enrollment ID: I20140228000613 |
| Provider Name | Jason Lue |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619141223 PECOS PAC ID: 2466525563 Enrollment ID: I20140303000440 |
| Provider Name | Vinod Nigam |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376542753 PECOS PAC ID: 3971653387 Enrollment ID: I20140304000855 |
| Provider Name | Elizabeth Pepe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700874039 PECOS PAC ID: 8426288713 Enrollment ID: I20140306001384 |
| Provider Name | Kamiar Massrour |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376791343 PECOS PAC ID: 4587704119 Enrollment ID: I20140310001736 |
| Provider Name | David Wells |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659447118 PECOS PAC ID: 0143128082 Enrollment ID: I20140313000790 |
| Provider Name | Laura M Rush |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1659795508 PECOS PAC ID: 7214169960 Enrollment ID: I20140410001462 |
| Provider Name | Peter Piampiano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386694040 PECOS PAC ID: 8224925953 Enrollment ID: I20140508001959 |
| Provider Name | Susana B Samaniego |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912323239 PECOS PAC ID: 1355564394 Enrollment ID: I20140521000610 |
| Provider Name | Jeffrey Caverly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912968686 PECOS PAC ID: 2961509500 Enrollment ID: I20140522002123 |
| Provider Name | Peilin Reed |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265484794 PECOS PAC ID: 5991783227 Enrollment ID: I20140602001890 |
| Provider Name | Joshua R Albrektson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104155258 PECOS PAC ID: 2466699855 Enrollment ID: I20140603002393 |
| Provider Name | Samara Peters |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164600938 PECOS PAC ID: 0244454288 Enrollment ID: I20140613001848 |
| Provider Name | Kendra E Harmon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043261563 PECOS PAC ID: 4284637471 Enrollment ID: I20140613002106 |
| Provider Name | Aaron Jun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033194253 PECOS PAC ID: 5496773061 Enrollment ID: I20140626000838 |
| Provider Name | Jose Ospina |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033373287 PECOS PAC ID: 7618147653 Enrollment ID: I20140626002168 |
| Provider Name | Douglas C Root |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770580987 PECOS PAC ID: 0446275846 Enrollment ID: I20140630001483 |
| Provider Name | Cheryle E Bakewell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679770283 PECOS PAC ID: 9931347986 Enrollment ID: I20140717000561 |
| Provider Name | Miranda C Haley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326334814 PECOS PAC ID: 8527202217 Enrollment ID: I20140717001234 |
| Provider Name | Alana C Yerman-morris |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437334463 PECOS PAC ID: 1557429800 Enrollment ID: I20140723001967 |
| Provider Name | Anthony J Pacitti |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598810343 PECOS PAC ID: 6002888302 Enrollment ID: I20140806002396 |
| Provider Name | Christopher J Morgan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316985914 PECOS PAC ID: 6901790765 Enrollment ID: I20140818001969 |
| Provider Name | Benjamin A Hart |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528470655 PECOS PAC ID: 0244458263 Enrollment ID: I20140904000118 |
| Provider Name | Laurel Matthews |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801960471 PECOS PAC ID: 0840298766 Enrollment ID: I20140915000784 |
| Provider Name | Hanna R Fylpaa |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427462258 PECOS PAC ID: 2163641457 Enrollment ID: I20140918001875 |
| Provider Name | Than Win |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427098581 PECOS PAC ID: 3173526167 Enrollment ID: I20140930001302 |
| Provider Name | Gajanan R Shanbhag |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114985140 PECOS PAC ID: 1052416864 Enrollment ID: I20141023000249 |
| Provider Name | Alice I Sato |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619012457 PECOS PAC ID: 4183889306 Enrollment ID: I20141112000590 |
| Provider Name | Thomas H N Quattlebaum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700176179 PECOS PAC ID: 8325292691 Enrollment ID: I20141209002153 |
| Provider Name | Alejandro Solano Bayardo |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1659500486 PECOS PAC ID: 8022237411 Enrollment ID: I20141212001041 |
| Provider Name | Deborah B Cornell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801824586 PECOS PAC ID: 4880752534 Enrollment ID: I20141223000823 |
| Provider Name | Joyce Ellen Kaferle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952482044 PECOS PAC ID: 6800936832 Enrollment ID: I20141224000463 |
| Provider Name | Sarah Lauren Cohen Rassier |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831235977 PECOS PAC ID: 9830362417 Enrollment ID: I20141229000965 |
| Provider Name | Carole Ann Livingston |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457690851 PECOS PAC ID: 0143544338 Enrollment ID: I20150116000998 |
| Provider Name | Linda Dew |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093799884 PECOS PAC ID: 7810882313 Enrollment ID: I20150120002328 |
| Provider Name | Mahua Biswas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932153731 PECOS PAC ID: 1254371602 Enrollment ID: I20150123000371 |
| Provider Name | Jane Elizabeth Curry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558418046 PECOS PAC ID: 8729303441 Enrollment ID: I20150220000662 |
| Provider Name | Scott Lewis Schissel |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720041296 PECOS PAC ID: 9537141593 Enrollment ID: I20150408001997 |
| Provider Name | Maggie Hudson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891193512 PECOS PAC ID: 3678891371 Enrollment ID: I20150409000139 |
| Provider Name | Laiandrea M Stewart |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245356088 PECOS PAC ID: 7012008212 Enrollment ID: I20150410002070 |
| Provider Name | Catherine E Cavanaugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831365311 PECOS PAC ID: 6507000718 Enrollment ID: I20150413000710 |
| Provider Name | Faisal Anwar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124054424 PECOS PAC ID: 2961409032 Enrollment ID: I20150415001851 |
| Provider Name | Jonathan Maurice Wortham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386940146 PECOS PAC ID: 1557592466 Enrollment ID: I20150416001744 |
| Provider Name | William Ratigan Ranger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235121989 PECOS PAC ID: 1153394853 Enrollment ID: I20150427002171 |
| Provider Name | Lance A Dell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114940228 PECOS PAC ID: 6103831326 Enrollment ID: I20150511000179 |
| Provider Name | Dara Kim Lee Lewis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578692018 PECOS PAC ID: 7719049212 Enrollment ID: I20150515000296 |
| Provider Name | Jason Christopher Kalan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932225356 PECOS PAC ID: 4789817792 Enrollment ID: I20150515001379 |
| Provider Name | Phillip Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194905299 PECOS PAC ID: 0244550044 Enrollment ID: I20150519001159 |
| Provider Name | Christopher Prince |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902989635 PECOS PAC ID: 4880648237 Enrollment ID: I20150522000599 |
| Provider Name | Olga A Rafaelian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295059038 PECOS PAC ID: 4981853967 Enrollment ID: I20150526000249 |
| Provider Name | Christopher H Fanta |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144267733 PECOS PAC ID: 6002988813 Enrollment ID: I20150526000403 |
| Provider Name | Dean U Shippey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821080854 PECOS PAC ID: 3072786805 Enrollment ID: I20150616000873 |
| Provider Name | Cody Randy Charlton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720182710 PECOS PAC ID: 8224349279 Enrollment ID: I20150618000185 |
| Provider Name | Herbert B Weingard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275646721 PECOS PAC ID: 3678678034 Enrollment ID: I20150624000332 |
| Provider Name | Shawna Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770982670 PECOS PAC ID: 7113248105 Enrollment ID: I20150714002932 |
| Provider Name | Melinda A Montoya |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760882880 PECOS PAC ID: 5698094571 Enrollment ID: I20150731016359 |
| Provider Name | John Clifford Camp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235154543 PECOS PAC ID: 9739183476 Enrollment ID: I20150804005132 |
| Provider Name | Justin Bidwell Sikes |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1952595605 PECOS PAC ID: 2264758457 Enrollment ID: I20150916002829 |
| Provider Name | Patrick W Murphy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063708774 PECOS PAC ID: 0547577579 Enrollment ID: I20150923001428 |
| Provider Name | Thomas R Reardon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174817423 PECOS PAC ID: 3678741097 Enrollment ID: I20150929001640 |
| Provider Name | Jessie Araminta Kerr |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083974034 PECOS PAC ID: 5890914477 Enrollment ID: I20150930000285 |
| Provider Name | Daniel Adeneye |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1770929929 PECOS PAC ID: 4486969763 Enrollment ID: I20151001002941 |
| Provider Name | Wiley D Thuet |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902168024 PECOS PAC ID: 6608199930 Enrollment ID: I20151005001030 |
| Provider Name | Qiratulanne Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407114374 PECOS PAC ID: 1951533280 Enrollment ID: I20151005001817 |
| Provider Name | Neil Amol Gholkar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144512336 PECOS PAC ID: 8921222035 Enrollment ID: I20151005002730 |
| Provider Name | Kellie Arviso |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841585353 PECOS PAC ID: 0042528457 Enrollment ID: I20151005003062 |
| Provider Name | Lydia S Kim |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780973396 PECOS PAC ID: 5193041218 Enrollment ID: I20151006002229 |
| Provider Name | Patrick O'brian Butsch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710247705 PECOS PAC ID: 4486871225 Enrollment ID: I20151008002096 |
| Provider Name | Kassy J Swanson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609128941 PECOS PAC ID: 1153630603 Enrollment ID: I20151022002500 |
| Provider Name | Kenneth Bernard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891094181 PECOS PAC ID: 3678730447 Enrollment ID: I20151026000853 |
| Provider Name | Janet L Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730348327 PECOS PAC ID: 7719296193 Enrollment ID: I20151026002367 |
| Provider Name | Dominick G Maggio |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679848501 PECOS PAC ID: 6709000987 Enrollment ID: I20151029002033 |
| Provider Name | Margaret Welsh Cavanaugh-hussey |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1558597039 PECOS PAC ID: 1951550805 Enrollment ID: I20151117002444 |
| Provider Name | Janet C Testoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568836765 PECOS PAC ID: 3072814565 Enrollment ID: I20151229002025 |
| Provider Name | Janice Yuchin Kao |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497869390 PECOS PAC ID: 3375867203 Enrollment ID: I20160111002175 |
| Provider Name | Charles E Page |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013020460 PECOS PAC ID: 4587687041 Enrollment ID: I20160122001030 |
| Provider Name | David B Durham |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1326264623 PECOS PAC ID: 6901986157 Enrollment ID: I20160123000013 |
| Provider Name | Tamara S Peshlakai |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508120189 PECOS PAC ID: 9537462643 Enrollment ID: I20160125000649 |
| Provider Name | Trisha E Schimek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184982050 PECOS PAC ID: 8123321106 Enrollment ID: I20160126000205 |
| Provider Name | Jeffrey Matthew Harvey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144531724 PECOS PAC ID: 7416195110 Enrollment ID: I20160126000758 |
| Provider Name | Murray Caplan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104987908 PECOS PAC ID: 3476443268 Enrollment ID: I20160217001951 |
| Provider Name | Marsha K Fearing |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023007184 PECOS PAC ID: 0143257493 Enrollment ID: I20160224002956 |
| Provider Name | David W Atwood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912166406 PECOS PAC ID: 4880990316 Enrollment ID: I20160309002761 |
| Provider Name | Robert Alan Green |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902134380 PECOS PAC ID: 9537284583 Enrollment ID: I20160314000825 |
| Provider Name | Matthew S Spiva |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003179193 PECOS PAC ID: 3779706346 Enrollment ID: I20160406000453 |
| Provider Name | Michitaka Kawata |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417186859 PECOS PAC ID: 7810178134 Enrollment ID: I20160406000711 |
| Provider Name | Deborah M Lusk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598151235 PECOS PAC ID: 4880906213 Enrollment ID: I20160425000709 |
| Provider Name | Daniel Lee Rowland |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629175302 PECOS PAC ID: 1658333828 Enrollment ID: I20160512000977 |
| Provider Name | Richard Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194701540 PECOS PAC ID: 3274529771 Enrollment ID: I20160518000255 |
| Provider Name | Prasad G Manoharan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871662361 PECOS PAC ID: 6709887409 Enrollment ID: I20160518000501 |
| Provider Name | Deborah Ann Scott |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1477518322 PECOS PAC ID: 8729031240 Enrollment ID: I20160518000576 |
| Provider Name | John C D Emilia |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215907837 PECOS PAC ID: 8224056809 Enrollment ID: I20160520000767 |
| Provider Name | Rodolfo D Vaglienty |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023036571 PECOS PAC ID: 7113958273 Enrollment ID: I20160520001806 |
| Provider Name | Michelle R Schenk |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306018734 PECOS PAC ID: 9537334594 Enrollment ID: I20160629000852 |
| Provider Name | Surender Kurapati |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073558383 PECOS PAC ID: 8628982428 Enrollment ID: I20160714001549 |
| Provider Name | Michael P Oleary |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1124079660 PECOS PAC ID: 4486641735 Enrollment ID: I20160818002425 |
| Provider Name | Shannon Heejin Lee |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1104278894 PECOS PAC ID: 4183919871 Enrollment ID: I20160819000349 |
| Provider Name | Michael S Jaung |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740628825 PECOS PAC ID: 5991091993 Enrollment ID: I20160830002767 |
| Provider Name | Donovan Bland |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811966898 PECOS PAC ID: 9234154956 Enrollment ID: I20160913000501 |
| Provider Name | Martin P Sorensen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1205816006 PECOS PAC ID: 4981857604 Enrollment ID: I20160916000762 |
| Provider Name | Jason B Girouard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285636191 PECOS PAC ID: 5698668853 Enrollment ID: I20160921000815 |
| Provider Name | Lance Whitehair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861833402 PECOS PAC ID: 4789983289 Enrollment ID: I20161004000529 |
| Provider Name | Elisabeth Dunning Tucker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497742977 PECOS PAC ID: 9830117589 Enrollment ID: I20161005001012 |
| Provider Name | Patrick F Caulfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992880348 PECOS PAC ID: 4688861149 Enrollment ID: I20161005001679 |
| Provider Name | Donna Ting |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578521209 PECOS PAC ID: 2860486123 Enrollment ID: I20161010001388 |
| Provider Name | Paul H Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316180037 PECOS PAC ID: 6204060510 Enrollment ID: I20161025001225 |
| Provider Name | Nathan Daniel Henrie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508109489 PECOS PAC ID: 5193950319 Enrollment ID: I20161103000333 |
| Provider Name | Erik S Anderson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932478872 PECOS PAC ID: 0840414330 Enrollment ID: I20161103001704 |
| Provider Name | Jetta Valle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720336910 PECOS PAC ID: 5991953911 Enrollment ID: I20161104001850 |
| Provider Name | Jacqueline D Michaud |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1992745111 PECOS PAC ID: 9931183084 Enrollment ID: I20161109001618 |
| Provider Name | Megan Nicole Henrie |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073888376 PECOS PAC ID: 9830478916 Enrollment ID: I20161112000063 |
| Provider Name | Armando I Del Rio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275635435 PECOS PAC ID: 2163611807 Enrollment ID: I20161117002011 |
| Provider Name | Kiki Shawn Wato |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689127565 PECOS PAC ID: 8527347129 Enrollment ID: I20161123000931 |
| Provider Name | Christopher S Parker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437322070 PECOS PAC ID: 9931489200 Enrollment ID: I20161201001965 |
| Provider Name | Margaret Miller |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396785952 PECOS PAC ID: 9830248319 Enrollment ID: I20161214000454 |
| Provider Name | Muhammad Khawaja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871724153 PECOS PAC ID: 3678719473 Enrollment ID: I20161217000008 |
| Provider Name | Jessica Cornett Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396181129 PECOS PAC ID: 7719276625 Enrollment ID: I20161221001819 |
| Provider Name | Paula P Claw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639537590 PECOS PAC ID: 8224319405 Enrollment ID: I20161230000207 |
| Provider Name | Paul Lampert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326010356 PECOS PAC ID: 4284532508 Enrollment ID: I20170104001773 |
| Provider Name | Triveni B Defries |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275970972 PECOS PAC ID: 9133401987 Enrollment ID: I20170131001813 |
| Provider Name | Lisa M Poyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548706930 PECOS PAC ID: 9638452949 Enrollment ID: I20170213000570 |
| Provider Name | Ryan A Peine |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538322425 PECOS PAC ID: 0446493548 Enrollment ID: I20170221000058 |
| Provider Name | Mark P Lambrecht |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1447237326 PECOS PAC ID: 8325322241 Enrollment ID: I20170221001293 |
| Provider Name | Sara G Sasse |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790914836 PECOS PAC ID: 5092099457 Enrollment ID: I20170302000660 |
| Provider Name | Douglas Accountius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730625047 PECOS PAC ID: 2062796451 Enrollment ID: I20170302002125 |
| Provider Name | Julie A Knutson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1013146109 PECOS PAC ID: 0244537918 Enrollment ID: I20170303000265 |
| Provider Name | Bernice Begay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578707055 PECOS PAC ID: 0244514651 Enrollment ID: I20170303000370 |
| Provider Name | Watson M Gutowski |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1639256688 PECOS PAC ID: 3678766888 Enrollment ID: I20170303000858 |
| Provider Name | Souheil El-chemaly |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1881996569 PECOS PAC ID: 0446437800 Enrollment ID: I20170303001264 |
| Provider Name | Hope Arhelger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700324886 PECOS PAC ID: 7719262450 Enrollment ID: I20170321001725 |
| Provider Name | Zeeshan Syed Ahmed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659534600 PECOS PAC ID: 3173790714 Enrollment ID: I20170323000576 |
| Provider Name | Alexander Brazalovich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295787133 PECOS PAC ID: 4688604630 Enrollment ID: I20170330002410 |
| Provider Name | Frederick W Adler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629030515 PECOS PAC ID: 7416845003 Enrollment ID: I20170410002226 |
| Provider Name | Jeffrey T Lauer |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1710946124 PECOS PAC ID: 9537334180 Enrollment ID: I20170501001041 |
| Provider Name | Amy R Frasure |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275821704 PECOS PAC ID: 5496913204 Enrollment ID: I20170505000687 |
| Provider Name | Tahir Alkhairy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023026234 PECOS PAC ID: 8527960434 Enrollment ID: I20170508002146 |
| Provider Name | Robert Tapley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306091061 PECOS PAC ID: 6204972680 Enrollment ID: I20170515001973 |
| Provider Name | Deborah L Perkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093028235 PECOS PAC ID: 6608062203 Enrollment ID: I20170516000593 |
| Provider Name | Aaron Lee Berkowitz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386878247 PECOS PAC ID: 2466613468 Enrollment ID: I20170606000335 |
| Provider Name | Jason E Frangos |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1699903906 PECOS PAC ID: 4789841966 Enrollment ID: I20170614000541 |
| Provider Name | John C Haughey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679739288 PECOS PAC ID: 6204967169 Enrollment ID: I20170624000105 |
| Provider Name | Viswanathan Rajagopalan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760626436 PECOS PAC ID: 7416177266 Enrollment ID: I20170628001006 |
| Provider Name | Matthew J Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669911236 PECOS PAC ID: 3173892387 Enrollment ID: I20170703000436 |
| Provider Name | Mark D Fallon Cyr |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174550909 PECOS PAC ID: 6406954866 Enrollment ID: I20170713001225 |
| Provider Name | Kristen A Dirks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528592409 PECOS PAC ID: 7618247248 Enrollment ID: I20170714000609 |
| Provider Name | Ariel D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669804365 PECOS PAC ID: 2466683966 Enrollment ID: I20170721002111 |
| Provider Name | Carrie Copeland |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518095033 PECOS PAC ID: 2163445222 Enrollment ID: I20170812000013 |
| Provider Name | Bijiibaa' Md Garrison |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033485743 PECOS PAC ID: 6204139728 Enrollment ID: I20170818000554 |
| Provider Name | Charles Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447240171 PECOS PAC ID: 9335230291 Enrollment ID: I20170825001969 |
| Provider Name | Harvette C Jenkins-bah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114914488 PECOS PAC ID: 7911953427 Enrollment ID: I20170907002981 |
| Provider Name | Erin H Schifeling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104239847 PECOS PAC ID: 6901179290 Enrollment ID: I20170908000379 |
| Provider Name | Jonas B. J. Telson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740600212 PECOS PAC ID: 7517257447 Enrollment ID: I20170908000671 |
| Provider Name | Daniel J Burke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235576299 PECOS PAC ID: 5991096810 Enrollment ID: I20170908000682 |
| Provider Name | Eve S Bruneau |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093153728 PECOS PAC ID: 2062785371 Enrollment ID: I20170908000975 |
| Provider Name | Tel M Todd |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477909646 PECOS PAC ID: 9032482070 Enrollment ID: I20170913001846 |
| Provider Name | Brenda L Riojas |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1073892865 PECOS PAC ID: 6406120385 Enrollment ID: I20170915000381 |
| Provider Name | Bryan Flint |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932160371 PECOS PAC ID: 6305004144 Enrollment ID: I20170923000444 |
| Provider Name | Lisa Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043639529 PECOS PAC ID: 9830310069 Enrollment ID: I20171003003884 |
| Provider Name | Julie Anne Caplow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801216338 PECOS PAC ID: 7911205588 Enrollment ID: I20171003004654 |
| Provider Name | Kathryn Storck |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063709517 PECOS PAC ID: 8325299696 Enrollment ID: I20171004001769 |
| Provider Name | Jessica S Hoy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255744678 PECOS PAC ID: 3173741808 Enrollment ID: I20171007000215 |
| Provider Name | William H Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952720302 PECOS PAC ID: 0446471676 Enrollment ID: I20171010002689 |
| Provider Name | Daniel Dworkis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902148505 PECOS PAC ID: 2961777180 Enrollment ID: I20171013000848 |
| Provider Name | Donna M Dineyazhe |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1922522440 PECOS PAC ID: 6103191333 Enrollment ID: I20171013001088 |
| Provider Name | Eleanor H Emery |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962816090 PECOS PAC ID: 5092933572 Enrollment ID: I20171013001564 |
| Provider Name | Stephen Shanks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114346129 PECOS PAC ID: 9931326667 Enrollment ID: I20171018000588 |
| Provider Name | Charles Schnorr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215201231 PECOS PAC ID: 1052633054 Enrollment ID: I20171018001098 |
| Provider Name | Cara Lee Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649793175 PECOS PAC ID: 8527334192 Enrollment ID: I20171026000563 |
| Provider Name | Tamara M Green |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194724476 PECOS PAC ID: 0941298210 Enrollment ID: I20171030000677 |
| Provider Name | Keith Whiteman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265847198 PECOS PAC ID: 7012135213 Enrollment ID: I20171031002332 |
| Provider Name | Garrett H. Riggs |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962410761 PECOS PAC ID: 2668630583 Enrollment ID: I20171101001006 |
| Provider Name | Yedida Zoe Rissman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245674704 PECOS PAC ID: 0749599314 Enrollment ID: I20171101001192 |
| Provider Name | Allegra Jayne Weiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992756985 PECOS PAC ID: 3577620285 Enrollment ID: I20171108001147 |
| Provider Name | Sara W Vazquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376692806 PECOS PAC ID: 6709983604 Enrollment ID: I20171115001161 |
| Provider Name | Ann M Hendrzak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558426502 PECOS PAC ID: 8628964723 Enrollment ID: I20171215001103 |
| Provider Name | Steven F Maher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407811011 PECOS PAC ID: 2567405152 Enrollment ID: I20171226001323 |
| Provider Name | Madeline Z Luke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184641854 PECOS PAC ID: 2264625789 Enrollment ID: I20180202002137 |
| Provider Name | Donielle Dawn Bigman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013429729 PECOS PAC ID: 5597025684 Enrollment ID: I20180209002054 |
| Provider Name | Lia Ilona Losonczy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598082828 PECOS PAC ID: 0749593390 Enrollment ID: I20180214001684 |
| Provider Name | Nicholas Kanaan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831423235 PECOS PAC ID: 7810148442 Enrollment ID: I20180221002528 |
| Provider Name | Pierre Lanthiez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801864970 PECOS PAC ID: 2769570860 Enrollment ID: I20180319000669 |
| Provider Name | Timothy H Cook |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578567533 PECOS PAC ID: 1456318062 Enrollment ID: I20180319001127 |
| Provider Name | Kelly Rochelle Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851807432 PECOS PAC ID: 1153683768 Enrollment ID: I20180320000584 |
| Provider Name | Mark Anthony Mccarthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558370973 PECOS PAC ID: 1951496546 Enrollment ID: I20180321000809 |
| Provider Name | Mark W Turpen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043380413 PECOS PAC ID: 2961661426 Enrollment ID: I20180402000321 |
| Provider Name | Jeremiah Donald Schuur |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285653816 PECOS PAC ID: 9335190255 Enrollment ID: I20180409000240 |
| Provider Name | Marie Suzette Jeoboam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659491769 PECOS PAC ID: 1153586235 Enrollment ID: I20180410000198 |
| Provider Name | Cecilia Alejandra Larocca |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1558688820 PECOS PAC ID: 5890912851 Enrollment ID: I20180411000085 |
| Provider Name | Norman Joseph Novelly |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1457332272 PECOS PAC ID: 1658444138 Enrollment ID: I20180417002023 |
| Provider Name | Michael Emeel Mousa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194025221 PECOS PAC ID: 6608189394 Enrollment ID: I20180424002663 |
| Provider Name | Nancy R Sagona |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679574461 PECOS PAC ID: 9537148762 Enrollment ID: I20180502001119 |
| Provider Name | Steven Maron |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366488686 PECOS PAC ID: 5890798276 Enrollment ID: I20180604002084 |
| Provider Name | Asha E Atwell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538457122 PECOS PAC ID: 1355655986 Enrollment ID: I20180607001067 |
| Provider Name | Janice A Bartleson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841237716 PECOS PAC ID: 2365455037 Enrollment ID: I20180607001368 |
| Provider Name | Colin Zepeda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861751729 PECOS PAC ID: 7214169861 Enrollment ID: I20180613000366 |
| Provider Name | Sarah E Reese |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285056440 PECOS PAC ID: 5890927222 Enrollment ID: I20180626000671 |
| Provider Name | Humberto Martinez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659420560 PECOS PAC ID: 3274595673 Enrollment ID: I20180709001543 |
| Provider Name | Paul B Fischbuch |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164841466 PECOS PAC ID: 4789931601 Enrollment ID: I20180724002747 |
| Provider Name | Timothy James Durkin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700078896 PECOS PAC ID: 8123172376 Enrollment ID: I20180802001810 |
| Provider Name | Elysia M Ison |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1467944041 PECOS PAC ID: 6800144049 Enrollment ID: I20180806000961 |
| Provider Name | John Allan Mcdougall |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1760773287 PECOS PAC ID: 0941505564 Enrollment ID: I20180813000455 |
| Provider Name | Lorinda Joy Price |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144239633 PECOS PAC ID: 3476801135 Enrollment ID: I20180813001680 |
| Provider Name | Christopher A Martin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306289707 PECOS PAC ID: 9638453780 Enrollment ID: I20180815000303 |
| Provider Name | Nuanphan S Poole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801393707 PECOS PAC ID: 4385993591 Enrollment ID: I20180822000261 |
| Provider Name | Bimal A Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407198534 PECOS PAC ID: 1850660580 Enrollment ID: I20180907000892 |
| Provider Name | Lindsay W Ryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427323740 PECOS PAC ID: 3779883863 Enrollment ID: I20180907001126 |
| Provider Name | Preyanka Makadia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659791044 PECOS PAC ID: 6103195136 Enrollment ID: I20180918004034 |
| Provider Name | Robert Irving Handin |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1699884692 PECOS PAC ID: 5597791095 Enrollment ID: I20181016002900 |
| Provider Name | Haytham Maria |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912254392 PECOS PAC ID: 1658668322 Enrollment ID: I20181031002167 |
| Provider Name | Elizabeth B Gay |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144412875 PECOS PAC ID: 7911051461 Enrollment ID: I20181106002089 |
| Provider Name | Kerena M Saltzgiver |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1396163036 PECOS PAC ID: 8123241072 Enrollment ID: I20181128000193 |
| Provider Name | Refina Willie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881063568 PECOS PAC ID: 6901141365 Enrollment ID: I20181213001465 |
| Provider Name | Lillian Claire Buchhalter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912391582 PECOS PAC ID: 8022363076 Enrollment ID: I20190103002488 |
| Provider Name | Franklin Lam |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1194166280 PECOS PAC ID: 3274835384 Enrollment ID: I20190109001979 |
| Provider Name | Julie K Johnson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497751929 PECOS PAC ID: 0042408973 Enrollment ID: I20190117003398 |
| Provider Name | Kristina Sycamore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699193813 PECOS PAC ID: 0446479976 Enrollment ID: I20190122002934 |
| Provider Name | Jennifer Lynn Mccain |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225294556 PECOS PAC ID: 4688994437 Enrollment ID: I20190201001362 |
| Provider Name | Morgan Nicole Dickerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295262293 PECOS PAC ID: 9133468333 Enrollment ID: I20190306001137 |
| Provider Name | Diane Griffith See |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376767905 PECOS PAC ID: 1254620131 Enrollment ID: I20190329000510 |
| Provider Name | Regan W Bergmark |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1104110683 PECOS PAC ID: 3577797505 Enrollment ID: I20190417001441 |
| Provider Name | Brian Allan Bergmark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750676375 PECOS PAC ID: 4183862089 Enrollment ID: I20190417001677 |
| Provider Name | Daniel Lucas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417905522 PECOS PAC ID: 8527040195 Enrollment ID: I20190502000487 |
| Provider Name | Diane T Levine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992297873 PECOS PAC ID: 0547503310 Enrollment ID: I20190517001047 |
| Provider Name | Chidi Ukatu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023212982 PECOS PAC ID: 1658464193 Enrollment ID: I20190617000080 |
| Provider Name | Tarik Asmerom |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730576232 PECOS PAC ID: 7416282223 Enrollment ID: I20190717000264 |
| Provider Name | Divya Singh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235264540 PECOS PAC ID: 5395751861 Enrollment ID: I20190726002140 |
| Provider Name | Margaret Prior |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336553189 PECOS PAC ID: 4082831243 Enrollment ID: I20190729002492 |
| Provider Name | Jenna E Landers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588011167 PECOS PAC ID: 0244598860 Enrollment ID: I20190805001513 |
| Provider Name | Kia Yang |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124687884 PECOS PAC ID: 9335477140 Enrollment ID: I20190817000047 |
| Provider Name | Brandon R Hill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245521350 PECOS PAC ID: 4587883525 Enrollment ID: I20190819002230 |
| Provider Name | Jonathan Noah Jordahl |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174985964 PECOS PAC ID: 4587930037 Enrollment ID: I20190821002056 |
| Provider Name | Frank R Vleugels |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1922373018 PECOS PAC ID: 1850520479 Enrollment ID: I20190821003040 |
| Provider Name | Sunmi Yang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821448846 PECOS PAC ID: 8527351857 Enrollment ID: I20190823000183 |
| Provider Name | Jeanie K Ringelberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093192122 PECOS PAC ID: 1456658533 Enrollment ID: I20190826000264 |
| Provider Name | Brianna Marie Hitchner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689036030 PECOS PAC ID: 9638460587 Enrollment ID: I20190910002270 |
| Provider Name | Ann Diamond |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033137385 PECOS PAC ID: 5092786418 Enrollment ID: I20190913000283 |
| Provider Name | Tommie Thomas Begay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124480942 PECOS PAC ID: 1153614565 Enrollment ID: I20190923002358 |
| Provider Name | Christina Anne Davidson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316300981 PECOS PAC ID: 0446542542 Enrollment ID: I20190930003022 |
| Provider Name | Zachary L Gitlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003203753 PECOS PAC ID: 6103145396 Enrollment ID: I20191004000939 |
| Provider Name | Kaitlyn R Lamarche |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306296744 PECOS PAC ID: 6709174923 Enrollment ID: I20191014000226 |
| Provider Name | Sham Joseph Persaud |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1982091906 PECOS PAC ID: 9133407539 Enrollment ID: I20191016000500 |
| Provider Name | Sabine I Mcreynolds |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851385645 PECOS PAC ID: 8820063803 Enrollment ID: I20191029002646 |
| Provider Name | Louis B Yu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619362035 PECOS PAC ID: 3971877523 Enrollment ID: I20191108001798 |
| Provider Name | Supriya Gupta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548521883 PECOS PAC ID: 5092004523 Enrollment ID: I20191203000373 |
| Provider Name | Marissa A Callahan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598306680 PECOS PAC ID: 3870926736 Enrollment ID: I20191206000565 |
| Provider Name | Jing Ren |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740669662 PECOS PAC ID: 7113234253 Enrollment ID: I20191223000271 |
| Provider Name | Liam James Kavin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093285181 PECOS PAC ID: 7517205305 Enrollment ID: I20191227000217 |
| Provider Name | Justin L Cashman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134123896 PECOS PAC ID: 1658463435 Enrollment ID: I20191227001700 |
| Provider Name | Kay Negishi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194103309 PECOS PAC ID: 4789987454 Enrollment ID: I20200123000364 |
| Provider Name | Mariam Popal |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1801063573 PECOS PAC ID: 9931365475 Enrollment ID: I20200210000652 |
| Provider Name | Matthew D Riscinti |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093101909 PECOS PAC ID: 9739414913 Enrollment ID: I20200213001641 |
| Provider Name | Ahmad Abdelaal |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255880738 PECOS PAC ID: 0244519973 Enrollment ID: I20200214000885 |
| Provider Name | Elizabeth G Hanson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891180840 PECOS PAC ID: 2163758525 Enrollment ID: I20200219000114 |
| Provider Name | Janet Selenski Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134122799 PECOS PAC ID: 6103715412 Enrollment ID: I20200302002155 |
| Provider Name | Ayesha P Venkateswaran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285047142 PECOS PAC ID: 1052615903 Enrollment ID: I20200303002357 |
| Provider Name | Mary Melissa Rigg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114130101 PECOS PAC ID: 8224298856 Enrollment ID: I20200401000011 |
| Provider Name | Jeffrey A Simon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366490617 PECOS PAC ID: 8820070162 Enrollment ID: I20200406000448 |
| Provider Name | Justin Jon Ritter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982237640 PECOS PAC ID: 9234569732 Enrollment ID: I20200424000427 |
| Provider Name | John R Henwood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386752293 PECOS PAC ID: 4082740311 Enrollment ID: I20200508000397 |
| Provider Name | Thanh-giang Vu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1962820241 PECOS PAC ID: 6709178825 Enrollment ID: I20200514000713 |
| Provider Name | Tyler Jb Law |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1902323033 PECOS PAC ID: 5193090207 Enrollment ID: I20200518001788 |
| Provider Name | Jessica C Dill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598127326 PECOS PAC ID: 4284901380 Enrollment ID: I20200521000416 |
| Provider Name | Suzanne J Atteberry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487870168 PECOS PAC ID: 3476601386 Enrollment ID: I20200521001544 |
| Provider Name | Sangeeta R Iyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730341306 PECOS PAC ID: 1951574730 Enrollment ID: I20200521002263 |
| Provider Name | Bernard Willis Parker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073136693 PECOS PAC ID: 8527489772 Enrollment ID: I20200527000363 |
| Provider Name | Lauren Ashley Bailey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295197556 PECOS PAC ID: 2264721299 Enrollment ID: I20200528003011 |
| Provider Name | Witzard Seide |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346578168 PECOS PAC ID: 2365751625 Enrollment ID: I20200529000603 |
| Provider Name | Ana Fuentevilla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679554430 PECOS PAC ID: 8022439926 Enrollment ID: I20200601003172 |
| Provider Name | Robert M Brickley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700262524 PECOS PAC ID: 0840559936 Enrollment ID: I20200603001937 |
| Provider Name | Phillip A Zappone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679120570 PECOS PAC ID: 9436481769 Enrollment ID: I20200603002446 |
| Provider Name | Cheryl K Chang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184659575 PECOS PAC ID: 7517982846 Enrollment ID: I20200605000667 |
| Provider Name | Matthew D Steimle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1710116132 PECOS PAC ID: 7416112024 Enrollment ID: I20200610000396 |
| Provider Name | Lauren A Tatum |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619167152 PECOS PAC ID: 6608925730 Enrollment ID: I20200618002809 |
| Provider Name | Robert H Spencer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235130154 PECOS PAC ID: 2668375114 Enrollment ID: I20200622000582 |
| Provider Name | Ethan F Fahrney |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417517533 PECOS PAC ID: 0042548810 Enrollment ID: I20200622001088 |
| Provider Name | Patricia L Wheeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295771152 PECOS PAC ID: 2466430491 Enrollment ID: I20200623000587 |
| Provider Name | Jane Yee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588046114 PECOS PAC ID: 3476886664 Enrollment ID: I20200623002169 |
| Provider Name | Astrid Haaland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851786073 PECOS PAC ID: 0749530152 Enrollment ID: I20200624002058 |
| Provider Name | David H Kruger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639142417 PECOS PAC ID: 6800851726 Enrollment ID: I20200624002495 |
| Provider Name | Shidrokh A Shakeri-cerejo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215914619 PECOS PAC ID: 9234551979 Enrollment ID: I20200625000567 |
| Provider Name | Danielle M Babbel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649610452 PECOS PAC ID: 3870875982 Enrollment ID: I20200625002756 |
| Provider Name | Emily A Signor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669859476 PECOS PAC ID: 5799065140 Enrollment ID: I20200629002979 |
| Provider Name | Barbara L Zimmerman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841267044 PECOS PAC ID: 2466346341 Enrollment ID: I20200706001371 |
| Provider Name | Sean P Rooks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316478274 PECOS PAC ID: 3577834662 Enrollment ID: I20200707002228 |
| Provider Name | Casey Dv Gradick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124360649 PECOS PAC ID: 3173745221 Enrollment ID: I20200708000922 |
| Provider Name | Jhana M Wendling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851462279 PECOS PAC ID: 3072512904 Enrollment ID: I20200708002740 |
| Provider Name | Roxanne Richards |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760788640 PECOS PAC ID: 3274593587 Enrollment ID: I20200709001791 |
| Provider Name | Claire E Ciarkowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568729622 PECOS PAC ID: 8022240936 Enrollment ID: I20200713001887 |
| Provider Name | Lucy C Unger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053775957 PECOS PAC ID: 9032485404 Enrollment ID: I20200713002072 |
| Provider Name | Shelly Ann Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508168238 PECOS PAC ID: 9234302373 Enrollment ID: I20200721000934 |
| Provider Name | David John Wallace |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1770780835 PECOS PAC ID: 5799957916 Enrollment ID: I20200724000852 |
| Provider Name | Saad L Sahi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306224290 PECOS PAC ID: 7618275108 Enrollment ID: I20200729002188 |
| Provider Name | Kristen C Roessler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083656151 PECOS PAC ID: 3173781572 Enrollment ID: I20200730003066 |
| Provider Name | Wendy C Carle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548397508 PECOS PAC ID: 8426110404 Enrollment ID: I20200731000386 |
| Provider Name | Jeffrey Hyland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023042504 PECOS PAC ID: 4486614450 Enrollment ID: I20200804000360 |
| Provider Name | Jaren Meldrum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437539319 PECOS PAC ID: 4385069616 Enrollment ID: I20200804002389 |
| Provider Name | Ciara D Hansen |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003424383 PECOS PAC ID: 0345665527 Enrollment ID: I20200805000825 |
| Provider Name | Freda L Ready |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841601242 PECOS PAC ID: 1658797451 Enrollment ID: I20200811002131 |
| Provider Name | Lisa Torgersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568800332 PECOS PAC ID: 9931332541 Enrollment ID: I20200811003473 |
| Provider Name | Aimee E Mcmullin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013443118 PECOS PAC ID: 8921376096 Enrollment ID: I20200812000077 |
| Provider Name | Dylan Rebecca Hanami |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033642996 PECOS PAC ID: 8426381963 Enrollment ID: I20200813002020 |
| Provider Name | Peter P Taillac |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467414581 PECOS PAC ID: 3173557006 Enrollment ID: I20200818000347 |
| Provider Name | Jacob Sypher |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831518554 PECOS PAC ID: 3476979352 Enrollment ID: I20200824000533 |
| Provider Name | Sara M Mccrate |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073044319 PECOS PAC ID: 9638592025 Enrollment ID: I20200831000760 |
| Provider Name | Marc A Cassone |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881057149 PECOS PAC ID: 0244526770 Enrollment ID: I20200908000456 |
| Provider Name | Elizabeth Marie Pines |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669906368 PECOS PAC ID: 3577831379 Enrollment ID: I20200908001335 |
| Provider Name | Michael Barish |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447683313 PECOS PAC ID: 4880026640 Enrollment ID: I20200909000201 |
| Provider Name | Alisa K Anderson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225486780 PECOS PAC ID: 8224323464 Enrollment ID: I20200911000389 |
| Provider Name | Michael Witkosky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134366818 PECOS PAC ID: 0244465177 Enrollment ID: I20200923000688 |
| Provider Name | William T Johanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316987043 PECOS PAC ID: 0648236968 Enrollment ID: I20200924000764 |
| Provider Name | David Ishimitsu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497919641 PECOS PAC ID: 3173783057 Enrollment ID: I20200924002219 |
| Provider Name | Zelda Gail Garcia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003049347 PECOS PAC ID: 9032538996 Enrollment ID: I20200928001254 |
| Provider Name | Jonathan I. Meyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265481725 PECOS PAC ID: 6709847833 Enrollment ID: I20200930000787 |
| Provider Name | Nathan R Elwood |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942628409 PECOS PAC ID: 5092934901 Enrollment ID: I20201001000140 |
| Provider Name | Roxanne Chan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851407787 PECOS PAC ID: 2961428222 Enrollment ID: I20201002000254 |
| Provider Name | Erin E Mccreary |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629432257 PECOS PAC ID: 2567758949 Enrollment ID: I20201008000772 |
| Provider Name | Mahdieh Haji Amou Assar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518953926 PECOS PAC ID: 5799675781 Enrollment ID: I20201013001345 |
| Provider Name | Todd Greenberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063410421 PECOS PAC ID: 8123926821 Enrollment ID: I20201020001300 |
| Provider Name | Amy S Hayes |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922012780 PECOS PAC ID: 6800858291 Enrollment ID: I20201023000205 |
| Provider Name | Wesley M Pedicini |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548792187 PECOS PAC ID: 1254684657 Enrollment ID: I20201125000761 |
| Provider Name | Silas L Wang |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699988899 PECOS PAC ID: 8123205937 Enrollment ID: I20201207000440 |
| Provider Name | Stephan O. Bamberger |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1003881319 PECOS PAC ID: 3577523471 Enrollment ID: I20201217000829 |
| Provider Name | Kathryn A Bowen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124090709 PECOS PAC ID: 3577688787 Enrollment ID: I20201218000148 |
| Provider Name | David M Crockett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104351592 PECOS PAC ID: 6709163132 Enrollment ID: I20201221000594 |
| Provider Name | Balaji Srinivas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700315934 PECOS PAC ID: 5294064135 Enrollment ID: I20201223000623 |
| Provider Name | Jonathan M Green |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033140553 PECOS PAC ID: 0345291548 Enrollment ID: I20201228001101 |
| Provider Name | Carl J Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932341211 PECOS PAC ID: 3476709353 Enrollment ID: I20210106002166 |
| Provider Name | Natalia Solenkova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457782328 PECOS PAC ID: 2961627195 Enrollment ID: I20210107001618 |
| Provider Name | Kenneth R Larsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003894940 PECOS PAC ID: 0345229449 Enrollment ID: I20210111001172 |
| Provider Name | Richard L Dejournett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982691341 PECOS PAC ID: 0749170520 Enrollment ID: I20210111001763 |
| Provider Name | Karthikeyan Viswanathan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396128336 PECOS PAC ID: 6103251442 Enrollment ID: I20210113001821 |
| Provider Name | Patrick M Ockerse |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043444904 PECOS PAC ID: 2769638626 Enrollment ID: I20210114001717 |
| Provider Name | Elizabeth Liu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447612932 PECOS PAC ID: 7517217839 Enrollment ID: I20210114002145 |
| Provider Name | Robert H Winokur |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386608230 PECOS PAC ID: 2163335159 Enrollment ID: I20210115000086 |
| Provider Name | Alphonse Guy Giordano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477514388 PECOS PAC ID: 5395793558 Enrollment ID: I20210119000976 |
| Provider Name | Rooshin B Dalal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194968784 PECOS PAC ID: 9638486913 Enrollment ID: I20210121000802 |
| Provider Name | John M Hendrick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780002261 PECOS PAC ID: 7315247129 Enrollment ID: I20210121003188 |
| Provider Name | Tasce R Bongiovanni |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124344130 PECOS PAC ID: 6406140938 Enrollment ID: I20210122002008 |
| Provider Name | Sharon A Bachman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942527007 PECOS PAC ID: 7214176890 Enrollment ID: I20210126000647 |
| Provider Name | James Chatham Jr |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629130141 PECOS PAC ID: 6002968773 Enrollment ID: I20210127000311 |
| Provider Name | Amy D Rice |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1588001861 PECOS PAC ID: 9638481484 Enrollment ID: I20210208000977 |
| Provider Name | John A Carroll |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376852301 PECOS PAC ID: 3971918707 Enrollment ID: I20210209000895 |
| Provider Name | Kwan Kew Lai |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881618353 PECOS PAC ID: 6002862059 Enrollment ID: I20210210000202 |
| Provider Name | Matthew J Fuller |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396060406 PECOS PAC ID: 0749420115 Enrollment ID: I20210217001596 |
| Provider Name | Maria Amada F Apacible |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326118704 PECOS PAC ID: 0749559839 Enrollment ID: I20210225001801 |
| Provider Name | Mina F Tanaka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740661248 PECOS PAC ID: 3072821198 Enrollment ID: I20210301001245 |
| Provider Name | Michele Idera |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639154537 PECOS PAC ID: 1254435605 Enrollment ID: I20210310003076 |
| Provider Name | Joshua Cady |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003392457 PECOS PAC ID: 4587914205 Enrollment ID: I20210330001275 |
| Provider Name | Elizabeth L Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144614470 PECOS PAC ID: 4284955618 Enrollment ID: I20210415000545 |
| Provider Name | Gerald B Holtz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578649554 PECOS PAC ID: 6507759867 Enrollment ID: I20210426000111 |
| Provider Name | Ramona Francine Yazzie |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386208486 PECOS PAC ID: 7810306917 Enrollment ID: I20210430001282 |
| Provider Name | Muhanad Al Jassar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790783884 PECOS PAC ID: 6002851201 Enrollment ID: I20210511001719 |
| Provider Name | Jessica L Bluto |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1457761678 PECOS PAC ID: 2769797521 Enrollment ID: I20210610000232 |
| Provider Name | Raven Ss Zamora |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1568576502 PECOS PAC ID: 0840623377 Enrollment ID: I20210615001324 |
| Provider Name | Nicole Christenson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730265752 PECOS PAC ID: 8628149291 Enrollment ID: I20210702000765 |
| Provider Name | Maria C Melo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528190964 PECOS PAC ID: 6305874942 Enrollment ID: I20210708000711 |
| Provider Name | Ryan Jean Kronen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134613854 PECOS PAC ID: 7618225970 Enrollment ID: I20210712002776 |
| Provider Name | Andrea Iyekepolo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285084426 PECOS PAC ID: 5193011377 Enrollment ID: I20210713003765 |
| Provider Name | Mohiuddin Bilal Shamsi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1588922686 PECOS PAC ID: 0042459828 Enrollment ID: I20210817001565 |
| Provider Name | James Fierbaugh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376048090 PECOS PAC ID: 3577996529 Enrollment ID: I20210817002064 |
| Provider Name | Brenda Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962073130 PECOS PAC ID: 4082010939 Enrollment ID: I20210901002310 |
| Provider Name | Pfawnn Eskee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821533811 PECOS PAC ID: 0648505198 Enrollment ID: I20210902001359 |
| Provider Name | Lindsay Dale |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942654736 PECOS PAC ID: 7517251291 Enrollment ID: I20210909003467 |
| Provider Name | Leah N Spatafore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841795978 PECOS PAC ID: 9830447747 Enrollment ID: I20210913000322 |
| Provider Name | Kathleen Ann Mckeown |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1982670071 PECOS PAC ID: 2365848645 Enrollment ID: I20210913000899 |
| Provider Name | Johanna S Salay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871013839 PECOS PAC ID: 6305279217 Enrollment ID: I20210916000603 |
| Provider Name | Diondria Sanders |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1205493194 PECOS PAC ID: 0941607865 Enrollment ID: I20210920003040 |
| Provider Name | Marina Zambrotta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720517352 PECOS PAC ID: 8729358601 Enrollment ID: I20210921000978 |
| Provider Name | Carl M Barsanti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861450637 PECOS PAC ID: 4385682699 Enrollment ID: I20211026002428 |
| Provider Name | Brianna Muller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164928099 PECOS PAC ID: 1850649872 Enrollment ID: I20211123001014 |
| Provider Name | Kevin T Dixon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881668507 PECOS PAC ID: 0345266979 Enrollment ID: I20211123002672 |
| Provider Name | Robert B Tucker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790745834 PECOS PAC ID: 9638253768 Enrollment ID: I20220113002084 |
| Provider Name | Kelly Bogaert |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679005425 PECOS PAC ID: 2769713593 Enrollment ID: I20220119000339 |
| Provider Name | Magdalena R Naylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184715294 PECOS PAC ID: 8426066150 Enrollment ID: I20220201000051 |
| Provider Name | Adam J Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124545744 PECOS PAC ID: 6507994936 Enrollment ID: I20220201000393 |
| Provider Name | Brian J. Chanatry |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942234315 PECOS PAC ID: 5395744791 Enrollment ID: I20220201000805 |
| Provider Name | Amy Du |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922452978 PECOS PAC ID: 3678823457 Enrollment ID: I20220202001135 |
| Provider Name | Brandon Mack |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639203664 PECOS PAC ID: 6103922877 Enrollment ID: I20220203000444 |
| Provider Name | Yang Veronica Pei |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043275993 PECOS PAC ID: 8224068705 Enrollment ID: I20220203002579 |
| Provider Name | Samuel Bergener |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780724419 PECOS PAC ID: 9537252069 Enrollment ID: I20220315002314 |
| Provider Name | Grace Rathna Francis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639621378 PECOS PAC ID: 4082009725 Enrollment ID: I20220316003180 |
| Provider Name | Junaid Aslam |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841685435 PECOS PAC ID: 0244652097 Enrollment ID: I20220323002022 |
| Provider Name | Barbara Fay Willis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245395029 PECOS PAC ID: 9537153432 Enrollment ID: I20220328002410 |
| Provider Name | Clarice M Montecalvo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457840068 PECOS PAC ID: 8628325222 Enrollment ID: I20220512001950 |
| Provider Name | Amber Lee Logan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1235865171 PECOS PAC ID: 9638551583 Enrollment ID: I20220809002045 |
| Provider Name | Donald Lee Helfer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154300523 PECOS PAC ID: 2466435292 Enrollment ID: I20220810000632 |
| Provider Name | Gayle J Weaver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477531531 PECOS PAC ID: 7012954266 Enrollment ID: I20220816001556 |
| Provider Name | Craig A Tuller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184280984 PECOS PAC ID: 9234465717 Enrollment ID: I20220830000553 |
| Provider Name | Kelly Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235524794 PECOS PAC ID: 0042565178 Enrollment ID: I20220830004462 |
| Provider Name | Anne Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1649732298 PECOS PAC ID: 8527393727 Enrollment ID: I20220912002506 |
| Provider Name | Claudia Tuffanelli-bouvier |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629493069 PECOS PAC ID: 6406136472 Enrollment ID: I20220920001877 |
| Provider Name | Tami Blecha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578156402 PECOS PAC ID: 0941617518 Enrollment ID: I20221010000946 |
| Provider Name | Jasdeep Gill |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629574496 PECOS PAC ID: 4486901709 Enrollment ID: I20221020002493 |
| Provider Name | Michael Scott Mcgee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407418551 PECOS PAC ID: 0941536593 Enrollment ID: I20221026000155 |
| Provider Name | Erin Michele Renfrew |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386209716 PECOS PAC ID: 2567799034 Enrollment ID: I20221027002049 |
| Provider Name | Renae Marie Hepfner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104310606 PECOS PAC ID: 6305264169 Enrollment ID: I20221028001824 |
| Provider Name | William Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720575871 PECOS PAC ID: 0749678522 Enrollment ID: I20221104001197 |
| Provider Name | Anthony W Sebastiano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962448662 PECOS PAC ID: 2163500224 Enrollment ID: I20221109003117 |
| Provider Name | Eliot M Gelwan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700952702 PECOS PAC ID: 5092767665 Enrollment ID: I20221115001169 |
| Provider Name | Jon C Vivolo |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851706881 PECOS PAC ID: 0941514202 Enrollment ID: I20221121000598 |
| Provider Name | Candace Lesniewski |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255978698 PECOS PAC ID: 4082082888 Enrollment ID: I20221129002605 |
| Provider Name | Holbrook H Stoecklein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780927541 PECOS PAC ID: 0547583007 Enrollment ID: I20221203000129 |
| Provider Name | Kaydee L Mccray |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1639811409 PECOS PAC ID: 7517336985 Enrollment ID: I20221206002412 |
| Provider Name | Vivian L Partida |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306349188 PECOS PAC ID: 6103256789 Enrollment ID: I20221216001647 |
| Provider Name | Nichele Raquel Salazar |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1437397718 PECOS PAC ID: 5193195642 Enrollment ID: I20221228001621 |
| Provider Name | Christina Anna Clarke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992937494 PECOS PAC ID: 6507237609 Enrollment ID: I20230128000054 |
| Provider Name | Alexander J Adami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780180968 PECOS PAC ID: 0648526087 Enrollment ID: I20230221001578 |
| Provider Name | Amber D Yazzie |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1336852037 PECOS PAC ID: 8921471400 Enrollment ID: I20230303000066 |
| Provider Name | Ryan Freestone |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588014989 PECOS PAC ID: 0941588156 Enrollment ID: I20230308001585 |
| Provider Name | Ali Batouli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326301383 PECOS PAC ID: 9436423118 Enrollment ID: I20230310000931 |
| Provider Name | Stephen Herring |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942718176 PECOS PAC ID: 7012264443 Enrollment ID: I20230420001631 |
| Provider Name | Sharlay K Butler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497142392 PECOS PAC ID: 0840595997 Enrollment ID: I20230425000620 |
| Provider Name | Scott Adamson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427516111 PECOS PAC ID: 6305187626 Enrollment ID: I20230426000308 |
| Provider Name | Mark E Henning |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598845687 PECOS PAC ID: 7315008703 Enrollment ID: I20230426001628 |
| Provider Name | Candice M Keyes |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891490892 PECOS PAC ID: 7214393214 Enrollment ID: I20230517002038 |
| Provider Name | Wesley Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730685579 PECOS PAC ID: 1557794351 Enrollment ID: I20230605002183 |
| Provider Name | Umair Saleem |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548528029 PECOS PAC ID: 3072896018 Enrollment ID: I20230831000450 |
| Provider Name | Parker D Lovelace |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588102164 PECOS PAC ID: 1052760717 Enrollment ID: I20231207000985 |
| Provider Name | Juan S Soche |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023672565 PECOS PAC ID: 3072841725 Enrollment ID: I20240127000397 |
| Provider Name | Jeffery Phillip Druck |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003925355 PECOS PAC ID: 9537144217 Enrollment ID: I20240207001121 |
| Provider Name | Omar Fares |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609335785 PECOS PAC ID: 6406186287 Enrollment ID: I20240209003361 |
| Provider Name | Ellen R Embick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285262196 PECOS PAC ID: 7618393612 Enrollment ID: I20240312003528 |
| Provider Name | Yumna Malik |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740858711 PECOS PAC ID: 2062859408 Enrollment ID: I20240321001509 |
| Provider Name | Jeffrey N Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851920698 PECOS PAC ID: 6305263294 Enrollment ID: I20240325001875 |
| Provider Name | Emily Frances Dollar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932662897 PECOS PAC ID: 3577891217 Enrollment ID: I20240327001605 |
| Provider Name | Cashana Betterly |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972967263 PECOS PAC ID: 5294027207 Enrollment ID: I20240419002470 |
| Provider Name | Sara Saad El-dein |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831576024 PECOS PAC ID: 2264737402 Enrollment ID: I20240424001033 |
| Provider Name | Brenda Camille Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295899763 PECOS PAC ID: 3779616354 Enrollment ID: I20240514001261 |
| Provider Name | Claire Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841637832 PECOS PAC ID: 8123262896 Enrollment ID: I20240531000140 |
| Provider Name | Amylia Black |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881947372 PECOS PAC ID: 4981858164 Enrollment ID: I20240531003920 |
| Provider Name | Kurt Doggwiler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942206933 PECOS PAC ID: 8921006164 Enrollment ID: I20240715001660 |
| Provider Name | Michael Morgan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740623313 PECOS PAC ID: 5092937599 Enrollment ID: I20240717002182 |
| Provider Name | Andrew Leamon |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750811865 PECOS PAC ID: 8527336023 Enrollment ID: I20240730003356 |
| Provider Name | Victoria L Wadman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881210425 PECOS PAC ID: 2163841180 Enrollment ID: I20240814002498 |
| Provider Name | Anjali Paramanandam |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194401745 PECOS PAC ID: 8729438486 Enrollment ID: I20240816002227 |
| Provider Name | Andrew Peters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770087769 PECOS PAC ID: 1557605235 Enrollment ID: I20240816002457 |
| Provider Name | Luke Hinzmann |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1871842435 PECOS PAC ID: 4082856273 Enrollment ID: I20240827001379 |
| Provider Name | James Cowan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114183670 PECOS PAC ID: 1951571207 Enrollment ID: I20240906000044 |
| Provider Name | Marschall S Runge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841351970 PECOS PAC ID: 0840108593 Enrollment ID: I20240911001955 |
| Provider Name | Robin Richard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306916218 PECOS PAC ID: 3476448507 Enrollment ID: I20240912000996 |
| Provider Name | Jessica Greenberg Cowan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710202478 PECOS PAC ID: 7012143548 Enrollment ID: I20241009004508 |
| Provider Name | Alana Claire Carstens Yalom |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932737616 PECOS PAC ID: 6305262304 Enrollment ID: I20241017003191 |
| Provider Name | Andrew Alto |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275374613 PECOS PAC ID: 3476099433 Enrollment ID: I20241017003862 |
| Provider Name | Daniel Wachter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306964184 PECOS PAC ID: 6002981230 Enrollment ID: I20241101003471 |
| Provider Name | Orrin Domingo Whaley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396576047 PECOS PAC ID: 6709319403 Enrollment ID: I20241104000400 |
| Provider Name | Hillary Baker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295363703 PECOS PAC ID: 6507390184 Enrollment ID: I20241106000680 |
| Provider Name | Joseph Davis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194330613 PECOS PAC ID: 2668873894 Enrollment ID: I20241126001699 |
| Provider Name | Matthew Fry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982284345 PECOS PAC ID: 9830599125 Enrollment ID: I20241127001348 |
| Provider Name | Rogelio Aguirre |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437795663 PECOS PAC ID: 6608200225 Enrollment ID: I20241213000383 |
| Provider Name | Jeffrey Morris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922111491 PECOS PAC ID: 4789736737 Enrollment ID: I20241219001026 |
| Provider Name | Anisha Tailor |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669080172 PECOS PAC ID: 5799109781 Enrollment ID: I20241223001772 |
| Provider Name | Molly Thayer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386271872 PECOS PAC ID: 2769807668 Enrollment ID: I20250305000126 |
Dhhs, Phs, Naihs, Shiprock Hospital Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: Us Highway 491 North, Shiprock, NM 87420 Phone: 505-368-6401 Fax: 505-368-6431 | |
Nizhoni Smiles, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: N Hwy 491, Shiprock, NM 87420 Phone: 505-368-5626 |