| St. Luke's Methodist Hospital | |
|
1026 A Ave Ne Cedar Rapids IA 52402-5036 | |
| (319) 369-7211 | |
| Not Available |
| Full Name | St. Luke's Methodist Hospital |
|---|---|
| Speciality | Internal Medicine |
| Location | 1026 A Ave Ne, Cedar Rapids, Iowa |
| Authorized Official Name and Position | Milton E Aunan (VP & CFO) |
| Authorized Official Contact | 3193697094 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Luke's Methodist Hospital Po Box 9306 Des Moines IA 50306-9306 Ph: (515) 471-9373 | St. Luke's Methodist Hospital 1026 A Ave Ne Cedar Rapids IA 52402-5036 Ph: (319) 369-7211 |
| NPI Number | 1073553939 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 07/18/2011 |
| Medicare PECOS PAC ID | 6608786751 |
|---|---|
| Medicare Enrollment ID | O20040204000942 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073553939 | NPI | - | NPPES |
| C62126 | Other | IA | RR MEDICARE |
| 0098098 | Medicaid | IA |
| Provider Name | Cindy L Hanawalt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316930779 PECOS PAC ID: 0244123321 Enrollment ID: I20040203000838 |
| Provider Name | Diane M Hoover |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073598215 PECOS PAC ID: 3476525270 Enrollment ID: I20040811001146 |
| Provider Name | Krishnarao Gorrepati |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588624811 PECOS PAC ID: 2062405095 Enrollment ID: I20041027000116 |
| Provider Name | Dustin L Arnold |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689617144 PECOS PAC ID: 9234193038 Enrollment ID: I20041111001041 |
| Provider Name | Farid F Manshadi |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1033197165 PECOS PAC ID: 2062476724 Enrollment ID: I20041112001110 |
| Provider Name | Hisham M Wagdy |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1053396283 PECOS PAC ID: 6901856343 Enrollment ID: I20050124001082 |
| Provider Name | Keith J Kopec |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588649875 PECOS PAC ID: 8729038161 Enrollment ID: I20050124001085 |
| Provider Name | Boothapuri Venkatesh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023093259 PECOS PAC ID: 0143279281 Enrollment ID: I20050314000168 |
| Provider Name | Subhi A Abu Halawa |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1417932708 PECOS PAC ID: 9133195803 Enrollment ID: I20050317000904 |
| Provider Name | Mohit K Chawla |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1861477002 PECOS PAC ID: 7315988367 Enrollment ID: I20050519000588 |
| Provider Name | Susan M Halter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144241837 PECOS PAC ID: 7416988647 Enrollment ID: I20050826000423 |
| Provider Name | Todd T Langager |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1992780183 PECOS PAC ID: 6709838956 Enrollment ID: I20050826000719 |
| Provider Name | James Russell Bell |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1528044310 PECOS PAC ID: 5193740785 Enrollment ID: I20051012001047 |
| Provider Name | Ladonna Woerdeman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1366522948 PECOS PAC ID: 3274559497 Enrollment ID: I20051018000234 |
| Provider Name | Ron Mark Oren |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1366422438 PECOS PAC ID: 5395761134 Enrollment ID: I20051020000556 |
| Provider Name | Julie K Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730165473 PECOS PAC ID: 3779502547 Enrollment ID: I20051122000368 |
| Provider Name | Marina V Stankovich |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578527974 PECOS PAC ID: 3779504287 Enrollment ID: I20051213000186 |
| Provider Name | Anita T Simison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629036546 PECOS PAC ID: 5698782662 Enrollment ID: I20060315000801 |
| Provider Name | Ahmet Ersin Atay |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1093790362 PECOS PAC ID: 2264484419 Enrollment ID: I20060327000879 |
| Provider Name | Richard T Kettelkamp |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922042894 PECOS PAC ID: 0749290674 Enrollment ID: I20060421000387 |
| Provider Name | Amy J Ganske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891891339 PECOS PAC ID: 3173529849 Enrollment ID: I20061020000210 |
| Provider Name | Roy H Lidtke |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1386641165 PECOS PAC ID: 2163456914 Enrollment ID: I20070404000635 |
| Provider Name | Garry D Weide |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1760559496 PECOS PAC ID: 3476658782 Enrollment ID: I20070416000287 |
| Provider Name | Meena Veluri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326249608 PECOS PAC ID: 6608968003 Enrollment ID: I20070815000158 |
| Provider Name | James Michael Levett |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1154329092 PECOS PAC ID: 0749374643 Enrollment ID: I20070924000141 |
| Provider Name | Carla S Huber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912193129 PECOS PAC ID: 3971690892 Enrollment ID: I20071024000555 |
| Provider Name | Holli A Lefavour |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194741157 PECOS PAC ID: 6800859513 Enrollment ID: I20080410000655 |
| Provider Name | Matthew J Mcmahon |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588692818 PECOS PAC ID: 6103840822 Enrollment ID: I20080624000524 |
| Provider Name | Judith K Anderson Bruner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750331039 PECOS PAC ID: 5890862932 Enrollment ID: I20080916000233 |
| Provider Name | Dana J Messenger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841493392 PECOS PAC ID: 0244397461 Enrollment ID: I20090316000112 |
| Provider Name | Ralph Saintfort |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184617995 PECOS PAC ID: 6002843810 Enrollment ID: I20090324000481 |
| Provider Name | Adam L Shires |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558441386 PECOS PAC ID: 4486707213 Enrollment ID: I20090727000662 |
| Provider Name | Wassef Karrowni |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1972713691 PECOS PAC ID: 0143375857 Enrollment ID: I20090902000181 |
| Provider Name | Patti A Zessin |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1336261866 PECOS PAC ID: 8426194598 Enrollment ID: I20091002000122 |
| Provider Name | Weiwei Li |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1871791210 PECOS PAC ID: 5193861292 Enrollment ID: I20091002000398 |
| Provider Name | Karen A Nelson Rietz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295721835 PECOS PAC ID: 6103964994 Enrollment ID: I20091116000570 |
| Provider Name | Stanley J Mathew |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1003053653 PECOS PAC ID: 5193874584 Enrollment ID: I20091214000184 |
| Provider Name | Brian Olshansky |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1962483347 PECOS PAC ID: 2062552110 Enrollment ID: I20100119000137 |
| Provider Name | Daniel A Trautman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912985680 PECOS PAC ID: 1759424971 Enrollment ID: I20100210000044 |
| Provider Name | John P Herring |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083694590 PECOS PAC ID: 4688577760 Enrollment ID: I20100513000401 |
| Provider Name | Julie A Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710003454 PECOS PAC ID: 3870626914 Enrollment ID: I20100727000351 |
| Provider Name | Douglas J Purdy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376528562 PECOS PAC ID: 9032243720 Enrollment ID: I20100817000768 |
| Provider Name | Leon L Qiao |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013992205 PECOS PAC ID: 0244364891 Enrollment ID: I20100818000034 |
| Provider Name | Sarah R Kluesner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679889661 PECOS PAC ID: 5395861868 Enrollment ID: I20100922000617 |
| Provider Name | Jennifer N Blume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407166473 PECOS PAC ID: 0244426377 Enrollment ID: I20101201000160 |
| Provider Name | Renee M Grummer-miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598891269 PECOS PAC ID: 0244308641 Enrollment ID: I20101208000036 |
| Provider Name | Eric T Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144438052 PECOS PAC ID: 8628259165 Enrollment ID: I20110216001072 |
| Provider Name | Laila A Payvandi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922261213 PECOS PAC ID: 9436335742 Enrollment ID: I20110523000392 |
| Provider Name | Ahmed M Abualfoul |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154504504 PECOS PAC ID: 9739367343 Enrollment ID: I20110630000471 |
| Provider Name | Addie N Ketelsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043519499 PECOS PAC ID: 7012195423 Enrollment ID: I20110706000333 |
| Provider Name | Pavan Chepyala |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1982828133 PECOS PAC ID: 5597833954 Enrollment ID: I20110803000306 |
| Provider Name | Brook N Sternberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376827113 PECOS PAC ID: 7315113198 Enrollment ID: I20111228000423 |
| Provider Name | Amit Pathak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225397037 PECOS PAC ID: 8729244082 Enrollment ID: I20120801000086 |
| Provider Name | Niyati Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942596986 PECOS PAC ID: 0244486736 Enrollment ID: I20120816000434 |
| Provider Name | Deepti S Kurra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255561023 PECOS PAC ID: 7618126574 Enrollment ID: I20121009000578 |
| Provider Name | Benjamin A Tallman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316291958 PECOS PAC ID: 3870743651 Enrollment ID: I20121101000640 |
| Provider Name | Melissa A Janssen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245584564 PECOS PAC ID: 1557516572 Enrollment ID: I20130223000118 |
| Provider Name | Melissa M Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356692131 PECOS PAC ID: 9638324502 Enrollment ID: I20130226000043 |
| Provider Name | Amanda M Oconnor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982867628 PECOS PAC ID: 0648416131 Enrollment ID: I20130430000153 |
| Provider Name | Matthew J Kidwell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508092552 PECOS PAC ID: 2860639846 Enrollment ID: I20130510000419 |
| Provider Name | Jessica L Deblois |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033552070 PECOS PAC ID: 6608016696 Enrollment ID: I20130716000524 |
| Provider Name | Waseemuddin Ahmed |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497913305 PECOS PAC ID: 1759532625 Enrollment ID: I20130820000995 |
| Provider Name | Kathryn R Reed |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487880258 PECOS PAC ID: 3870736960 Enrollment ID: I20130820001063 |
| Provider Name | Linda D Hodges |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528074671 PECOS PAC ID: 0547386740 Enrollment ID: I20130904000303 |
| Provider Name | Leslie M Greenlee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700105780 PECOS PAC ID: 5496989691 Enrollment ID: I20131001000285 |
| Provider Name | Erin E Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407297351 PECOS PAC ID: 4587890165 Enrollment ID: I20131204001657 |
| Provider Name | Sachin S Nunnewar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114161908 PECOS PAC ID: 1850445578 Enrollment ID: I20131206000822 |
| Provider Name | Claire M Baumgartner |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1952575524 PECOS PAC ID: 5698924066 Enrollment ID: I20131217002008 |
| Provider Name | Sarah R Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871927681 PECOS PAC ID: 7214165109 Enrollment ID: I20140123000800 |
| Provider Name | Amanda Mary Forystek |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679866123 PECOS PAC ID: 9638319767 Enrollment ID: I20140314001940 |
| Provider Name | Eric N Boyum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093034266 PECOS PAC ID: 7517107956 Enrollment ID: I20140319002351 |
| Provider Name | Evan Q Ouyang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477848190 PECOS PAC ID: 6608016027 Enrollment ID: I20140410000211 |
| Provider Name | Georges P Hajj |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1619175114 PECOS PAC ID: 5294974721 Enrollment ID: I20140506001867 |
| Provider Name | Erin E Balk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942615042 PECOS PAC ID: 3971721069 Enrollment ID: I20140903001078 |
| Provider Name | William Ching |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285831636 PECOS PAC ID: 2062584584 Enrollment ID: I20140915001725 |
| Provider Name | Kristy Ann Kapfhamer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518109172 PECOS PAC ID: 9537393632 Enrollment ID: I20140918002384 |
| Provider Name | Megan M Adams-rieck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558568469 PECOS PAC ID: 0244310746 Enrollment ID: I20141010001051 |
| Provider Name | Sharon A Collins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730186958 PECOS PAC ID: 6608098736 Enrollment ID: I20141105001432 |
| Provider Name | Andrea Nicole Weber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205194370 PECOS PAC ID: 9830339969 Enrollment ID: I20150105000741 |
| Provider Name | Jason Joseph Miiller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1699069138 PECOS PAC ID: 7810117702 Enrollment ID: I20150314000221 |
| Provider Name | Jamsheed H Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578850277 PECOS PAC ID: 6002133261 Enrollment ID: I20150326001998 |
| Provider Name | Terrie Lee Vann Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093706194 PECOS PAC ID: 6709875248 Enrollment ID: I20150424000863 |
| Provider Name | Michael J Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104175405 PECOS PAC ID: 3779735683 Enrollment ID: I20150504002270 |
| Provider Name | Ojas Bansal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467766410 PECOS PAC ID: 2769702406 Enrollment ID: I20150521000349 |
| Provider Name | Jay Diaz-parlet |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417011875 PECOS PAC ID: 9032246046 Enrollment ID: I20150610000685 |
| Provider Name | Ankur Vyas |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1528222320 PECOS PAC ID: 1052551082 Enrollment ID: I20150707002423 |
| Provider Name | Manuel Proenza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336401256 PECOS PAC ID: 9931348521 Enrollment ID: I20150717001132 |
| Provider Name | Shana Lea Coker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376860502 PECOS PAC ID: 7719106400 Enrollment ID: I20150730011236 |
| Provider Name | Wesley R Benn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174905772 PECOS PAC ID: 5496069619 Enrollment ID: I20150731016975 |
| Provider Name | Lisa Jo Mahoney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861875635 PECOS PAC ID: 5294040614 Enrollment ID: I20150813012230 |
| Provider Name | Molly A Garber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871979823 PECOS PAC ID: 1759697451 Enrollment ID: I20150826000272 |
| Provider Name | Oluwarotimi Adepoju |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982950937 PECOS PAC ID: 6608182084 Enrollment ID: I20150831001795 |
| Provider Name | Katie M Maybanks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396120036 PECOS PAC ID: 3274849146 Enrollment ID: I20150909000564 |
| Provider Name | Devin Rh Smith |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1306136197 PECOS PAC ID: 0941517437 Enrollment ID: I20150916000849 |
| Provider Name | Amiee L Luedeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881061471 PECOS PAC ID: 5294042727 Enrollment ID: I20150916002100 |
| Provider Name | Kiley S Schroeder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750753174 PECOS PAC ID: 2668782087 Enrollment ID: I20151113001410 |
| Provider Name | Aubrie A Stuckey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679944904 PECOS PAC ID: 6800196379 Enrollment ID: I20151207000233 |
| Provider Name | Naomi Bloom |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851464846 PECOS PAC ID: 4880760982 Enrollment ID: I20151210002663 |
| Provider Name | Ravneet Gill |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1013352004 PECOS PAC ID: 6800039900 Enrollment ID: I20160209000999 |
| Provider Name | Ginger R Massey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326058074 PECOS PAC ID: 4789687187 Enrollment ID: I20160425001581 |
| Provider Name | Richard T Pardilla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467879619 PECOS PAC ID: 6901022847 Enrollment ID: I20160606001345 |
| Provider Name | Cyndi J Mccormick |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356754337 PECOS PAC ID: 2365660867 Enrollment ID: I20160623001916 |
| Provider Name | Fahed Al Darazi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1497063200 PECOS PAC ID: 9234376153 Enrollment ID: I20160708001936 |
| Provider Name | Corissa Vidal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134570278 PECOS PAC ID: 3476846304 Enrollment ID: I20160729000378 |
| Provider Name | Michelle M Wenzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639522899 PECOS PAC ID: 8527352038 Enrollment ID: I20160805001774 |
| Provider Name | Brittni M Benda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821333774 PECOS PAC ID: 4880988070 Enrollment ID: I20160811000133 |
| Provider Name | Nicholas R Appleby |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1396002960 PECOS PAC ID: 2769701275 Enrollment ID: I20160811000178 |
| Provider Name | Emily J Fye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588118731 PECOS PAC ID: 8123313319 Enrollment ID: I20160826001879 |
| Provider Name | Kyle Preuninger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811443450 PECOS PAC ID: 2466749387 Enrollment ID: I20160921000389 |
| Provider Name | Timothy Daniel Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841602315 PECOS PAC ID: 2062639586 Enrollment ID: I20160926001574 |
| Provider Name | Usha H Chhatlani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669891719 PECOS PAC ID: 6103042056 Enrollment ID: I20161025000366 |
| Provider Name | Diane K Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467652206 PECOS PAC ID: 4486935129 Enrollment ID: I20170111001963 |
| Provider Name | Marie E Volbrecht |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1265485866 PECOS PAC ID: 3678573557 Enrollment ID: I20170518000131 |
| Provider Name | Bethany A Kirton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548794951 PECOS PAC ID: 6901174515 Enrollment ID: I20170622000630 |
| Provider Name | Teresa Anne Young |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124331699 PECOS PAC ID: 9830463413 Enrollment ID: I20170920001810 |
| Provider Name | Jamie M Truscott |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013350289 PECOS PAC ID: 9537461934 Enrollment ID: I20171013001701 |
| Provider Name | Heather N Dommer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417475971 PECOS PAC ID: 9436425543 Enrollment ID: I20171017002954 |
| Provider Name | Jennifer B Driscoll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497260491 PECOS PAC ID: 6507127081 Enrollment ID: I20180223002507 |
| Provider Name | Jacob N Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548613490 PECOS PAC ID: 1052605524 Enrollment ID: I20180703002150 |
| Provider Name | Katheryn L Paulsen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427445790 PECOS PAC ID: 2860706751 Enrollment ID: I20180911002460 |
| Provider Name | Nhan-ai T Truong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114313913 PECOS PAC ID: 3173823010 Enrollment ID: I20181030002052 |
| Provider Name | Mackenzie A Behof |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578031951 PECOS PAC ID: 1456694462 Enrollment ID: I20190515000092 |
| Provider Name | Tiffany Marie Ehlers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205491552 PECOS PAC ID: 9335474642 Enrollment ID: I20190709002109 |
| Provider Name | Arpit Sothwal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518309681 PECOS PAC ID: 9133420888 Enrollment ID: I20190827001402 |
| Provider Name | Tyrone Galbreath |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1356636245 PECOS PAC ID: 7416178199 Enrollment ID: I20190916000545 |
| Provider Name | Heather M Mactaggart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275165482 PECOS PAC ID: 5496184145 Enrollment ID: I20200401002627 |
| Provider Name | Murtadha Abdulhussein |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316280738 PECOS PAC ID: 0547529752 Enrollment ID: I20200612001035 |
| Provider Name | Amy Leclere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083224844 PECOS PAC ID: 9739599051 Enrollment ID: I20201027002774 |
| Provider Name | Hope E Breitbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568075331 PECOS PAC ID: 1052725553 Enrollment ID: I20210125000995 |
| Provider Name | Maria Swisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568063667 PECOS PAC ID: 1153736780 Enrollment ID: I20210212001122 |
| Provider Name | Jennifer Christine Hohneke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558995589 PECOS PAC ID: 6305251794 Enrollment ID: I20210217001164 |
| Provider Name | Kathryn Elizabeth Farley |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306453121 PECOS PAC ID: 0446665517 Enrollment ID: I20210223001902 |
| Provider Name | Andreas Kyvernitakis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538556717 PECOS PAC ID: 3274821475 Enrollment ID: I20211008001266 |
| Provider Name | Brittney Nicole Both |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164093365 PECOS PAC ID: 7911395603 Enrollment ID: I20211029000879 |
| Provider Name | Maridith Hollis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730612086 PECOS PAC ID: 9234484213 Enrollment ID: I20211124000974 |
| Provider Name | Bill T Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023578713 PECOS PAC ID: 5698001410 Enrollment ID: I20211129000472 |
| Provider Name | Talha A Farid |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396090353 PECOS PAC ID: 0042614190 Enrollment ID: I20211202001314 |
| Provider Name | Alvise F Bernabei |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588679013 PECOS PAC ID: 0941218507 Enrollment ID: I20211221002056 |
| Provider Name | A. Michael Borkon |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1336190602 PECOS PAC ID: 6002707908 Enrollment ID: I20220131000141 |
| Provider Name | Tanner N Castel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417602418 PECOS PAC ID: 9537554951 Enrollment ID: I20220322002986 |
| Provider Name | Amy Vincent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598425720 PECOS PAC ID: 1951796218 Enrollment ID: I20220323001608 |
| Provider Name | Kelli Marie Udelhofen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962663468 PECOS PAC ID: 6800065145 Enrollment ID: I20220603000916 |
| Provider Name | William E Curtis |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1215090527 PECOS PAC ID: 0042220071 Enrollment ID: I20220606001181 |
| Provider Name | Brandan K Penaluna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497312326 PECOS PAC ID: 9133454242 Enrollment ID: I20220707001877 |
| Provider Name | Eugene Crafton |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508874850 PECOS PAC ID: 0042388795 Enrollment ID: I20220902001116 |
| Provider Name | Jess Joymon |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1598916405 PECOS PAC ID: 0042500704 Enrollment ID: I20221013001577 |
| Provider Name | Cyril E Tabe |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1558457135 PECOS PAC ID: 4183624125 Enrollment ID: I20221207003118 |
| Provider Name | Brooke O Olson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992384903 PECOS PAC ID: 6204238116 Enrollment ID: I20230602000107 |
| Provider Name | Xiaoxi Yang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578068375 PECOS PAC ID: 2860748480 Enrollment ID: I20230622002825 |
| Provider Name | Brigid Adviento |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265924849 PECOS PAC ID: 2668729302 Enrollment ID: I20230627002159 |
| Provider Name | Carolyn Wong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952937880 PECOS PAC ID: 6709208275 Enrollment ID: I20230703001584 |
| Provider Name | Bailey J Zaruba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053099051 PECOS PAC ID: 3870954738 Enrollment ID: I20230725003822 |
| Provider Name | Elissa Charlotte Zakrasek |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1720397946 PECOS PAC ID: 6507119070 Enrollment ID: I20231116001258 |
| Provider Name | Heather Harris |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336394766 PECOS PAC ID: 6608144217 Enrollment ID: I20231128002322 |
| Provider Name | Ashfaq A. Khan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1093754731 PECOS PAC ID: 5698763738 Enrollment ID: I20240105000987 |
| Provider Name | Nidhi Madan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1285049197 PECOS PAC ID: 2860762101 Enrollment ID: I20240119000311 |
| Provider Name | Michele Tangeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730951922 PECOS PAC ID: 0244683191 Enrollment ID: I20240127000400 |
| Provider Name | Amanda Jo Norton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669159117 PECOS PAC ID: 1153774542 Enrollment ID: I20240201002640 |
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