| Iu Health Medical Group Riley Specialists, LLC | |
|
705 Riley Hospital Dr Indianapolis IN 46202-5109 | |
| (317) 944-5000 | |
| Not Available |
| Full Name | Iu Health Medical Group Riley Specialists, LLC |
|---|---|
| Speciality | Pediatrics |
| Location | 705 Riley Hospital Dr, Indianapolis, Indiana |
| Authorized Official Name and Position | Todd Williams (CFO) |
| Authorized Official Contact | 3179483525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iu Health Medical Group Riley Specialists, LLC 250 N Shadeland Ave Indianapolis IN 46219-4959 | Iu Health Medical Group Riley Specialists, LLC 705 Riley Hospital Dr Indianapolis IN 46202-5109 Ph: (317) 944-5000 |
| NPI Number | 1699561480 |
|---|---|
| Provider Enumeration Date | 04/17/2025 |
| Last Update Date | 09/02/2025 |
| Certification Date | 09/02/2025 |
| Medicare PECOS PAC ID | 9638669815 |
|---|---|
| Medicare Enrollment ID | O20251106001468 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699561480 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | () | Secondary |
| 208000000X | Pediatrics | () | Primary |
| Provider Name | Francis E Marshalleck |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1477593846 PECOS PAC ID: 2163335423 Enrollment ID: I20031112000079 |
| Provider Name | Tiffanie R Johnson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932142809 PECOS PAC ID: 3678477205 Enrollment ID: I20031125000045 |
| Provider Name | Joseph Marino Buadoo-croffie |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164538690 PECOS PAC ID: 7719961085 Enrollment ID: I20040615000617 |
| Provider Name | Derek T Sprunger |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184625311 PECOS PAC ID: 8426032434 Enrollment ID: I20040616001396 |
| Provider Name | Jeffrey D Macke |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174632129 PECOS PAC ID: 9335114255 Enrollment ID: I20040901001290 |
| Provider Name | Corina Nailescu |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1043328057 PECOS PAC ID: 8123096526 Enrollment ID: I20040923000277 |
| Provider Name | Hasnaa Eskandar Jalou |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1568447514 PECOS PAC ID: 1951370196 Enrollment ID: I20040925000048 |
| Provider Name | Steven J Steiner |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760413991 PECOS PAC ID: 7214906114 Enrollment ID: I20040928000606 |
| Provider Name | Mary Verghese |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265466908 PECOS PAC ID: 9739158643 Enrollment ID: I20040928000644 |
| Provider Name | Chansamone Saysana |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1225089881 PECOS PAC ID: 3375502511 Enrollment ID: I20041005000273 |
| Provider Name | Deborah K Hamby |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780782698 PECOS PAC ID: 0345209516 Enrollment ID: I20041005000473 |
| Provider Name | Mary R Rouse |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578509345 PECOS PAC ID: 1456259340 Enrollment ID: I20041005000710 |
| Provider Name | Mary M Weakley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801868989 PECOS PAC ID: 6305805441 Enrollment ID: I20041005001015 |
| Provider Name | Tamara S. Hannon |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1750354510 PECOS PAC ID: 8123092665 Enrollment ID: I20041006001353 |
| Provider Name | Dana L Donaldson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649271867 PECOS PAC ID: 8820057698 Enrollment ID: I20041007000196 |
| Provider Name | Erin J Phipps |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063460319 PECOS PAC ID: 6709846801 Enrollment ID: I20041013000770 |
| Provider Name | Christopher O Wood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073553293 PECOS PAC ID: 8325000722 Enrollment ID: I20041028000499 |
| Provider Name | David D Weaver |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1508822545 PECOS PAC ID: 6305808403 Enrollment ID: I20041101000751 |
| Provider Name | Eric a Albright |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1437135506 PECOS PAC ID: 5294799912 Enrollment ID: I20041112000800 |
| Provider Name | Richard B Gunderman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760420814 PECOS PAC ID: 1850355744 Enrollment ID: I20041119000420 |
| Provider Name | Laurence E Walsh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235153636 PECOS PAC ID: 9739145004 Enrollment ID: I20041208000501 |
| Provider Name | Bruce H Matt |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1013941558 PECOS PAC ID: 2365338431 Enrollment ID: I20050125000821 |
| Provider Name | Thomas L. Klausmeier |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1932151800 PECOS PAC ID: 7214987965 Enrollment ID: I20050131000259 |
| Provider Name | Kirstan K Meldrum |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1720073497 PECOS PAC ID: 7416900667 Enrollment ID: I20050228000602 |
| Provider Name | William G Kronenberger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184678609 PECOS PAC ID: 4587554464 Enrollment ID: I20050419001471 |
| Provider Name | John C Stevens |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053404947 PECOS PAC ID: 7618915588 Enrollment ID: I20050420001381 |
| Provider Name | Robert K Darragh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265541262 PECOS PAC ID: 9638117450 Enrollment ID: I20050421001366 |
| Provider Name | Boaz Karmazyn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750320107 PECOS PAC ID: 0840239612 Enrollment ID: I20050502000055 |
| Provider Name | Sharon M Hubbard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053308106 PECOS PAC ID: 6507834090 Enrollment ID: I20050705000257 |
| Provider Name | Kimberly S Schneider |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649266677 PECOS PAC ID: 1052357449 Enrollment ID: I20050707000660 |
| Provider Name | Kari a Lemme |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881764520 PECOS PAC ID: 3173550118 Enrollment ID: I20050721000625 |
| Provider Name | Matthew R Wanner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134142300 PECOS PAC ID: 3870521479 Enrollment ID: I20050803000513 |
| Provider Name | Gregory S Montgomery |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1902915960 PECOS PAC ID: 1951381813 Enrollment ID: I20050809000447 |
| Provider Name | Erica a Eugster |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1629183140 PECOS PAC ID: 4284650672 Enrollment ID: I20051014000445 |
| Provider Name | Stacy Marie Kritzmire |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699726604 PECOS PAC ID: 7517984602 Enrollment ID: I20051027001117 |
| Provider Name | Frederick John Rescorla |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831169820 PECOS PAC ID: 8224042650 Enrollment ID: I20060206000461 |
| Provider Name | Alan P Ladd |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437129434 PECOS PAC ID: 7618981051 Enrollment ID: I20060206000518 |
| Provider Name | Lisa Roberta Delaney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831132828 PECOS PAC ID: 8729094594 Enrollment ID: I20060302000648 |
| Provider Name | John Stephen Fuqua |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1669587184 PECOS PAC ID: 7719997881 Enrollment ID: I20060503000736 |
| Provider Name | Rosalia Misseri |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1538127501 PECOS PAC ID: 2365412350 Enrollment ID: I20060721000140 |
| Provider Name | Morton C Green |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770534877 PECOS PAC ID: 5294730131 Enrollment ID: I20060927000180 |
| Provider Name | John D Emhardt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699725994 PECOS PAC ID: 9032114988 Enrollment ID: I20060927000260 |
| Provider Name | Eugene Patrick Presto |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154391563 PECOS PAC ID: 1456382878 Enrollment ID: I20060927000382 |
| Provider Name | Jacquelyn E Allison |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588601116 PECOS PAC ID: 4385649250 Enrollment ID: I20060927000396 |
| Provider Name | Robert G Presson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407809833 PECOS PAC ID: 5193710960 Enrollment ID: I20060927000404 |
| Provider Name | Scott G Walker |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831142181 PECOS PAC ID: 5799780664 Enrollment ID: I20060927000439 |
| Provider Name | James a Tolley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588617831 PECOS PAC ID: 9537164421 Enrollment ID: I20060928000008 |
| Provider Name | George J Sheplock |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881641140 PECOS PAC ID: 5799780680 Enrollment ID: I20060928000017 |
| Provider Name | William L Mcniece |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679524367 PECOS PAC ID: 5496750325 Enrollment ID: I20060928000041 |
| Provider Name | Michael S Mazurek |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780637108 PECOS PAC ID: 5092710996 Enrollment ID: I20060928000088 |
| Provider Name | Leigh B Latham |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679524318 PECOS PAC ID: 1456356351 Enrollment ID: I20060928000097 |
| Provider Name | Doris M Hardacker |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508817503 PECOS PAC ID: 6406851310 Enrollment ID: I20060928000136 |
| Provider Name | Ronald M. Payne |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083646723 PECOS PAC ID: 9830129576 Enrollment ID: I20061003000419 |
| Provider Name | Alvaro J Tori |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1841239241 PECOS PAC ID: 0042219990 Enrollment ID: I20061204000386 |
| Provider Name | Todd D Nebesio |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1487621769 PECOS PAC ID: 7012916992 Enrollment ID: I20061205000026 |
| Provider Name | Jennifer H Kersey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427076603 PECOS PAC ID: 7012916414 Enrollment ID: I20061213000085 |
| Provider Name | Anita N Haggstrom |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1639288723 PECOS PAC ID: 3971579251 Enrollment ID: I20070112000199 |
| Provider Name | Brenna C Mcdonald |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821166315 PECOS PAC ID: 4981702255 Enrollment ID: I20070611000166 |
| Provider Name | Nadine George Haddad |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1285749713 PECOS PAC ID: 5597864744 Enrollment ID: I20070628000449 |
| Provider Name | Mara E Nitu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1770692741 PECOS PAC ID: 5193825719 Enrollment ID: I20070712000083 |
| Provider Name | Susan H Ballinger |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1780793869 PECOS PAC ID: 6406956663 Enrollment ID: I20070717000502 |
| Provider Name | Elizabeth Weinstein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205039583 PECOS PAC ID: 8527169382 Enrollment ID: I20070723000828 |
| Provider Name | Kathryn M Haider |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1144421041 PECOS PAC ID: 0749372977 Enrollment ID: I20070817000383 |
| Provider Name | Jason F Woodward |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972726123 PECOS PAC ID: 6901999119 Enrollment ID: I20070904000688 |
| Provider Name | Christine B Caltoum |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386620854 PECOS PAC ID: 8325133721 Enrollment ID: I20071113000041 |
| Provider Name | Zeina M Nabhan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265650527 PECOS PAC ID: 2961582911 Enrollment ID: I20080103000626 |
| Provider Name | Jacqueline a Maiers |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043423247 PECOS PAC ID: 6608957121 Enrollment ID: I20080122000588 |
| Provider Name | Lisa H Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043293236 PECOS PAC ID: 4880776434 Enrollment ID: I20080205000056 |
| Provider Name | Leslie a Hulvershorn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073782611 PECOS PAC ID: 1759467970 Enrollment ID: I20080327000445 |
| Provider Name | Matthew C Hamilton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447419486 PECOS PAC ID: 9335212075 Enrollment ID: I20080714000637 |
| Provider Name | Michael C Blakley |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1184607038 PECOS PAC ID: 7315010972 Enrollment ID: I20080716000128 |
| Provider Name | Timothy M Cordes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851409825 PECOS PAC ID: 0345309688 Enrollment ID: I20081031000504 |
| Provider Name | Richard C Rink |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1720074149 PECOS PAC ID: 4486624418 Enrollment ID: I20090112000436 |
| Provider Name | Andrea D Weist |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407965494 PECOS PAC ID: 1759445893 Enrollment ID: I20090204000255 |
| Provider Name | Noha F Minshawi-patterson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811165517 PECOS PAC ID: 1052477148 Enrollment ID: I20090225000210 |
| Provider Name | Blake a Froberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851444707 PECOS PAC ID: 9931266400 Enrollment ID: I20090327000178 |
| Provider Name | Joseph O Neil |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902915085 PECOS PAC ID: 1850448929 Enrollment ID: I20090406000586 |
| Provider Name | Ann M Lagges |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083661391 PECOS PAC ID: 9638236417 Enrollment ID: I20090430000073 |
| Provider Name | Eugenia P Molleston |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881701654 PECOS PAC ID: 5890844872 Enrollment ID: I20090521000441 |
| Provider Name | Christopher T Jackman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609081264 PECOS PAC ID: 7214087170 Enrollment ID: I20090615000633 |
| Provider Name | Abigail F Klemsz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912014770 PECOS PAC ID: 3779635446 Enrollment ID: I20090710000525 |
| Provider Name | Rebekah L Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356537351 PECOS PAC ID: 0941353395 Enrollment ID: I20090801000028 |
| Provider Name | Valerie J Weesner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639302797 PECOS PAC ID: 3274679493 Enrollment ID: I20091001000323 |
| Provider Name | Elizabeth L Begyn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306170626 PECOS PAC ID: 0547307241 Enrollment ID: I20091029000365 |
| Provider Name | Sandeep Batra |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1699855635 PECOS PAC ID: 8527044908 Enrollment ID: I20091103000442 |
| Provider Name | Girish V Vitalpur |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1770593352 PECOS PAC ID: 6709924277 Enrollment ID: I20091104000268 |
| Provider Name | Abhay Singhal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962595850 PECOS PAC ID: 9931241312 Enrollment ID: I20100122000573 |
| Provider Name | David W Dunn |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184661472 PECOS PAC ID: 3173658341 Enrollment ID: I20100315000228 |
| Provider Name | Amy C. Wilson |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1578770608 PECOS PAC ID: 6901933324 Enrollment ID: I20100416000105 |
| Provider Name | Rebecca S. Rose |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861689663 PECOS PAC ID: 3072643683 Enrollment ID: I20100608000785 |
| Provider Name | Michael a Acquaviva |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972765444 PECOS PAC ID: 5294867875 Enrollment ID: I20100716000565 |
| Provider Name | Patricia a Treadwell |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1508892613 PECOS PAC ID: 3577696319 Enrollment ID: I20100730000856 |
| Provider Name | Darlene R House |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558563874 PECOS PAC ID: 6507999034 Enrollment ID: I20100804000034 |
| Provider Name | Allison M Yancey |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1396949178 PECOS PAC ID: 7618000829 Enrollment ID: I20100809000158 |
| Provider Name | Laurie Ackerman |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1477667426 PECOS PAC ID: 0345209821 Enrollment ID: I20100820001047 |
| Provider Name | Heather a Smith |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1831392935 PECOS PAC ID: 8729102306 Enrollment ID: I20100903000081 |
| Provider Name | Brandon Patrick Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366615478 PECOS PAC ID: 3375668973 Enrollment ID: I20100920001084 |
| Provider Name | Mark P Cain |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912993320 PECOS PAC ID: 1052381084 Enrollment ID: I20101004000490 |
| Provider Name | Michelle S. Howenstine |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1568571693 PECOS PAC ID: 2365636891 Enrollment ID: I20101028001353 |
| Provider Name | Marcia V Felker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255548558 PECOS PAC ID: 9335333228 Enrollment ID: I20101104000922 |
| Provider Name | Anne G Farrell |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548378524 PECOS PAC ID: 0345436465 Enrollment ID: I20101130001445 |
| Provider Name | Mark D Rodefeld |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1841393311 PECOS PAC ID: 7517154438 Enrollment ID: I20101203001243 |
| Provider Name | Eric S Ebenroth |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134237100 PECOS PAC ID: 6305033275 Enrollment ID: I20101206000420 |
| Provider Name | Mark H Hoyer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013020353 PECOS PAC ID: 3577750207 Enrollment ID: I20101207001316 |
| Provider Name | Mark W Turrentine |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1952416356 PECOS PAC ID: 2466647821 Enrollment ID: I20101213000262 |
| Provider Name | Shamaila Waseem |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457381519 PECOS PAC ID: 7911194162 Enrollment ID: I20101214000461 |
| Provider Name | April L Graves |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1558672592 PECOS PAC ID: 1153510011 Enrollment ID: I20110106001155 |
| Provider Name | Debbie Jo Hall |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992703581 PECOS PAC ID: 4688863939 Enrollment ID: I20110118001014 |
| Provider Name | Marcus S. Schamberger |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316962640 PECOS PAC ID: 8628257466 Enrollment ID: I20110125000818 |
| Provider Name | Emily C. Walvoord |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1023044419 PECOS PAC ID: 4880873629 Enrollment ID: I20110125000846 |
| Provider Name | John C Christenson |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1548364052 PECOS PAC ID: 0042499477 Enrollment ID: I20110131001055 |
| Provider Name | Sandra Hervey Schwab |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346284387 PECOS PAC ID: 4880675875 Enrollment ID: I20110217000373 |
| Provider Name | Myda Khalid |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1629146568 PECOS PAC ID: 1153504071 Enrollment ID: I20110330000186 |
| Provider Name | Martin H Plawecki |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679730261 PECOS PAC ID: 8123204872 Enrollment ID: I20110516000219 |
| Provider Name | Sabeena Hubbard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124209903 PECOS PAC ID: 4385718063 Enrollment ID: I20110629000002 |
| Provider Name | Heather R Saavedra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295823102 PECOS PAC ID: 8820270747 Enrollment ID: I20110707000335 |
| Provider Name | April a Jones |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1679860993 PECOS PAC ID: 0143490870 Enrollment ID: I20110907000863 |
| Provider Name | Stacey Elaine Tarvin |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1639380769 PECOS PAC ID: 0446420103 Enrollment ID: I20110907001193 |
| Provider Name | Martin Kaefer |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1740276880 PECOS PAC ID: 9032189063 Enrollment ID: I20111027000066 |
| Provider Name | David Plager |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1922009083 PECOS PAC ID: 7416926258 Enrollment ID: I20111201000166 |
| Provider Name | W. Scott Goebel |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1518077957 PECOS PAC ID: 5991962680 Enrollment ID: I20120208000456 |
| Provider Name | Daniel E Neely |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1144221326 PECOS PAC ID: 8729246210 Enrollment ID: I20120301000487 |
| Provider Name | Jason Z Niehaus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578798286 PECOS PAC ID: 6406017177 Enrollment ID: I20120406000000 |
| Provider Name | Melissa D Bell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083710990 PECOS PAC ID: 0547366437 Enrollment ID: I20120514000562 |
| Provider Name | Cory D Showalter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699982553 PECOS PAC ID: 3476628496 Enrollment ID: I20120523000381 |
| Provider Name | Courtney M. Rowan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1801005020 PECOS PAC ID: 4981867975 Enrollment ID: I20120601000174 |
| Provider Name | Michael J. Hobson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1437332541 PECOS PAC ID: 6406980259 Enrollment ID: I20120605000222 |
| Provider Name | Seethal A. Jacob |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447486907 PECOS PAC ID: 9931363835 Enrollment ID: I20120605000469 |
| Provider Name | Samer M.A. Abu Sultaneh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1730393869 PECOS PAC ID: 3678757317 Enrollment ID: I20120608000379 |
| Provider Name | Aura I. Cristea |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477724862 PECOS PAC ID: 7315101854 Enrollment ID: I20120612000582 |
| Provider Name | Mark E Fons |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1699863647 PECOS PAC ID: 3274798384 Enrollment ID: I20120622000116 |
| Provider Name | Megan B Marine |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780845941 PECOS PAC ID: 6406011527 Enrollment ID: I20120622000278 |
| Provider Name | Molly A. Bozic |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1801086269 PECOS PAC ID: 0042475014 Enrollment ID: I20120626000521 |
| Provider Name | Benjamin Michael Whittam |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1508913328 PECOS PAC ID: 1052576618 Enrollment ID: I20120705000026 |
| Provider Name | Melissa D Lah |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1962607820 PECOS PAC ID: 2264698356 Enrollment ID: I20120717000538 |
| Provider Name | Riad Lutfi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1558504506 PECOS PAC ID: 6406012590 Enrollment ID: I20120717000587 |
| Provider Name | Charles P.B. Vanderpool |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1033266820 PECOS PAC ID: 4880850767 Enrollment ID: I20120720000322 |
| Provider Name | Michael W Johansen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578772158 PECOS PAC ID: 0648436204 Enrollment ID: I20120725000928 |
| Provider Name | Brian N Egan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659579308 PECOS PAC ID: 2961668207 Enrollment ID: I20120731000765 |
| Provider Name | Rachel B Yoder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124347703 PECOS PAC ID: 0749436608 Enrollment ID: I20120808000459 |
| Provider Name | Jodi L. Skiles |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700094679 PECOS PAC ID: 6204083108 Enrollment ID: I20120829000010 |
| Provider Name | Julianne M Giust |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245458744 PECOS PAC ID: 1254511934 Enrollment ID: I20121114000084 |
| Provider Name | Angela M Dietrich Kusch |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174709182 PECOS PAC ID: 4284886045 Enrollment ID: I20121201000051 |
| Provider Name | Amber D Hunt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487974622 PECOS PAC ID: 1951554443 Enrollment ID: I20130111000472 |
| Provider Name | Sunil S Tholpady |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1689887150 PECOS PAC ID: 7517103682 Enrollment ID: I20130415000482 |
| Provider Name | Sean M Thompson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740414168 PECOS PAC ID: 3274770359 Enrollment ID: I20130508000652 |
| Provider Name | Kirsten M Kloepfer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730394206 PECOS PAC ID: 8527245927 Enrollment ID: I20130528000486 |
| Provider Name | Troy a Markel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932397015 PECOS PAC ID: 6608015987 Enrollment ID: I20130618000042 |
| Provider Name | Amanda D Benaderet |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619138989 PECOS PAC ID: 9133385008 Enrollment ID: I20130805000111 |
| Provider Name | Nayan T Srivastava |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801113444 PECOS PAC ID: 0840437547 Enrollment ID: I20130805000685 |
| Provider Name | Rania Karam Abbasi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073786802 PECOS PAC ID: 5193962702 Enrollment ID: I20130816000013 |
| Provider Name | Patrick William Clements |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477872463 PECOS PAC ID: 2567602295 Enrollment ID: I20130821000545 |
| Provider Name | Benjamin K Nti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407082068 PECOS PAC ID: 2668615949 Enrollment ID: I20130905000848 |
| Provider Name | Matthew L Cooper |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912168915 PECOS PAC ID: 8325282577 Enrollment ID: I20130910000575 |
| Provider Name | Christopher W Mastropietro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871520338 PECOS PAC ID: 7012912330 Enrollment ID: I20130925000686 |
| Provider Name | Jessica M Kanis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558442715 PECOS PAC ID: 8325193485 Enrollment ID: I20131015000871 |
| Provider Name | Nancy B Johnson |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1962517490 PECOS PAC ID: 0547494981 Enrollment ID: I20131017001817 |
| Provider Name | Jill C Fodstad |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710237458 PECOS PAC ID: 4183859465 Enrollment ID: I20131022000721 |
| Provider Name | Sarah Isis Delima |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427218098 PECOS PAC ID: 5294971677 Enrollment ID: I20140320001173 |
| Provider Name | Amy E Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437358413 PECOS PAC ID: 9234390485 Enrollment ID: I20140411001145 |
| Provider Name | Kerry M. Hege |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1316109598 PECOS PAC ID: 1052544665 Enrollment ID: I20140506002166 |
| Provider Name | Henry Robert Knouse |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275824500 PECOS PAC ID: 8123265139 Enrollment ID: I20140508001262 |
| Provider Name | Gregory W Faris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720235401 PECOS PAC ID: 2062684186 Enrollment ID: I20140509000652 |
| Provider Name | Evans M. Machogu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871755884 PECOS PAC ID: 0941423693 Enrollment ID: I20140527000984 |
| Provider Name | Adam C. Kean |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689708208 PECOS PAC ID: 4183873680 Enrollment ID: I20140609000972 |
| Provider Name | Jordan C Huskins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902048325 PECOS PAC ID: 1658595897 Enrollment ID: I20140610001052 |
| Provider Name | Julie D Dunlap |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124253646 PECOS PAC ID: 3072752807 Enrollment ID: I20140702001385 |
| Provider Name | Kamal M. M. Abulebda |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336395565 PECOS PAC ID: 4587889605 Enrollment ID: I20140703001832 |
| Provider Name | Ryan D. Alexy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114118452 PECOS PAC ID: 4183776156 Enrollment ID: I20140710001207 |
| Provider Name | Emily L Mueller |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1376835975 PECOS PAC ID: 8820213622 Enrollment ID: I20140711001082 |
| Provider Name | John J Parent |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1528226784 PECOS PAC ID: 1557501293 Enrollment ID: I20140718000717 |
| Provider Name | Stephanie M. Ware |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1174555999 PECOS PAC ID: 3577511831 Enrollment ID: I20140804000440 |
| Provider Name | Phornphat Rasamimari |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821075383 PECOS PAC ID: 9436164308 Enrollment ID: I20140819000261 |
| Provider Name | Denisse M Ambler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356439830 PECOS PAC ID: 9638265440 Enrollment ID: I20140908001143 |
| Provider Name | Kevin M Valentine |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1710135868 PECOS PAC ID: 9335206127 Enrollment ID: I20140911000829 |
| Provider Name | Deepika Kakkera |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508853102 PECOS PAC ID: 7719911098 Enrollment ID: I20141202000984 |
| Provider Name | Pankaj Chhangani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952364838 PECOS PAC ID: 4385665181 Enrollment ID: I20150410001843 |
| Provider Name | Mark D Ayers |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093981342 PECOS PAC ID: 1153569066 Enrollment ID: I20150605000313 |
| Provider Name | Mouhammad Yabrodi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1356505101 PECOS PAC ID: 1557672193 Enrollment ID: I20150623001474 |
| Provider Name | Matthew M. Jones |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790929842 PECOS PAC ID: 2769793322 Enrollment ID: I20150623002335 |
| Provider Name | Charline S Boente |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1114211505 PECOS PAC ID: 9931410511 Enrollment ID: I20150623002845 |
| Provider Name | Julie Elizabeth Stark |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043576770 PECOS PAC ID: 1951548353 Enrollment ID: I20150625001402 |
| Provider Name | Allison C Burke |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710277298 PECOS PAC ID: 0446490460 Enrollment ID: I20150626001286 |
| Provider Name | Sara E Lay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679703730 PECOS PAC ID: 4385957570 Enrollment ID: I20150716002280 |
| Provider Name | Matthew L Friedman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073779963 PECOS PAC ID: 0143533851 Enrollment ID: I20150723007314 |
| Provider Name | Susan Catherine Conrad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265667901 PECOS PAC ID: 1557507043 Enrollment ID: I20150724010777 |
| Provider Name | Matthew Landman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548317431 PECOS PAC ID: 1254573389 Enrollment ID: I20150727000082 |
| Provider Name | Elizabeth Ann Collins |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073831939 PECOS PAC ID: 6709023096 Enrollment ID: I20150727002292 |
| Provider Name | Wasim a Khasawneh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508054446 PECOS PAC ID: 7113187790 Enrollment ID: I20151006000265 |
| Provider Name | Jyoti K Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073779641 PECOS PAC ID: 8820307283 Enrollment ID: I20151027002853 |
| Provider Name | Geoffrey P Hays |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326481219 PECOS PAC ID: 6709027659 Enrollment ID: I20151125001136 |
| Provider Name | Don B. Sanders |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1598874364 PECOS PAC ID: 0648329029 Enrollment ID: I20160407000883 |
| Provider Name | Alex J Serafin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1538455654 PECOS PAC ID: 4385960830 Enrollment ID: I20160412002316 |
| Provider Name | Robert C Burns |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811066608 PECOS PAC ID: 3375590680 Enrollment ID: I20160509000855 |
| Provider Name | Jian Ye |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831408137 PECOS PAC ID: 5496064412 Enrollment ID: I20160519001325 |
| Provider Name | Aaron G Watters |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811288152 PECOS PAC ID: 8325286230 Enrollment ID: I20160519002161 |
| Provider Name | Brian D. Leland |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1972821726 PECOS PAC ID: 7517108921 Enrollment ID: I20160525000288 |
| Provider Name | Christopher Adam Sinsabaugh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184035396 PECOS PAC ID: 5698991057 Enrollment ID: I20160525000739 |
| Provider Name | Lindsey N Haut |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124466396 PECOS PAC ID: 4486895513 Enrollment ID: I20160525002543 |
| Provider Name | Jeremy L Herrmann |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1184881641 PECOS PAC ID: 3779721691 Enrollment ID: I20160608002428 |
| Provider Name | Callyn B. Riggs |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255673000 PECOS PAC ID: 5395036040 Enrollment ID: I20160628000157 |
| Provider Name | Brian Wallace Gray |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770791378 PECOS PAC ID: 1557653375 Enrollment ID: I20160714000722 |
| Provider Name | Nucharin Supakul |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205140431 PECOS PAC ID: 8921245218 Enrollment ID: I20160714001382 |
| Provider Name | Tyler S Arnold |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083930234 PECOS PAC ID: 3971818980 Enrollment ID: I20160714002030 |
| Provider Name | Ashley D Mcginn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1225459191 PECOS PAC ID: 0446544522 Enrollment ID: I20160812000207 |
| Provider Name | Francisco J Angulo Parker |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1336452960 PECOS PAC ID: 9638463599 Enrollment ID: I20160816000989 |
| Provider Name | Stephanie E Hullmann |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518314160 PECOS PAC ID: 9638464423 Enrollment ID: I20160817002958 |
| Provider Name | Jessica L Camilleri |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1679890925 PECOS PAC ID: 5294974663 Enrollment ID: I20160829002485 |
| Provider Name | Anne C Whitehead |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932498904 PECOS PAC ID: 0244474708 Enrollment ID: I20160907002516 |
| Provider Name | Lee Doyle Murphy |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1134482193 PECOS PAC ID: 2466751631 Enrollment ID: I20161027001442 |
| Provider Name | Tanna J Boyer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497929624 PECOS PAC ID: 0042452724 Enrollment ID: I20161110002230 |
| Provider Name | Tyler W Christman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598077489 PECOS PAC ID: 5597069419 Enrollment ID: I20161121001210 |
| Provider Name | Daniel H Slubowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194110494 PECOS PAC ID: 6507178407 Enrollment ID: I20161230001105 |
| Provider Name | Kyra D Reed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396002598 PECOS PAC ID: 7012157407 Enrollment ID: I20170413002160 |
| Provider Name | David S Hains |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1912168675 PECOS PAC ID: 5890826937 Enrollment ID: I20170420001804 |
| Provider Name | Sandeep Puranik |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1336556943 PECOS PAC ID: 0244517910 Enrollment ID: I20170505001034 |
| Provider Name | Martha M Rodriguez |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1376951012 PECOS PAC ID: 2769789254 Enrollment ID: I20170508000034 |
| Provider Name | Robert B Blake |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396035481 PECOS PAC ID: 2365719432 Enrollment ID: I20170519001285 |
| Provider Name | Rupa Radhakrishnan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881829133 PECOS PAC ID: 3274772082 Enrollment ID: I20170525001121 |
| Provider Name | Christine Huang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467714907 PECOS PAC ID: 2769759554 Enrollment ID: I20170526001068 |
| Provider Name | Prashant Malviya |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689981565 PECOS PAC ID: 4284947987 Enrollment ID: I20170613000226 |
| Provider Name | Matthew Lawrence Yuknis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396036158 PECOS PAC ID: 2466699079 Enrollment ID: I20170614000950 |
| Provider Name | James B Wood |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1053554733 PECOS PAC ID: 6305093535 Enrollment ID: I20170614001136 |
| Provider Name | Brock H Medsker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871819714 PECOS PAC ID: 4981903887 Enrollment ID: I20170615000349 |
| Provider Name | Nathanael D Swinger |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1033405253 PECOS PAC ID: 3971759796 Enrollment ID: I20170615002176 |
| Provider Name | Kanika Puri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487934204 PECOS PAC ID: 2567685621 Enrollment ID: I20170619002135 |
| Provider Name | Melissa S Oliver |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1326337304 PECOS PAC ID: 2860762275 Enrollment ID: I20170718002033 |
| Provider Name | Sean J Pfaff |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1598077356 PECOS PAC ID: 9739480203 Enrollment ID: I20170718003322 |
| Provider Name | Gabriel M Krause |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790049666 PECOS PAC ID: 8123252293 Enrollment ID: I20170724002043 |
| Provider Name | Brett H Graham |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1861572117 PECOS PAC ID: 9032005194 Enrollment ID: I20170725002301 |
| Provider Name | Kathleen M Overholt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447545892 PECOS PAC ID: 1355642893 Enrollment ID: I20170726002015 |
| Provider Name | Monica Forbes-amrhein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679860795 PECOS PAC ID: 5890934624 Enrollment ID: I20170727000925 |
| Provider Name | Kyle W. Jackson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194967604 PECOS PAC ID: 6204107766 Enrollment ID: I20170802002667 |
| Provider Name | Andrew L Schwaderer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720073356 PECOS PAC ID: 6608802681 Enrollment ID: I20170818000362 |
| Provider Name | Kelly L Donahue |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194126789 PECOS PAC ID: 6507130366 Enrollment ID: I20170919000404 |
| Provider Name | Sara Daluga |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902219736 PECOS PAC ID: 7416221973 Enrollment ID: I20170921001862 |
| Provider Name | Jana B Chan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497273015 PECOS PAC ID: 2668746066 Enrollment ID: I20170925000515 |
| Provider Name | Heather P Kelker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376839852 PECOS PAC ID: 2163724410 Enrollment ID: I20171011001853 |
| Provider Name | Theodore Ernest Wilson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699035030 PECOS PAC ID: 0941438568 Enrollment ID: I20171031002674 |
| Provider Name | Kara Beth Kowalczyk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063826501 PECOS PAC ID: 4880819275 Enrollment ID: I20171130001082 |
| Provider Name | Larry W Markham |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912959743 PECOS PAC ID: 7012915887 Enrollment ID: I20180111001360 |
| Provider Name | Zeynep N Salih |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144313032 PECOS PAC ID: 0446280655 Enrollment ID: I20180126001310 |
| Provider Name | Sarah E Wing |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1851737068 PECOS PAC ID: 3678715695 Enrollment ID: I20180508000276 |
| Provider Name | Pamela C Soriano |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144609033 PECOS PAC ID: 1557626504 Enrollment ID: I20180523000889 |
| Provider Name | Roxanna Lefort |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033301759 PECOS PAC ID: 7810038437 Enrollment ID: I20180523003033 |
| Provider Name | Molly Anne Mcpheron |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225476930 PECOS PAC ID: 4082855267 Enrollment ID: I20180601001182 |
| Provider Name | Stefan William Malin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1447639224 PECOS PAC ID: 7113239369 Enrollment ID: I20180703001312 |
| Provider Name | Kristen M Schroeder |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265877690 PECOS PAC ID: 9032351028 Enrollment ID: I20180716001787 |
| Provider Name | Neha Dhingra Pottanat |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1760776207 PECOS PAC ID: 3779830179 Enrollment ID: I20180717000728 |
| Provider Name | Abdul Hamid Khan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134401896 PECOS PAC ID: 3870767734 Enrollment ID: I20180801002588 |
| Provider Name | Meghan Drayton Jackson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215251558 PECOS PAC ID: 4587805049 Enrollment ID: I20180823001090 |
| Provider Name | Tina Marie Schade Willis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801809934 PECOS PAC ID: 9537129366 Enrollment ID: I20180927001945 |
| Provider Name | Amanda Saraf |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902164817 PECOS PAC ID: 7113228669 Enrollment ID: I20181001001392 |
| Provider Name | Erin E Conboy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295099240 PECOS PAC ID: 5092952259 Enrollment ID: I20181019002447 |
| Provider Name | Gabriela M Rodriguez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558806448 PECOS PAC ID: 0345594891 Enrollment ID: I20181119003161 |
| Provider Name | Anuja Bandyopadhyay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134431489 PECOS PAC ID: 9830313337 Enrollment ID: I20181203001994 |
| Provider Name | Jay Jin |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1356605299 PECOS PAC ID: 0840436846 Enrollment ID: I20190319001690 |
| Provider Name | Elizabeth Anne Wetzel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336341635 PECOS PAC ID: 7416095831 Enrollment ID: I20190321002414 |
| Provider Name | Kathryn Harlow Adams |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386900694 PECOS PAC ID: 2961642533 Enrollment ID: I20190323000124 |
| Provider Name | Joshua David Roth |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1154681369 PECOS PAC ID: 5496998379 Enrollment ID: I20190326000810 |
| Provider Name | Alka Khaitan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1013142942 PECOS PAC ID: 2567768898 Enrollment ID: I20190606002034 |
| Provider Name | Kari L Kendall |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1831503077 PECOS PAC ID: 8628295532 Enrollment ID: I20190613000258 |
| Provider Name | Heather Nicole Muston |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1992142004 PECOS PAC ID: 1355575259 Enrollment ID: I20190614000161 |
| Provider Name | Jenna L Streicher |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1619264660 PECOS PAC ID: 8820381627 Enrollment ID: I20190626003779 |
| Provider Name | Clayre E Tanis-arens |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326466160 PECOS PAC ID: 2062713563 Enrollment ID: I20190718001788 |
| Provider Name | Drew Anthony Streicher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578820585 PECOS PAC ID: 2860794013 Enrollment ID: I20190726000681 |
| Provider Name | Matthew Aaron Miller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447696703 PECOS PAC ID: 1153563176 Enrollment ID: I20190726000971 |
| Provider Name | Thomas James Feehan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780001081 PECOS PAC ID: 8325348667 Enrollment ID: I20190729000154 |
| Provider Name | Michelle Casey Starr |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1083989172 PECOS PAC ID: 3971822685 Enrollment ID: I20190820000552 |
| Provider Name | Gabrielle Christine Geddes |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1972803161 PECOS PAC ID: 8325281363 Enrollment ID: I20190823003249 |
| Provider Name | Andrew Lyle Rodenbarger |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114293024 PECOS PAC ID: 8022329069 Enrollment ID: I20190829001747 |
| Provider Name | Jessica Lucille Horan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396189056 PECOS PAC ID: 0840504510 Enrollment ID: I20190906000792 |
| Provider Name | Rachael Rae Schulte |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205192408 PECOS PAC ID: 5092044065 Enrollment ID: I20190917002264 |
| Provider Name | Britney Grayson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194081760 PECOS PAC ID: 5496024242 Enrollment ID: I20190926001150 |
| Provider Name | Ramiz Musa Saeed Mohammed |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194278507 PECOS PAC ID: 9032440524 Enrollment ID: I20191015000986 |
| Provider Name | Sara Katherine Kane |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255728903 PECOS PAC ID: 6406154897 Enrollment ID: I20191217003303 |
| Provider Name | Poonam M Puranik |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184903106 PECOS PAC ID: 3476868837 Enrollment ID: I20191218001955 |
| Provider Name | Sara E. Cartwright |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1740629617 PECOS PAC ID: 0446489496 Enrollment ID: I20200107001305 |
| Provider Name | Elaine a Gilbert |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629572789 PECOS PAC ID: 3779919451 Enrollment ID: I20200129001812 |
| Provider Name | Sushil Gupta |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1982896759 PECOS PAC ID: 3678729951 Enrollment ID: I20200203000963 |
| Provider Name | Brandon a Sparks |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457797060 PECOS PAC ID: 0345539458 Enrollment ID: I20200303002903 |
| Provider Name | Senthil Packiasabapathy Kuthalingam |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1033613773 PECOS PAC ID: 8729416664 Enrollment ID: I20200307000117 |
| Provider Name | Colin Michael Rogerson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1548673841 PECOS PAC ID: 2668696519 Enrollment ID: I20200330000114 |
| Provider Name | Harish S.R. Rao |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1356535017 PECOS PAC ID: 7517287014 Enrollment ID: I20200413001307 |
| Provider Name | Miriam Kim |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1891052171 PECOS PAC ID: 9638480882 Enrollment ID: I20200415002021 |
| Provider Name | Wenhua Chen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1952795890 PECOS PAC ID: 2264862564 Enrollment ID: I20200521002063 |
| Provider Name | David Chrobak |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669836003 PECOS PAC ID: 9032409354 Enrollment ID: I20200528000096 |
| Provider Name | Hebatullah M Ismail |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1578705547 PECOS PAC ID: 6002033073 Enrollment ID: I20200625000933 |
| Provider Name | Michael M Ross |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780868786 PECOS PAC ID: 6305083957 Enrollment ID: I20200709000241 |
| Provider Name | Jared Robert Shields |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376937607 PECOS PAC ID: 8426361692 Enrollment ID: I20200727001680 |
| Provider Name | Billy E Beechler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942313002 PECOS PAC ID: 1153747894 Enrollment ID: I20200812002629 |
| Provider Name | Robert G Tysklind |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205254711 PECOS PAC ID: 7113249095 Enrollment ID: I20200813000306 |
| Provider Name | Corissa Elizabeth Dionisio |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295122299 PECOS PAC ID: 5395057152 Enrollment ID: I20200817001975 |
| Provider Name | Juliane H Lee |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285660175 PECOS PAC ID: 1254350531 Enrollment ID: I20200825001756 |
| Provider Name | Jennifer Belsky |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1275950438 PECOS PAC ID: 9032410733 Enrollment ID: I20200827000838 |
| Provider Name | Lindsay Jo Blazin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275875643 PECOS PAC ID: 9436576980 Enrollment ID: I20200828000400 |
| Provider Name | Nausheen Zia |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457616286 PECOS PAC ID: 5698069706 Enrollment ID: I20201002000136 |
| Provider Name | Daniel R Germeroth |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679967954 PECOS PAC ID: 0042524985 Enrollment ID: I20201008001590 |
| Provider Name | Michele S Tsai Owens |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134583750 PECOS PAC ID: 7810240280 Enrollment ID: I20201009002463 |
| Provider Name | Gabriel Paris |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417266818 PECOS PAC ID: 6901107887 Enrollment ID: I20201016001690 |
| Provider Name | Lindsey M Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1932513447 PECOS PAC ID: 5294959797 Enrollment ID: I20201020001081 |
| Provider Name | Julia E Lamotte |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477162808 PECOS PAC ID: 9335569953 Enrollment ID: I20201021001041 |
| Provider Name | April Rahrig |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1942542253 PECOS PAC ID: 6800192410 Enrollment ID: I20201109001424 |
| Provider Name | Gregory Howard Borschel |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1275548125 PECOS PAC ID: 2264438167 Enrollment ID: I20201110001029 |
| Provider Name | Sarah a Koch |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1992235022 PECOS PAC ID: 7618387077 Enrollment ID: I20201113001794 |
| Provider Name | Nadeem Abbasi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194986489 PECOS PAC ID: 7113199688 Enrollment ID: I20201120001917 |
| Provider Name | Jackson G Schneider |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1689933020 PECOS PAC ID: 4486894565 Enrollment ID: I20201202001930 |
| Provider Name | Levi Funches |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407909955 PECOS PAC ID: 8921319682 Enrollment ID: I20201208000982 |
| Provider Name | Melissa D Kunkel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962644237 PECOS PAC ID: 2163660218 Enrollment ID: I20201210001433 |
| Provider Name | Muayad Alali |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1558736405 PECOS PAC ID: 8123321189 Enrollment ID: I20201229000093 |
| Provider Name | Bittu Dhaval Majmudar-sheth |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679913263 PECOS PAC ID: 1355698127 Enrollment ID: I20201230001036 |
| Provider Name | Jodie Meara |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922412162 PECOS PAC ID: 5092932186 Enrollment ID: I20210111001483 |
| Provider Name | Samina Bhumbra |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1033539416 PECOS PAC ID: 8628292315 Enrollment ID: I20210111002093 |
| Provider Name | Melinda H Markham |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992913560 PECOS PAC ID: 7911080924 Enrollment ID: I20210127002288 |
| Provider Name | Khalid Al Katranji |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063852762 PECOS PAC ID: 0042453045 Enrollment ID: I20210305002021 |
| Provider Name | Baljit K Rehal |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1558696179 PECOS PAC ID: 5193131621 Enrollment ID: I20210309000980 |
| Provider Name | Jessica M Seaborn |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1487094801 PECOS PAC ID: 6305268277 Enrollment ID: I20210324000834 |
| Provider Name | Shaina M Hecht |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1033536222 PECOS PAC ID: 8325349079 Enrollment ID: I20210407000893 |
| Provider Name | Anthony J Ross |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1376961730 PECOS PAC ID: 1052720059 Enrollment ID: I20210504000483 |
| Provider Name | Andrew J Vogler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366805913 PECOS PAC ID: 8820490832 Enrollment ID: I20210714000633 |
| Provider Name | Daniel T Cater |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1548640808 PECOS PAC ID: 1456662287 Enrollment ID: I20210720001457 |
| Provider Name | Anisha Gohil |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1265859292 PECOS PAC ID: 3678847738 Enrollment ID: I20210723001646 |
| Provider Name | Kateryna V Pinyerd |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437513058 PECOS PAC ID: 5496048696 Enrollment ID: I20210809001120 |
| Provider Name | Mariju Fleur Baluyot |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528452810 PECOS PAC ID: 0749592434 Enrollment ID: I20210810002750 |
| Provider Name | Melissa a Lachajewski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487061123 PECOS PAC ID: 2365846417 Enrollment ID: I20210811001835 |
| Provider Name | Melissa Kay Hord |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518374347 PECOS PAC ID: 7618372426 Enrollment ID: I20210817002308 |
| Provider Name | Tyler Joseph Knight |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184157133 PECOS PAC ID: 0446655203 Enrollment ID: I20210818000413 |
| Provider Name | Erika L Daley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235549759 PECOS PAC ID: 4587889670 Enrollment ID: I20210824000396 |
| Provider Name | Daniel Franklyn Drake |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679951800 PECOS PAC ID: 0244520880 Enrollment ID: I20210824000497 |
| Provider Name | Megan a Coughlin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962797308 PECOS PAC ID: 6103058060 Enrollment ID: I20210824000986 |
| Provider Name | Jignesh Kishor Tailor |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1629669643 PECOS PAC ID: 2668887308 Enrollment ID: I20210824002530 |
| Provider Name | Steven D Rhodes |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1407243330 PECOS PAC ID: 4183935901 Enrollment ID: I20210824003192 |
| Provider Name | Barrett P Cromeens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538425418 PECOS PAC ID: 3476846320 Enrollment ID: I20210825000641 |
| Provider Name | Lauren Elizabeth Sowa |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1811376593 PECOS PAC ID: 2163724733 Enrollment ID: I20210826000161 |
| Provider Name | Matthew Partain |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174917280 PECOS PAC ID: 4587940986 Enrollment ID: I20210826002078 |
| Provider Name | Priya Joshi |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1013302769 PECOS PAC ID: 3375839962 Enrollment ID: I20210831002717 |
| Provider Name | David V Braitman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598151383 PECOS PAC ID: 3476866021 Enrollment ID: I20210831002728 |
| Provider Name | Amanda V Broderick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720752553 PECOS PAC ID: 7214333293 Enrollment ID: I20210831002831 |
| Provider Name | Sarah E Bauer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215321682 PECOS PAC ID: 4284935073 Enrollment ID: I20210920001393 |
| Provider Name | Derryl Joseph Miller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760860266 PECOS PAC ID: 4183935786 Enrollment ID: I20210921000178 |
| Provider Name | Ashley Arnoldi Moeller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336594209 PECOS PAC ID: 9830480862 Enrollment ID: I20210924000435 |
| Provider Name | Erika L. Zevin |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1811308208 PECOS PAC ID: 7618276882 Enrollment ID: I20210930000225 |
| Provider Name | Hannah Michelle Deluna |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891283792 PECOS PAC ID: 8022363191 Enrollment ID: I20211001000723 |
| Provider Name | Pi Chun Cheng |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1134488471 PECOS PAC ID: 6002056181 Enrollment ID: I20211007001396 |
| Provider Name | Megan M Wilde |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386080463 PECOS PAC ID: 3375843956 Enrollment ID: I20211102001770 |
| Provider Name | Emma J Cordes |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1699195487 PECOS PAC ID: 4486950508 Enrollment ID: I20211105000194 |
| Provider Name | Pankaj Pandharinath Dangle |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1255560595 PECOS PAC ID: 9537450150 Enrollment ID: I20211105000495 |
| Provider Name | Mary Hart Benecke |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033629977 PECOS PAC ID: 9739428988 Enrollment ID: I20220111001589 |
| Provider Name | Elaine Leo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1902287667 PECOS PAC ID: 9234464793 Enrollment ID: I20220112002493 |
| Provider Name | Anna Katherine Chambers |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992319933 PECOS PAC ID: 1557753076 Enrollment ID: I20220113000665 |
| Provider Name | Laura Anne Bobinsky |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1346554623 PECOS PAC ID: 5092107524 Enrollment ID: I20220113001186 |
| Provider Name | Sarah K Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639536204 PECOS PAC ID: 1658763859 Enrollment ID: I20220120001807 |
| Provider Name | Jaimini Ashvinkumar Khatri |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568905354 PECOS PAC ID: 7416349436 Enrollment ID: I20220124001919 |
| Provider Name | Laura C Heinekamp |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336814920 PECOS PAC ID: 0244622272 Enrollment ID: I20220124002430 |
| Provider Name | Kaitlyn R Schmitt |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1194491274 PECOS PAC ID: 8921491499 Enrollment ID: I20220204000514 |
| Provider Name | Laurie Jo Niederhauser |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558434696 PECOS PAC ID: 4284027756 Enrollment ID: I20220204000572 |
| Provider Name | Mohannad Moallem |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003026501 PECOS PAC ID: 2860661527 Enrollment ID: I20220204001474 |
| Provider Name | Nina B Root |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1649528654 PECOS PAC ID: 2567856404 Enrollment ID: I20220218001281 |
| Provider Name | Laura Marie Shopp |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346628617 PECOS PAC ID: 5092026732 Enrollment ID: I20220224000384 |
| Provider Name | Rohan a Thompson |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1376501304 PECOS PAC ID: 2668418310 Enrollment ID: I20220407000404 |
| Provider Name | Danielle E Soranno |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1982725289 PECOS PAC ID: 6204070295 Enrollment ID: I20220519001121 |
| Provider Name | Clinton Matthew Bunde |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962063198 PECOS PAC ID: 1951638733 Enrollment ID: I20220601001135 |
| Provider Name | Daniel C Peltier |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1669732657 PECOS PAC ID: 1557670668 Enrollment ID: I20220603001435 |
| Provider Name | Carla Marie Black |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124473749 PECOS PAC ID: 0941595136 Enrollment ID: I20220609000353 |
| Provider Name | Brian Jacob O'neill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700311677 PECOS PAC ID: 4880961275 Enrollment ID: I20220621002222 |
| Provider Name | Christopher L Newman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487181517 PECOS PAC ID: 9335416866 Enrollment ID: I20220622002418 |
| Provider Name | Scott Thomas Wagoner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134738057 PECOS PAC ID: 1254710148 Enrollment ID: I20220623001785 |
| Provider Name | Roja Fallah |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1538589841 PECOS PAC ID: 3971859166 Enrollment ID: I20220627002732 |
| Provider Name | Emily Anne Meudt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972031953 PECOS PAC ID: 7618245374 Enrollment ID: I20220707001519 |
| Provider Name | Derrick L Goubeaux |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1770825382 PECOS PAC ID: 3678715539 Enrollment ID: I20220713000289 |
| Provider Name | Brandon Michael Tanner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043692478 PECOS PAC ID: 1052624533 Enrollment ID: I20220726003353 |
| Provider Name | Allison Elizabeth Meyer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952968711 PECOS PAC ID: 8325420847 Enrollment ID: I20220801000984 |
| Provider Name | Jason a Santiago |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053845289 PECOS PAC ID: 0840672184 Enrollment ID: I20220802003440 |
| Provider Name | Mira K Trivedi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750778643 PECOS PAC ID: 0840672077 Enrollment ID: I20220803003348 |
| Provider Name | Jacob Kirt Olson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225396237 PECOS PAC ID: 0941682926 Enrollment ID: I20220808002206 |
| Provider Name | Rabia Qaiser |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639365802 PECOS PAC ID: 7911149224 Enrollment ID: I20220811000989 |
| Provider Name | Sarah a Daily |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538699517 PECOS PAC ID: 5395018477 Enrollment ID: I20220813000317 |
| Provider Name | Katelyn Greer Makar |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1730525197 PECOS PAC ID: 3476869454 Enrollment ID: I20220817003459 |
| Provider Name | Nomi Kate Sherwin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285169300 PECOS PAC ID: 0446528574 Enrollment ID: I20220901002743 |
| Provider Name | Erin a Henneberry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427586916 PECOS PAC ID: 9638445265 Enrollment ID: I20220908002443 |
| Provider Name | Casey Anne Pederson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881103067 PECOS PAC ID: 0547646747 Enrollment ID: I20220926000657 |
| Provider Name | Emily J Kalscheur |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194452300 PECOS PAC ID: 1557747912 Enrollment ID: I20221007002593 |
| Provider Name | Nurcicek Padem |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1578978938 PECOS PAC ID: 2163722141 Enrollment ID: I20221021001842 |
| Provider Name | Anne-marie Nicole Fleckenstein |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1386366391 PECOS PAC ID: 2668848243 Enrollment ID: I20221024000351 |
| Provider Name | Aki S Puryear |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033138243 PECOS PAC ID: 9032011093 Enrollment ID: I20221027001973 |
| Provider Name | Jenna L Trost |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508343070 PECOS PAC ID: 3375910169 Enrollment ID: I20221108001905 |
| Provider Name | Jessica C Win |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952729048 PECOS PAC ID: 2567683444 Enrollment ID: I20221115001295 |
| Provider Name | Katherine Laycock |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1902290307 PECOS PAC ID: 2769760701 Enrollment ID: I20221205000675 |
| Provider Name | Wail Ali |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033340492 PECOS PAC ID: 2860709433 Enrollment ID: I20221214000351 |
| Provider Name | Makram Obeid |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477746667 PECOS PAC ID: 2466687157 Enrollment ID: I20221215001173 |
| Provider Name | Brianna M Liberio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962866376 PECOS PAC ID: 5991039919 Enrollment ID: I20230119001774 |
| Provider Name | Maddison N Tolliver-lynn |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1477267383 PECOS PAC ID: 7214308147 Enrollment ID: I20230131003572 |
| Provider Name | Katherine Nicole Schwartzkopf |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1952709867 PECOS PAC ID: 3678945300 Enrollment ID: I20230207000579 |
| Provider Name | Paola America a Huaynate Cuadrado |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538414347 PECOS PAC ID: 1951603166 Enrollment ID: I20230225000332 |
| Provider Name | Matthew C Lewis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548420425 PECOS PAC ID: 9436397585 Enrollment ID: I20230308000226 |
| Provider Name | Lauren Castaneda |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740676162 PECOS PAC ID: 0547515488 Enrollment ID: I20230322000773 |
| Provider Name | Adnan Bhutta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295825792 PECOS PAC ID: 0446356570 Enrollment ID: I20230414000225 |
| Provider Name | Harry Lin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982230918 PECOS PAC ID: 9830556752 Enrollment ID: I20230608002183 |
| Provider Name | Betsy Wilson Stevens |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124657697 PECOS PAC ID: 1052733417 Enrollment ID: I20230612001362 |
| Provider Name | Osayame a Ekhaguere |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568729333 PECOS PAC ID: 8325288434 Enrollment ID: I20230613002040 |
| Provider Name | Hiba I El Fadeel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831695964 PECOS PAC ID: 8224383302 Enrollment ID: I20230622001929 |
| Provider Name | Carly a Smith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497250286 PECOS PAC ID: 9537415989 Enrollment ID: I20230630000803 |
| Provider Name | Seema Shashank Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093202707 PECOS PAC ID: 2860757382 Enrollment ID: I20230705001029 |
| Provider Name | Nikhil Varun Batra |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053803700 PECOS PAC ID: 6901265768 Enrollment ID: I20230711003575 |
| Provider Name | Brigid R Marriott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013609809 PECOS PAC ID: 3870954860 Enrollment ID: I20230808000439 |
| Provider Name | Marciana Laster |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1700127792 PECOS PAC ID: 8426326877 Enrollment ID: I20230809002777 |
| Provider Name | Simran Kaur Jutla |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1235633850 PECOS PAC ID: 7113328162 Enrollment ID: I20230825002933 |
| Provider Name | Brian Weiss |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1033274840 PECOS PAC ID: 5890687693 Enrollment ID: I20230911001431 |
| Provider Name | Chaowapong Jarasvaraparn |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083090054 PECOS PAC ID: 4183901341 Enrollment ID: I20231006000861 |
| Provider Name | Imran Malik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104061704 PECOS PAC ID: 0941420426 Enrollment ID: I20231024002832 |
| Provider Name | Sabena F Hussain |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659725810 PECOS PAC ID: 8123313491 Enrollment ID: I20231103001422 |
| Provider Name | Jessica Ann Zavadil |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356837066 PECOS PAC ID: 0941619308 Enrollment ID: I20231208000759 |
| Provider Name | Julia K Raduka |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194216085 PECOS PAC ID: 5991050395 Enrollment ID: I20231214002092 |
| Provider Name | Saba Jafri |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033343850 PECOS PAC ID: 1658529433 Enrollment ID: I20240110002766 |
| Provider Name | Michael D Lintner |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1376864777 PECOS PAC ID: 1557589637 Enrollment ID: I20240201001728 |
| Provider Name | Alexander R Tuttle |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1376071829 PECOS PAC ID: 8123398328 Enrollment ID: I20240205002500 |
| Provider Name | Rachel T Han |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962850420 PECOS PAC ID: 7113218082 Enrollment ID: I20240220001322 |
| Provider Name | Bradford Turk Miller |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144752288 PECOS PAC ID: 4688096217 Enrollment ID: I20240311002833 |
| Provider Name | Sarah C Studyvin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568880227 PECOS PAC ID: 0143577395 Enrollment ID: I20240325001024 |
| Provider Name | Erick Forno |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1356461420 PECOS PAC ID: 6204988298 Enrollment ID: I20240511000258 |
| Provider Name | Dominic a Nardi |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1669025722 PECOS PAC ID: 7810383536 Enrollment ID: I20240511000308 |
| Provider Name | Matthew J Henry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063032068 PECOS PAC ID: 8921428970 Enrollment ID: I20240514001972 |
| Provider Name | David C Scofield |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861952350 PECOS PAC ID: 9638402423 Enrollment ID: I20240515003140 |
| Provider Name | Susan Anne Siekierski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366518425 PECOS PAC ID: 4688016702 Enrollment ID: I20240521003013 |
| Provider Name | Kathryn Huggins |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013363563 PECOS PAC ID: 4082905898 Enrollment ID: I20240521003386 |
| Provider Name | Mariah R Ozkir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508363995 PECOS PAC ID: 9537424114 Enrollment ID: I20240525000368 |
| Provider Name | Florence Feng Sun |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568969012 PECOS PAC ID: 8325393655 Enrollment ID: I20240528001216 |
| Provider Name | Jordan B Ferguson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538697537 PECOS PAC ID: 2466722301 Enrollment ID: I20240612003246 |
| Provider Name | Zachary I Kleiman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699112227 PECOS PAC ID: 2163648247 Enrollment ID: I20240615000100 |
| Provider Name | Joseph Russell Lee Wells |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093275505 PECOS PAC ID: 1052771797 Enrollment ID: I20240619000498 |
| Provider Name | Erin R Rudzinski |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1003963950 PECOS PAC ID: 2365588647 Enrollment ID: I20240620002492 |
| Provider Name | Thomas Wayne Larrew |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1427408632 PECOS PAC ID: 4587944905 Enrollment ID: I20240621003158 |
| Provider Name | Jason Chu |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295052827 PECOS PAC ID: 8022312198 Enrollment ID: I20240624001588 |
| Provider Name | Umesh Dyamenahalli |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659461150 PECOS PAC ID: 2860483815 Enrollment ID: I20240626002660 |
| Provider Name | Paige Severeid |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1346730934 PECOS PAC ID: 8224373964 Enrollment ID: I20240716003262 |
| Provider Name | Sanjeev R Chilukuri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760988026 PECOS PAC ID: 8123374451 Enrollment ID: I20240724001773 |
| Provider Name | Joann Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316396906 PECOS PAC ID: 0547658684 Enrollment ID: I20240725003006 |
| Provider Name | Kelsey Kathleen Wiggs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376117291 PECOS PAC ID: 6305382276 Enrollment ID: I20240726003568 |
| Provider Name | Jonathan Bardahl |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1932638186 PECOS PAC ID: 2961776463 Enrollment ID: I20240805002665 |
| Provider Name | Blair N Welch |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013442946 PECOS PAC ID: 3971871187 Enrollment ID: I20240807001947 |
| Provider Name | Alexandra Rodriguez Hernandez |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1467986133 PECOS PAC ID: 0840738803 Enrollment ID: I20240821002968 |
| Provider Name | Trevor Nicholas Taylor |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194570762 PECOS PAC ID: 1052850559 Enrollment ID: I20240828003468 |
| Provider Name | Ashley R Powell |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1497591945 PECOS PAC ID: 4183163520 Enrollment ID: I20240828005040 |
| Provider Name | Jessica Suzanne Jones |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962805374 PECOS PAC ID: 8820537293 Enrollment ID: I20240829000778 |
| Provider Name | Kathryn E Hawa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1477915676 PECOS PAC ID: 7416242201 Enrollment ID: I20240830000903 |
| Provider Name | Ward P Myers |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427224328 PECOS PAC ID: 6204988264 Enrollment ID: I20240905002915 |
| Provider Name | Katherine C Anderson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003379116 PECOS PAC ID: 5991038978 Enrollment ID: I20240913000564 |
| Provider Name | Alix Mclaughlin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124860358 PECOS PAC ID: 7517407729 Enrollment ID: I20240913001429 |
| Provider Name | Kaitlyn Edwards |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194344572 PECOS PAC ID: 5193147452 Enrollment ID: I20240920003062 |
| Provider Name | Samantha H Averill |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1306371356 PECOS PAC ID: 8426325853 Enrollment ID: I20240927003022 |
| Provider Name | Jessica Ann Thoe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194222729 PECOS PAC ID: 3173878394 Enrollment ID: I20241007002776 |
| Provider Name | Emily Grace Mullins |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376389577 PECOS PAC ID: 6901337336 Enrollment ID: I20241009001061 |
| Provider Name | Evelina Pearson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497592281 PECOS PAC ID: 4587196779 Enrollment ID: I20241012000314 |
| Provider Name | Elham L Zayed |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1194450577 PECOS PAC ID: 3072984954 Enrollment ID: I20241018002546 |
| Provider Name | Madison N Hagerty |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1679354682 PECOS PAC ID: 2769914373 Enrollment ID: I20241021000314 |
| Provider Name | Chasten L Hamilton |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134950561 PECOS PAC ID: 5193257731 Enrollment ID: I20241021001430 |
| Provider Name | Keith W Torrey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528445756 PECOS PAC ID: 9032442009 Enrollment ID: I20241022002887 |
| Provider Name | Kyla M Tolliver |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669850780 PECOS PAC ID: 8527373554 Enrollment ID: I20241023000441 |
| Provider Name | Haroon Ali |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285082743 PECOS PAC ID: 9335431287 Enrollment ID: I20241028001779 |
| Provider Name | Anshika Kaushik |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1326437138 PECOS PAC ID: 0547691032 Enrollment ID: I20241203003906 |
| Provider Name | Jeffrey Loughead |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548254394 PECOS PAC ID: 8527962133 Enrollment ID: I20241210002456 |
| Provider Name | Sarah Mary Elsakr |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336639079 PECOS PAC ID: 5698203560 Enrollment ID: I20250107001070 |
| Provider Name | Praveen Kumar Boddu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609494384 PECOS PAC ID: 5991112419 Enrollment ID: I20250512001213 |
| Provider Name | Megan Mary Dewey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1912427618 PECOS PAC ID: 6204167463 Enrollment ID: I20250514001467 |
| Provider Name | Alyx Debra Posorske |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205332707 PECOS PAC ID: 1759636582 Enrollment ID: I20250516000203 |
| Provider Name | Kasi Eastep |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043672256 PECOS PAC ID: 4284965575 Enrollment ID: I20250519003176 |
| Provider Name | Jennifer Rohan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619402245 PECOS PAC ID: 5890068522 Enrollment ID: I20250529002887 |
| Provider Name | Amina M Jaji |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447770938 PECOS PAC ID: 4082984604 Enrollment ID: I20250619002454 |
| Provider Name | Charles Bryce Stevenson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1457408338 PECOS PAC ID: 1153477880 Enrollment ID: I20250623002799 |
| Provider Name | Jonathan Pacheco |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831832245 PECOS PAC ID: 2668983131 Enrollment ID: I20250623003809 |
| Provider Name | Andrew Blair Kohner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275060782 PECOS PAC ID: 3577973015 Enrollment ID: I20250626000453 |
| Provider Name | Catalina Reusche |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134869514 PECOS PAC ID: 1658735915 Enrollment ID: I20250630003335 |
| Provider Name | Grace Elizabeth Eib |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871112482 PECOS PAC ID: 0648692905 Enrollment ID: I20250703001615 |
| Provider Name | Olena Kostyuk |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801250212 PECOS PAC ID: 7214263748 Enrollment ID: I20250708000260 |
| Provider Name | Fatih Zor |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1548903982 PECOS PAC ID: 1254796956 Enrollment ID: I20250708001665 |
| Provider Name | Amber M Lee |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376005744 PECOS PAC ID: 7416280706 Enrollment ID: I20250714002396 |
| Provider Name | Taylor a Curry |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982138921 PECOS PAC ID: 4688099815 Enrollment ID: I20250725000897 |
| Provider Name | Amy W. JZ |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598225989 PECOS PAC ID: 2466785084 Enrollment ID: I20250730003939 |
| Provider Name | Natalie Guerrero Cofie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598225013 PECOS PAC ID: 6406237445 Enrollment ID: I20250802000156 |
| Provider Name | Leah a Garvin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083275291 PECOS PAC ID: 8325377393 Enrollment ID: I20250804000102 |
| Provider Name | Thomas James Svenstrup |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750900312 PECOS PAC ID: 6901344134 Enrollment ID: I20250805002351 |
| Provider Name | Sara Holmstrom |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093177396 PECOS PAC ID: 6204121601 Enrollment ID: I20250819003924 |
| Provider Name | Jason Axt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124222617 PECOS PAC ID: 2769784735 Enrollment ID: I20250819004536 |
| Provider Name | Jonathan Christian Vacek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1962897538 PECOS PAC ID: 5193008282 Enrollment ID: I20250912002651 |
| Provider Name | Benjamin William Weiner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750960159 PECOS PAC ID: 0749689479 Enrollment ID: I20250920000136 |
| Provider Name | Nichole M Slick |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033728704 PECOS PAC ID: 1557858636 Enrollment ID: I20251013003890 |
| Provider Name | Olivia Lee Campbell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386433969 PECOS PAC ID: 0840787859 Enrollment ID: I20251014002106 |
| Provider Name | Alexa Aracelis Engel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184202962 PECOS PAC ID: 0941748966 Enrollment ID: I20251015000196 |
| Provider Name | Shrea Goswami |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255835146 PECOS PAC ID: 8325440696 Enrollment ID: I20251015002776 |
| Provider Name | Jorge Moises Gonzales Cordova |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649830415 PECOS PAC ID: 2062746787 Enrollment ID: I20251015003919 |
| Provider Name | Tianna Vandermissen Yeung |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760995088 PECOS PAC ID: 0244617736 Enrollment ID: I20251024000470 |
| Provider Name | Richa Lakhotia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639503832 PECOS PAC ID: 1456643691 Enrollment ID: I20251024002588 |
| Provider Name | Tania E Morales Zelaya |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821719832 PECOS PAC ID: 7719476902 Enrollment ID: I20251028003958 |
| Provider Name | Brianna Lynn Jehl |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144010778 PECOS PAC ID: 5092207092 Enrollment ID: I20251126001766 |
| Provider Name | Anna Marie Deitch |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013411701 PECOS PAC ID: 1557854486 Enrollment ID: I20251201000179 |
| Provider Name | Elizabeth Koval |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1144110024 PECOS PAC ID: 5193218907 Enrollment ID: I20251201002605 |
| Provider Name | Nidhi Karve |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316574742 PECOS PAC ID: 5496116659 Enrollment ID: I20251202000965 |
| Provider Name | Mary Kathleen Gaugler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144727702 PECOS PAC ID: 0446515027 Enrollment ID: I20251202001187 |
| Provider Name | Jennifer Lynn Chmielewski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376106419 PECOS PAC ID: 8820322969 Enrollment ID: I20251202002161 |
| Provider Name | Asna Asrar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598224594 PECOS PAC ID: 9638404486 Enrollment ID: I20251208000740 |
| Provider Name | Luis Murguia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982109963 PECOS PAC ID: 4587911219 Enrollment ID: I20251209000447 |
| Provider Name | Alexandra N Theisen |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1225486160 PECOS PAC ID: 5991096075 Enrollment ID: I20251215003345 |
| Provider Name | Amogh Kambalyal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578022885 PECOS PAC ID: 8325450430 Enrollment ID: I20260202000127 |
| Provider Name | Stephanie Ann Samuel Adaikalam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1679136741 PECOS PAC ID: 2567796600 Enrollment ID: I20260319000863 |
| Provider Name | Rita W Saroufim |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396356820 PECOS PAC ID: 6800212432 Enrollment ID: I20260401002908 |
| Provider Name | Rebecca Long Hetrick |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1588123541 PECOS PAC ID: 3375924111 Enrollment ID: I20260408000538 |
Indiana Behavior Analysis Academy Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2417 Baur Dr, Indianapolis, IN 46220 Phone: 317-414-2147 |
Smarty Pants Daycare Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5355 N Post Rd, Indianapolis, IN 46216 Phone: 317-993-2439 |
Gardenpoint Recovery LLC Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2555 55th Pl Ste 213, Indianapolis, IN 46220 Phone: 317-622-9141 |
St. Vincent Stress Center Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 8401 Harcourt Rd, Indianapolis, IN 46260 Phone: 317-338-4600 |
Reach for Youth, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5401 Shelby St, Indianapolis, IN 46227 Phone: 317-788-4451 Fax: 317-788-4465 |
Hns Consulting Services Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4954 E 56th St Ste 14, Indianapolis, IN 46220 Phone: 317-640-6997 |