| Port Huron Hospital Physician Grp | |
|
1209 Richardson St Port Huron MI 48060-3548 | |
| (810) 984-5156 | |
| Not Available |
| Full Name | Port Huron Hospital Physician Grp |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 1209 Richardson St, Port Huron, Michigan |
| Authorized Official Name and Position | Bridget Sholtis (VP/CFO) |
| Authorized Official Contact | 8109893749 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Port Huron Hospital Physician Grp 1221 Pine Grove Ave Port Huron MI 48060-3511 Ph: (810) 984-5156 | Port Huron Hospital Physician Grp 1209 Richardson St Port Huron MI 48060-3548 Ph: (810) 984-5156 |
| NPI Number | 1386888170 |
|---|---|
| Provider Enumeration Date | 04/24/2009 |
| Last Update Date | 07/30/2020 |
| Certification Date | 07/30/2020 |
| Medicare PECOS PAC ID | 9931018702 |
|---|---|
| Medicare Enrollment ID | O20040204000779 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386888170 | NPI | - | NPPES |
| Provider Name | Laura V Lucio Reincke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851392930 PECOS PAC ID: 4880598515 Enrollment ID: I20031124000360 |
| Provider Name | Vernon E Dencklau |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1821087453 PECOS PAC ID: 8527958537 Enrollment ID: I20040316000059 |
| Provider Name | Vasken Sarkis Artinian |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1922074863 PECOS PAC ID: 1456338789 Enrollment ID: I20040702001163 |
| Provider Name | Sanjay Batra |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1114981917 PECOS PAC ID: 8426034406 Enrollment ID: I20050314000252 |
| Provider Name | James Martin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972592541 PECOS PAC ID: 5496794018 Enrollment ID: I20050503000358 |
| Provider Name | Carl Matthew Pesta |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114983913 PECOS PAC ID: 5890714661 Enrollment ID: I20051122000427 |
| Provider Name | Divyakant B Gandhi |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1912004458 PECOS PAC ID: 0648237198 Enrollment ID: I20060214000258 |
| Provider Name | Timothy L Lukas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669436184 PECOS PAC ID: 1658359658 Enrollment ID: I20060302000393 |
| Provider Name | Leonard T Karadimas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194797654 PECOS PAC ID: 4880672880 Enrollment ID: I20060302000406 |
| Provider Name | James J Giliberto |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629057054 PECOS PAC ID: 6608821335 Enrollment ID: I20060314000413 |
| Provider Name | Mark T Jaroch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932209418 PECOS PAC ID: 1658395199 Enrollment ID: I20060327000493 |
| Provider Name | John Grabowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477517191 PECOS PAC ID: 8921011834 Enrollment ID: I20060719000073 |
| Provider Name | G Blair Dowden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750379194 PECOS PAC ID: 7810935632 Enrollment ID: I20060925000427 |
| Provider Name | Suheb Mashkoor Hasan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104933621 PECOS PAC ID: 0648200964 Enrollment ID: I20061003000019 |
| Provider Name | Peter Y Tseng |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023076866 PECOS PAC ID: 0840385894 Enrollment ID: I20071005000036 |
| Provider Name | Anthony L Joseph |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831298223 PECOS PAC ID: 5890883219 Enrollment ID: I20071119000618 |
| Provider Name | Jody A Britz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164483707 PECOS PAC ID: 5193806958 Enrollment ID: I20080117000535 |
| Provider Name | Amanda L Harding |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255543179 PECOS PAC ID: 0143300483 Enrollment ID: I20080726000052 |
| Provider Name | Surjit Mahal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558331884 PECOS PAC ID: 7810064995 Enrollment ID: I20080917000057 |
| Provider Name | Lakshmi Sunitha Garlapati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275741944 PECOS PAC ID: 3476617309 Enrollment ID: I20090121000520 |
| Provider Name | Wisam A Salman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972706133 PECOS PAC ID: 6305983701 Enrollment ID: I20091016000120 |
| Provider Name | Michael Anthony Basha |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1598732430 PECOS PAC ID: 0547302317 Enrollment ID: I20100118000245 |
| Provider Name | Ali Hamad Haidar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1104892058 PECOS PAC ID: 9234047929 Enrollment ID: I20100127000916 |
| Provider Name | John Vincent Brooks |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1598731473 PECOS PAC ID: 8628105962 Enrollment ID: I20100419000736 |
| Provider Name | Kimberley Clark-paul |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952410987 PECOS PAC ID: 2860470481 Enrollment ID: I20101118001064 |
| Provider Name | Fouad Azoury |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1265735047 PECOS PAC ID: 8022299437 Enrollment ID: I20110217000864 |
| Provider Name | Nikesh Ardeshna |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255541363 PECOS PAC ID: 6507937448 Enrollment ID: I20120420000393 |
| Provider Name | Bharath Naravetla |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477741890 PECOS PAC ID: 1658421789 Enrollment ID: I20130109000406 |
| Provider Name | Ahmed A Shalabi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558558320 PECOS PAC ID: 9234298381 Enrollment ID: I20130408000307 |
| Provider Name | Belal Hegazy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205103793 PECOS PAC ID: 5092956409 Enrollment ID: I20130729000123 |
| Provider Name | Omar Habib |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689873010 PECOS PAC ID: 0648350538 Enrollment ID: I20150220001889 |
| Provider Name | Ryan M Goodmanson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1053726000 PECOS PAC ID: 7618297177 Enrollment ID: I20161110001160 |
| Provider Name | Joseph Cuppari |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1538470067 PECOS PAC ID: 0749509438 Enrollment ID: I20170524002644 |
| Provider Name | Hitesh V Vashi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093101685 PECOS PAC ID: 6608178066 Enrollment ID: I20180706000763 |
| Provider Name | Josephine M Kamendat |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801387592 PECOS PAC ID: 5092062547 Enrollment ID: I20180716001972 |
| Provider Name | Todor Toromanovski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801237847 PECOS PAC ID: 6901125160 Enrollment ID: I20180807003442 |
| Provider Name | Umair Ali Daimee |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1841687506 PECOS PAC ID: 2567764285 Enrollment ID: I20181110000393 |
| Provider Name | Rita M Aouad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164777926 PECOS PAC ID: 9133369200 Enrollment ID: I20190112000272 |
| Provider Name | Roozbeh Mansour |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063745388 PECOS PAC ID: 3072828367 Enrollment ID: I20190416001110 |
| Provider Name | Katherine Foley |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1164786570 PECOS PAC ID: 1951671957 Enrollment ID: I20190516000815 |
| Provider Name | Nicholas D Sousa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134533912 PECOS PAC ID: 0345549911 Enrollment ID: I20190621001290 |
| Provider Name | Daniel J Goyes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528445244 PECOS PAC ID: 3375841133 Enrollment ID: I20190716000922 |
| Provider Name | Laura Anne Karadimas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790336907 PECOS PAC ID: 0941638589 Enrollment ID: I20200315000061 |
| Provider Name | Omar Basha |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831526573 PECOS PAC ID: 5092017392 Enrollment ID: I20200402002090 |
| Provider Name | Donald Lake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871014944 PECOS PAC ID: 1658616727 Enrollment ID: I20210217000765 |
| Provider Name | Michael P Dick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013936814 PECOS PAC ID: 2264326743 Enrollment ID: I20210222002028 |
| Provider Name | Amy C Storey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013459320 PECOS PAC ID: 4587900469 Enrollment ID: I20210226000715 |
| Provider Name | Devon Banda |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1316320534 PECOS PAC ID: 2860705704 Enrollment ID: I20210419002249 |
| Provider Name | Sonali S Vashi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417453424 PECOS PAC ID: 3072878875 Enrollment ID: I20210719002046 |
| Provider Name | Shrey Patel |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1508205048 PECOS PAC ID: 1052615382 Enrollment ID: I20210921003937 |
| Provider Name | Simon Chiu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033291935 PECOS PAC ID: 2365606902 Enrollment ID: I20211220002329 |
| Provider Name | Kristy M Stoutenburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376200352 PECOS PAC ID: 5395137004 Enrollment ID: I20220110000083 |
| Provider Name | Jill Marie Nevorski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164186615 PECOS PAC ID: 9234521444 Enrollment ID: I20220120002087 |
| Provider Name | Atul Sheth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942392212 PECOS PAC ID: 4284530288 Enrollment ID: I20220217000245 |
| Provider Name | Kevin Dwight Morton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356793269 PECOS PAC ID: 9234424946 Enrollment ID: I20220526001257 |
| Provider Name | Hnin Lwin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528547932 PECOS PAC ID: 5890038285 Enrollment ID: I20220526002802 |
| Provider Name | Hira Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770144164 PECOS PAC ID: 3779819164 Enrollment ID: I20220805001432 |
| Provider Name | Krishna S Vempati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710412457 PECOS PAC ID: 3779968441 Enrollment ID: I20220915002894 |
| Provider Name | Angad S Pordal |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437688462 PECOS PAC ID: 7517342850 Enrollment ID: I20220922000969 |
| Provider Name | Daniel James Marcath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093467136 PECOS PAC ID: 1658742077 Enrollment ID: I20230123002500 |
Anchor Counseling Services, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1423 Pine Grove Ave, Port Huron, MI 48060 Phone: 810-990-8720 | |
Dr. M. Rousseau, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 732 Holland Ave, Port Huron, MI 48060 Phone: 810-434-6280 | |
St. Clair County Sheriff Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1170 Michigan Rd, Port Huron, MI 48060 Phone: 810-966-1625 Fax: 810-966-4306 | |
St Clair County Community Mental Health Authority Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2415 24th St, Port Huron, MI 48060 Phone: 810-488-8840 Fax: 810-966-3393 | |
Changing Course Counseling, Plc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1423 Pine Grove Avenue, Port Huron, MI 48060 Phone: 810-357-9318 Fax: 810-479-9684 | |
St Clair County Community Mental Health Authority Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3111 Electric Ave, Port Huron, MI 48060 Phone: 810-985-8900 | |
Flint Odyssey House, Inc. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1431 Lapeer Ave, Port Huron, MI 48060 Phone: 810-238-7226 |