| St Vincent Hospital Physician Service Group | |
|
835 S Van Buren St Green Bay WI 54301-3526 | |
| (920) 433-8287 | |
| (920) 433-8765 |
| Full Name | St Vincent Hospital Physician Service Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 835 S Van Buren St, Green Bay, Wisconsin |
| Authorized Official Name and Position | Patricia Allen (CFO) |
| Authorized Official Contact | 9208845660 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Vincent Hospital Physician Service Group Po Box 13508 Green Bay WI 54307-3508 Ph: (920) 433-8287 | St Vincent Hospital Physician Service Group 835 S Van Buren St Green Bay WI 54301-3526 Ph: (920) 433-8287 |
| NPI Number | 1689694911 |
|---|---|
| Provider Enumeration Date | 07/20/2006 |
| Last Update Date | 12/23/2021 |
| Certification Date | 12/23/2021 |
| Medicare PECOS PAC ID | 5799694675 |
|---|---|
| Medicare Enrollment ID | O20040126000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689694911 | NPI | - | NPPES |
| Provider Name | David J Palubiak |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1871596627 PECOS PAC ID: 4981507209 Enrollment ID: I20040202000499 |
| Provider Name | Gregory M Bottei |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245255561 PECOS PAC ID: 8224924816 Enrollment ID: I20040223000096 |
| Provider Name | Geffrey E Cavallin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225061625 PECOS PAC ID: 8325934920 Enrollment ID: I20040223000161 |
| Provider Name | Karla J Roth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508890971 PECOS PAC ID: 8022006097 Enrollment ID: I20040506000438 |
| Provider Name | Kenneth J Hujet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376576678 PECOS PAC ID: 0042280927 Enrollment ID: I20040728000924 |
| Provider Name | Francis J Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073598322 PECOS PAC ID: 5698748069 Enrollment ID: I20040813000998 |
| Provider Name | Todd S Fergus |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083694111 PECOS PAC ID: 9234163767 Enrollment ID: I20050923000085 |
| Provider Name | Ravindra Hanumaiah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740237775 PECOS PAC ID: 9537183355 Enrollment ID: I20060119000778 |
| Provider Name | Thomas J Smith |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1649273400 PECOS PAC ID: 6002726098 Enrollment ID: I20060406000435 |
| Provider Name | Robert R Kohl |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1689628901 PECOS PAC ID: 7214948561 Enrollment ID: I20060526000087 |
| Provider Name | Jerry M Winkler |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1851365910 PECOS PAC ID: 5496648834 Enrollment ID: I20060726000127 |
| Provider Name | David L Groteluschen |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1679538011 PECOS PAC ID: 3971516519 Enrollment ID: I20060726000134 |
| Provider Name | John D Hutto |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1972714285 PECOS PAC ID: 3971604539 Enrollment ID: I20070726000208 |
| Provider Name | Gianina L Sibla |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275736530 PECOS PAC ID: 7315032315 Enrollment ID: I20071005000448 |
| Provider Name | Moshood A Lawal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457559296 PECOS PAC ID: 7416044664 Enrollment ID: I20071105000141 |
| Provider Name | Kelechi N Chiori |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922271907 PECOS PAC ID: 2860568375 Enrollment ID: I20080908000256 |
| Provider Name | Matthew L Ryan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1548233612 PECOS PAC ID: 7214839489 Enrollment ID: I20081003000340 |
| Provider Name | Jason W Hoppe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508899899 PECOS PAC ID: 5193884484 Enrollment ID: I20081031000060 |
| Provider Name | David W Rentmeester |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538186101 PECOS PAC ID: 8820143092 Enrollment ID: I20090911000541 |
| Provider Name | Sarah J Lulloff |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1215953062 PECOS PAC ID: 4587710512 Enrollment ID: I20090916000588 |
| Provider Name | Ruth Callaway Warren |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1124096185 PECOS PAC ID: 6608913512 Enrollment ID: I20091124000158 |
| Provider Name | Rehan Sajjad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841376167 PECOS PAC ID: 7517867286 Enrollment ID: I20100423000770 |
| Provider Name | Susan M Werchek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275857864 PECOS PAC ID: 8729117593 Enrollment ID: I20100603000976 |
| Provider Name | Anthony J Jaslowski |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1467546507 PECOS PAC ID: 8921011644 Enrollment ID: I20100720000023 |
| Provider Name | Paul M Smullen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033234406 PECOS PAC ID: 2668665696 Enrollment ID: I20101021001201 |
| Provider Name | David R Beck |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326169822 PECOS PAC ID: 6406032457 Enrollment ID: I20110509000855 |
| Provider Name | Ndidiamaka C Agu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760636070 PECOS PAC ID: 0840469177 Enrollment ID: I20110803000169 |
| Provider Name | Patricia A Giesler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255619730 PECOS PAC ID: 0749450252 Enrollment ID: I20110818000818 |
| Provider Name | Simil S Gala |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073716445 PECOS PAC ID: 6709057664 Enrollment ID: I20110926000469 |
| Provider Name | Stacy C Milquette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154604387 PECOS PAC ID: 2668644568 Enrollment ID: I20111019000708 |
| Provider Name | Marcy Godlewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699027235 PECOS PAC ID: 1557511599 Enrollment ID: I20121026000713 |
| Provider Name | Dawn R Giese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548504996 PECOS PAC ID: 4385898931 Enrollment ID: I20130206000442 |
| Provider Name | Sara Aerts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750628970 PECOS PAC ID: 7517105984 Enrollment ID: I20130523000481 |
| Provider Name | Brian L Burnette |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1952523680 PECOS PAC ID: 2567557184 Enrollment ID: I20130705000043 |
| Provider Name | Tal Pollak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770831158 PECOS PAC ID: 9234370982 Enrollment ID: I20130723000904 |
| Provider Name | Stephanie A Julius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992122485 PECOS PAC ID: 1759504921 Enrollment ID: I20140516000941 |
| Provider Name | Richard Amankwah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164712741 PECOS PAC ID: 6901022540 Enrollment ID: I20140717000527 |
| Provider Name | Paul Aj Baillargeon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598907875 PECOS PAC ID: 7618197674 Enrollment ID: I20140925002508 |
| Provider Name | Kayla R Guns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063821502 PECOS PAC ID: 3375763980 Enrollment ID: I20141002001688 |
| Provider Name | Alishia L Parma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922413830 PECOS PAC ID: 3870713266 Enrollment ID: I20141007001858 |
| Provider Name | Bradley C Heraly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063730042 PECOS PAC ID: 1254552508 Enrollment ID: I20141030000091 |
| Provider Name | Diane M Gulbrand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376940411 PECOS PAC ID: 3375868631 Enrollment ID: I20150207000028 |
| Provider Name | Kristin A Lohr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114319100 PECOS PAC ID: 8820315740 Enrollment ID: I20150402000058 |
| Provider Name | Barbi L Kaplan Frenkel |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1992796148 PECOS PAC ID: 5092617134 Enrollment ID: I20150717000635 |
| Provider Name | Shirley N Tetteh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114210473 PECOS PAC ID: 9638318504 Enrollment ID: I20150911000555 |
| Provider Name | Edgard A Badine |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1528191723 PECOS PAC ID: 3870692320 Enrollment ID: I20150914001017 |
| Provider Name | Catherine A Long |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306019138 PECOS PAC ID: 0749422293 Enrollment ID: I20150923003371 |
| Provider Name | Alin Sora |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275554131 PECOS PAC ID: 3678603073 Enrollment ID: I20160210002393 |
| Provider Name | Kamal Abbi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1588827778 PECOS PAC ID: 8022235753 Enrollment ID: I20160315000043 |
| Provider Name | Brittany R Burg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154780922 PECOS PAC ID: 6103123674 Enrollment ID: I20160328002153 |
| Provider Name | Michael Guiou |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1548436363 PECOS PAC ID: 7012151251 Enrollment ID: I20160330002501 |
| Provider Name | Danielle J Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245786441 PECOS PAC ID: 6901184332 Enrollment ID: I20161104001702 |
| Provider Name | Alla Al-habib |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588900096 PECOS PAC ID: 1355627068 Enrollment ID: I20170412001467 |
| Provider Name | Divya Hotchandani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891740262 PECOS PAC ID: 1254343452 Enrollment ID: I20170503002387 |
| Provider Name | Tamara Marie Ann Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477070308 PECOS PAC ID: 4284908856 Enrollment ID: I20170920001479 |
| Provider Name | Varoon R Thavapalan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568740546 PECOS PAC ID: 6709000417 Enrollment ID: I20171002001834 |
| Provider Name | Alexandra Barbara Osuchowski |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699095646 PECOS PAC ID: 8224279609 Enrollment ID: I20180411001233 |
| Provider Name | Alexander Starr |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1790722619 PECOS PAC ID: 9436113263 Enrollment ID: I20180730001240 |
| Provider Name | Kristin M Gardon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366933608 PECOS PAC ID: 3779832902 Enrollment ID: I20180822000865 |
| Provider Name | Brittany M Walczyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326525049 PECOS PAC ID: 9436408507 Enrollment ID: I20180822002783 |
| Provider Name | Arnaldo Efrain Velez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427242536 PECOS PAC ID: 3870736176 Enrollment ID: I20181218002398 |
| Provider Name | Christian A Rosado |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871804468 PECOS PAC ID: 3274774930 Enrollment ID: I20190208000011 |
| Provider Name | Amanda Beinemann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043694672 PECOS PAC ID: 0143535914 Enrollment ID: I20190406000000 |
| Provider Name | Ismael Shaukat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780814863 PECOS PAC ID: 2769514652 Enrollment ID: I20190409001209 |
| Provider Name | Christina M. Burch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619902392 PECOS PAC ID: 8921159898 Enrollment ID: I20190626004012 |
| Provider Name | Gina M Perez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376190165 PECOS PAC ID: 3577893007 Enrollment ID: I20190926002045 |
| Provider Name | Laura M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336776350 PECOS PAC ID: 6507296100 Enrollment ID: I20200422003064 |
| Provider Name | Dawit Worku |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942732789 PECOS PAC ID: 3072848043 Enrollment ID: I20200620000057 |
| Provider Name | Jeffrey Sadowsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275517336 PECOS PAC ID: 9638100035 Enrollment ID: I20200709000464 |
| Provider Name | Adrian A Salmon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528282456 PECOS PAC ID: 8123124807 Enrollment ID: I20200716002518 |
| Provider Name | Tamer Abdelhak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326100660 PECOS PAC ID: 8022019504 Enrollment ID: I20200724000045 |
| Provider Name | Chad Miller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467477901 PECOS PAC ID: 4183522212 Enrollment ID: I20200724000195 |
| Provider Name | Heather Linn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780620898 PECOS PAC ID: 0244234284 Enrollment ID: I20200724001034 |
| Provider Name | Shilpa Tilwalli |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639339641 PECOS PAC ID: 6608942735 Enrollment ID: I20200729000037 |
| Provider Name | Sindhu Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871710483 PECOS PAC ID: 4082860663 Enrollment ID: I20200810000541 |
| Provider Name | Kara E Ward |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073756227 PECOS PAC ID: 1951534866 Enrollment ID: I20200810002271 |
| Provider Name | Andrew R Freedman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598766743 PECOS PAC ID: 7911990460 Enrollment ID: I20200811001199 |
| Provider Name | Alan Eric Bakst |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275580185 PECOS PAC ID: 9537168968 Enrollment ID: I20200827000079 |
| Provider Name | Adam Evans |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1417101411 PECOS PAC ID: 8921263112 Enrollment ID: I20201103001842 |
| Provider Name | Valeria Serban |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306942933 PECOS PAC ID: 8426153974 Enrollment ID: I20201109003305 |
| Provider Name | Gillian Jones |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184041782 PECOS PAC ID: 5799087664 Enrollment ID: I20201112003204 |
| Provider Name | Prakashkumar Nagindas Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629079801 PECOS PAC ID: 7719881267 Enrollment ID: I20201125000122 |
| Provider Name | Arun K Sherma |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942474614 PECOS PAC ID: 1153616313 Enrollment ID: I20201204001816 |
| Provider Name | German Echeverry |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1689995771 PECOS PAC ID: 3577794197 Enrollment ID: I20210122000525 |
| Provider Name | Chadbourne A Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801482294 PECOS PAC ID: 4587078076 Enrollment ID: I20210125000724 |
| Provider Name | Melissa B Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558965640 PECOS PAC ID: 0941614465 Enrollment ID: I20210125001535 |
| Provider Name | Jessica T Weiland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871198507 PECOS PAC ID: 5597179911 Enrollment ID: I20210126003169 |
| Provider Name | Patricia A Stukenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295315695 PECOS PAC ID: 7113327404 Enrollment ID: I20210608001398 |
| Provider Name | Angelica T Hon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144892464 PECOS PAC ID: 5799189742 Enrollment ID: I20210812001983 |
| Provider Name | Alex Coffman |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1871045690 PECOS PAC ID: 0941604912 Enrollment ID: I20210812002714 |
| Provider Name | Abigail Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740953355 PECOS PAC ID: 6901202548 Enrollment ID: I20210908001510 |
| Provider Name | Kristin J Donnelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932875002 PECOS PAC ID: 4587060918 Enrollment ID: I20210909001645 |
| Provider Name | Meghan N Boll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992471973 PECOS PAC ID: 0345648655 Enrollment ID: I20211015002721 |
| Provider Name | Anand Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003133315 PECOS PAC ID: 0244456036 Enrollment ID: I20220114000855 |
| Provider Name | Ayaz Khawaja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881943256 PECOS PAC ID: 4082850888 Enrollment ID: I20220114000999 |
| Provider Name | Haitham S Alabsi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538587803 PECOS PAC ID: 7416279690 Enrollment ID: I20220114001623 |
| Provider Name | Henrikas Vaitkevicius |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699953372 PECOS PAC ID: 8729246012 Enrollment ID: I20220118001617 |
| Provider Name | Mark Hebert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831740331 PECOS PAC ID: 7012343890 Enrollment ID: I20220330001722 |
| Provider Name | Yasir Yafai |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205395381 PECOS PAC ID: 8224417357 Enrollment ID: I20220621002161 |
| Provider Name | Anda B Scorza |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699068130 PECOS PAC ID: 3779873864 Enrollment ID: I20220627000595 |
| Provider Name | Sally Lynn Haen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093451155 PECOS PAC ID: 2769864750 Enrollment ID: I20220808002719 |
| Provider Name | Sriman Swarup |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1457760340 PECOS PAC ID: 2769787209 Enrollment ID: I20220817003006 |
| Provider Name | Jordan Abel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417273301 PECOS PAC ID: 4789806522 Enrollment ID: I20221111000425 |
| Provider Name | Kristie Ann Wickman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649618323 PECOS PAC ID: 6305215476 Enrollment ID: I20221212002468 |
| Provider Name | Halley Borseth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780317321 PECOS PAC ID: 8224408588 Enrollment ID: I20221230001667 |
| Provider Name | Kaylee Lynn Hawks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003520255 PECOS PAC ID: 6507238987 Enrollment ID: I20230213000724 |
| Provider Name | Tigist D Gemechu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518469782 PECOS PAC ID: 9234496498 Enrollment ID: I20230228002071 |
| Provider Name | Ahmed U Otokiti |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760867204 PECOS PAC ID: 9537410824 Enrollment ID: I20230316001775 |
| Provider Name | Joshua Denk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174147987 PECOS PAC ID: 2466876040 Enrollment ID: I20230627002735 |
Goodine Counseling Ltd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1050 Circle Dr Ste B, Green Bay, WI 54304 Phone: 920-660-9797 | |
Thriveworks Clinical - Wisconsin Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2920 S Webster Ave Ste E, Green Bay, WI 54301 Phone: 855-284-7483 | |
Gam Behavioral Health Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3021 Holmgren Way, Suite 203a, Green Bay, WI 54304 Phone: 920-339-9307 Fax: 920-339-9374 | |
Goodine Counseling Ltd Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2300 Riverside Dr, Green Bay, WI 54301 Phone: 920-362-0447 | |
Healthy Hope Counseling Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 916 Willard Dr Ste 136, Green Bay, WI 54304 Phone: 920-328-0717 Fax: 920-328-0715 | |
Julie Feld And Associates Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 S Webster Ave, Green Bay, WI 54301 Phone: 920-884-8138 Fax: 920-884-8148 | |
Spectrum Behavioral Health Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 1496 Bellevue St, Suite 101, Green Bay, WI 54311 Phone: 920-784-2644 |