| Adventhealth Primary Care Network Inc | |
|
900 Hope Way Altamonte Springs FL 32714-1502 | |
| (407) 357-1000 | |
| Not Available |
| Full Name | Adventhealth Primary Care Network Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 900 Hope Way, Altamonte Springs, Florida |
| Authorized Official Name and Position | Kelly J Pettijohn (SVP-CFO) |
| Authorized Official Contact | 4073571000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Adventhealth Primary Care Network Inc 900 Hope Way Altamonte Springs FL 32714-1502 Ph: (407) 357-1000 | Adventhealth Primary Care Network Inc 900 Hope Way Altamonte Springs FL 32714-1502 Ph: (407) 357-1000 |
| NPI Number | 1093493637 |
|---|---|
| Provider Enumeration Date | 07/05/2023 |
| Last Update Date | 09/15/2023 |
| Certification Date | 09/15/2023 |
| Medicare PECOS PAC ID | 1557722410 |
|---|---|
| Medicare Enrollment ID | O20230725004134 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093493637 | NPI | - | NPPES |
| Provider Name | Mark Lee Craft |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689657926 PECOS PAC ID: 5496669178 Enrollment ID: I20031117000781 |
| Provider Name | April Dawn Morris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538129705 PECOS PAC ID: 5991604654 Enrollment ID: I20040102000223 |
| Provider Name | Edward Scanlan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861475196 PECOS PAC ID: 4981591989 Enrollment ID: I20040303001014 |
| Provider Name | Andrew D Tagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831161140 PECOS PAC ID: 2062304835 Enrollment ID: I20040326000463 |
| Provider Name | Michele Hornstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972542256 PECOS PAC ID: 1759374184 Enrollment ID: I20040403000023 |
| Provider Name | Randi Ann Rodrigues |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023003100 PECOS PAC ID: 5890789853 Enrollment ID: I20040413000137 |
| Provider Name | Jose O Delgado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801889688 PECOS PAC ID: 6507850138 Enrollment ID: I20040414001150 |
| Provider Name | Gregory a Berland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265427405 PECOS PAC ID: 5597744797 Enrollment ID: I20040720000091 |
| Provider Name | Jessy Casimiro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639157902 PECOS PAC ID: 5092779355 Enrollment ID: I20041116000834 |
| Provider Name | Carol Tanner St James |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740478197 PECOS PAC ID: 5395709968 Enrollment ID: I20041116001134 |
| Provider Name | Enid Milland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720091853 PECOS PAC ID: 6305804311 Enrollment ID: I20041222000308 |
| Provider Name | Michael P Desouza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649292020 PECOS PAC ID: 4587614318 Enrollment ID: I20050128000427 |
| Provider Name | Nidal El Rimawi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104804525 PECOS PAC ID: 2668411166 Enrollment ID: I20050425001001 |
| Provider Name | Derek Magnuson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124115126 PECOS PAC ID: 4082657473 Enrollment ID: I20050607000396 |
| Provider Name | Jerry W Bishop |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982607875 PECOS PAC ID: 2961390760 Enrollment ID: I20050818000271 |
| Provider Name | Debra Hastings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366441230 PECOS PAC ID: 0941225122 Enrollment ID: I20051006000604 |
| Provider Name | Jin Y Soh Urbano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942240767 PECOS PAC ID: 6901823475 Enrollment ID: I20051025000445 |
| Provider Name | Mark W Lastarza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831165448 PECOS PAC ID: 8426075706 Enrollment ID: I20051026000449 |
| Provider Name | Lindsey Repass Wolf |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306845276 PECOS PAC ID: 8921026337 Enrollment ID: I20051103001091 |
| Provider Name | Herma L Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770568339 PECOS PAC ID: 2466473392 Enrollment ID: I20051207000719 |
| Provider Name | Shannon C Delong |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497752679 PECOS PAC ID: 0345264263 Enrollment ID: I20060118000971 |
| Provider Name | Mohammed Asif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811928674 PECOS PAC ID: 4082629209 Enrollment ID: I20060209000233 |
| Provider Name | Yasemin S Ritland |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164479317 PECOS PAC ID: 9032121504 Enrollment ID: I20060627000206 |
| Provider Name | Eric a Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194774596 PECOS PAC ID: 6406868728 Enrollment ID: I20060630000286 |
| Provider Name | Danielle Lee Albritton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114969151 PECOS PAC ID: 8325051071 Enrollment ID: I20060724000238 |
| Provider Name | Milton J Arana |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003859919 PECOS PAC ID: 9436162047 Enrollment ID: I20060727000387 |
| Provider Name | Ana I Figueroa |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073628442 PECOS PAC ID: 4284631458 Enrollment ID: I20061031000461 |
| Provider Name | Deborah I Greaves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174560163 PECOS PAC ID: 9931201878 Enrollment ID: I20070224000004 |
| Provider Name | Ivonne Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407899412 PECOS PAC ID: 3678676251 Enrollment ID: I20070320000410 |
| Provider Name | Samuel P Shay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659326692 PECOS PAC ID: 9032000393 Enrollment ID: I20070405000005 |
| Provider Name | Jecebu Ceballos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740394352 PECOS PAC ID: 6608973342 Enrollment ID: I20070515000245 |
| Provider Name | Svetlana Y Rogozina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568576437 PECOS PAC ID: 3971555640 Enrollment ID: I20070530000484 |
| Provider Name | Daniel L Cochran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770510372 PECOS PAC ID: 3173598034 Enrollment ID: I20070828000515 |
| Provider Name | Jacquelyn H Nystrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083818553 PECOS PAC ID: 8325132913 Enrollment ID: I20070913000035 |
| Provider Name | Tapan P Bhatt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164625281 PECOS PAC ID: 0749379451 Enrollment ID: I20071204000144 |
| Provider Name | Janelle Griffith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770764516 PECOS PAC ID: 9638259591 Enrollment ID: I20080104000002 |
| Provider Name | Shrish Calla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497976526 PECOS PAC ID: 6204907710 Enrollment ID: I20080611000184 |
| Provider Name | Kimberly Anne Keller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366481483 PECOS PAC ID: 7315995909 Enrollment ID: I20080618000253 |
| Provider Name | Pamela Lynn Menzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477675718 PECOS PAC ID: 9436221918 Enrollment ID: I20080627000104 |
| Provider Name | Vivian M Theriault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740494962 PECOS PAC ID: 5890867857 Enrollment ID: I20080708000400 |
| Provider Name | Robert M Rodgers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972547354 PECOS PAC ID: 7416848767 Enrollment ID: I20080828000480 |
| Provider Name | Perri L Dumbacher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497705131 PECOS PAC ID: 2466485495 Enrollment ID: I20081009000460 |
| Provider Name | Jeffrey J Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093779175 PECOS PAC ID: 8224196738 Enrollment ID: I20081027000630 |
| Provider Name | Marcus J Merriweather |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538343215 PECOS PAC ID: 7113083692 Enrollment ID: I20090309000133 |
| Provider Name | Randall J Rogers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083741722 PECOS PAC ID: 8325198989 Enrollment ID: I20090603000093 |
| Provider Name | Ananth Krishnan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073521902 PECOS PAC ID: 7416003629 Enrollment ID: I20090914000055 |
| Provider Name | Suzanne E Villalobos |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316021777 PECOS PAC ID: 5991841637 Enrollment ID: I20091009000095 |
| Provider Name | Christine a Aziz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437354958 PECOS PAC ID: 5890835185 Enrollment ID: I20091217000292 |
| Provider Name | Joel M Weinberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568411577 PECOS PAC ID: 6709937865 Enrollment ID: I20091222000441 |
| Provider Name | Hezi Cohen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265427587 PECOS PAC ID: 3678663341 Enrollment ID: I20091228000379 |
| Provider Name | Rae E Ringenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477500494 PECOS PAC ID: 7315080686 Enrollment ID: I20100209000330 |
| Provider Name | James W Badman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265470405 PECOS PAC ID: 8325181621 Enrollment ID: I20100209000514 |
| Provider Name | Rachel Solomon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902849458 PECOS PAC ID: 2668516683 Enrollment ID: I20100215000312 |
| Provider Name | Chuong H Vu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366484446 PECOS PAC ID: 0941344980 Enrollment ID: I20100215000512 |
| Provider Name | Johnna G Mantineo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952371312 PECOS PAC ID: 1951446194 Enrollment ID: I20100226000702 |
| Provider Name | James Mcdonnell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396849915 PECOS PAC ID: 3870628720 Enrollment ID: I20100317000130 |
| Provider Name | Arthur R Polin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134224561 PECOS PAC ID: 5890820765 Enrollment ID: I20100317000460 |
| Provider Name | Hugh a Rutledge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437254885 PECOS PAC ID: 8527193499 Enrollment ID: I20100317000589 |
| Provider Name | Ruben E Perez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932178308 PECOS PAC ID: 4789719592 Enrollment ID: I20100318000626 |
| Provider Name | Jaima Peyton Woodiwiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902822323 PECOS PAC ID: 7911036512 Enrollment ID: I20100519000781 |
| Provider Name | Diego T Torres II |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821093105 PECOS PAC ID: 7911991963 Enrollment ID: I20100607000631 |
| Provider Name | Jon W Beasley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386671774 PECOS PAC ID: 3375673379 Enrollment ID: I20100618000311 |
| Provider Name | Biren R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376579185 PECOS PAC ID: 0446380331 Enrollment ID: I20100621000443 |
| Provider Name | Elizabeth Dorothy Plonka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588608939 PECOS PAC ID: 0143351916 Enrollment ID: I20100623000820 |
| Provider Name | Reginald Schutt-aine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083672380 PECOS PAC ID: 4789684283 Enrollment ID: I20100629000196 |
| Provider Name | Thomas Jude Montaldo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003864992 PECOS PAC ID: 0244230746 Enrollment ID: I20100713000518 |
| Provider Name | Sharon M Sibley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700806502 PECOS PAC ID: 1355474248 Enrollment ID: I20100728001233 |
| Provider Name | Ram M Amilineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457457541 PECOS PAC ID: 3971636515 Enrollment ID: I20100803000135 |
| Provider Name | Jeffrey David Wartman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295730414 PECOS PAC ID: 7517857683 Enrollment ID: I20100817001432 |
| Provider Name | Ashwinkumar R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801844071 PECOS PAC ID: 7416071741 Enrollment ID: I20100824000399 |
| Provider Name | Steven L Attermann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538173026 PECOS PAC ID: 9234110362 Enrollment ID: I20100908001079 |
| Provider Name | Sage P Naran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407971807 PECOS PAC ID: 9234254459 Enrollment ID: I20100913000022 |
| Provider Name | Eddie Waldheim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881797082 PECOS PAC ID: 3476678962 Enrollment ID: I20100921001127 |
| Provider Name | Hursel L Adkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811092737 PECOS PAC ID: 7416854195 Enrollment ID: I20100928000329 |
| Provider Name | Glenda F Parker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760521132 PECOS PAC ID: 3779679311 Enrollment ID: I20101004001328 |
| Provider Name | Donald W Liebelt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710969076 PECOS PAC ID: 7214908540 Enrollment ID: I20101015000781 |
| Provider Name | Laurence Neufeld |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083694640 PECOS PAC ID: 7214827047 Enrollment ID: I20101026001076 |
| Provider Name | Tina L Fischer Carne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912995499 PECOS PAC ID: 2062508690 Enrollment ID: I20101101000196 |
| Provider Name | Margaret Ann Colleran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457356677 PECOS PAC ID: 9537293261 Enrollment ID: I20101124000711 |
| Provider Name | Cesar a Unyon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053396309 PECOS PAC ID: 9234326901 Enrollment ID: I20101207000608 |
| Provider Name | Amir F Guirguis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669421418 PECOS PAC ID: 2860489606 Enrollment ID: I20101228000266 |
| Provider Name | Alan J Iezzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952590028 PECOS PAC ID: 6002866902 Enrollment ID: I20110209000518 |
| Provider Name | Steven L Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124125505 PECOS PAC ID: 4587847934 Enrollment ID: I20110323000492 |
| Provider Name | John Morrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396936936 PECOS PAC ID: 7618093584 Enrollment ID: I20110630000193 |
| Provider Name | Justin N Menezes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194013169 PECOS PAC ID: 4183895733 Enrollment ID: I20110912000757 |
| Provider Name | Rajani P Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710936695 PECOS PAC ID: 8820269004 Enrollment ID: I20110920000144 |
| Provider Name | Cynthia P Roever |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295976702 PECOS PAC ID: 3375715634 Enrollment ID: I20111010000178 |
| Provider Name | Tanam S Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043475155 PECOS PAC ID: 5890960157 Enrollment ID: I20111214001004 |
| Provider Name | Amanda R Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689813305 PECOS PAC ID: 3274670492 Enrollment ID: I20111222000115 |
| Provider Name | Patty J Lodge |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184664583 PECOS PAC ID: 0345407516 Enrollment ID: I20120131000782 |
| Provider Name | Kimberly a Jerome |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518235159 PECOS PAC ID: 6507026549 Enrollment ID: I20120328000569 |
| Provider Name | Dawn Winslow Coley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437417151 PECOS PAC ID: 3577727072 Enrollment ID: I20120613000521 |
| Provider Name | Gigi Kwok |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821358433 PECOS PAC ID: 9830354521 Enrollment ID: I20120702000348 |
| Provider Name | Gretchen L Winans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568770691 PECOS PAC ID: 7416104617 Enrollment ID: I20120823000050 |
| Provider Name | Elizabeth B Sasse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427310440 PECOS PAC ID: 9931358561 Enrollment ID: I20120925000689 |
| Provider Name | Craig W Burns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982605523 PECOS PAC ID: 0244480572 Enrollment ID: I20121023000530 |
| Provider Name | Mercedes D Wierman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003188236 PECOS PAC ID: 0244481885 Enrollment ID: I20121108000301 |
| Provider Name | Rebecca H Mangali |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225327042 PECOS PAC ID: 1658524541 Enrollment ID: I20121228000250 |
| Provider Name | Payal J Patel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598013302 PECOS PAC ID: 0840443651 Enrollment ID: I20130103000175 |
| Provider Name | Margarette Lespinasse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609112408 PECOS PAC ID: 6901059468 Enrollment ID: I20130111000147 |
| Provider Name | Kashif I Qureshi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215290382 PECOS PAC ID: 2365695632 Enrollment ID: I20130117000237 |
| Provider Name | Nancy L. Dahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861743122 PECOS PAC ID: 4587818018 Enrollment ID: I20130208000053 |
| Provider Name | Karen L Steinbrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710241229 PECOS PAC ID: 2062657513 Enrollment ID: I20130404000079 |
| Provider Name | Molly E Jimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699059618 PECOS PAC ID: 6709023609 Enrollment ID: I20130514000262 |
| Provider Name | Kathryn M Malan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740575497 PECOS PAC ID: 5496992778 Enrollment ID: I20130812000482 |
| Provider Name | Crystal Dejesus |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063775765 PECOS PAC ID: 6800020579 Enrollment ID: I20131011000943 |
| Provider Name | Courtney L Miller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982030391 PECOS PAC ID: 8022242601 Enrollment ID: I20131015000596 |
| Provider Name | Sarah D Mehuron |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255620084 PECOS PAC ID: 1355576182 Enrollment ID: I20131031001661 |
| Provider Name | Veronica L Chastain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730400060 PECOS PAC ID: 9638304272 Enrollment ID: I20131106001465 |
| Provider Name | Kelly a Doggett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669818175 PECOS PAC ID: 0749415347 Enrollment ID: I20131107001305 |
| Provider Name | Romeena Tejiram Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679810212 PECOS PAC ID: 9830325596 Enrollment ID: I20131202001263 |
| Provider Name | Wendy C Acosta Luna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912336520 PECOS PAC ID: 6709013642 Enrollment ID: I20131220000698 |
| Provider Name | Nicole Morgan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063425031 PECOS PAC ID: 0648297754 Enrollment ID: I20140410001722 |
| Provider Name | Zofia Kletter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477978674 PECOS PAC ID: 3577795913 Enrollment ID: I20140417000146 |
| Provider Name | Jennifer Ann Meeks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720347651 PECOS PAC ID: 8022246917 Enrollment ID: I20140821001218 |
| Provider Name | Allison Onkala |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326455965 PECOS PAC ID: 5193943264 Enrollment ID: I20140903000195 |
| Provider Name | Amit D Desai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447545850 PECOS PAC ID: 2264669142 Enrollment ID: I20140917001427 |
| Provider Name | Jonathan Screnock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285677294 PECOS PAC ID: 9537155239 Enrollment ID: I20140917002269 |
| Provider Name | Lana Ann Doxtater Massaro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548374663 PECOS PAC ID: 8426155318 Enrollment ID: I20141014002441 |
| Provider Name | Jodi L Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164826731 PECOS PAC ID: 4880916949 Enrollment ID: I20141201001791 |
| Provider Name | Tamika J Lott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386791879 PECOS PAC ID: 3678633591 Enrollment ID: I20150127000722 |
| Provider Name | Roxann Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710327622 PECOS PAC ID: 0941524573 Enrollment ID: I20150130000615 |
| Provider Name | Stacey Lynn Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922497601 PECOS PAC ID: 0042537045 Enrollment ID: I20150401001649 |
| Provider Name | Hossam S Naguib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235188087 PECOS PAC ID: 5698675403 Enrollment ID: I20150505001666 |
| Provider Name | Yanelis Leyva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063766228 PECOS PAC ID: 2466773551 Enrollment ID: I20150601002346 |
| Provider Name | Chiamaka C Iheme |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326479460 PECOS PAC ID: 8820227085 Enrollment ID: I20150708001583 |
| Provider Name | Belinda Joy Gavino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750711636 PECOS PAC ID: 4981918968 Enrollment ID: I20150804005720 |
| Provider Name | Lawrence L Pedley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801239223 PECOS PAC ID: 3173752813 Enrollment ID: I20151002000513 |
| Provider Name | Marie M Collazo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346640356 PECOS PAC ID: 3476863994 Enrollment ID: I20151112000504 |
| Provider Name | Nadia Zhylin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386018455 PECOS PAC ID: 2961703848 Enrollment ID: I20151217002732 |
| Provider Name | Emmanuelle M Ballenilla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629443676 PECOS PAC ID: 4486957164 Enrollment ID: I20160129002198 |
| Provider Name | Bernice a Pritchett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700847449 PECOS PAC ID: 4183675150 Enrollment ID: I20160217002543 |
| Provider Name | Candice J Rosen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871958207 PECOS PAC ID: 2567768286 Enrollment ID: I20160307001525 |
| Provider Name | Christian T Atkins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033542444 PECOS PAC ID: 4284933177 Enrollment ID: I20160427001293 |
| Provider Name | Alexandra Gabriel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184050767 PECOS PAC ID: 3577790864 Enrollment ID: I20160823002225 |
| Provider Name | Jennifer Toro Galarza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720411598 PECOS PAC ID: 9335435023 Enrollment ID: I20160906002468 |
| Provider Name | Christopher R Buelvas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144659384 PECOS PAC ID: 3971899097 Enrollment ID: I20160915000959 |
| Provider Name | Haroldo Melo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457516254 PECOS PAC ID: 4880865088 Enrollment ID: I20160930001774 |
| Provider Name | Farhan Rehman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750722708 PECOS PAC ID: 8426350034 Enrollment ID: I20161011001281 |
| Provider Name | Jorge M Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952444648 PECOS PAC ID: 8022306596 Enrollment ID: I20161017000713 |
| Provider Name | Jennifer Lyn Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073974192 PECOS PAC ID: 2668766288 Enrollment ID: I20161028000889 |
| Provider Name | Mini Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740631639 PECOS PAC ID: 0042598716 Enrollment ID: I20161101000004 |
| Provider Name | Jeneaurey Melendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881022895 PECOS PAC ID: 0749569135 Enrollment ID: I20161107001810 |
| Provider Name | Lauren M Bedney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528497526 PECOS PAC ID: 2062640469 Enrollment ID: I20161109001657 |
| Provider Name | Alexandra Thomas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689121246 PECOS PAC ID: 1658650619 Enrollment ID: I20161115000349 |
| Provider Name | Yekatherine Rasmussen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235345687 PECOS PAC ID: 1951493261 Enrollment ID: I20170306000526 |
| Provider Name | Mark Christopher Roque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467802892 PECOS PAC ID: 8729363361 Enrollment ID: I20170323000489 |
| Provider Name | Sunita Roque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255884409 PECOS PAC ID: 2668759820 Enrollment ID: I20170426001340 |
| Provider Name | Alexander L Kushnir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477970705 PECOS PAC ID: 5496025728 Enrollment ID: I20170719003436 |
| Provider Name | Jason Michael Florimonte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538161518 PECOS PAC ID: 9739184011 Enrollment ID: I20170821003257 |
| Provider Name | Paula Jean Knapp-baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528167145 PECOS PAC ID: 8224059464 Enrollment ID: I20170901001277 |
| Provider Name | Hyrum Anthony Brodniak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619319563 PECOS PAC ID: 6709014681 Enrollment ID: I20171002001966 |
| Provider Name | Sue-wei Luu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669819512 PECOS PAC ID: 8022251370 Enrollment ID: I20171104000071 |
| Provider Name | Kate L Leon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467970228 PECOS PAC ID: 0941566806 Enrollment ID: I20171108002940 |
| Provider Name | Gurpawan Dhaliwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871889816 PECOS PAC ID: 4789807108 Enrollment ID: I20171127001802 |
| Provider Name | Tashrique Alam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821473299 PECOS PAC ID: 1658630637 Enrollment ID: I20180119001637 |
| Provider Name | Kristin D Nelson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053819680 PECOS PAC ID: 5799048583 Enrollment ID: I20180409001081 |
| Provider Name | Devlin H O'connor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053759035 PECOS PAC ID: 2365741105 Enrollment ID: I20180427001127 |
| Provider Name | Subha Jose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588192082 PECOS PAC ID: 1850655861 Enrollment ID: I20180427001139 |
| Provider Name | Dasrine K Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295235943 PECOS PAC ID: 2860756699 Enrollment ID: I20180503000325 |
| Provider Name | Kathryn Dianne Herden |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750734604 PECOS PAC ID: 8022302751 Enrollment ID: I20180529001000 |
| Provider Name | Kate-lynn Holder |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740773407 PECOS PAC ID: 9032467667 Enrollment ID: I20180730002497 |
| Provider Name | William Gottschalk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306231873 PECOS PAC ID: 7618225855 Enrollment ID: I20180806000479 |
| Provider Name | Melissa Sepe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396222824 PECOS PAC ID: 3577814110 Enrollment ID: I20180920003530 |
| Provider Name | April Renee Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811473275 PECOS PAC ID: 5890046239 Enrollment ID: I20180924001386 |
| Provider Name | Arianna E Becker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205215985 PECOS PAC ID: 5799048161 Enrollment ID: I20181005002152 |
| Provider Name | Patricia Jean Pamas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104313469 PECOS PAC ID: 7113278276 Enrollment ID: I20181109002289 |
| Provider Name | Lisa Marie Peto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720485170 PECOS PAC ID: 8628348364 Enrollment ID: I20181110000089 |
| Provider Name | Rose Boscaino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235615295 PECOS PAC ID: 5597009084 Enrollment ID: I20181211001250 |
| Provider Name | Dominiqua Lint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053882290 PECOS PAC ID: 2264778349 Enrollment ID: I20190110000819 |
| Provider Name | Jaclyn Ann Gunn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639548654 PECOS PAC ID: 9335431931 Enrollment ID: I20190115001419 |
| Provider Name | Yun Mi Sung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003390014 PECOS PAC ID: 1951648344 Enrollment ID: I20190123001932 |
| Provider Name | Jessica Lynn Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043502529 PECOS PAC ID: 2264755321 Enrollment ID: I20190304001518 |
| Provider Name | Anna Viktorovna Ferrer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659849446 PECOS PAC ID: 3779822887 Enrollment ID: I20190307002771 |
| Provider Name | Nicole A. Buchanan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154558203 PECOS PAC ID: 2860545407 Enrollment ID: I20190415001065 |
| Provider Name | Matthew Ormond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952870545 PECOS PAC ID: 5597008292 Enrollment ID: I20190521001860 |
| Provider Name | Erin G Hough |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013437706 PECOS PAC ID: 5193084325 Enrollment ID: I20190524000742 |
| Provider Name | Sue-ellen Elizabeth Griffith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083066187 PECOS PAC ID: 9739474073 Enrollment ID: I20190610000680 |
| Provider Name | Robert Lee Solomon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073960357 PECOS PAC ID: 4486940582 Enrollment ID: I20190702002845 |
| Provider Name | Lauren Marie Conroy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548623549 PECOS PAC ID: 9234426289 Enrollment ID: I20190812001270 |
| Provider Name | Todd Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790130862 PECOS PAC ID: 9931487790 Enrollment ID: I20190815002088 |
| Provider Name | Amanda Nadeau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164881009 PECOS PAC ID: 9537420047 Enrollment ID: I20190827003496 |
| Provider Name | Sabrina Snedaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215423439 PECOS PAC ID: 5991033920 Enrollment ID: I20190828002647 |
| Provider Name | Melissa a Morello |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700231719 PECOS PAC ID: 3173801958 Enrollment ID: I20190910000176 |
| Provider Name | Desirae Friend |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447512199 PECOS PAC ID: 1658524202 Enrollment ID: I20191007000541 |
| Provider Name | Gilbert Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417326992 PECOS PAC ID: 3375875511 Enrollment ID: I20191021003374 |
| Provider Name | Katrina Emilia Noboa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316594112 PECOS PAC ID: 5395077457 Enrollment ID: I20191023001581 |
| Provider Name | Kiet T La |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083147862 PECOS PAC ID: 1052687837 Enrollment ID: I20200107002367 |
| Provider Name | Jenet M George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710398862 PECOS PAC ID: 1850681263 Enrollment ID: I20200221001311 |
| Provider Name | Pamela Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962032607 PECOS PAC ID: 7719314178 Enrollment ID: I20200224002270 |
| Provider Name | Kathleen Paige Dixon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720575632 PECOS PAC ID: 3173951993 Enrollment ID: I20200310000725 |
| Provider Name | Shana Lee Vongkhankeo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073144994 PECOS PAC ID: 1355770868 Enrollment ID: I20200405000006 |
| Provider Name | Tayanna Lawlor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750899217 PECOS PAC ID: 4880954692 Enrollment ID: I20200412000029 |
| Provider Name | Kerri Al Quinones Lumsden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871125278 PECOS PAC ID: 2769812106 Enrollment ID: I20200425000162 |
| Provider Name | Joseph Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760442834 PECOS PAC ID: 6002077633 Enrollment ID: I20200526000733 |
| Provider Name | Evelyn I Rodriguez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083791941 PECOS PAC ID: 4981631769 Enrollment ID: I20200609001395 |
| Provider Name | Lei Gong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497934004 PECOS PAC ID: 5597818773 Enrollment ID: I20200715002302 |
| Provider Name | Jennifer E Kelley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104359876 PECOS PAC ID: 4880954338 Enrollment ID: I20200716002562 |
| Provider Name | Christopher Lee Paik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548748957 PECOS PAC ID: 5193149557 Enrollment ID: I20200720001124 |
| Provider Name | Amy Alexandra Reyes Arnaldy |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1003298779 PECOS PAC ID: 6901150630 Enrollment ID: I20200724000153 |
| Provider Name | Jubeth Carlene Burlison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376077719 PECOS PAC ID: 0941560767 Enrollment ID: I20200728001605 |
| Provider Name | Dru E Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538791306 PECOS PAC ID: 3678999679 Enrollment ID: I20200821000422 |
| Provider Name | Maria Caratas Epstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457714818 PECOS PAC ID: 1355671173 Enrollment ID: I20200821001673 |
| Provider Name | Steven M Pouls |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063513687 PECOS PAC ID: 2860483443 Enrollment ID: I20200902000128 |
| Provider Name | Elizabeth Fisher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699156679 PECOS PAC ID: 5092028035 Enrollment ID: I20200909001355 |
| Provider Name | Beatriz Bustamante |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710504428 PECOS PAC ID: 3072931344 Enrollment ID: I20200918000327 |
| Provider Name | Merlyn Varona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295349173 PECOS PAC ID: 4880013580 Enrollment ID: I20200930000416 |
| Provider Name | Victoria Tirado Michiel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679172571 PECOS PAC ID: 3476964677 Enrollment ID: I20201119000184 |
| Provider Name | Marisha Sirdar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770016966 PECOS PAC ID: 5193097228 Enrollment ID: I20210205000118 |
| Provider Name | Yahaira Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205428398 PECOS PAC ID: 7416362835 Enrollment ID: I20210217002014 |
| Provider Name | Mikala Patricia Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467059790 PECOS PAC ID: 7719395557 Enrollment ID: I20210416000678 |
| Provider Name | Sarah Sakala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447892096 PECOS PAC ID: 9739589102 Enrollment ID: I20210608000248 |
| Provider Name | Wyniqua Studivant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578021796 PECOS PAC ID: 7214279934 Enrollment ID: I20210628002167 |
| Provider Name | Yorlenis Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043743297 PECOS PAC ID: 9032546262 Enrollment ID: I20210707003764 |
| Provider Name | Mariam Javed Mayet-khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851897367 PECOS PAC ID: 5395177216 Enrollment ID: I20210721002282 |
| Provider Name | Alison Marie Jimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891367538 PECOS PAC ID: 2466855697 Enrollment ID: I20210727000367 |
| Provider Name | Trinh Duong Pham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174028047 PECOS PAC ID: 3476802331 Enrollment ID: I20210728002064 |
| Provider Name | Jennifer C Dasque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881183168 PECOS PAC ID: 6709289580 Enrollment ID: I20210730003140 |
| Provider Name | Katerina Sarmiento |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811472533 PECOS PAC ID: 5991109415 Enrollment ID: I20210805002304 |
| Provider Name | Carlos Romano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730679929 PECOS PAC ID: 7618217324 Enrollment ID: I20210816001602 |
| Provider Name | Alicia Abel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902432347 PECOS PAC ID: 5496150815 Enrollment ID: I20210824001510 |
| Provider Name | Mary Elizabeth Hafele-kott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225603038 PECOS PAC ID: 2860899978 Enrollment ID: I20210916000158 |
| Provider Name | Jared Scott Levine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033702469 PECOS PAC ID: 5092112151 Enrollment ID: I20210916002313 |
| Provider Name | Jose Omar Burgos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053804997 PECOS PAC ID: 5092069435 Enrollment ID: I20210917001175 |
| Provider Name | Thuy T Kolomiyets |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578156238 PECOS PAC ID: 5294133369 Enrollment ID: I20211005001480 |
| Provider Name | Glenda Denisse Rosa Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447564828 PECOS PAC ID: 3476880352 Enrollment ID: I20211012000713 |
| Provider Name | Elena Marie Lushine |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1447873567 PECOS PAC ID: 3375931686 Enrollment ID: I20211019000949 |
| Provider Name | Ramzi Zureikat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851529119 PECOS PAC ID: 1153577358 Enrollment ID: I20211021003173 |
| Provider Name | Reham Hanna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881986586 PECOS PAC ID: 4385032432 Enrollment ID: I20211022001666 |
| Provider Name | Nishtha Garg |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013505189 PECOS PAC ID: 5395134357 Enrollment ID: I20211112000098 |
| Provider Name | Nina Theodora Camperlengo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609890128 PECOS PAC ID: 7113182387 Enrollment ID: I20211116002879 |
| Provider Name | Ryan Scott Tidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336712033 PECOS PAC ID: 0042609703 Enrollment ID: I20211118000758 |
| Provider Name | Loretta Blanchard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104103613 PECOS PAC ID: 4688839137 Enrollment ID: I20211124001535 |
| Provider Name | Kayla Weston |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396407300 PECOS PAC ID: 2567852635 Enrollment ID: I20211203000747 |
| Provider Name | Delayna Siqueira |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285390328 PECOS PAC ID: 7315337300 Enrollment ID: I20211207000121 |
| Provider Name | Jewell Marie Conway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184227779 PECOS PAC ID: 6507257078 Enrollment ID: I20211217001303 |
| Provider Name | Cassandra Nichole Warner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124787742 PECOS PAC ID: 1052702131 Enrollment ID: I20211228001098 |
| Provider Name | Dawn a Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184393183 PECOS PAC ID: 4587057740 Enrollment ID: I20220210001794 |
| Provider Name | Cheryl Adley Gulenay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538665559 PECOS PAC ID: 2365781069 Enrollment ID: I20220321000900 |
| Provider Name | Vola Harivony Le Roux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710422399 PECOS PAC ID: 2668755984 Enrollment ID: I20220322000195 |
| Provider Name | Krisha G Shah |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881349975 PECOS PAC ID: 1355737859 Enrollment ID: I20220411000605 |
| Provider Name | Myron Elliot Fuller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932766060 PECOS PAC ID: 1052707452 Enrollment ID: I20220412002213 |
| Provider Name | Mary Lilko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902808983 PECOS PAC ID: 7719871904 Enrollment ID: I20220419000638 |
| Provider Name | Katrina N Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518510965 PECOS PAC ID: 5294147989 Enrollment ID: I20220428000669 |
| Provider Name | Alissa Hogue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992181051 PECOS PAC ID: 8426367897 Enrollment ID: I20220507000206 |
| Provider Name | Chloe Louise Kindred |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790348191 PECOS PAC ID: 6507108792 Enrollment ID: I20220607002210 |
| Provider Name | Morgan Macintyre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427517432 PECOS PAC ID: 2365879913 Enrollment ID: I20220613002604 |
| Provider Name | Oscar Radi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700438454 PECOS PAC ID: 5496134900 Enrollment ID: I20220614000061 |
| Provider Name | Italia Cegla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861139990 PECOS PAC ID: 8224418850 Enrollment ID: I20220629001374 |
| Provider Name | Jacob W Albert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265929319 PECOS PAC ID: 4183974561 Enrollment ID: I20220713004275 |
| Provider Name | Joseph Anthony Libby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861574279 PECOS PAC ID: 2860417110 Enrollment ID: I20220714004205 |
| Provider Name | Ahmad Emara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477013613 PECOS PAC ID: 2860726452 Enrollment ID: I20220718000722 |
| Provider Name | Laraey King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538622691 PECOS PAC ID: 6305171919 Enrollment ID: I20220720002372 |
| Provider Name | Nancy Si |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265992705 PECOS PAC ID: 1658608625 Enrollment ID: I20220802000192 |
| Provider Name | Andrea Claire Miser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528562584 PECOS PAC ID: 3870975030 Enrollment ID: I20220804000600 |
| Provider Name | Tamara Sealy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225477094 PECOS PAC ID: 6103138862 Enrollment ID: I20220809000077 |
| Provider Name | Natalie N Caplinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962964908 PECOS PAC ID: 3274916960 Enrollment ID: I20220812001084 |
| Provider Name | Eric C Nordstrom |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639828106 PECOS PAC ID: 3779966486 Enrollment ID: I20220812002265 |
| Provider Name | James Pense |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962898775 PECOS PAC ID: 4082922463 Enrollment ID: I20220817002182 |
| Provider Name | Paras Bajaj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972066736 PECOS PAC ID: 6103209192 Enrollment ID: I20220824002576 |
| Provider Name | Shabnam Siddiqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144883398 PECOS PAC ID: 5597007328 Enrollment ID: I20220829000820 |
| Provider Name | Amanda a Hussein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518528124 PECOS PAC ID: 1355670530 Enrollment ID: I20220829003607 |
| Provider Name | Nicholas Pantelis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992265110 PECOS PAC ID: 2466783071 Enrollment ID: I20220830000144 |
| Provider Name | Dmitry Aleks Drapach |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669487542 PECOS PAC ID: 9032205331 Enrollment ID: I20220830000398 |
| Provider Name | Isabel Cruz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386372324 PECOS PAC ID: 0244614808 Enrollment ID: I20220830004568 |
| Provider Name | Zaynab Rasheed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437688538 PECOS PAC ID: 2769755032 Enrollment ID: I20220901002230 |
| Provider Name | Stephanie Mathis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295499572 PECOS PAC ID: 0749664092 Enrollment ID: I20220906000430 |
| Provider Name | Kassie Falcon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972064780 PECOS PAC ID: 9931439692 Enrollment ID: I20220908000784 |
| Provider Name | Ryan Sean Tubbs |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053777979 PECOS PAC ID: 9830573914 Enrollment ID: I20220909000004 |
| Provider Name | Rachel White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538892567 PECOS PAC ID: 0345625406 Enrollment ID: I20220911000020 |
| Provider Name | Magdeley Mordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932757101 PECOS PAC ID: 4284019118 Enrollment ID: I20220913004076 |
| Provider Name | Stephannie Rey-cubero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285201822 PECOS PAC ID: 6103202601 Enrollment ID: I20221006003169 |
| Provider Name | Alicia Benjamin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134697592 PECOS PAC ID: 0941537831 Enrollment ID: I20221018001658 |
| Provider Name | Maureen Alvarado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568801470 PECOS PAC ID: 2567605256 Enrollment ID: I20221115000953 |
| Provider Name | Tabatha Harley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598336075 PECOS PAC ID: 9436547999 Enrollment ID: I20221201002984 |
| Provider Name | Allison Michelle Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578292637 PECOS PAC ID: 2365811437 Enrollment ID: I20221212002208 |
| Provider Name | Valencia C Dulcio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467028787 PECOS PAC ID: 1052780160 Enrollment ID: I20221213000613 |
| Provider Name | Darshan Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336466200 PECOS PAC ID: 1052532496 Enrollment ID: I20221214002015 |
| Provider Name | Sunil Bharwani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699967877 PECOS PAC ID: 9537242250 Enrollment ID: I20221228001719 |
| Provider Name | Lauren Haas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942925953 PECOS PAC ID: 3577933712 Enrollment ID: I20230103002917 |
| Provider Name | Francie Marie Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831800812 PECOS PAC ID: 8123498136 Enrollment ID: I20230109003043 |
| Provider Name | Analaura Vallejo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083326235 PECOS PAC ID: 9830560333 Enrollment ID: I20230119003135 |
| Provider Name | Meghan Marie Cequerella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720790017 PECOS PAC ID: 1850762030 Enrollment ID: I20230126000600 |
| Provider Name | Marilou Galvan Folk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952030835 PECOS PAC ID: 4183096761 Enrollment ID: I20230207003687 |
| Provider Name | Sarah Mcandrew |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679921548 PECOS PAC ID: 3971899956 Enrollment ID: I20230223002816 |
| Provider Name | Rachel Etta Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952015588 PECOS PAC ID: 8123491099 Enrollment ID: I20230224001306 |
| Provider Name | Nicole Johnson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053952499 PECOS PAC ID: 5890120349 Enrollment ID: I20230227001517 |
| Provider Name | Maya Laprade |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730758566 PECOS PAC ID: 9032516430 Enrollment ID: I20230322001834 |
| Provider Name | Melinda Marty Morgan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437856606 PECOS PAC ID: 0042684201 Enrollment ID: I20230330000238 |
| Provider Name | Isabella Caterina Katz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235845512 PECOS PAC ID: 0941675326 Enrollment ID: I20230418000030 |
| Provider Name | Anjali Hardeo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568025088 PECOS PAC ID: 0941623128 Enrollment ID: I20230418002736 |
| Provider Name | Paola Gabriela Macias |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104524107 PECOS PAC ID: 2264897933 Enrollment ID: I20230502002014 |
| Provider Name | Cayla L Milford |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992402515 PECOS PAC ID: 7315302098 Enrollment ID: I20230502002712 |
| Provider Name | Alicia Critcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780372771 PECOS PAC ID: 0345606356 Enrollment ID: I20230517002739 |
| Provider Name | Ann Nevin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720775034 PECOS PAC ID: 7315304896 Enrollment ID: I20230530001081 |
| Provider Name | Manju Kanikunnel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942615851 PECOS PAC ID: 1658599493 Enrollment ID: I20230531002456 |
| Provider Name | Jacquelyn Campo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467140939 PECOS PAC ID: 9830556174 Enrollment ID: I20230601001516 |
| Provider Name | Aftaab Aliahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679107064 PECOS PAC ID: 9537527791 Enrollment ID: I20230620002053 |
| Provider Name | Nicole German |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235839366 PECOS PAC ID: 0840659843 Enrollment ID: I20230710000954 |
| Provider Name | Asheema Bacchus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699209296 PECOS PAC ID: 3476824707 Enrollment ID: I20230711002756 |
| Provider Name | Trevor a Owens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942839386 PECOS PAC ID: 8527485879 Enrollment ID: I20230720003587 |
| Provider Name | Monica Mansour |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427679513 PECOS PAC ID: 3971924937 Enrollment ID: I20230728002674 |
| Provider Name | Heather Vermilyea |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952939977 PECOS PAC ID: 7719301894 Enrollment ID: I20230731000084 |
| Provider Name | Andrew Brendan Dill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215922182 PECOS PAC ID: 8921012139 Enrollment ID: I20230804000268 |
| Provider Name | Celeste Vickery |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780211821 PECOS PAC ID: 8426470931 Enrollment ID: I20230804001426 |
| Provider Name | Maria Lopez Craig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295354231 PECOS PAC ID: 1658792254 Enrollment ID: I20230807002290 |
| Provider Name | Syreeta Bogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962181263 PECOS PAC ID: 8628430618 Enrollment ID: I20230808000821 |
| Provider Name | Manuel Calcagno Casasnovas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023647344 PECOS PAC ID: 6406218429 Enrollment ID: I20230808002544 |
| Provider Name | Nilesh Prakash Dialani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972120582 PECOS PAC ID: 3274956420 Enrollment ID: I20230817003714 |
| Provider Name | Sierra Colclough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598444895 PECOS PAC ID: 0840653994 Enrollment ID: I20230823000802 |
| Provider Name | Anne Marie Rhoton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952787251 PECOS PAC ID: 7416257753 Enrollment ID: I20230828000072 |
| Provider Name | Katelyn M Kozinski-burkhart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962106955 PECOS PAC ID: 5698138121 Enrollment ID: I20230830002907 |
| Provider Name | Anna Millan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669549572 PECOS PAC ID: 7012977655 Enrollment ID: I20230831000247 |
| Provider Name | Trudy-ann Alston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043716749 PECOS PAC ID: 6305241316 Enrollment ID: I20230831002224 |
| Provider Name | Dianet Falcon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932779535 PECOS PAC ID: 4284029349 Enrollment ID: I20230906004262 |
| Provider Name | Austin Rand Shoener |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346733011 PECOS PAC ID: 9739573684 Enrollment ID: I20230907002642 |
| Provider Name | Stamatis Damalos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407485071 PECOS PAC ID: 9436503679 Enrollment ID: I20230921003821 |
| Provider Name | Nicole Elizabeth Woodel Shoener |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386164473 PECOS PAC ID: 1850714650 Enrollment ID: I20230926001311 |
| Provider Name | Daniel O'bryan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497315592 PECOS PAC ID: 3971926809 Enrollment ID: I20230929001883 |
| Provider Name | Raya Blackwell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194414292 PECOS PAC ID: 6002260445 Enrollment ID: I20231003003587 |
| Provider Name | Farhan Siddiqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033537865 PECOS PAC ID: 3870892383 Enrollment ID: I20231006001877 |
| Provider Name | Cha Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285743971 PECOS PAC ID: 9234137563 Enrollment ID: I20231010000327 |
| Provider Name | Sara Thurgood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154618155 PECOS PAC ID: 0345507265 Enrollment ID: I20231010003982 |
| Provider Name | Liliya Glavatskyy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275318941 PECOS PAC ID: 4880041474 Enrollment ID: I20231102003292 |
| Provider Name | David Orion Doyle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952093924 PECOS PAC ID: 0840647764 Enrollment ID: I20231114001186 |
| Provider Name | Madhumita Lettman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144849142 PECOS PAC ID: 6709207368 Enrollment ID: I20231201000299 |
| Provider Name | Adam Cerissi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114488384 PECOS PAC ID: 3779932371 Enrollment ID: I20231207003107 |
| Provider Name | Sonia Kanacheril |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699303487 PECOS PAC ID: 3678998598 Enrollment ID: I20240103000098 |
| Provider Name | Christina Erin Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699432823 PECOS PAC ID: 5193175156 Enrollment ID: I20240103002050 |
| Provider Name | Nicholas a Landers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164206413 PECOS PAC ID: 5294186235 Enrollment ID: I20240104000182 |
| Provider Name | Emma Wasson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033870746 PECOS PAC ID: 9830540889 Enrollment ID: I20240104000475 |
| Provider Name | Laura Prevatt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992579817 PECOS PAC ID: 0345692406 Enrollment ID: I20240115001042 |
| Provider Name | Marcia S Bates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568172575 PECOS PAC ID: 8426400821 Enrollment ID: I20240122002976 |
| Provider Name | Hannah Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295398667 PECOS PAC ID: 4082099593 Enrollment ID: I20240124004932 |
| Provider Name | Melissa Ann Lovemore Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770369332 PECOS PAC ID: 8921451980 Enrollment ID: I20240126000960 |
| Provider Name | Christian Aguado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548897135 PECOS PAC ID: 3870911019 Enrollment ID: I20240216003316 |
| Provider Name | Deborah Conran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699775056 PECOS PAC ID: 1759461981 Enrollment ID: I20240311001852 |
| Provider Name | Alexandra Rae Weinstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154103489 PECOS PAC ID: 2961849351 Enrollment ID: I20240320004133 |
| Provider Name | Shanie Wray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114654373 PECOS PAC ID: 2264879501 Enrollment ID: I20240322002037 |
| Provider Name | Michael Joseph Marinari |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992568273 PECOS PAC ID: 3072951326 Enrollment ID: I20240404003340 |
| Provider Name | Vivekanand Pantangi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508123183 PECOS PAC ID: 9537474739 Enrollment ID: I20240426000717 |
| Provider Name | Kayla Caldwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518741057 PECOS PAC ID: 5395187355 Enrollment ID: I20240522004306 |
| Provider Name | Victoria Lemons |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992563373 PECOS PAC ID: 2062854474 Enrollment ID: I20240530000489 |
| Provider Name | Christal Perez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689286023 PECOS PAC ID: 2961945951 Enrollment ID: I20240618004365 |
| Provider Name | Orlando Zarate |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720509565 PECOS PAC ID: 7416388285 Enrollment ID: I20240627004266 |
| Provider Name | Crystal Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952155772 PECOS PAC ID: 6002350121 Enrollment ID: I20240701001482 |
| Provider Name | Judithe Paulius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134507874 PECOS PAC ID: 4981994167 Enrollment ID: I20240702002569 |
| Provider Name | Sharrell N Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588094130 PECOS PAC ID: 0941439095 Enrollment ID: I20240703002921 |
| Provider Name | Joanne Mora |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154531796 PECOS PAC ID: 5799076741 Enrollment ID: I20240710001670 |
| Provider Name | Jessica R.L. Bradshaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558104919 PECOS PAC ID: 0244776714 Enrollment ID: I20240719002371 |
| Provider Name | Matthew James Zoght |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942872387 PECOS PAC ID: 5395281521 Enrollment ID: I20240724003050 |
| Provider Name | Janet Chen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437731395 PECOS PAC ID: 6507267077 Enrollment ID: I20240812001829 |
| Provider Name | Maleeha Ahmad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275104382 PECOS PAC ID: 4981007648 Enrollment ID: I20240822001600 |
| Provider Name | Aura Marie Amoros Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558949503 PECOS PAC ID: 4486193356 Enrollment ID: I20240823002293 |
| Provider Name | Jennifer D Brinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861236424 PECOS PAC ID: 3274072988 Enrollment ID: I20240826004132 |
| Provider Name | Austin Louis Ciccati |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043884463 PECOS PAC ID: 7810436995 Enrollment ID: I20240903004220 |
| Provider Name | Carlos Angel Romero |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689927220 PECOS PAC ID: 6204244700 Enrollment ID: I20240910004253 |
| Provider Name | Pontea Niaki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497329767 PECOS PAC ID: 3173064466 Enrollment ID: I20240926002983 |
| Provider Name | Margaret Yip |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447830815 PECOS PAC ID: 0143621581 Enrollment ID: I20240926003173 |
| Provider Name | Emily Rebekah Green |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801629100 PECOS PAC ID: 9830620962 Enrollment ID: I20241001000794 |
| Provider Name | Timothy Quinn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659390235 PECOS PAC ID: 3375698293 Enrollment ID: I20241004003017 |
| Provider Name | Sydnee Kiara Sovercool |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902644206 PECOS PAC ID: 7517499817 Enrollment ID: I20241011000167 |
| Provider Name | Judeen Dian Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639651326 PECOS PAC ID: 8426581927 Enrollment ID: I20241022004971 |
| Provider Name | Ricardo Jesus Barranon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073189148 PECOS PAC ID: 0648703074 Enrollment ID: I20241024000088 |
| Provider Name | Evelyn Exposito Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881273332 PECOS PAC ID: 9830595172 Enrollment ID: I20241028001112 |
| Provider Name | Brett Michael Urie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427875756 PECOS PAC ID: 5294268181 Enrollment ID: I20241030003979 |
| Provider Name | Edwin Ortiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114758901 PECOS PAC ID: 1951835305 Enrollment ID: I20241107004174 |
| Provider Name | Montoya Wyatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083444640 PECOS PAC ID: 8224563770 Enrollment ID: I20241121001122 |
| Provider Name | Amanda Barton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730902883 PECOS PAC ID: 8527593607 Enrollment ID: I20241126002891 |
| Provider Name | Rachna Kamath |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972337889 PECOS PAC ID: 2961937909 Enrollment ID: I20241127001187 |
| Provider Name | Kaley Elizabeth Debord |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477388312 PECOS PAC ID: 1557897790 Enrollment ID: I20241211000690 |
| Provider Name | Cory Hensley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114752714 PECOS PAC ID: 4183150378 Enrollment ID: I20241211002676 |
| Provider Name | Naila Manahil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811505159 PECOS PAC ID: 4880019439 Enrollment ID: I20241216001321 |
| Provider Name | Diana Victoria Huaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417728262 PECOS PAC ID: 7517494149 Enrollment ID: I20241220002185 |
| Provider Name | Cassidy Donnarumma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073342275 PECOS PAC ID: 4981131208 Enrollment ID: I20241227002406 |
| Provider Name | Arleen N/a Velez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598502288 PECOS PAC ID: 1850820101 Enrollment ID: I20250130004080 |
| Provider Name | Shilpa Kurapati Abraham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679398986 PECOS PAC ID: 6608305800 Enrollment ID: I20250131001898 |
| Provider Name | Kelsey Ciocia |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801380415 PECOS PAC ID: 5890049357 Enrollment ID: I20250218000348 |
| Provider Name | Monica Faye Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730910928 PECOS PAC ID: 9638690779 Enrollment ID: I20250305003968 |
| Provider Name | Sarah Nicole Crumb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538905237 PECOS PAC ID: 1850812694 Enrollment ID: I20250310000579 |
| Provider Name | Mariana Cediel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609607746 PECOS PAC ID: 0446771984 Enrollment ID: I20250312003419 |
| Provider Name | Kyle Woods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104283464 PECOS PAC ID: 1153626759 Enrollment ID: I20250318003900 |
| Provider Name | Yi-wen Chen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417306366 PECOS PAC ID: 1557654324 Enrollment ID: I20250327002620 |
| Provider Name | Jackson Andraski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528899853 PECOS PAC ID: 7911420963 Enrollment ID: I20250331001549 |
| Provider Name | Caroline Frances Bueche |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205633526 PECOS PAC ID: 8820511793 Enrollment ID: I20250401002227 |
| Provider Name | Abigail L Zamora |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578393112 PECOS PAC ID: 9133643620 Enrollment ID: I20250407000360 |
| Provider Name | Candice Paff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477378404 PECOS PAC ID: 5991229957 Enrollment ID: I20250411000432 |
| Provider Name | Star Emison |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730918400 PECOS PAC ID: 5799203675 Enrollment ID: I20250514002694 |
| Provider Name | Massiel Santos Diaz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063014165 PECOS PAC ID: 9032507819 Enrollment ID: I20250702004376 |
| Provider Name | Elianna Reynolds |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528628278 PECOS PAC ID: 6507270683 Enrollment ID: I20250717001650 |
| Provider Name | Marissa N Mangum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881486686 PECOS PAC ID: 5395251144 Enrollment ID: I20250719000130 |
| Provider Name | Arisse Calarco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396638193 PECOS PAC ID: 2961918057 Enrollment ID: I20250724001333 |
| Provider Name | Peter Izzo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063755700 PECOS PAC ID: 3779878343 Enrollment ID: I20250801001770 |
| Provider Name | Haley Dorothy Calhoun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255228060 PECOS PAC ID: 4688172331 Enrollment ID: I20250812001322 |
| Provider Name | Kelley Renee Devoe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730839465 PECOS PAC ID: 2466832613 Enrollment ID: I20250818000059 |
| Provider Name | Sameer Patel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639905169 PECOS PAC ID: 8820597735 Enrollment ID: I20250818003361 |
| Provider Name | Skyler Joal Pavlish-carpenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558250357 PECOS PAC ID: 4082113873 Enrollment ID: I20250819001214 |
| Provider Name | Grace L Benmhend |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255080958 PECOS PAC ID: 5890171722 Enrollment ID: I20250820004580 |
| Provider Name | Cooper Jan Vissers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427792472 PECOS PAC ID: 0941689434 Enrollment ID: I20250827005220 |
| Provider Name | David Bernstein |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356039630 PECOS PAC ID: 9032613955 Enrollment ID: I20250915004255 |
| Provider Name | Ramneet Kooner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881327088 PECOS PAC ID: 3577067065 Enrollment ID: I20250917004716 |
| Provider Name | Ethan Thomas Stuart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831077734 PECOS PAC ID: 6002311230 Enrollment ID: I20250926002273 |
| Provider Name | David E Gay |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487383089 PECOS PAC ID: 1557741741 Enrollment ID: I20250930000287 |
| Provider Name | Neil Navarrez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659911857 PECOS PAC ID: 9032513684 Enrollment ID: I20250930003082 |
| Provider Name | Cassondra Chatham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295623924 PECOS PAC ID: 7315436342 Enrollment ID: I20251030001161 |
| Provider Name | Harshal Jani |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154361566 PECOS PAC ID: 4789628280 Enrollment ID: I20251122000129 |
| Provider Name | Thomas Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356226880 PECOS PAC ID: 3678066883 Enrollment ID: I20251205001912 |
| Provider Name | Brooke Dennis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346112547 PECOS PAC ID: 2961996988 Enrollment ID: I20251208003296 |
| Provider Name | Jillian a Straub |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063389948 PECOS PAC ID: 4284128620 Enrollment ID: I20251212000131 |
| Provider Name | Anthony Marco |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699643494 PECOS PAC ID: 8921593963 Enrollment ID: I20251217003926 |
| Provider Name | Kelcey Noel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841171063 PECOS PAC ID: 4183119860 Enrollment ID: I20251219001642 |
| Provider Name | Brian Pierce |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538515457 PECOS PAC ID: 9234498635 Enrollment ID: I20260108000879 |
| Provider Name | Kristen Mazur |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427619170 PECOS PAC ID: 6406278043 Enrollment ID: I20260112001030 |
| Provider Name | Monica Franceschini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023627056 PECOS PAC ID: 7517444888 Enrollment ID: I20260119000291 |
| Provider Name | Stephen Nolan Day |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427936624 PECOS PAC ID: 3577041805 Enrollment ID: I20260128004577 |
| Provider Name | Brooke T Schaefer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689555286 PECOS PAC ID: 7911485909 Enrollment ID: I20260130003359 |
| Provider Name | Sydney Meade |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689531204 PECOS PAC ID: 8921587866 Enrollment ID: I20260210003090 |
| Provider Name | Natalie Anne Heierman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265381628 PECOS PAC ID: 9638659410 Enrollment ID: I20260219002152 |
| Provider Name | Luis Joel Guzman Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336760552 PECOS PAC ID: 7810470861 Enrollment ID: I20260309002316 |
| Provider Name | Andy Johnson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568356137 PECOS PAC ID: 0446733216 Enrollment ID: I20260310002914 |
| Provider Name | Nicole Alexandra Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831053362 PECOS PAC ID: 6305320102 Enrollment ID: I20260319002665 |
| Provider Name | Fazlah Lakhan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205785227 PECOS PAC ID: 6305321449 Enrollment ID: I20260326003363 |
| Provider Name | Katherine Giselle Moya Boquin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457218588 PECOS PAC ID: 4789169848 Enrollment ID: I20260326003874 |
| Provider Name | Jenny Kidd Nickless |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326916875 PECOS PAC ID: 6103301072 Enrollment ID: I20260328000223 |
| Provider Name | Linda J Petek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598255515 PECOS PAC ID: 0042795734 Enrollment ID: I20260331002098 |
| Provider Name | Gabriela Oliva |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275491599 PECOS PAC ID: 4183109895 Enrollment ID: I20260331002707 |
| Provider Name | Alexis Mallon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366336133 PECOS PAC ID: 6901381458 Enrollment ID: I20260401003344 |
| Provider Name | Evelyn Cuevas Campos |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568357788 PECOS PAC ID: 1759857550 Enrollment ID: I20260420000966 |
| Provider Name | Jenna Joslyn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1427848688 PECOS PAC ID: 8527575752 Enrollment ID: I20260421003248 |
| Provider Name | Bryant Freeman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326470105 PECOS PAC ID: 3072080522 Enrollment ID: I20260422001523 |
| Provider Name | Connor Palmer Lore |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013801679 PECOS PAC ID: 4688141831 Enrollment ID: I20260425000244 |
| Provider Name | Stephannie Samantha Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679363832 PECOS PAC ID: 3375010473 Enrollment ID: I20260427001171 |
| Provider Name | Cody Janton Heintzelman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174034359 PECOS PAC ID: 7012268980 Enrollment ID: I20260508002426 |
| Provider Name | Arian Garcia Puente |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336093236 PECOS PAC ID: 3870061500 Enrollment ID: I20260511002689 |
| Provider Name | Aaron Hisel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114398591 PECOS PAC ID: 3870803984 Enrollment ID: I20260519004657 |
| Provider Name | Thu-minh Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528926888 PECOS PAC ID: 2567931397 Enrollment ID: I20260520004095 |
| Provider Name | George Wennerberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659666717 PECOS PAC ID: 2567722804 Enrollment ID: I20260521002762 |
Real Medical Altamonte Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Marcia Dr, Altamonte Springs, FL 32714 Phone: 407-573-6627 Fax: 407-378-7755 |
Adventhealth Primary Care Plus Forest City Cove Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 9439 Forest City Cv Ste 1080, Altamonte Springs, FL 32714 Phone: 407-691-8240 |
Gregory P Samano II DO PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 499 E Central Pkwy Ste 100, Altamonte Springs, FL 32701 Phone: 407-543-3461 Fax: 407-678-0627 |
Mark E. Weigley, M.D., P.A. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 685 Palm Springs Dr, Suite 1a, Altamonte Springs, FL 32701 Phone: 407-339-5959 Fax: 407-339-5951 |
Beach Medical X4 LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 104 Marcia Dr, Altamonte Springs, FL 32714 Phone: 407-502-0073 |
Mueller Institute for Holistic Medicine PLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 251 Maitland Ave, Ste. 104, Altamonte Springs, FL 32701 Phone: 407-332-5703 Fax: 407-332-5744 |