| Asante Physician Partners | |
|
2620 E Barnett Rd Suite H Medford OR 97504-8344 | |
| (541) 789-4728 | |
| (541) 789-4765 |
| Full Name | Asante Physician Partners |
|---|---|
| Speciality | Family Medicine |
| Location | 2620 E Barnett Rd, Medford, Oregon |
| Authorized Official Name and Position | Angie Simonson (ASANTE SENIOR VP OF OPERATIONS) |
| Authorized Official Contact | 5417894133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Asante Physician Partners 2620 E Barnett Rd Suite H Medford OR 97504-8344 Ph: (541) 789-2559 | Asante Physician Partners 2620 E Barnett Rd Suite H Medford OR 97504-8344 Ph: (541) 789-4728 |
| NPI Number | 1922381326 |
|---|---|
| Provider Enumeration Date | 09/21/2011 |
| Last Update Date | 02/10/2024 |
| Certification Date | 02/10/2024 |
| Medicare PECOS PAC ID | 8325206246 |
|---|---|
| Medicare Enrollment ID | O20120223000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922381326 | NPI | - | NPPES |
| Provider Name | David D Candelaria |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033112271 PECOS PAC ID: 0547165292 Enrollment ID: I20031204001109 |
| Provider Name | Juan M Castillo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609957877 PECOS PAC ID: 6901704469 Enrollment ID: I20031222000787 |
| Provider Name | Timothy L Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982794293 PECOS PAC ID: 0547156838 Enrollment ID: I20040226000063 |
| Provider Name | Bobbie J Smith-ede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285631648 PECOS PAC ID: 5193718229 Enrollment ID: I20040406000006 |
| Provider Name | Elizabeth B Hirni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598754129 PECOS PAC ID: 2365435344 Enrollment ID: I20040406000434 |
| Provider Name | Elizabeth Allen North |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336111616 PECOS PAC ID: 1254329808 Enrollment ID: I20040504000006 |
| Provider Name | John T Gallen |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1114993656 PECOS PAC ID: 3173513413 Enrollment ID: I20040517001435 |
| Provider Name | John M Terhes |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114906443 PECOS PAC ID: 9436135159 Enrollment ID: I20040624001413 |
| Provider Name | Martha M Cavazos |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1639197742 PECOS PAC ID: 2163484387 Enrollment ID: I20041101000084 |
| Provider Name | Gary D Marks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861569212 PECOS PAC ID: 8325003916 Enrollment ID: I20041123000410 |
| Provider Name | Oscar a Sanchez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063412427 PECOS PAC ID: 2769430503 Enrollment ID: I20050107000518 |
| Provider Name | Jill T Steinsiek |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1336115872 PECOS PAC ID: 9133166556 Enrollment ID: I20050415000852 |
| Provider Name | Beth a Leone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134232515 PECOS PAC ID: 7214976372 Enrollment ID: I20050427001389 |
| Provider Name | Kenneth L Millsap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750305066 PECOS PAC ID: 4082655162 Enrollment ID: I20050519000959 |
| Provider Name | Donna M Bradshaw |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952390593 PECOS PAC ID: 0042238404 Enrollment ID: I20051104000257 |
| Provider Name | Stephen Christensen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043271869 PECOS PAC ID: 9537187414 Enrollment ID: I20051109000563 |
| Provider Name | Amanda B Alford |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992787808 PECOS PAC ID: 3779589650 Enrollment ID: I20061017000284 |
| Provider Name | Sarah Ann Lamanuzzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235243049 PECOS PAC ID: 9931114857 Enrollment ID: I20061204000523 |
| Provider Name | Gabriel R Mayland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669586467 PECOS PAC ID: 6406864263 Enrollment ID: I20070102000116 |
| Provider Name | Leah S Bernard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487737573 PECOS PAC ID: 5799786851 Enrollment ID: I20070117000088 |
| Provider Name | Charles Carmeci |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1730237082 PECOS PAC ID: 5092811794 Enrollment ID: I20070425000641 |
| Provider Name | Erin B Brender |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588709521 PECOS PAC ID: 5193823243 Enrollment ID: I20070613000320 |
| Provider Name | Willscott E Naugler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689698342 PECOS PAC ID: 6507868767 Enrollment ID: I20070803000179 |
| Provider Name | Timothy M Simrell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568501054 PECOS PAC ID: 6305938333 Enrollment ID: I20070822001256 |
| Provider Name | Tim F Johnston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518002427 PECOS PAC ID: 9032203302 Enrollment ID: I20070917000720 |
| Provider Name | John L Sager |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306808043 PECOS PAC ID: 6305945726 Enrollment ID: I20070926000044 |
| Provider Name | Nancy C O'neal |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669433991 PECOS PAC ID: 6901994128 Enrollment ID: I20071121000154 |
| Provider Name | Carl Jeffrey Berg |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1396876314 PECOS PAC ID: 9739286311 Enrollment ID: I20071127000519 |
| Provider Name | Ahsan Jaffar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235323619 PECOS PAC ID: 3274620653 Enrollment ID: I20071220000281 |
| Provider Name | Brian J Allen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124298617 PECOS PAC ID: 7113003336 Enrollment ID: I20080327000442 |
| Provider Name | Jose M Mondesi Garrido |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053589648 PECOS PAC ID: 1557436367 Enrollment ID: I20080813000488 |
| Provider Name | James a Stubenrauch |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902060338 PECOS PAC ID: 8325116114 Enrollment ID: I20081007000255 |
| Provider Name | Ellen L Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760408850 PECOS PAC ID: 7517981244 Enrollment ID: I20081125000488 |
| Provider Name | Brett M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053561241 PECOS PAC ID: 3375603061 Enrollment ID: I20090702000653 |
| Provider Name | Leonard Wilk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326180688 PECOS PAC ID: 2365534054 Enrollment ID: I20090707000738 |
| Provider Name | Agnieszka L Dobiecka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659557148 PECOS PAC ID: 9537234109 Enrollment ID: I20090923000350 |
| Provider Name | Richard S Nelson |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1649499443 PECOS PAC ID: 8729186705 Enrollment ID: I20090928000652 |
| Provider Name | Jennifer Wabin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598979171 PECOS PAC ID: 7618037243 Enrollment ID: I20091104000355 |
| Provider Name | Adrian G Sue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588724611 PECOS PAC ID: 5799828539 Enrollment ID: I20100202000872 |
| Provider Name | George E Schultz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235225129 PECOS PAC ID: 1052454568 Enrollment ID: I20100205000503 |
| Provider Name | Byron B Telford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568598860 PECOS PAC ID: 1658409438 Enrollment ID: I20100514000881 |
| Provider Name | Margaret M Bismarck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427093301 PECOS PAC ID: 7911031091 Enrollment ID: I20100811000213 |
| Provider Name | Leslie Stone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396896114 PECOS PAC ID: 3971401969 Enrollment ID: I20100819001035 |
| Provider Name | Minette C Lukban |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518287739 PECOS PAC ID: 7315139029 Enrollment ID: I20101012001259 |
| Provider Name | Daniel R Fear |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1407848948 PECOS PAC ID: 4688769391 Enrollment ID: I20101014000726 |
| Provider Name | Ismeth S Abbas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245328020 PECOS PAC ID: 6406842996 Enrollment ID: I20101014000838 |
| Provider Name | Peter W Adesman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952381394 PECOS PAC ID: 9931240983 Enrollment ID: I20101028001009 |
| Provider Name | Mohamed Siyad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780862391 PECOS PAC ID: 1254525066 Enrollment ID: I20101104001356 |
| Provider Name | Jon R Morgenstern |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932128832 PECOS PAC ID: 6305031873 Enrollment ID: I20101110000106 |
| Provider Name | Aaron D Martin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932374808 PECOS PAC ID: 7517152531 Enrollment ID: I20101116000272 |
| Provider Name | William H Palm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134168560 PECOS PAC ID: 3375730682 Enrollment ID: I20101213001120 |
| Provider Name | Christopher Charles Davis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790014074 PECOS PAC ID: 8224210117 Enrollment ID: I20110314000997 |
| Provider Name | Gregory F Winters |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891761037 PECOS PAC ID: 3476694423 Enrollment ID: I20110413000999 |
| Provider Name | Somnath B Ghosh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1962698712 PECOS PAC ID: 8123215449 Enrollment ID: I20110720000479 |
| Provider Name | Radek Dutkiewicz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841376423 PECOS PAC ID: 0446331524 Enrollment ID: I20110831000439 |
| Provider Name | Laura a Smiricky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245205582 PECOS PAC ID: 1052362969 Enrollment ID: I20111005000576 |
| Provider Name | Shaik I Basha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578712378 PECOS PAC ID: 0244403723 Enrollment ID: I20111027000862 |
| Provider Name | Patrick K Honsinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922111392 PECOS PAC ID: 5799959375 Enrollment ID: I20111116000493 |
| Provider Name | Carl Russell Griesser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316214281 PECOS PAC ID: 9234305012 Enrollment ID: I20111228000412 |
| Provider Name | Caroline E Fisher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386612760 PECOS PAC ID: 4486601341 Enrollment ID: I20120727000714 |
| Provider Name | Richard K Huffaker |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841498300 PECOS PAC ID: 4688730203 Enrollment ID: I20120906000555 |
| Provider Name | Ellen S Plummer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699965053 PECOS PAC ID: 5294985875 Enrollment ID: I20121016000547 |
| Provider Name | Estin K Yang |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1386887628 PECOS PAC ID: 7618128430 Enrollment ID: I20121102000550 |
| Provider Name | Stephani Kathleen Cook |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205180098 PECOS PAC ID: 1951554609 Enrollment ID: I20130109000396 |
| Provider Name | Mackenzie E Loughland |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366603045 PECOS PAC ID: 7618148883 Enrollment ID: I20130123000290 |
| Provider Name | Hilary R Redden |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649476847 PECOS PAC ID: 2062667603 Enrollment ID: I20130618000489 |
| Provider Name | Megan M Frost |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255533550 PECOS PAC ID: 5496990897 Enrollment ID: I20130627000025 |
| Provider Name | Minal B Jaju |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427491620 PECOS PAC ID: 1052551421 Enrollment ID: I20130708000402 |
| Provider Name | Dani J Thomas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1104056092 PECOS PAC ID: 6507025111 Enrollment ID: I20130715000676 |
| Provider Name | Adam M Mougey |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255482360 PECOS PAC ID: 0840352001 Enrollment ID: I20130726000205 |
| Provider Name | Daniel R Oreskovich |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578875654 PECOS PAC ID: 4789826504 Enrollment ID: I20130807000729 |
| Provider Name | Rosemary O Chiedozi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902122690 PECOS PAC ID: 9739323379 Enrollment ID: I20130920000237 |
| Provider Name | Lina Dorfmeister |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699875278 PECOS PAC ID: 0042318081 Enrollment ID: I20130923000801 |
| Provider Name | David E Sanchez Vasquez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619285798 PECOS PAC ID: 5991930786 Enrollment ID: I20131104000209 |
| Provider Name | Saman a Selahi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174750335 PECOS PAC ID: 8224288295 Enrollment ID: I20140207001062 |
| Provider Name | Jordan T Personius |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013347640 PECOS PAC ID: 6204065311 Enrollment ID: I20140213001251 |
| Provider Name | Daniel C Wieking |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093976045 PECOS PAC ID: 6507011319 Enrollment ID: I20140325000750 |
| Provider Name | Mirela Cvijanovic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811314974 PECOS PAC ID: 6800010836 Enrollment ID: I20140613001696 |
| Provider Name | Anuj Mittal |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1336317775 PECOS PAC ID: 0446475693 Enrollment ID: I20140702002083 |
| Provider Name | Nandita Suresh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417242173 PECOS PAC ID: 7214154566 Enrollment ID: I20140808001822 |
| Provider Name | Danelle N Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518369776 PECOS PAC ID: 5597986398 Enrollment ID: I20141020002745 |
| Provider Name | Andrew T Young |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013273804 PECOS PAC ID: 4385899038 Enrollment ID: I20141111000001 |
| Provider Name | Lora J.M. Bergert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881790426 PECOS PAC ID: 2860453693 Enrollment ID: I20150114001708 |
| Provider Name | Leslie a Sanchez-goettler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306985312 PECOS PAC ID: 6608919568 Enrollment ID: I20150204001247 |
| Provider Name | Jason M Van Brunt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619379815 PECOS PAC ID: 2860717311 Enrollment ID: I20150204002158 |
| Provider Name | Kenneth J Durrant |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578952537 PECOS PAC ID: 3577889443 Enrollment ID: I20150312000292 |
| Provider Name | Dorian E Fowler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588815138 PECOS PAC ID: 2961561006 Enrollment ID: I20150330000640 |
| Provider Name | Daniel a Kahn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144265463 PECOS PAC ID: 9234142126 Enrollment ID: I20150512002801 |
| Provider Name | Laurel L Bell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760470207 PECOS PAC ID: 9436219367 Enrollment ID: I20150602002682 |
| Provider Name | Daniel G Mcallister |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629079504 PECOS PAC ID: 7012907918 Enrollment ID: I20150619002247 |
| Provider Name | Rebecca a Leggett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841410198 PECOS PAC ID: 7618057795 Enrollment ID: I20150729010431 |
| Provider Name | Mirela Titianu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043575244 PECOS PAC ID: 1355655630 Enrollment ID: I20150730011997 |
| Provider Name | Diya Mohammad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427339738 PECOS PAC ID: 8123332871 Enrollment ID: I20150807015661 |
| Provider Name | Anna S Antonopulos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689831927 PECOS PAC ID: 1951433812 Enrollment ID: I20150811003869 |
| Provider Name | Arun Thekkekarott Kuruvila |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649534389 PECOS PAC ID: 6204069685 Enrollment ID: I20150827002327 |
| Provider Name | Michael R Blumhardt |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1952462798 PECOS PAC ID: 0345228607 Enrollment ID: I20150923001828 |
| Provider Name | Matthew E Hiesterman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154642387 PECOS PAC ID: 2860701372 Enrollment ID: I20151023001780 |
| Provider Name | Daniel Neville |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033588546 PECOS PAC ID: 5597074708 Enrollment ID: I20151028002142 |
| Provider Name | Kristina M Wallace |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417326984 PECOS PAC ID: 3072823335 Enrollment ID: I20151117001760 |
| Provider Name | Craig a Berg |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1659763639 PECOS PAC ID: 6709186000 Enrollment ID: I20151118000458 |
| Provider Name | Samantha H Coggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508230335 PECOS PAC ID: 0042513459 Enrollment ID: I20160119001764 |
| Provider Name | Justin P Hadaller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134521909 PECOS PAC ID: 9133443641 Enrollment ID: I20160316000802 |
| Provider Name | Nancy M Obispo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871983353 PECOS PAC ID: 6901123140 Enrollment ID: I20160509000851 |
| Provider Name | Stephen D Hubbard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679911432 PECOS PAC ID: 1658696794 Enrollment ID: I20160614002688 |
| Provider Name | Vipul Mahajan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467795864 PECOS PAC ID: 9436450210 Enrollment ID: I20160811000828 |
| Provider Name | David Harris Delman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669764924 PECOS PAC ID: 4082833926 Enrollment ID: I20160831000741 |
| Provider Name | Angela Douglas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265571285 PECOS PAC ID: 5698080075 Enrollment ID: I20160831002677 |
| Provider Name | Suleiman M Omar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851690317 PECOS PAC ID: 3274753199 Enrollment ID: I20161004001940 |
| Provider Name | Sarah Kahn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851681928 PECOS PAC ID: 0345495784 Enrollment ID: I20161013001783 |
| Provider Name | Lucy M Ortega |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952490427 PECOS PAC ID: 9436344249 Enrollment ID: I20161018002329 |
| Provider Name | Steven R Newhall |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023404035 PECOS PAC ID: 3577876796 Enrollment ID: I20161020000983 |
| Provider Name | Kayla B Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780037945 PECOS PAC ID: 6204114481 Enrollment ID: I20161021001292 |
| Provider Name | Beatrice U Song |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457420150 PECOS PAC ID: 5799966115 Enrollment ID: I20161028001232 |
| Provider Name | Sharon P Krische |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457701930 PECOS PAC ID: 9739468042 Enrollment ID: I20161109000703 |
| Provider Name | Elisabeth Anacius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003109828 PECOS PAC ID: 7810155090 Enrollment ID: I20161109001708 |
| Provider Name | Jacqueline Wilk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528251840 PECOS PAC ID: 3870872997 Enrollment ID: I20161114001147 |
| Provider Name | Katie L Townes-mcmann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366687998 PECOS PAC ID: 2365688454 Enrollment ID: I20161130002528 |
| Provider Name | Clarence C Bone |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275958944 PECOS PAC ID: 4082837471 Enrollment ID: I20161212002185 |
| Provider Name | Mehul U Daulat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508270745 PECOS PAC ID: 2466671276 Enrollment ID: I20170112002022 |
| Provider Name | Ramesh Mishra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487967212 PECOS PAC ID: 5991946303 Enrollment ID: I20170201002668 |
| Provider Name | Nicole M Cowley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225321391 PECOS PAC ID: 9638391956 Enrollment ID: I20170612001955 |
| Provider Name | Nicole N Shirvani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295175347 PECOS PAC ID: 7315215522 Enrollment ID: I20170612002686 |
| Provider Name | Son T DO |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1285668822 PECOS PAC ID: 2668371337 Enrollment ID: I20170626001871 |
| Provider Name | Robyn Borghese |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669688560 PECOS PAC ID: 1456483403 Enrollment ID: I20170718003472 |
| Provider Name | Julie G Ohlschwager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831636067 PECOS PAC ID: 9133499429 Enrollment ID: I20170719002102 |
| Provider Name | Pratibha Seshadri |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1801143615 PECOS PAC ID: 4789957564 Enrollment ID: I20170829003969 |
| Provider Name | Fouad Otaki |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013229996 PECOS PAC ID: 8426349614 Enrollment ID: I20170907003101 |
| Provider Name | Bradley M Dekorte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699185256 PECOS PAC ID: 0244453348 Enrollment ID: I20171201001523 |
| Provider Name | Daxson R Motis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326565136 PECOS PAC ID: 1951669274 Enrollment ID: I20171214001868 |
| Provider Name | Michael Welch |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063802015 PECOS PAC ID: 7113245580 Enrollment ID: I20171220001309 |
| Provider Name | Jacob Dean Thompson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801314372 PECOS PAC ID: 3375801194 Enrollment ID: I20171227000757 |
| Provider Name | Jared D Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952631103 PECOS PAC ID: 3870737463 Enrollment ID: I20180413001513 |
| Provider Name | Lindsey Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629588504 PECOS PAC ID: 0941567721 Enrollment ID: I20180802001724 |
| Provider Name | Alexander E Bonato |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083137251 PECOS PAC ID: 0840548749 Enrollment ID: I20180809001174 |
| Provider Name | Amy Lynne Card |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003162959 PECOS PAC ID: 8325273733 Enrollment ID: I20180831000773 |
| Provider Name | Lindsay M Wenger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679916480 PECOS PAC ID: 2264651470 Enrollment ID: I20181010002290 |
| Provider Name | Alyse K Power |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578941373 PECOS PAC ID: 7315259884 Enrollment ID: I20181102002638 |
| Provider Name | Melissa M Greive |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134567027 PECOS PAC ID: 9830433358 Enrollment ID: I20181210002168 |
| Provider Name | John C Byers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013405729 PECOS PAC ID: 8820332315 Enrollment ID: I20181211001392 |
| Provider Name | Tahir Mahmood |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508111089 PECOS PAC ID: 1658685482 Enrollment ID: I20190102001629 |
| Provider Name | Ayodeji a Oduola |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942530266 PECOS PAC ID: 6305009077 Enrollment ID: I20190110000750 |
| Provider Name | Jessie K Hermant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225516537 PECOS PAC ID: 4183961774 Enrollment ID: I20190118002729 |
| Provider Name | Ryan K Wehmann |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720315104 PECOS PAC ID: 8325173578 Enrollment ID: I20190130001092 |
| Provider Name | Colette M Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902386378 PECOS PAC ID: 5890033013 Enrollment ID: I20190214000588 |
| Provider Name | Priscilla Kim Codiga |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629009402 PECOS PAC ID: 7315926979 Enrollment ID: I20190301002403 |
| Provider Name | Gritz Pierre |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215319140 PECOS PAC ID: 2961718259 Enrollment ID: I20190311000280 |
| Provider Name | Ossama Al Masalmeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851654776 PECOS PAC ID: 0648571182 Enrollment ID: I20190620000506 |
| Provider Name | Kathryn SM Hardaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073079430 PECOS PAC ID: 4688909773 Enrollment ID: I20190711001851 |
| Provider Name | Kamika Gower-allum |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790238657 PECOS PAC ID: 3072849967 Enrollment ID: I20190730004729 |
| Provider Name | Grant C Lightfoot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952754111 PECOS PAC ID: 0648500546 Enrollment ID: I20190918003665 |
| Provider Name | Stephanie a Estes |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1003357401 PECOS PAC ID: 8123396595 Enrollment ID: I20190925000413 |
| Provider Name | Rajpreet Singh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316391956 PECOS PAC ID: 8022305473 Enrollment ID: I20191001001964 |
| Provider Name | Joy Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265467849 PECOS PAC ID: 0244236529 Enrollment ID: I20191101001147 |
| Provider Name | Christina R Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528532108 PECOS PAC ID: 7416289962 Enrollment ID: I20191101001360 |
| Provider Name | Carla a Cochran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003284068 PECOS PAC ID: 0345544573 Enrollment ID: I20191101001415 |
| Provider Name | Nizar Salem |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346546785 PECOS PAC ID: 8123298031 Enrollment ID: I20191104001536 |
| Provider Name | Levi D Vance |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902465511 PECOS PAC ID: 2163854456 Enrollment ID: I20191106002598 |
| Provider Name | Kevin L Kruenegel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992022693 PECOS PAC ID: 6204951163 Enrollment ID: I20191224000328 |
| Provider Name | Ekaterina Evguenievna Alchits |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922449081 PECOS PAC ID: 7113227513 Enrollment ID: I20191228000306 |
| Provider Name | Rachel M Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497218614 PECOS PAC ID: 5698101483 Enrollment ID: I20200226001920 |
| Provider Name | William B Haynal |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1114218120 PECOS PAC ID: 5597063271 Enrollment ID: I20200304001962 |
| Provider Name | Karen L Gibbons-berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861448227 PECOS PAC ID: 8820077498 Enrollment ID: I20200326003433 |
| Provider Name | Consuelo V Bartyzal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336781863 PECOS PAC ID: 0345679247 Enrollment ID: I20200327001801 |
| Provider Name | Murtaza Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356780514 PECOS PAC ID: 1658514534 Enrollment ID: I20200416000551 |
| Provider Name | Christian James Wayne Burrell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033476817 PECOS PAC ID: 9133366636 Enrollment ID: I20200416000585 |
| Provider Name | Alicia Bennett |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023317633 PECOS PAC ID: 6002033370 Enrollment ID: I20200416001888 |
| Provider Name | Christopher Vincent Fanale |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598776452 PECOS PAC ID: 6103803465 Enrollment ID: I20200417003385 |
| Provider Name | Byron Roderick Spencer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518941343 PECOS PAC ID: 4789721978 Enrollment ID: I20200423002308 |
| Provider Name | Rishi Shravan Arora |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912314279 PECOS PAC ID: 5395044598 Enrollment ID: I20200506001075 |
| Provider Name | David J Downey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508205972 PECOS PAC ID: 5496997579 Enrollment ID: I20200604001119 |
| Provider Name | Adam Kristopher Graham |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427252725 PECOS PAC ID: 2860653334 Enrollment ID: I20200617003367 |
| Provider Name | Kristin C Gannett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679197982 PECOS PAC ID: 9133543663 Enrollment ID: I20200623002662 |
| Provider Name | Hannah D Wolsiefer-leak |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1043741010 PECOS PAC ID: 0345511218 Enrollment ID: I20200623002807 |
| Provider Name | Jennifer G Henderson |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1902123888 PECOS PAC ID: 4587888268 Enrollment ID: I20200630002485 |
| Provider Name | Gemma C Bornick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386961415 PECOS PAC ID: 1052566270 Enrollment ID: I20200707001921 |
| Provider Name | Ian Stuart Hallows |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528482650 PECOS PAC ID: 8022342203 Enrollment ID: I20200721000763 |
| Provider Name | Shannon E Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740532480 PECOS PAC ID: 0547410045 Enrollment ID: I20200721002867 |
| Provider Name | Zia a Choudhury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700316544 PECOS PAC ID: 6709202377 Enrollment ID: I20200805003306 |
| Provider Name | Erica Zaworski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841687027 PECOS PAC ID: 5193141935 Enrollment ID: I20200811003175 |
| Provider Name | Jeffrey C Wagner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033321914 PECOS PAC ID: 2769580075 Enrollment ID: I20200914002936 |
| Provider Name | Nicole Y Roth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689029852 PECOS PAC ID: 2062741499 Enrollment ID: I20200917002816 |
| Provider Name | Shelly Haug |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710277215 PECOS PAC ID: 0648526392 Enrollment ID: I20200920000039 |
| Provider Name | Baxter Ballantine Allen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710253737 PECOS PAC ID: 0547530743 Enrollment ID: I20200923000947 |
| Provider Name | Rachel Jessica Lammers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316560865 PECOS PAC ID: 3779902663 Enrollment ID: I20200925001523 |
| Provider Name | Theodore a Crum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881918811 PECOS PAC ID: 8628214541 Enrollment ID: I20201001000331 |
| Provider Name | Andrew Mark Tijerina |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619590221 PECOS PAC ID: 8224457650 Enrollment ID: I20201002002323 |
| Provider Name | Michael Fusaro |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194109785 PECOS PAC ID: 0345546511 Enrollment ID: I20201027003142 |
| Provider Name | Virginia L Vanwart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649873530 PECOS PAC ID: 2264846179 Enrollment ID: I20210203002021 |
| Provider Name | Leslie C Tietjen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164071858 PECOS PAC ID: 7214269125 Enrollment ID: I20210205000647 |
| Provider Name | Connor W Hyde |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295333060 PECOS PAC ID: 6800204900 Enrollment ID: I20210408001921 |
| Provider Name | Chalita Atallah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265731418 PECOS PAC ID: 9638478589 Enrollment ID: I20210421001784 |
| Provider Name | Tala Salem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245760586 PECOS PAC ID: 8022417351 Enrollment ID: I20210518003104 |
| Provider Name | Alok L Shrestha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558509034 PECOS PAC ID: 7012186570 Enrollment ID: I20210610003620 |
| Provider Name | Jennifer Perry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548640006 PECOS PAC ID: 5395145148 Enrollment ID: I20210615003477 |
| Provider Name | Summaya a Latif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356737118 PECOS PAC ID: 6709199748 Enrollment ID: I20210624001617 |
| Provider Name | Jessie Magnani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487041455 PECOS PAC ID: 8325449168 Enrollment ID: I20210630001572 |
| Provider Name | Shelby Y Legrotte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861076317 PECOS PAC ID: 2163825324 Enrollment ID: I20210726001504 |
| Provider Name | Molly Matthews |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891124970 PECOS PAC ID: 5890076053 Enrollment ID: I20210817003125 |
| Provider Name | Shaan Wadhawan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376037556 PECOS PAC ID: 6204183460 Enrollment ID: I20210830001293 |
| Provider Name | Minh Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881954469 PECOS PAC ID: 5092023846 Enrollment ID: I20210830001617 |
| Provider Name | Madison Knox |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1598338956 PECOS PAC ID: 8527465061 Enrollment ID: I20210924002669 |
| Provider Name | Zhi Cheng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083076954 PECOS PAC ID: 0648565390 Enrollment ID: I20211001002293 |
| Provider Name | Elena Higuchi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316435019 PECOS PAC ID: 6305244963 Enrollment ID: I20211012002098 |
| Provider Name | Samuel J Driver |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982294377 PECOS PAC ID: 1254720014 Enrollment ID: I20211116002665 |
| Provider Name | Rebecca Werner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881739332 PECOS PAC ID: 6901902857 Enrollment ID: I20220204000602 |
| Provider Name | Carolyn Kor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972952471 PECOS PAC ID: 7113215047 Enrollment ID: I20220303001520 |
| Provider Name | Ross Harrison |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1841610920 PECOS PAC ID: 4981911864 Enrollment ID: I20220511002278 |
| Provider Name | Bilal Samhouri |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1013460500 PECOS PAC ID: 0244526838 Enrollment ID: I20220523002013 |
| Provider Name | Benjamin B Barsotti |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003947649 PECOS PAC ID: 5092869636 Enrollment ID: I20220617002495 |
| Provider Name | Emily E Giesen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174986590 PECOS PAC ID: 5698064681 Enrollment ID: I20220627002367 |
| Provider Name | Scott Douglas Heath |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952910887 PECOS PAC ID: 4284044793 Enrollment ID: I20220719003910 |
| Provider Name | Saad Sami Mir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356603161 PECOS PAC ID: 2466606926 Enrollment ID: I20220721002799 |
| Provider Name | Kyle J Rutledge |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265828446 PECOS PAC ID: 9133499460 Enrollment ID: I20220727001045 |
| Provider Name | Charles M Dungan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275278996 PECOS PAC ID: 3971986548 Enrollment ID: I20220815000708 |
| Provider Name | Palak Dwarkesh Parikh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295909331 PECOS PAC ID: 2668629205 Enrollment ID: I20220815000887 |
| Provider Name | Christina Kalemkeris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376093054 PECOS PAC ID: 7012292832 Enrollment ID: I20220915001836 |
| Provider Name | Roxanne L Alsbury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629481064 PECOS PAC ID: 3274838800 Enrollment ID: I20220921000945 |
| Provider Name | Zachary I Norman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427439801 PECOS PAC ID: 8224386164 Enrollment ID: I20220930001210 |
| Provider Name | Nathaniel Kelly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548823552 PECOS PAC ID: 6204212053 Enrollment ID: I20220930001389 |
| Provider Name | Danielle Hammons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598319246 PECOS PAC ID: 9436588951 Enrollment ID: I20221003000230 |
| Provider Name | Ronald L Estes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750313326 PECOS PAC ID: 5991785024 Enrollment ID: I20221004000616 |
| Provider Name | Brenton R Mccoy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821388901 PECOS PAC ID: 7214255082 Enrollment ID: I20221128002022 |
| Provider Name | Andre T Bobo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437299724 PECOS PAC ID: 6507818333 Enrollment ID: I20221202001431 |
| Provider Name | Katharine a Walz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487048377 PECOS PAC ID: 2769795285 Enrollment ID: I20221207002066 |
| Provider Name | Dominic Anthony Hovsepian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154749588 PECOS PAC ID: 5991136160 Enrollment ID: I20221207002807 |
| Provider Name | Neelanjan Ray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942445861 PECOS PAC ID: 2961681309 Enrollment ID: I20221219000876 |
| Provider Name | Fuad-al Ali |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932581428 PECOS PAC ID: 7012224744 Enrollment ID: I20221222002621 |
| Provider Name | Steven J Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306160031 PECOS PAC ID: 1254649353 Enrollment ID: I20221228000781 |
| Provider Name | Rut Dinkar Dholakia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164633913 PECOS PAC ID: 3870789415 Enrollment ID: I20230106001201 |
| Provider Name | Michelle E Trowbridge |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548284359 PECOS PAC ID: 3678473493 Enrollment ID: I20230111000914 |
| Provider Name | Jingxin Wang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336501741 PECOS PAC ID: 7416336979 Enrollment ID: I20230111001327 |
| Provider Name | Carlos Salazar |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407261456 PECOS PAC ID: 7810216967 Enrollment ID: I20230120001425 |
| Provider Name | Raymond Silva |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1184665747 PECOS PAC ID: 7719051994 Enrollment ID: I20230203002102 |
| Provider Name | Lynsee Anne Hudson Lang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699821371 PECOS PAC ID: 2062505639 Enrollment ID: I20230227000951 |
| Provider Name | Scott Daniel Caganap |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962845073 PECOS PAC ID: 7315239548 Enrollment ID: I20230301001376 |
| Provider Name | Stephanie M Urban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518420942 PECOS PAC ID: 8921471525 Enrollment ID: I20230301002538 |
| Provider Name | Courtney N Nelson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760188148 PECOS PAC ID: 2567835101 Enrollment ID: I20230302001299 |
| Provider Name | Matthew Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629740394 PECOS PAC ID: 3971997768 Enrollment ID: I20230302002658 |
| Provider Name | Kelly E Fruth |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730701285 PECOS PAC ID: 4880003946 Enrollment ID: I20230324000980 |
| Provider Name | Usha Thapalia Aryal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073712287 PECOS PAC ID: 2163657362 Enrollment ID: I20230324001990 |
| Provider Name | Amy M Nieberlein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982078549 PECOS PAC ID: 4587958707 Enrollment ID: I20230327001453 |
| Provider Name | Arifa Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225598899 PECOS PAC ID: 8123359783 Enrollment ID: I20230417001943 |
| Provider Name | Rachael a Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912614868 PECOS PAC ID: 4486019262 Enrollment ID: I20230501000562 |
| Provider Name | Sonal Bhatia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356605844 PECOS PAC ID: 3476862087 Enrollment ID: I20230508001314 |
| Provider Name | Amir Laktineh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407204027 PECOS PAC ID: 2062704265 Enrollment ID: I20230508002023 |
| Provider Name | Asil Naim Al-abed Daoud |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629424395 PECOS PAC ID: 2163849589 Enrollment ID: I20230511001493 |
| Provider Name | Saviour K Achilike |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033506688 PECOS PAC ID: 9032440433 Enrollment ID: I20230517003443 |
| Provider Name | Hamza N Salam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1104278605 PECOS PAC ID: 0446543706 Enrollment ID: I20230518000889 |
| Provider Name | Neelambuj Regmi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1033648365 PECOS PAC ID: 4789002106 Enrollment ID: I20230518000913 |
| Provider Name | Jessica Lynn Danison |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477874618 PECOS PAC ID: 2163640590 Enrollment ID: I20230523003343 |
| Provider Name | Raya M.F. Al Ghalayini |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255990735 PECOS PAC ID: 1951636950 Enrollment ID: I20230619001131 |
| Provider Name | Mason T Hinchcliff |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1548765407 PECOS PAC ID: 2769739077 Enrollment ID: I20230622003012 |
| Provider Name | Chris Arca |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275987216 PECOS PAC ID: 0840658845 Enrollment ID: I20230707002147 |
| Provider Name | Nathaniel L Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477174076 PECOS PAC ID: 7012339765 Enrollment ID: I20230714002269 |
| Provider Name | Shahzana Shahzad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053932194 PECOS PAC ID: 6406277698 Enrollment ID: I20230726000555 |
| Provider Name | Danielle M Jacks |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1730597147 PECOS PAC ID: 4587951827 Enrollment ID: I20230811001814 |
| Provider Name | John C Brockington |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548200777 PECOS PAC ID: 8022104272 Enrollment ID: I20230914003281 |
| Provider Name | Mark a Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770938003 PECOS PAC ID: 7618268533 Enrollment ID: I20231003001632 |
| Provider Name | Priscilla N Ekerson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598956252 PECOS PAC ID: 0244501609 Enrollment ID: I20231016001593 |
| Provider Name | Jamal Farooq Khattak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144648429 PECOS PAC ID: 7214242643 Enrollment ID: I20231017001715 |
| Provider Name | Meyeon Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649566316 PECOS PAC ID: 0547493603 Enrollment ID: I20231026003948 |
| Provider Name | Vanessa Sui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558821975 PECOS PAC ID: 1052653391 Enrollment ID: I20231030003591 |
| Provider Name | Thomas C Pitts |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750624656 PECOS PAC ID: 9133357775 Enrollment ID: I20231106003127 |
| Provider Name | Jennifer a Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942081054 PECOS PAC ID: 0143677971 Enrollment ID: I20231115002599 |
| Provider Name | Rylee C Stahla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447030234 PECOS PAC ID: 3072962570 Enrollment ID: I20231208002906 |
| Provider Name | Iryna I Kulyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144008608 PECOS PAC ID: 6103275003 Enrollment ID: I20231218000029 |
| Provider Name | Taylor Boney |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1649626789 PECOS PAC ID: 2163712746 Enrollment ID: I20231219002458 |
| Provider Name | Nicole D Parrotta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407231590 PECOS PAC ID: 1850635145 Enrollment ID: I20240102001400 |
| Provider Name | Benjamin Ray Merbler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134748114 PECOS PAC ID: 9133511611 Enrollment ID: I20240105003863 |
| Provider Name | Saher Suleman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851747935 PECOS PAC ID: 6507235629 Enrollment ID: I20240118003905 |
| Provider Name | Nolan M Bastendorff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104505031 PECOS PAC ID: 0749625192 Enrollment ID: I20240226002295 |
| Provider Name | Zachary a Lawson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639891344 PECOS PAC ID: 0648615476 Enrollment ID: I20240301003258 |
| Provider Name | Justin Rahmes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588129886 PECOS PAC ID: 0446589840 Enrollment ID: I20240325003706 |
| Provider Name | Shannon L Analla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619741196 PECOS PAC ID: 2062859879 Enrollment ID: I20240328000014 |
| Provider Name | Robert P Boyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346557550 PECOS PAC ID: 4789086513 Enrollment ID: I20240426003059 |
| Provider Name | Julia K Kostka |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1295398782 PECOS PAC ID: 0042650483 Enrollment ID: I20240501003817 |
| Provider Name | Brittany Leigh Tabler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679830566 PECOS PAC ID: 8628343043 Enrollment ID: I20240510003011 |
| Provider Name | Jorge Aldo a Barajas Ochoa |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1619463601 PECOS PAC ID: 6002290285 Enrollment ID: I20240514001816 |
| Provider Name | Andrew C W Baldwin |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1437440179 PECOS PAC ID: 1052603784 Enrollment ID: I20240520001557 |
| Provider Name | Tyler Richard Scott |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366897365 PECOS PAC ID: 4082902697 Enrollment ID: I20240524003479 |
| Provider Name | Muhammad Butt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801040209 PECOS PAC ID: 9537226931 Enrollment ID: I20240606001263 |
| Provider Name | Amber Hatchett |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861170482 PECOS PAC ID: 8426492109 Enrollment ID: I20240617003403 |
| Provider Name | Joseph M Jackmovich |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992326987 PECOS PAC ID: 9234550690 Enrollment ID: I20240618001829 |
| Provider Name | Hannah Courtney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285210674 PECOS PAC ID: 2466996681 Enrollment ID: I20240628002201 |
| Provider Name | Charmaine Clarisse D Abalos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700376050 PECOS PAC ID: 0244588804 Enrollment ID: I20240628003405 |
| Provider Name | Theresa V Kalemkeris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972352524 PECOS PAC ID: 7517401318 Enrollment ID: I20240703003390 |
| Provider Name | Cody L Toschik |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669975413 PECOS PAC ID: 2163844846 Enrollment ID: I20240715001793 |
| Provider Name | Allen David Swanson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295391670 PECOS PAC ID: 3779983424 Enrollment ID: I20240719002908 |
| Provider Name | Philip L Grady |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629086699 PECOS PAC ID: 4880854660 Enrollment ID: I20240722000441 |
| Provider Name | Mariano Porto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396032934 PECOS PAC ID: 2961792429 Enrollment ID: I20240729001256 |
| Provider Name | Bo Peng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598348765 PECOS PAC ID: 8921545468 Enrollment ID: I20240801004414 |
| Provider Name | Julia N Oni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275105785 PECOS PAC ID: 2668875832 Enrollment ID: I20240805000856 |
| Provider Name | Prabin Phuyal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881358612 PECOS PAC ID: 3375080260 Enrollment ID: I20240809001136 |
| Provider Name | Aaron Winder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417267295 PECOS PAC ID: 7315485208 Enrollment ID: I20240809001353 |
| Provider Name | Rayaan Asad Chaudhry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821765108 PECOS PAC ID: 5294273009 Enrollment ID: I20240812001998 |
| Provider Name | Nicole a Gifford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891365953 PECOS PAC ID: 5395148597 Enrollment ID: I20240823000290 |
| Provider Name | Kathryn a Polovitz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457557191 PECOS PAC ID: 3678729878 Enrollment ID: I20240909002934 |
| Provider Name | Whitney Huffingham |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780182477 PECOS PAC ID: 9436412251 Enrollment ID: I20240920001297 |
| Provider Name | Bobbi B Keyser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669133427 PECOS PAC ID: 1951832963 Enrollment ID: I20241001004516 |
| Provider Name | Maritza E Feliz Cepin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457757254 PECOS PAC ID: 3779907837 Enrollment ID: I20241015003812 |
| Provider Name | Amanda M Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851119119 PECOS PAC ID: 6901339290 Enrollment ID: I20241024003088 |
| Provider Name | Yue Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699412353 PECOS PAC ID: 8729514880 Enrollment ID: I20241212001112 |
| Provider Name | Gyaneshwar Shrestha |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538612908 PECOS PAC ID: 9638407174 Enrollment ID: I20250129003238 |
| Provider Name | Andrew Ferguson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760989172 PECOS PAC ID: 1355691940 Enrollment ID: I20250318003890 |
| Provider Name | Kevin M Dischert |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1922323047 PECOS PAC ID: 6709188287 Enrollment ID: I20250408003728 |
| Provider Name | Jessica Faith Yeager Akram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023816121 PECOS PAC ID: 0941728489 Enrollment ID: I20250519000703 |
| Provider Name | Vamshi Krishna Sai Balasetti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467894675 PECOS PAC ID: 9830321991 Enrollment ID: I20250527001248 |
| Provider Name | Ankush Bansal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013913102 PECOS PAC ID: 6305947649 Enrollment ID: I20250602000452 |
| Provider Name | Jennifer J Davenport |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225292154 PECOS PAC ID: 3173687241 Enrollment ID: I20250604001544 |
| Provider Name | Sarah C Fabry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154703783 PECOS PAC ID: 8325330111 Enrollment ID: I20250721001042 |
| Provider Name | Gagan Bohara |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851037196 PECOS PAC ID: 6800237413 Enrollment ID: I20250724002104 |
| Provider Name | Dylan R Mathis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922748102 PECOS PAC ID: 5698159309 Enrollment ID: I20250804002869 |
| Provider Name | Sirish R Pandey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831834522 PECOS PAC ID: 0840798799 Enrollment ID: I20250810000136 |
| Provider Name | Jasdeep Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598497646 PECOS PAC ID: 1557745189 Enrollment ID: I20250811000121 |
| Provider Name | Kourosh Kahkeshani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992048615 PECOS PAC ID: 1759714504 Enrollment ID: I20250811001395 |
| Provider Name | Billy Bravo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033389150 PECOS PAC ID: 5698954592 Enrollment ID: I20250815000803 |
| Provider Name | Suzanne M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245600428 PECOS PAC ID: 4385033216 Enrollment ID: I20250818004503 |
| Provider Name | Shireen Jindani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285810598 PECOS PAC ID: 5991863235 Enrollment ID: I20250821002804 |
| Provider Name | Ignacio Aguilar |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184432668 PECOS PAC ID: 4385164979 Enrollment ID: I20250828004298 |
| Provider Name | Kimberly a Petetit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952290876 PECOS PAC ID: 2567963424 Enrollment ID: I20250902000276 |
| Provider Name | Jane N Stevens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952522138 PECOS PAC ID: 8224129374 Enrollment ID: I20250903004103 |
| Provider Name | Mikias a Kebede |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053622399 PECOS PAC ID: 2769626472 Enrollment ID: I20250905003990 |
| Provider Name | Lyndsey a Cotton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235021536 PECOS PAC ID: 6800390519 Enrollment ID: I20250916004800 |
| Provider Name | Joey Gee |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1710058698 PECOS PAC ID: 9436051505 Enrollment ID: I20250926002415 |
| Provider Name | Brett Hebert |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932733813 PECOS PAC ID: 5395196315 Enrollment ID: I20250928000175 |
| Provider Name | Xem M Bui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194390187 PECOS PAC ID: 0244639672 Enrollment ID: I20251031003316 |
| Provider Name | Kristina E Duffy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184695348 PECOS PAC ID: 9133392426 Enrollment ID: I20251117000682 |
| Provider Name | Rushin N Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033531546 PECOS PAC ID: 6406078187 Enrollment ID: I20251120004075 |
| Provider Name | Angie Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609216795 PECOS PAC ID: 7517268774 Enrollment ID: I20251121001749 |
| Provider Name | Jerry a Ugbo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295613388 PECOS PAC ID: 4981199510 Enrollment ID: I20251222000708 |
| Provider Name | Alan Rosenbaum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1548680994 PECOS PAC ID: 4183933096 Enrollment ID: I20260212000405 |
| Provider Name | Rachel Ann Dillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477076297 PECOS PAC ID: 3173895372 Enrollment ID: I20260320000294 |
| Provider Name | Mayya Geha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972584654 PECOS PAC ID: 0840450979 Enrollment ID: I20260408004102 |
| Provider Name | Selina Mahmood |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194385104 PECOS PAC ID: 9234465022 Enrollment ID: I20260421002850 |
| Provider Name | Caleb John Podraza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528039328 PECOS PAC ID: 3173707734 Enrollment ID: I20260428002143 |
| Provider Name | Joan Nold |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497708481 PECOS PAC ID: 4688617988 Enrollment ID: I20260430000643 |
| Provider Name | Zuzetee Odalis Poo Bermudez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700756939 PECOS PAC ID: 7416424056 Enrollment ID: I20260430003137 |
| Provider Name | Caleb Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972131571 PECOS PAC ID: 9133541345 Enrollment ID: I20260504005378 |
| Provider Name | Kanayo Afamefina Ezeanolue |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215053582 PECOS PAC ID: 9931232253 Enrollment ID: I20260505003008 |
| Provider Name | Taranjeet Kaur |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760725147 PECOS PAC ID: 6002041472 Enrollment ID: I20260513001484 |
| Provider Name | Christopher Paisley Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134063779 PECOS PAC ID: 4587133475 Enrollment ID: I20260520002536 |
| Provider Name | Uchenna Ogbozor |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790064913 PECOS PAC ID: 9537483318 Enrollment ID: I20260603002313 |
| Provider Name | Michael Witman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225054026 PECOS PAC ID: 7315328416 Enrollment ID: I20260611003617 |
| Provider Name | Mary F Colby-hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093840928 PECOS PAC ID: 8325511751 Enrollment ID: I20260625004918 |
Good Health Direct Primary Care LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 814 E Jackson St Ste A, Medford, OR 97504 Phone: 541-414-7512 |
Ups Medford (cdrc - Expansion) Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2825 E Barnett Rd, Medford, OR 97504 Phone: 503-494-9000 |
Rogue Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 E Main St, Medford, OR 97504 Phone: 541-842-7705 Fax: 541-842-7640 |
Beckett Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3200 Juanipero Way, Medford, OR 97504 Phone: 541-858-8170 Fax: 541-858-8167 |
Pmg Medford Physiatry Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 920 Royal Ave, Medford, OR 97504 Phone: 541-732-8400 Fax: 541-732-8401 |
Pmg South Heart Rhythm Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504 Phone: 541-732-7850 Fax: 541-732-7851 |