| Ascension Macomb Oakland Hospital | |
|
11800 E 12 Mile Rd Warren MI 48093-3472 | |
| (586) 573-5000 | |
| Not Available |
| Full Name | Ascension Macomb Oakland Hospital |
|---|---|
| Speciality | Family Medicine |
| Location | 11800 E 12 Mile Rd, Warren, Michigan |
| Authorized Official Name and Position | Sarah Starkel (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2486808121 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Macomb Oakland Hospital 3195 Solutions Center Box 773195 Chicago IL 60677-0001 Ph: (248) 680-8000 | Ascension Macomb Oakland Hospital 11800 E 12 Mile Rd Warren MI 48093-3472 Ph: (586) 573-5000 |
| NPI Number | 1134176472 |
|---|---|
| Provider Enumeration Date | 05/30/2006 |
| Last Update Date | 12/07/2023 |
| Medicare PECOS PAC ID | 7315859725 |
|---|---|
| Medicare Enrollment ID | O20031107000047 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134176472 | NPI | - | NPPES |
| 700H201530 | Other | MI | BCBSM GROUP |
| Provider Name | Chakrapani Ranganathan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194709584 PECOS PAC ID: 9830085703 Enrollment ID: I20040226000652 |
| Provider Name | Christine A Crader |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366440463 PECOS PAC ID: 7719876671 Enrollment ID: I20040311000050 |
| Provider Name | Gary R Katz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255329355 PECOS PAC ID: 0244121036 Enrollment ID: I20040322001418 |
| Provider Name | Reza R Dabir |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1750351383 PECOS PAC ID: 3375525629 Enrollment ID: I20040602000415 |
| Provider Name | Phillip Lorane Robinson |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1366424392 PECOS PAC ID: 1658359906 Enrollment ID: I20040714001269 |
| Provider Name | Rafael L Barretto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942202122 PECOS PAC ID: 2567434707 Enrollment ID: I20040809001246 |
| Provider Name | Douglas Moore |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1194729053 PECOS PAC ID: 0042285199 Enrollment ID: I20041109001126 |
| Provider Name | Brigitte Lorenz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235131160 PECOS PAC ID: 2466404207 Enrollment ID: I20050223000205 |
| Provider Name | Michael Won Lee |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1275590523 PECOS PAC ID: 9931154911 Enrollment ID: I20050314000541 |
| Provider Name | Shyla R Vengalil |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295720001 PECOS PAC ID: 0941229819 Enrollment ID: I20051121000510 |
| Provider Name | Mitchell P Dombrowski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396730255 PECOS PAC ID: 8224920061 Enrollment ID: I20051121000532 |
| Provider Name | Brian A Mason |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952396780 PECOS PAC ID: 4688693567 Enrollment ID: I20051121000574 |
| Provider Name | Mark S Juzych |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1053359125 PECOS PAC ID: 4385537265 Enrollment ID: I20051216000514 |
| Provider Name | Mark L Mcdermott |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1326085820 PECOS PAC ID: 7719908813 Enrollment ID: I20051216000538 |
| Provider Name | Jason I Soffa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194791368 PECOS PAC ID: 3870508211 Enrollment ID: I20060207000460 |
| Provider Name | Lisa Lillian Gilbertahee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295705168 PECOS PAC ID: 5193730430 Enrollment ID: I20060208000334 |
| Provider Name | Gary L Berg |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083698997 PECOS PAC ID: 4183537210 Enrollment ID: I20060209000093 |
| Provider Name | Alvise F Bernabei |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1588679013 PECOS PAC ID: 0941218507 Enrollment ID: I20060323000752 |
| Provider Name | Mubashir A Sabir |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265477418 PECOS PAC ID: 9739105354 Enrollment ID: I20060801000402 |
| Provider Name | Daphne P Tumaneng |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417901174 PECOS PAC ID: 4587667506 Enrollment ID: I20060811000471 |
| Provider Name | Betty L Daniels |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205854775 PECOS PAC ID: 5294738969 Enrollment ID: I20060818000104 |
| Provider Name | Asima S Hussain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780696567 PECOS PAC ID: 2062516792 Enrollment ID: I20070405000032 |
| Provider Name | Arlin H French |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1538154125 PECOS PAC ID: 8123125481 Enrollment ID: I20070524000168 |
| Provider Name | Saroj Misra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336130970 PECOS PAC ID: 7214037365 Enrollment ID: I20070703000241 |
| Provider Name | William S Bloom |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1215950100 PECOS PAC ID: 7315859493 Enrollment ID: I20070730000055 |
| Provider Name | Kathleen T Blazoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558452805 PECOS PAC ID: 5092807941 Enrollment ID: I20070822001478 |
| Provider Name | Salem M Sayar |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1346326238 PECOS PAC ID: 7517059215 Enrollment ID: I20070827000310 |
| Provider Name | Despina Zefiras Walsworth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265554216 PECOS PAC ID: 2567558406 Enrollment ID: I20071023000559 |
| Provider Name | Michael S Sherman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1063403335 PECOS PAC ID: 6406937283 Enrollment ID: I20080117000738 |
| Provider Name | Timothy R Schmakel |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1811008154 PECOS PAC ID: 1153403324 Enrollment ID: I20080126000030 |
| Provider Name | Patricia A Dwyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316116478 PECOS PAC ID: 5294810412 Enrollment ID: I20080312000587 |
| Provider Name | Jennifer M Nowasielski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790991909 PECOS PAC ID: 8527132026 Enrollment ID: I20080731000769 |
| Provider Name | Jason O Holcomb |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740309624 PECOS PAC ID: 4587758859 Enrollment ID: I20080916000296 |
| Provider Name | Jacquelyn N Rodriguez |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427264902 PECOS PAC ID: 2769541101 Enrollment ID: I20081030000283 |
| Provider Name | Steven A Acker |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003889205 PECOS PAC ID: 6305906629 Enrollment ID: I20081117000518 |
| Provider Name | Todd J Frush |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427264910 PECOS PAC ID: 7618041328 Enrollment ID: I20090715000107 |
| Provider Name | Sandra J Cagle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265513980 PECOS PAC ID: 1355480047 Enrollment ID: I20091210000107 |
| Provider Name | Andres G Santiviago |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457342149 PECOS PAC ID: 6507981297 Enrollment ID: I20100917001025 |
| Provider Name | Sheryl L Shoebottom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629373253 PECOS PAC ID: 6103000849 Enrollment ID: I20110405000385 |
| Provider Name | Peter Joseph Maceroni |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124221668 PECOS PAC ID: 6709054000 Enrollment ID: I20110712000237 |
| Provider Name | Kathleen T Rudd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124310198 PECOS PAC ID: 2365614344 Enrollment ID: I20111018000025 |
| Provider Name | Diana Rebecca Silas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528371929 PECOS PAC ID: 3870767031 Enrollment ID: I20111128000363 |
| Provider Name | Lisa A Boone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710259189 PECOS PAC ID: 9436319415 Enrollment ID: I20120328001010 |
| Provider Name | Alan M Afsari |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629045760 PECOS PAC ID: 2860490257 Enrollment ID: I20120530000035 |
| Provider Name | Adham Alsamsam |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578711636 PECOS PAC ID: 4082879184 Enrollment ID: I20120622000018 |
| Provider Name | Benjamin J Best |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609997188 PECOS PAC ID: 6204006448 Enrollment ID: I20120718000805 |
| Provider Name | Marilyn J Snowden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982965125 PECOS PAC ID: 3375548555 Enrollment ID: I20120718000923 |
| Provider Name | Mini Varghese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386925410 PECOS PAC ID: 5698927457 Enrollment ID: I20121201000032 |
| Provider Name | Mincy Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558685701 PECOS PAC ID: 7315191467 Enrollment ID: I20130125000357 |
| Provider Name | Rachel A Nixon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780817593 PECOS PAC ID: 9234374521 Enrollment ID: I20130313000484 |
| Provider Name | Paige E Paladino |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255651170 PECOS PAC ID: 2860638202 Enrollment ID: I20130409000628 |
| Provider Name | Latisha Myles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457699084 PECOS PAC ID: 2365688595 Enrollment ID: I20130415000024 |
| Provider Name | Katherine A Paquette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932250206 PECOS PAC ID: 6901047315 Enrollment ID: I20130729000124 |
| Provider Name | Carlos A Ramirez Neyra |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1023230927 PECOS PAC ID: 3678738648 Enrollment ID: I20130910000331 |
| Provider Name | Molly Veale |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992025811 PECOS PAC ID: 7416182068 Enrollment ID: I20131106001962 |
| Provider Name | Cassie Konja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629204797 PECOS PAC ID: 8729216163 Enrollment ID: I20140110001376 |
| Provider Name | Clifford Michael Houseman |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1093938482 PECOS PAC ID: 8527208529 Enrollment ID: I20140402002302 |
| Provider Name | Sarah L Griffith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528388444 PECOS PAC ID: 5597989426 Enrollment ID: I20140617000513 |
| Provider Name | Jennifer L Burlingame |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003110552 PECOS PAC ID: 0941425110 Enrollment ID: I20140701001594 |
| Provider Name | Wendy A Machuta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407104664 PECOS PAC ID: 8022234566 Enrollment ID: I20140718001519 |
| Provider Name | Lisa Kopacka-jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841349180 PECOS PAC ID: 3779701537 Enrollment ID: I20140820001946 |
| Provider Name | Sandra Moreland |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811919327 PECOS PAC ID: 9032339833 Enrollment ID: I20140930000058 |
| Provider Name | Andrew P Jovanovski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437460714 PECOS PAC ID: 0345462891 Enrollment ID: I20141118000176 |
| Provider Name | Sheeba John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720482839 PECOS PAC ID: 9638494248 Enrollment ID: I20150202001010 |
| Provider Name | Mallory Mcdonough |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144569559 PECOS PAC ID: 9830417245 Enrollment ID: I20150415001691 |
| Provider Name | Emmanuel Tolentino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376934158 PECOS PAC ID: 6204156680 Enrollment ID: I20150527000283 |
| Provider Name | Jeffrey Michael Kadzielewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932465457 PECOS PAC ID: 8224359823 Enrollment ID: I20150608002645 |
| Provider Name | Brandon Osmanski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720347339 PECOS PAC ID: 9335450527 Enrollment ID: I20150615000785 |
| Provider Name | Ronald A Bonaventura |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063880573 PECOS PAC ID: 2860792645 Enrollment ID: I20151201000385 |
| Provider Name | Xihui Lin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1871868190 PECOS PAC ID: 4385935006 Enrollment ID: I20160627002146 |
| Provider Name | Stephen Marshall Kehres |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598103038 PECOS PAC ID: 9032412846 Enrollment ID: I20160701000876 |
| Provider Name | Jennifer Minna Hanna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770962128 PECOS PAC ID: 6800192550 Enrollment ID: I20160713001439 |
| Provider Name | Jennifer K Caruso |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558596015 PECOS PAC ID: 0244478394 Enrollment ID: I20160810001517 |
| Provider Name | Tonya M Wall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487028379 PECOS PAC ID: 8628362555 Enrollment ID: I20160815002985 |
| Provider Name | Jonathan A Hesson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750645362 PECOS PAC ID: 4082904610 Enrollment ID: I20160923000438 |
| Provider Name | James R Mcnutt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790088623 PECOS PAC ID: 1850512393 Enrollment ID: I20170405000508 |
| Provider Name | Jon W Mackey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043621451 PECOS PAC ID: 6901109438 Enrollment ID: I20170706002135 |
| Provider Name | Benjamin R Collins-hamel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649698622 PECOS PAC ID: 6800199126 Enrollment ID: I20170707002743 |
| Provider Name | Dina Kassab |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205273315 PECOS PAC ID: 9032415633 Enrollment ID: I20171009003374 |
| Provider Name | Erin J Bouhana |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588003966 PECOS PAC ID: 2769626449 Enrollment ID: I20180123003237 |
| Provider Name | Lynn T Mejia |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215955117 PECOS PAC ID: 2062773088 Enrollment ID: I20180307001365 |
| Provider Name | Tyffany Florczyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861872004 PECOS PAC ID: 4981967734 Enrollment ID: I20180410001204 |
| Provider Name | Adam Mohamed Fahs |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1063822377 PECOS PAC ID: 6305061425 Enrollment ID: I20180615000687 |
| Provider Name | Jason J Rizqallah |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043565443 PECOS PAC ID: 9335447101 Enrollment ID: I20180621000227 |
| Provider Name | Dayna Snyder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750818118 PECOS PAC ID: 3577810407 Enrollment ID: I20180723003104 |
| Provider Name | Ryan M Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477089357 PECOS PAC ID: 4688922990 Enrollment ID: I20180802002539 |
| Provider Name | Kristen M Light |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013435619 PECOS PAC ID: 0143579649 Enrollment ID: I20180816001316 |
| Provider Name | Arshi Lehal |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1720341886 PECOS PAC ID: 3870890056 Enrollment ID: I20190219000916 |
| Provider Name | Paul Knapp |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528410099 PECOS PAC ID: 2860735909 Enrollment ID: I20190513002652 |
| Provider Name | Kristopher M George |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1033173463 PECOS PAC ID: 3476586181 Enrollment ID: I20190517000044 |
| Provider Name | Nicholas D Sousa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134533912 PECOS PAC ID: 0345549911 Enrollment ID: I20190621001290 |
| Provider Name | Pradeepa Yoganathan |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1104137728 PECOS PAC ID: 7517151772 Enrollment ID: I20190729003122 |
| Provider Name | Sawsan W Jamil |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790942993 PECOS PAC ID: 8022246354 Enrollment ID: I20191008003858 |
| Provider Name | Jennifer A Larade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366956252 PECOS PAC ID: 2264864164 Enrollment ID: I20191114001993 |
| Provider Name | Claude C Lerose |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1831536861 PECOS PAC ID: 3173820370 Enrollment ID: I20191219001199 |
| Provider Name | Sanjay Kumar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457665671 PECOS PAC ID: 6002057445 Enrollment ID: I20200122000553 |
| Provider Name | Danielle M Hurst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124492723 PECOS PAC ID: 4880999036 Enrollment ID: I20200203000328 |
| Provider Name | Alan H Klein |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609877463 PECOS PAC ID: 3173663457 Enrollment ID: I20200413001398 |
| Provider Name | Andrew L Molnar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417439761 PECOS PAC ID: 8123458536 Enrollment ID: I20200428000025 |
| Provider Name | Andrew Joseph Plaza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225699911 PECOS PAC ID: 7911328034 Enrollment ID: I20200528000453 |
| Provider Name | Jared D Goldberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760846513 PECOS PAC ID: 4587954243 Enrollment ID: I20200720001058 |
| Provider Name | Dorian R Michelson Axiak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043820178 PECOS PAC ID: 8224456280 Enrollment ID: I20200908003210 |
| Provider Name | Brett J Malbin |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1902256787 PECOS PAC ID: 0749566818 Enrollment ID: I20200911000940 |
| Provider Name | Michael Bousamra |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1669411781 PECOS PAC ID: 8628975885 Enrollment ID: I20201217000213 |
| Provider Name | Monica Joanna Petela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831781632 PECOS PAC ID: 9032525449 Enrollment ID: I20210310000784 |
| Provider Name | Frederic Shaw Joyce |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1316994304 PECOS PAC ID: 1355236571 Enrollment ID: I20210324002366 |
| Provider Name | Paul F Bermudez |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1326427477 PECOS PAC ID: 5890075535 Enrollment ID: I20210524000293 |
| Provider Name | Anthony Konja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639673601 PECOS PAC ID: 7911253042 Enrollment ID: I20210908001528 |
| Provider Name | Kristen A Kenny |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447741467 PECOS PAC ID: 0345674339 Enrollment ID: I20211115000723 |
| Provider Name | Elisheva Ellenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831711936 PECOS PAC ID: 9638560782 Enrollment ID: I20211227001145 |
| Provider Name | Amanda Mae Bachman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104589373 PECOS PAC ID: 6709278237 Enrollment ID: I20220113001270 |
| Provider Name | Wanda Theresa Bignotti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225551716 PECOS PAC ID: 6901292648 Enrollment ID: I20220406002203 |
| Provider Name | Anna G Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225619448 PECOS PAC ID: 6103212709 Enrollment ID: I20220407001659 |
| Provider Name | Brian A Benenati |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1700373867 PECOS PAC ID: 9931430204 Enrollment ID: I20220608000568 |
| Provider Name | Sanar Sabah Yokhana |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043673809 PECOS PAC ID: 4183913916 Enrollment ID: I20220718000913 |
| Provider Name | Sharon I Obuzor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902473911 PECOS PAC ID: 7719350867 Enrollment ID: I20230310001233 |
| Provider Name | Shannon Schmaus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154771830 PECOS PAC ID: 9537534441 Enrollment ID: I20230406001838 |
| Provider Name | Chioma Camille Okekpe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740685593 PECOS PAC ID: 3577834167 Enrollment ID: I20230512001154 |
| Provider Name | Lisa Rose Shammas |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1952965865 PECOS PAC ID: 9537494778 Enrollment ID: I20230608000892 |
| Provider Name | Philip Shaheen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639551880 PECOS PAC ID: 8729395165 Enrollment ID: I20230718003113 |
| Provider Name | Michael James Farrug |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740573104 PECOS PAC ID: 4587014717 Enrollment ID: I20231229000928 |
| Provider Name | Nathan E Maroney |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1902210222 PECOS PAC ID: 2466802699 Enrollment ID: I20231229001059 |
| Provider Name | Tiffni Teresa Rankin |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1437169703 PECOS PAC ID: 2961853106 Enrollment ID: I20240111003421 |
| Provider Name | Diana Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861160665 PECOS PAC ID: 5496107872 Enrollment ID: I20240122002363 |
Peter L Wickens D.o.,p.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14050 E 14 Mile Rd, Warren, MI 48088 Phone: 586-293-2088 Fax: 586-293-5502 | |
Family Medicine And Sleep Specialist Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11670 Martin Rd, Warren, MI 48093 Phone: 586-754-3830 Fax: 586-754-3840 | |
Tricounty Hospitalists, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11800 E 12 Mile Rd, Warren, MI 48093 Phone: 586-573-5000 Fax: 248-265-4082 | |
Madison Associates Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3410 E 12 Mile Rd, Suite C, Warren, MI 48092 Phone: 810-751-7733 | |
Warren Gastroenterology Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 27560 Hoover Rd, Warren, MI 48093 Phone: 586-757-6400 Fax: 586-757-8400 | |
Md Urgent Care & Family Practice Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12640 E 12 Mile Rd, Warren, MI 48093 Phone: 586-751-2020 Fax: 586-745-4756 | |
Eastern Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 28401 Hoover Rd Ste 2, Warren, MI 48093 Phone: 586-754-3830 Fax: 586-754-3840 |