| Ascension Medical Group Promed | |
|
7901 Angling Rd Portage MI 49024-0714 | |
| (269) 552-2912 | |
| (269) 552-2835 |
| Full Name | Ascension Medical Group Promed |
|---|---|
| Speciality | Family Medicine |
| Location | 7901 Angling Rd, Portage, Michigan |
| Authorized Official Name and Position | Marina Houghton (CFO) |
| Authorized Official Contact | 2692264800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ascension Medical Group Promed 1717 Shaffer St Ste 2 Kalamazoo MI 49048-1623 Ph: (269) 226-5607 | Ascension Medical Group Promed 7901 Angling Rd Portage MI 49024-0714 Ph: (269) 552-2912 |
| NPI Number | 1497709869 |
|---|---|
| Provider Enumeration Date | 05/20/2006 |
| Last Update Date | 12/30/2022 |
| Medicare PECOS PAC ID | 7315856077 |
|---|---|
| Medicare Enrollment ID | O20031216000478 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497709869 | NPI | - | NPPES |
| Provider Name | Shawn M Pertunen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548266158 PECOS PAC ID: 7416851456 Enrollment ID: I20031121000441 |
| Provider Name | Luis Vega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659398592 PECOS PAC ID: 9133024045 Enrollment ID: I20031204000221 |
| Provider Name | Thomas J Rohs |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194775205 PECOS PAC ID: 8325944580 Enrollment ID: I20031209000477 |
| Provider Name | Daniel E Stewart |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114978426 PECOS PAC ID: 5092611269 Enrollment ID: I20031209000510 |
| Provider Name | Christine T Wade |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083723647 PECOS PAC ID: 8123920923 Enrollment ID: I20040122000822 |
| Provider Name | Anthony King |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194700104 PECOS PAC ID: 9638081367 Enrollment ID: I20040219000026 |
| Provider Name | Robert C Kiser |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1720080351 PECOS PAC ID: 7113813742 Enrollment ID: I20040223000319 |
| Provider Name | Tarun K Sharma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790748077 PECOS PAC ID: 4789574559 Enrollment ID: I20040316001190 |
| Provider Name | Matthew S Dikin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1700871175 PECOS PAC ID: 7315839941 Enrollment ID: I20040327000119 |
| Provider Name | Igor G Kaps |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326001496 PECOS PAC ID: 8820080922 Enrollment ID: I20040401000047 |
| Provider Name | Fayyaz Mahmood |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396709523 PECOS PAC ID: 7517959364 Enrollment ID: I20040401000062 |
| Provider Name | Kenneth J Tobin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700962727 PECOS PAC ID: 3072507631 Enrollment ID: I20040414001363 |
| Provider Name | Mustafa G Boxwala |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1548260128 PECOS PAC ID: 2860394475 Enrollment ID: I20040628000643 |
| Provider Name | Gregorio Uy Tan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316926751 PECOS PAC ID: 0244218576 Enrollment ID: I20040712001404 |
| Provider Name | Phillip Lorane Robinson |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1366424392 PECOS PAC ID: 1658359906 Enrollment ID: I20040714001269 |
| Provider Name | Kristy K Davis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619936945 PECOS PAC ID: 4981683190 Enrollment ID: I20040720000141 |
| Provider Name | Aajay N Shah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710933932 PECOS PAC ID: 5294714416 Enrollment ID: I20040721000588 |
| Provider Name | Julie A Noteboom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083722425 PECOS PAC ID: 0941280432 Enrollment ID: I20040723001206 |
| Provider Name | Amy M Hackman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558327049 PECOS PAC ID: 6901879394 Enrollment ID: I20040813001149 |
| Provider Name | Alicia M Williams |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1649256314 PECOS PAC ID: 1850203597 Enrollment ID: I20040827000674 |
| Provider Name | Megan G Deibel |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1457466955 PECOS PAC ID: 8325013287 Enrollment ID: I20040902000045 |
| Provider Name | Eve Rider |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194793646 PECOS PAC ID: 1850373283 Enrollment ID: I20040916000105 |
| Provider Name | Fresca Swaniker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982754719 PECOS PAC ID: 4789652678 Enrollment ID: I20040920000040 |
| Provider Name | Janie B Allgor |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1629050950 PECOS PAC ID: 2466421037 Enrollment ID: I20040930000036 |
| Provider Name | Michael D Engel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386606671 PECOS PAC ID: 2163491580 Enrollment ID: I20041001000015 |
| Provider Name | Theresa R Newberry |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1679683601 PECOS PAC ID: 1355310715 Enrollment ID: I20041001000378 |
| Provider Name | Joseph C Roth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124120597 PECOS PAC ID: 8224007737 Enrollment ID: I20041012001081 |
| Provider Name | Jeannette M Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952419566 PECOS PAC ID: 3173583358 Enrollment ID: I20041012001323 |
| Provider Name | Eliezer N Melendez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518926393 PECOS PAC ID: 5698735496 Enrollment ID: I20041015000597 |
| Provider Name | Kellie D Sanders |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972612174 PECOS PAC ID: 1658339650 Enrollment ID: I20041222000145 |
| Provider Name | Roseanne L Yancey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720198799 PECOS PAC ID: 5698733202 Enrollment ID: I20041229000642 |
| Provider Name | Michael P Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033158183 PECOS PAC ID: 6002865136 Enrollment ID: I20050115000131 |
| Provider Name | Ronald Cheek |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013957927 PECOS PAC ID: 0840240008 Enrollment ID: I20050125000938 |
| Provider Name | Ashish P Verma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699735936 PECOS PAC ID: 9537110069 Enrollment ID: I20050202000393 |
| Provider Name | Robert Scott Schaefer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932195393 PECOS PAC ID: 3173417482 Enrollment ID: I20050221000496 |
| Provider Name | Tom T Saad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417908930 PECOS PAC ID: 4880591015 Enrollment ID: I20050224000392 |
| Provider Name | Samuel K Payne |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1740366970 PECOS PAC ID: 2769435080 Enrollment ID: I20050228000264 |
| Provider Name | Susan K Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073620720 PECOS PAC ID: 0749234417 Enrollment ID: I20050304000702 |
| Provider Name | Mailvaganam Sridharan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598714990 PECOS PAC ID: 7911985510 Enrollment ID: I20050404000991 |
| Provider Name | Travis D Terrell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891781944 PECOS PAC ID: 0446297568 Enrollment ID: I20050411000875 |
| Provider Name | Michael Valitutto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326074378 PECOS PAC ID: 1557301520 Enrollment ID: I20050510000022 |
| Provider Name | Jyothirmai Bobba |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710060066 PECOS PAC ID: 8628012853 Enrollment ID: I20050617000393 |
| Provider Name | Linda L Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942311725 PECOS PAC ID: 2466497276 Enrollment ID: I20050622000927 |
| Provider Name | Paul A Lange |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1609835313 PECOS PAC ID: 2365487774 Enrollment ID: I20050627000574 |
| Provider Name | Michael A Warlick |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1740259811 PECOS PAC ID: 2163467473 Enrollment ID: I20050627000598 |
| Provider Name | Abdul S Shaikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619088358 PECOS PAC ID: 5294771895 Enrollment ID: I20050706000061 |
| Provider Name | Mary H Hoekstra |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932276037 PECOS PAC ID: 2769418474 Enrollment ID: I20050714000130 |
| Provider Name | Prabhash Tatineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477664167 PECOS PAC ID: 7618904574 Enrollment ID: I20050721000833 |
| Provider Name | Mark E Meyer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1104806678 PECOS PAC ID: 4082526496 Enrollment ID: I20050805000625 |
| Provider Name | Mark J Krinock |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1598745952 PECOS PAC ID: 9032172358 Enrollment ID: I20050805000642 |
| Provider Name | Dean D Kindler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053381608 PECOS PAC ID: 7214924885 Enrollment ID: I20050815000934 |
| Provider Name | John G Gustafson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1992777437 PECOS PAC ID: 5395781108 Enrollment ID: I20050820000105 |
| Provider Name | Mary E Vajgrt |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1396713509 PECOS PAC ID: 5193756658 Enrollment ID: I20050824000543 |
| Provider Name | Sugandhi Sridharan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033173794 PECOS PAC ID: 8628009529 Enrollment ID: I20050830000429 |
| Provider Name | Rockelle D Rogers |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962596502 PECOS PAC ID: 8123052917 Enrollment ID: I20050921000599 |
| Provider Name | Michael Joseph Oneka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366457129 PECOS PAC ID: 6002840402 Enrollment ID: I20050926000074 |
| Provider Name | Kelly Dermody Ybema |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831179407 PECOS PAC ID: 2860426103 Enrollment ID: I20050926000519 |
| Provider Name | Anne M Cavanagh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669441457 PECOS PAC ID: 1658305800 Enrollment ID: I20050927000152 |
| Provider Name | Nicoara C Oprescu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225146533 PECOS PAC ID: 3971538711 Enrollment ID: I20050930000143 |
| Provider Name | Mirjana Stancic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073656963 PECOS PAC ID: 1355376096 Enrollment ID: I20050930000217 |
| Provider Name | Frederic L Such |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205932159 PECOS PAC ID: 1254366990 Enrollment ID: I20050930000227 |
| Provider Name | Michael Frederick Trexler |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1003927898 PECOS PAC ID: 8325073067 Enrollment ID: I20050930000245 |
| Provider Name | Mary P Fuehr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881678225 PECOS PAC ID: 0042245375 Enrollment ID: I20051005000554 |
| Provider Name | Daniel F Barnas |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1962495614 PECOS PAC ID: 0941225247 Enrollment ID: I20051006000176 |
| Provider Name | Jesse W Duranceau |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255447769 PECOS PAC ID: 5991799595 Enrollment ID: I20051007000814 |
| Provider Name | John L Bradtke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659317071 PECOS PAC ID: 7517864747 Enrollment ID: I20051007000834 |
| Provider Name | Chandramouli Madala |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487629283 PECOS PAC ID: 1951327337 Enrollment ID: I20051017000062 |
| Provider Name | Sandra Rae Dejong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447360433 PECOS PAC ID: 5496771107 Enrollment ID: I20051021000534 |
| Provider Name | David N Makowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407963531 PECOS PAC ID: 7911923628 Enrollment ID: I20051021000543 |
| Provider Name | Jennifer Parks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700805199 PECOS PAC ID: 9931125432 Enrollment ID: I20051024000137 |
| Provider Name | Tammy J Vanderstelt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588775365 PECOS PAC ID: 0840219408 Enrollment ID: I20051114000656 |
| Provider Name | Robert J Baker |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1689642803 PECOS PAC ID: 1850310210 Enrollment ID: I20051115000333 |
| Provider Name | Mary E Kaiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144242371 PECOS PAC ID: 9335168251 Enrollment ID: I20051121000072 |
| Provider Name | Stuart R Verseman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275583304 PECOS PAC ID: 6709806961 Enrollment ID: I20051202000040 |
| Provider Name | David S Davenport |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972572972 PECOS PAC ID: 8628099413 Enrollment ID: I20051208000108 |
| Provider Name | Lanetta A Coleman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033150032 PECOS PAC ID: 4789607854 Enrollment ID: I20060104000801 |
| Provider Name | William R Bogan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376688127 PECOS PAC ID: 4880617885 Enrollment ID: I20060105000083 |
| Provider Name | Genevieve T Bastos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902843774 PECOS PAC ID: 5890719314 Enrollment ID: I20060123000704 |
| Provider Name | Cheryl A Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992777163 PECOS PAC ID: 4981610508 Enrollment ID: I20060306000440 |
| Provider Name | Richard Lovy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407882855 PECOS PAC ID: 2668489691 Enrollment ID: I20060315000489 |
| Provider Name | Alvise F Bernabei |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1588679013 PECOS PAC ID: 0941218507 Enrollment ID: I20060323000752 |
| Provider Name | Douglas G Campbell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225028921 PECOS PAC ID: 5698784601 Enrollment ID: I20060419000081 |
| Provider Name | David J Brockman |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1013961929 PECOS PAC ID: 6204847429 Enrollment ID: I20060531000175 |
| Provider Name | Connie L Van Es |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174540116 PECOS PAC ID: 1355344458 Enrollment ID: I20060810000095 |
| Provider Name | Thomas A Goodwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568481448 PECOS PAC ID: 5799789061 Enrollment ID: I20060830000097 |
| Provider Name | Bryon D Boley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487685657 PECOS PAC ID: 8224032339 Enrollment ID: I20060901000363 |
| Provider Name | Mona K Merritt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144272816 PECOS PAC ID: 0749285237 Enrollment ID: I20060915000109 |
| Provider Name | Sandhya R Sood Mcmillen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215946199 PECOS PAC ID: 9234136219 Enrollment ID: I20061106000147 |
| Provider Name | Carolyn Amy Von Maur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023114477 PECOS PAC ID: 9032116975 Enrollment ID: I20061107000106 |
| Provider Name | Jeffery L Wilt |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1033226097 PECOS PAC ID: 4880600634 Enrollment ID: I20061121000649 |
| Provider Name | Kimberly D Wallace |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750327045 PECOS PAC ID: 9537168976 Enrollment ID: I20061212000221 |
| Provider Name | William M Katz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1013024140 PECOS PAC ID: 8527074376 Enrollment ID: I20061219000423 |
| Provider Name | Michelle R Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932284973 PECOS PAC ID: 5193725224 Enrollment ID: I20070112000451 |
| Provider Name | Alan Smiy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114965845 PECOS PAC ID: 7517924889 Enrollment ID: I20070118000314 |
| Provider Name | James T Mclaren |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1710943725 PECOS PAC ID: 2668436445 Enrollment ID: I20070222000042 |
| Provider Name | Patrick J Rowley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1043318439 PECOS PAC ID: 3375646557 Enrollment ID: I20070308000159 |
| Provider Name | Patricia A Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750479192 PECOS PAC ID: 5890899108 Enrollment ID: I20070327000080 |
| Provider Name | James S Palmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144316373 PECOS PAC ID: 2365546967 Enrollment ID: I20070409000113 |
| Provider Name | Ronald J Zegerius |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1629053368 PECOS PAC ID: 5698687333 Enrollment ID: I20070417000657 |
| Provider Name | Tim Alexander Fischell |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1891771440 PECOS PAC ID: 1052416740 Enrollment ID: I20070425000486 |
| Provider Name | Gael G Kabell |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720053010 PECOS PAC ID: 5294774626 Enrollment ID: I20070504000029 |
| Provider Name | Angela K Adamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114906823 PECOS PAC ID: 9335037530 Enrollment ID: I20070509000208 |
| Provider Name | Angela L Kuiper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184751786 PECOS PAC ID: 1254438096 Enrollment ID: I20070514000138 |
| Provider Name | Robert J Lapenna |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1740265636 PECOS PAC ID: 4587576228 Enrollment ID: I20070608000504 |
| Provider Name | Marti Joy Peters Sparling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285754101 PECOS PAC ID: 2163522632 Enrollment ID: I20070712000609 |
| Provider Name | John J Spitzer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164530077 PECOS PAC ID: 5799877015 Enrollment ID: I20070816000378 |
| Provider Name | William F Lapenna |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1154302347 PECOS PAC ID: 4880506526 Enrollment ID: I20070822000728 |
| Provider Name | Aimee W Simpson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386848182 PECOS PAC ID: 2163515560 Enrollment ID: I20070830000318 |
| Provider Name | Donna J Thurn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306934385 PECOS PAC ID: 7810080223 Enrollment ID: I20070830000393 |
| Provider Name | Paulette L Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831398379 PECOS PAC ID: 8729171764 Enrollment ID: I20070906000562 |
| Provider Name | Jack D Parks |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922219666 PECOS PAC ID: 7113011743 Enrollment ID: I20070913000341 |
| Provider Name | Renee C Lassila |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619903317 PECOS PAC ID: 2860586047 Enrollment ID: I20070919000232 |
| Provider Name | Sara A Schugars |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629288386 PECOS PAC ID: 1951495043 Enrollment ID: I20070920000200 |
| Provider Name | Rosa S Maira |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487761664 PECOS PAC ID: 5890889745 Enrollment ID: I20070921000794 |
| Provider Name | Joyce L Byers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477746261 PECOS PAC ID: 8921194564 Enrollment ID: I20071012000396 |
| Provider Name | Thomas Knuth |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922023837 PECOS PAC ID: 1850325739 Enrollment ID: I20071109000218 |
| Provider Name | Steven M Nitsch |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1891780888 PECOS PAC ID: 8729984166 Enrollment ID: I20071221000343 |
| Provider Name | Tim G Adams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023096880 PECOS PAC ID: 8022199728 Enrollment ID: I20080119000107 |
| Provider Name | Natalie Elizabeth Kelly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417139601 PECOS PAC ID: 2668555814 Enrollment ID: I20080211000524 |
| Provider Name | Lynne M Lounsbury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861492423 PECOS PAC ID: 0547345522 Enrollment ID: I20080314000546 |
| Provider Name | Thomas Gregory Ryan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851386478 PECOS PAC ID: 4880786797 Enrollment ID: I20080317000638 |
| Provider Name | Mark A Noffsinger |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477548428 PECOS PAC ID: 5698729218 Enrollment ID: I20080318000230 |
| Provider Name | Todd Lester Ream |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255326211 PECOS PAC ID: 2466406095 Enrollment ID: I20080320000608 |
| Provider Name | Scott D Piereson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518075829 PECOS PAC ID: 5799754156 Enrollment ID: I20080408000805 |
| Provider Name | James Bailey Babel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093765331 PECOS PAC ID: 9931005196 Enrollment ID: I20080417000152 |
| Provider Name | Yazdi N Amaria |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619976271 PECOS PAC ID: 9537053046 Enrollment ID: I20080520000700 |
| Provider Name | Angela Y Van Poppel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770771875 PECOS PAC ID: 9436229846 Enrollment ID: I20080528000207 |
| Provider Name | Veera Pavan Kotaru |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710154927 PECOS PAC ID: 7113098229 Enrollment ID: I20080617000766 |
| Provider Name | Alice F Doe |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1124238654 PECOS PAC ID: 6103997044 Enrollment ID: I20080619000527 |
| Provider Name | Xiaoke Liu |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1528046034 PECOS PAC ID: 5890868533 Enrollment ID: I20080714000624 |
| Provider Name | Vishal Gupta |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1861507824 PECOS PAC ID: 0446342778 Enrollment ID: I20080806000186 |
| Provider Name | Shadi Idris |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891919312 PECOS PAC ID: 5698849677 Enrollment ID: I20080808000643 |
| Provider Name | Jonathan T Martinek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851594139 PECOS PAC ID: 5294801973 Enrollment ID: I20080903000463 |
| Provider Name | Sonia Veronica Eden |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1518002070 PECOS PAC ID: 2769583400 Enrollment ID: I20081008000432 |
| Provider Name | Christian W Ertl |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881691178 PECOS PAC ID: 8224197447 Enrollment ID: I20081103000653 |
| Provider Name | Daniel C Hood |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639127970 PECOS PAC ID: 6608788005 Enrollment ID: I20081208000270 |
| Provider Name | Jason R Ladwig |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1073705935 PECOS PAC ID: 8022102797 Enrollment ID: I20081208000525 |
| Provider Name | Roger M Kushner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962467621 PECOS PAC ID: 8820038334 Enrollment ID: I20090109000495 |
| Provider Name | Daniel Makande |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447279989 PECOS PAC ID: 7810051604 Enrollment ID: I20090122000377 |
| Provider Name | Marijo Steenstra |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346222361 PECOS PAC ID: 3870657547 Enrollment ID: I20090123000365 |
| Provider Name | Timur Raghib |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003034588 PECOS PAC ID: 4880758341 Enrollment ID: I20090127000729 |
| Provider Name | Megan D Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831335124 PECOS PAC ID: 4284790718 Enrollment ID: I20090310000435 |
| Provider Name | Beth A Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972724821 PECOS PAC ID: 3476645680 Enrollment ID: I20090311000586 |
| Provider Name | Michael K Hardiman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881701027 PECOS PAC ID: 1759439755 Enrollment ID: I20090430000541 |
| Provider Name | Xue Wang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043243959 PECOS PAC ID: 9335297068 Enrollment ID: I20090506000265 |
| Provider Name | Kirsten M Johantgen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285736371 PECOS PAC ID: 4880742303 Enrollment ID: I20090511000177 |
| Provider Name | Rajiv Rangrass |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508977539 PECOS PAC ID: 9638228588 Enrollment ID: I20090522000391 |
| Provider Name | Sean P Obrien |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1952368896 PECOS PAC ID: 1355491861 Enrollment ID: I20090603000655 |
| Provider Name | Sally J Vellenga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780794826 PECOS PAC ID: 3375694912 Enrollment ID: I20090622000605 |
| Provider Name | Susan M Miller |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1700988052 PECOS PAC ID: 1254482896 Enrollment ID: I20090622000649 |
| Provider Name | Terri J Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215044235 PECOS PAC ID: 5890846349 Enrollment ID: I20090624000301 |
| Provider Name | Brian A Lishawa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154334399 PECOS PAC ID: 0547311508 Enrollment ID: I20090702000265 |
| Provider Name | Karen M Wessendorf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760592711 PECOS PAC ID: 3678625324 Enrollment ID: I20090710000331 |
| Provider Name | Hunter G Brumblay |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1881716959 PECOS PAC ID: 0840342267 Enrollment ID: I20090716000195 |
| Provider Name | Venu Gourineni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154473635 PECOS PAC ID: 8628120797 Enrollment ID: I20090721000361 |
| Provider Name | Brian N Dishinger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982727426 PECOS PAC ID: 6800949330 Enrollment ID: I20090731000392 |
| Provider Name | Lokesh K Kebbehundi Marigowda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174730188 PECOS PAC ID: 6406900521 Enrollment ID: I20090824000492 |
| Provider Name | Gretchen G Barnas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013124114 PECOS PAC ID: 3971659004 Enrollment ID: I20090915000451 |
| Provider Name | Gene C Yu |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1255354262 PECOS PAC ID: 8224184502 Enrollment ID: I20090929000337 |
| Provider Name | Ibrahim H Abou Daya |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790950715 PECOS PAC ID: 8022154921 Enrollment ID: I20091007000179 |
| Provider Name | Steven Konicki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164512034 PECOS PAC ID: 6103841747 Enrollment ID: I20091009000183 |
| Provider Name | Jennifer L Frink |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306067434 PECOS PAC ID: 6305983032 Enrollment ID: I20091028000522 |
| Provider Name | Mary Ellen Yealin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164534582 PECOS PAC ID: 2365580172 Enrollment ID: I20091117000147 |
| Provider Name | Yon Y Graham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750497335 PECOS PAC ID: 9436291267 Enrollment ID: I20100116000300 |
| Provider Name | Michael T Ku |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497862650 PECOS PAC ID: 2860534690 Enrollment ID: I20100116000339 |
| Provider Name | Al J Pinon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669580981 PECOS PAC ID: 5294877031 Enrollment ID: I20100116000370 |
| Provider Name | Mary E Slater |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760590657 PECOS PAC ID: 6406840008 Enrollment ID: I20100116000390 |
| Provider Name | Lawrence A Ulmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174618052 PECOS PAC ID: 2365584109 Enrollment ID: I20100116000405 |
| Provider Name | Larry E Wile |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679683635 PECOS PAC ID: 3072655810 Enrollment ID: I20100116000416 |
| Provider Name | Stephen Louis Peck |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1124127162 PECOS PAC ID: 2062445349 Enrollment ID: I20100126000067 |
| Provider Name | Kimberly A Kendall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962737288 PECOS PAC ID: 3577606557 Enrollment ID: I20100130000385 |
| Provider Name | Keyur N Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770543803 PECOS PAC ID: 8022152628 Enrollment ID: I20100220000107 |
| Provider Name | Alexandra G Oprescu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902914385 PECOS PAC ID: 1355485582 Enrollment ID: I20100225000407 |
| Provider Name | Timothy S Gatz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689780231 PECOS PAC ID: 1658416243 Enrollment ID: I20100308000226 |
| Provider Name | Constance A Mumford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134236979 PECOS PAC ID: 4082759675 Enrollment ID: I20100308000244 |
| Provider Name | Montie R Gould |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184666331 PECOS PAC ID: 6709785462 Enrollment ID: I20100315000790 |
| Provider Name | Michael F Chen |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1215904305 PECOS PAC ID: 7113054024 Enrollment ID: I20100426000289 |
| Provider Name | Amber Darey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134199698 PECOS PAC ID: 9537297544 Enrollment ID: I20100512001029 |
| Provider Name | Amanda Rose Henry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548464035 PECOS PAC ID: 4880723493 Enrollment ID: I20100519000938 |
| Provider Name | Kurt Helgerson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457388449 PECOS PAC ID: 1658400684 Enrollment ID: I20100528000638 |
| Provider Name | Stacey E Watson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003926049 PECOS PAC ID: 4587794342 Enrollment ID: I20100604001163 |
| Provider Name | David E Martin |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1750346888 PECOS PAC ID: 7517943590 Enrollment ID: I20100610000509 |
| Provider Name | Peter A Newhouse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932299781 PECOS PAC ID: 7214067149 Enrollment ID: I20100618000759 |
| Provider Name | Kevin L Beyer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013970383 PECOS PAC ID: 1254350895 Enrollment ID: I20100715000801 |
| Provider Name | Aijaz H Turk |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689636367 PECOS PAC ID: 5395657704 Enrollment ID: I20100720000926 |
| Provider Name | Brij M Dewan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194787861 PECOS PAC ID: 5799697108 Enrollment ID: I20100720000998 |
| Provider Name | Jill Winkler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962463141 PECOS PAC ID: 3577511815 Enrollment ID: I20100816001021 |
| Provider Name | David C Brown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578524179 PECOS PAC ID: 6305894643 Enrollment ID: I20100817000335 |
| Provider Name | Laurence Weber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992766430 PECOS PAC ID: 1850349192 Enrollment ID: I20100817000544 |
| Provider Name | Michael Dandois |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114988359 PECOS PAC ID: 4587612825 Enrollment ID: I20100817000677 |
| Provider Name | Gabriella Palmitessa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053372219 PECOS PAC ID: 2961536644 Enrollment ID: I20100817000739 |
| Provider Name | Emily G Kane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578765806 PECOS PAC ID: 5991997827 Enrollment ID: I20101008001216 |
| Provider Name | Deborah R Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154639748 PECOS PAC ID: 9537351176 Enrollment ID: I20101014000300 |
| Provider Name | Benjamin D Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144317728 PECOS PAC ID: 8224043708 Enrollment ID: I20101101001478 |
| Provider Name | Roderick V Dizon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689785495 PECOS PAC ID: 9739270307 Enrollment ID: I20101102000166 |
| Provider Name | Niaz Mohammad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437352689 PECOS PAC ID: 8224222450 Enrollment ID: I20101102000653 |
| Provider Name | Letizia A Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114085487 PECOS PAC ID: 8123215852 Enrollment ID: I20101207001300 |
| Provider Name | Dennis S Vanwormer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336129568 PECOS PAC ID: 2860689973 Enrollment ID: I20101214001305 |
| Provider Name | Frank S Saltiel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1215976543 PECOS PAC ID: 4880506500 Enrollment ID: I20101228000656 |
| Provider Name | Donald Charles Doyle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427164854 PECOS PAC ID: 2163611070 Enrollment ID: I20110107000530 |
| Provider Name | Trina R Boyles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558677120 PECOS PAC ID: 8820277692 Enrollment ID: I20110125001204 |
| Provider Name | Larry J Diaz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952301038 PECOS PAC ID: 1658351671 Enrollment ID: I20110203000547 |
| Provider Name | Rodabeh H Mirian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942489026 PECOS PAC ID: 7810178431 Enrollment ID: I20110301001047 |
| Provider Name | Kaitlin T Chappell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518267137 PECOS PAC ID: 1759563117 Enrollment ID: I20110308000045 |
| Provider Name | Hassan Issa |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1720278708 PECOS PAC ID: 9032241625 Enrollment ID: I20110707000476 |
| Provider Name | Kerri J Heerspink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902185358 PECOS PAC ID: 1254502750 Enrollment ID: I20110913000639 |
| Provider Name | Vessela Giger-mateeva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487896254 PECOS PAC ID: 4789855776 Enrollment ID: I20110923000201 |
| Provider Name | Lyndsey M Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508140625 PECOS PAC ID: 2567634462 Enrollment ID: I20111019000725 |
| Provider Name | Maria House |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1023002151 PECOS PAC ID: 7618868456 Enrollment ID: I20111102000187 |
| Provider Name | Linda E Kline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730465584 PECOS PAC ID: 8527232388 Enrollment ID: I20111114000672 |
| Provider Name | Robert Raymond Gerl |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831169861 PECOS PAC ID: 9436167384 Enrollment ID: I20120202000609 |
| Provider Name | Jennifer Lynn Dear |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609864164 PECOS PAC ID: 0749293595 Enrollment ID: I20120203000262 |
| Provider Name | Beverly R Deblecourt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144591629 PECOS PAC ID: 8426216730 Enrollment ID: I20120215000940 |
| Provider Name | Nicole L Wolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982979712 PECOS PAC ID: 7416117320 Enrollment ID: I20120330000475 |
| Provider Name | Kelly Noel Becker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629355813 PECOS PAC ID: 3375703002 Enrollment ID: I20120404000335 |
| Provider Name | Pamela M Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669744660 PECOS PAC ID: 5193986099 Enrollment ID: I20120420000353 |
| Provider Name | Susan L Mastenbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205194248 PECOS PAC ID: 3476715376 Enrollment ID: I20120509000543 |
| Provider Name | Jerry W Pratt |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1639145634 PECOS PAC ID: 4688749179 Enrollment ID: I20120727000416 |
| Provider Name | Eriks A Lusis |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1093812349 PECOS PAC ID: 5092971598 Enrollment ID: I20120727000686 |
| Provider Name | Cameron J Vanlaningham |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427251214 PECOS PAC ID: 7517123029 Enrollment ID: I20120727000719 |
| Provider Name | Anthony Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801060397 PECOS PAC ID: 7416104583 Enrollment ID: I20120823000912 |
| Provider Name | Jonathan Dargo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760649594 PECOS PAC ID: 4385891431 Enrollment ID: I20120824000838 |
| Provider Name | Joanna M Olewicz |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790954097 PECOS PAC ID: 4981890217 Enrollment ID: I20120926000407 |
| Provider Name | Michael T Shook |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912290875 PECOS PAC ID: 7618126962 Enrollment ID: I20121002000744 |
| Provider Name | Iqbal Hussain |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467655621 PECOS PAC ID: 6709035702 Enrollment ID: I20121008000551 |
| Provider Name | Rebecca A Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144510777 PECOS PAC ID: 7517119001 Enrollment ID: I20121207000374 |
| Provider Name | Bhumit P Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144457722 PECOS PAC ID: 1557527157 Enrollment ID: I20121219000302 |
| Provider Name | Gamal Mostafa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245261031 PECOS PAC ID: 9234115981 Enrollment ID: I20130206000213 |
| Provider Name | Sue Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780934810 PECOS PAC ID: 9537305917 Enrollment ID: I20130410000392 |
| Provider Name | Kevin F Dedoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154662443 PECOS PAC ID: 7315183043 Enrollment ID: I20130424000802 |
| Provider Name | William S Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659581270 PECOS PAC ID: 0446498893 Enrollment ID: I20130524000599 |
| Provider Name | Craig P Greenberg |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1326154329 PECOS PAC ID: 5799773701 Enrollment ID: I20130708000071 |
| Provider Name | Sophie Dojacques |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669406542 PECOS PAC ID: 2961477229 Enrollment ID: I20130717000755 |
| Provider Name | Kenneth D Kreitel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750503181 PECOS PAC ID: 2961644265 Enrollment ID: I20130816000133 |
| Provider Name | Duncan R Chapman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437474152 PECOS PAC ID: 9234372475 Enrollment ID: I20130906000833 |
| Provider Name | David A Perez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346551082 PECOS PAC ID: 8325285315 Enrollment ID: I20130911000097 |
| Provider Name | Carey S Hill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821017161 PECOS PAC ID: 0840376224 Enrollment ID: I20130924000482 |
| Provider Name | William J Curtiss |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558569236 PECOS PAC ID: 3173767688 Enrollment ID: I20130924000654 |
| Provider Name | Armand B Tanase |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1154594356 PECOS PAC ID: 2860565629 Enrollment ID: I20131022001254 |
| Provider Name | Tracy L Bradstreet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518390681 PECOS PAC ID: 7416182670 Enrollment ID: I20131024001846 |
| Provider Name | Saadat Abbasi |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1912005596 PECOS PAC ID: 4284861378 Enrollment ID: I20131217000931 |
| Provider Name | Stephanie J French |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578992335 PECOS PAC ID: 7719115732 Enrollment ID: I20140118000310 |
| Provider Name | David Tsai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528377975 PECOS PAC ID: 6608005301 Enrollment ID: I20140129000252 |
| Provider Name | Raymond S Majkrzak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336213669 PECOS PAC ID: 4486748456 Enrollment ID: I20140219001952 |
| Provider Name | James H Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982974143 PECOS PAC ID: 0840453601 Enrollment ID: I20140324001392 |
| Provider Name | Saadia K Rahman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811005184 PECOS PAC ID: 4486885050 Enrollment ID: I20140324001965 |
| Provider Name | Raigan Burkall Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205097227 PECOS PAC ID: 3779740295 Enrollment ID: I20140509000576 |
| Provider Name | Shah-naz Khan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1063615904 PECOS PAC ID: 1254499809 Enrollment ID: I20140529000839 |
| Provider Name | Akintayo R Sokunbi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1164694337 PECOS PAC ID: 7113085507 Enrollment ID: I20140612000455 |
| Provider Name | James R Jastifer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821257957 PECOS PAC ID: 0446491963 Enrollment ID: I20140702002577 |
| Provider Name | Davi Ponte De Sa Leitao |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1407084064 PECOS PAC ID: 9133344070 Enrollment ID: I20140708002347 |
| Provider Name | Jessica D Segedy White |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114213154 PECOS PAC ID: 5092945493 Enrollment ID: I20140710000771 |
| Provider Name | Ashley E Diehl |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316230865 PECOS PAC ID: 1052541000 Enrollment ID: I20140714000437 |
| Provider Name | Rebecca A Runge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235421223 PECOS PAC ID: 5294950994 Enrollment ID: I20140715000154 |
| Provider Name | Nishani D Samaraweera |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841483567 PECOS PAC ID: 4789845892 Enrollment ID: I20140804000862 |
| Provider Name | David Harold Pyatt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194034918 PECOS PAC ID: 7214154400 Enrollment ID: I20140812001404 |
| Provider Name | Gurkaran Singh Garcha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659667574 PECOS PAC ID: 7315164456 Enrollment ID: I20140813000774 |
| Provider Name | Corey A Shack |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1588904254 PECOS PAC ID: 5193942902 Enrollment ID: I20140818002323 |
| Provider Name | Evan H Pelc |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811286966 PECOS PAC ID: 8022236686 Enrollment ID: I20140825000869 |
| Provider Name | Mamoun Abdoh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1982868196 PECOS PAC ID: 7416175799 Enrollment ID: I20140828000610 |
| Provider Name | Polly Anne Syc-vega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851708903 PECOS PAC ID: 8527287861 Enrollment ID: I20140918000101 |
| Provider Name | Robin L Webb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851316236 PECOS PAC ID: 9537061973 Enrollment ID: I20140923000910 |
| Provider Name | Seth B Langsam |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225321797 PECOS PAC ID: 2769602424 Enrollment ID: I20140930002287 |
| Provider Name | Elizabeth M Kluka |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1295917946 PECOS PAC ID: 3678742574 Enrollment ID: I20141009002578 |
| Provider Name | Nidhi Mishra |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1962663674 PECOS PAC ID: 4688805401 Enrollment ID: I20141111000940 |
| Provider Name | Muhammad K Hameed |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1851556062 PECOS PAC ID: 9638333065 Enrollment ID: I20141126001738 |
| Provider Name | Megan Lomonaco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205231446 PECOS PAC ID: 5890019764 Enrollment ID: I20150123002079 |
| Provider Name | Julie M Eilenberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639567738 PECOS PAC ID: 9638497043 Enrollment ID: I20150415001763 |
| Provider Name | Laura R Mandrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972996122 PECOS PAC ID: 4486973757 Enrollment ID: I20150507002413 |
| Provider Name | Joshua R Bradish |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1861712994 PECOS PAC ID: 9931429057 Enrollment ID: I20150513001197 |
| Provider Name | Darcy Dornbos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023403458 PECOS PAC ID: 2365753134 Enrollment ID: I20150619001288 |
| Provider Name | Quratulain Chaudhry |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1982917282 PECOS PAC ID: 9032343082 Enrollment ID: I20150622000211 |
| Provider Name | Paul J Simpson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043530942 PECOS PAC ID: 4486887460 Enrollment ID: I20150707000146 |
| Provider Name | Alain R Elian |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871750844 PECOS PAC ID: 9335379502 Enrollment ID: I20150708000678 |
| Provider Name | Min Luo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962663906 PECOS PAC ID: 1456543644 Enrollment ID: I20150708001495 |
| Provider Name | Adnan Kassier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144575283 PECOS PAC ID: 7719118116 Enrollment ID: I20150720000145 |
| Provider Name | Timothy K Schubert |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124388822 PECOS PAC ID: 8820229255 Enrollment ID: I20150722003490 |
| Provider Name | Mary Ibe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326168188 PECOS PAC ID: 5092028670 Enrollment ID: I20150727000424 |
| Provider Name | Jagadeesh K Kalavakunta |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1457510505 PECOS PAC ID: 5294049367 Enrollment ID: I20150803001316 |
| Provider Name | Bridgit Bell |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1063525426 PECOS PAC ID: 2264482868 Enrollment ID: I20150929003391 |
| Provider Name | Trisha L Farrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275508632 PECOS PAC ID: 4880902592 Enrollment ID: I20150930000476 |
| Provider Name | Silviu Alexandru Locovei |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1679734271 PECOS PAC ID: 0345414405 Enrollment ID: I20150930002715 |
| Provider Name | Susan S Pattison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417098021 PECOS PAC ID: 5991013286 Enrollment ID: I20151007000226 |
| Provider Name | Keith Kenter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1982662474 PECOS PAC ID: 9335264100 Enrollment ID: I20151007002516 |
| Provider Name | Robert J Rosenblatt |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1649259052 PECOS PAC ID: 9830003961 Enrollment ID: I20151105001216 |
| Provider Name | Richard T Nguyen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023185030 PECOS PAC ID: 7719087063 Enrollment ID: I20151106000243 |
| Provider Name | Julie Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467824284 PECOS PAC ID: 7911217468 Enrollment ID: I20151112001379 |
| Provider Name | Patrick O Mccormick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700256625 PECOS PAC ID: 4789994112 Enrollment ID: I20151113001737 |
| Provider Name | Mary J Fillmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821316837 PECOS PAC ID: 5890956577 Enrollment ID: I20151215002041 |
| Provider Name | Jamie M Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992084222 PECOS PAC ID: 1850539529 Enrollment ID: I20160127002345 |
| Provider Name | Amanda A Wehner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356709919 PECOS PAC ID: 6204134463 Enrollment ID: I20160421000604 |
| Provider Name | Hemasri Tokala |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1053630749 PECOS PAC ID: 1153612379 Enrollment ID: I20160620000771 |
| Provider Name | Deepthi T Rao |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1215167838 PECOS PAC ID: 3779803010 Enrollment ID: I20160719001407 |
| Provider Name | Amanda R Richhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275985400 PECOS PAC ID: 3476847559 Enrollment ID: I20160812000149 |
| Provider Name | Julia A Kaseman |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1679884381 PECOS PAC ID: 2567617137 Enrollment ID: I20160812000338 |
| Provider Name | Stephanie D Markle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992937403 PECOS PAC ID: 9931326196 Enrollment ID: I20160818000182 |
| Provider Name | Joseph Weistroffer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780656678 PECOS PAC ID: 2860550902 Enrollment ID: I20160902001363 |
| Provider Name | Dennis M Steward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093260762 PECOS PAC ID: 9234427329 Enrollment ID: I20161005000495 |
| Provider Name | Jennifer Lynn Zachary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336692532 PECOS PAC ID: 3072891514 Enrollment ID: I20161103000832 |
| Provider Name | Debra A Taubel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407801160 PECOS PAC ID: 7214929892 Enrollment ID: I20161123001863 |
| Provider Name | Arlene R Word-white |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114142437 PECOS PAC ID: 0042493678 Enrollment ID: I20161129002281 |
| Provider Name | Amanda R Ezekiel |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1437606670 PECOS PAC ID: 0547540569 Enrollment ID: I20161209000718 |
| Provider Name | Kelley Christine Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013468107 PECOS PAC ID: 9436430477 Enrollment ID: I20170105000263 |
| Provider Name | Thomas J Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548703481 PECOS PAC ID: 3274814249 Enrollment ID: I20170105001394 |
| Provider Name | Richard A Semones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356606933 PECOS PAC ID: 5193956548 Enrollment ID: I20170127001666 |
| Provider Name | Renee Janisse |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679017099 PECOS PAC ID: 5890078695 Enrollment ID: I20170201001014 |
| Provider Name | Cynthia A De Meester |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558476168 PECOS PAC ID: 4486656501 Enrollment ID: I20170214001554 |
| Provider Name | Kelly J Pasch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245782804 PECOS PAC ID: 2365726254 Enrollment ID: I20170221000325 |
| Provider Name | Darius Dewitt Hollings |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1194971945 PECOS PAC ID: 7810181294 Enrollment ID: I20170425000707 |
| Provider Name | Christine E Wine |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851767503 PECOS PAC ID: 0941587687 Enrollment ID: I20170504002489 |
| Provider Name | Katheryn E Clark |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1417489931 PECOS PAC ID: 1557648995 Enrollment ID: I20170511002198 |
| Provider Name | Holly Tuyls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700321841 PECOS PAC ID: 6608144035 Enrollment ID: I20170607003026 |
| Provider Name | Michael L Adix |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1134361215 PECOS PAC ID: 9032487897 Enrollment ID: I20170620000951 |
| Provider Name | David Steiger |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1013114487 PECOS PAC ID: 1951566025 Enrollment ID: I20170621002744 |
| Provider Name | Amanda J Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912433582 PECOS PAC ID: 2769750314 Enrollment ID: I20170622002222 |
| Provider Name | Paul J Rohr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477080844 PECOS PAC ID: 9739458670 Enrollment ID: I20170707002321 |
| Provider Name | Jose Ricardo F Po |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073743118 PECOS PAC ID: 9931497666 Enrollment ID: I20170710002439 |
| Provider Name | Alexander J Witte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932512779 PECOS PAC ID: 4688890817 Enrollment ID: I20170710002626 |
| Provider Name | Andrew Geeslin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891088332 PECOS PAC ID: 1153551957 Enrollment ID: I20170726000847 |
| Provider Name | Sarah E Charters |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497041479 PECOS PAC ID: 2769610922 Enrollment ID: I20170731000635 |
| Provider Name | Elise Simpson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972949220 PECOS PAC ID: 9739481417 Enrollment ID: I20170731000701 |
| Provider Name | Ahna C Falzon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962922732 PECOS PAC ID: 1153692918 Enrollment ID: I20170814000109 |
| Provider Name | David L Mayor |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1407135189 PECOS PAC ID: 7113230764 Enrollment ID: I20170814001435 |
| Provider Name | Mary B Avendt-reeber |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891081972 PECOS PAC ID: 6204139264 Enrollment ID: I20170818002666 |
| Provider Name | Yolanda H Cobley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053836650 PECOS PAC ID: 6901179761 Enrollment ID: I20170830002737 |
| Provider Name | Kali Barrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982125746 PECOS PAC ID: 3577836220 Enrollment ID: I20170831002691 |
| Provider Name | Renee Kristine Birchmeier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780104182 PECOS PAC ID: 3072886399 Enrollment ID: I20170908001434 |
| Provider Name | Richard A Finedell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144746637 PECOS PAC ID: 2365716776 Enrollment ID: I20170925001090 |
| Provider Name | Robert G. Sawyer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699806836 PECOS PAC ID: 0042228702 Enrollment ID: I20170927003627 |
| Provider Name | Melinda Vandyke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952820235 PECOS PAC ID: 8820354319 Enrollment ID: I20171116001804 |
| Provider Name | Elizabeth N Amaya |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1881105385 PECOS PAC ID: 7911265699 Enrollment ID: I20180102000234 |
| Provider Name | Adam C Quiring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760900823 PECOS PAC ID: 7810255593 Enrollment ID: I20180102000261 |
| Provider Name | Estavanica B Ries |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801303904 PECOS PAC ID: 8224399357 Enrollment ID: I20180306000204 |
| Provider Name | Iman Essam Mohamed |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1942297270 PECOS PAC ID: 4284529140 Enrollment ID: I20180320003290 |
| Provider Name | Heather M Simon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790285534 PECOS PAC ID: 6608139092 Enrollment ID: I20180418000132 |
| Provider Name | Aleyda C Elliott |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1245737212 PECOS PAC ID: 0941565741 Enrollment ID: I20180529000397 |
| Provider Name | Kimberly R Meles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902031057 PECOS PAC ID: 0648535203 Enrollment ID: I20180531001637 |
| Provider Name | Jason T Ryan |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1093035008 PECOS PAC ID: 9436389467 Enrollment ID: I20180621000382 |
| Provider Name | Jasmeen Gill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477937589 PECOS PAC ID: 8820344880 Enrollment ID: I20180705000279 |
| Provider Name | Stuart Alan Stein |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093797037 PECOS PAC ID: 0749179406 Enrollment ID: I20180710002201 |
| Provider Name | Francisco B Rodriguez |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1063434504 PECOS PAC ID: 3678543394 Enrollment ID: I20180710002907 |
| Provider Name | Lisa M Mcintosh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407941578 PECOS PAC ID: 6305941915 Enrollment ID: I20180717001373 |
| Provider Name | Jawwad Yusuf |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548425622 PECOS PAC ID: 0345473534 Enrollment ID: I20180731002629 |
| Provider Name | Sourabh Aggarwal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154677417 PECOS PAC ID: 1153552351 Enrollment ID: I20180731002643 |
| Provider Name | Alok Dash |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1598974826 PECOS PAC ID: 0042451577 Enrollment ID: I20180802003332 |
| Provider Name | Brianna L Shipp |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1366933780 PECOS PAC ID: 9032467261 Enrollment ID: I20180806000198 |
| Provider Name | Wendy Wildern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164917787 PECOS PAC ID: 6800144627 Enrollment ID: I20180809004946 |
| Provider Name | Ryan A Jamoua |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255695987 PECOS PAC ID: 5395094957 Enrollment ID: I20180815003307 |
| Provider Name | Brandon James Hooks |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720346620 PECOS PAC ID: 7719207380 Enrollment ID: I20180822003080 |
| Provider Name | Jamie K Nevins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386141018 PECOS PAC ID: 6800145897 Enrollment ID: I20180824000833 |
| Provider Name | Nicholas Miladore |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1588925119 PECOS PAC ID: 8325278237 Enrollment ID: I20180824001314 |
| Provider Name | Craig J Raberding |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1831455484 PECOS PAC ID: 4587968847 Enrollment ID: I20180828000166 |
| Provider Name | Samantha Luci Leonard-ndomb |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689016354 PECOS PAC ID: 7517183452 Enrollment ID: I20180907000622 |
| Provider Name | Desmond A Jackson |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1043650765 PECOS PAC ID: 2961755947 Enrollment ID: I20181020000093 |
| Provider Name | Nicholas D Badgley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366921520 PECOS PAC ID: 4880947498 Enrollment ID: I20181030000220 |
| Provider Name | Alta Deroo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184791725 PECOS PAC ID: 7618150152 Enrollment ID: I20181030001328 |
| Provider Name | Jayeson Varghese Philip |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679927602 PECOS PAC ID: 8022352376 Enrollment ID: I20181128000276 |
| Provider Name | Angela K Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063995173 PECOS PAC ID: 3375887797 Enrollment ID: I20181211002912 |
| Provider Name | Christie M Graziano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073088357 PECOS PAC ID: 4688919368 Enrollment ID: I20181227002371 |
| Provider Name | Jordan T Wroblewski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144648551 PECOS PAC ID: 6709122765 Enrollment ID: I20190111000980 |
| Provider Name | Olga Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780047274 PECOS PAC ID: 9032482245 Enrollment ID: I20190211001977 |
| Provider Name | Christina M Lawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417422700 PECOS PAC ID: 5799023057 Enrollment ID: I20190212000331 |
| Provider Name | April Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386157915 PECOS PAC ID: 4587903224 Enrollment ID: I20190225001987 |
| Provider Name | Vicky F Mikowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851863617 PECOS PAC ID: 5496094427 Enrollment ID: I20190308000757 |
| Provider Name | Jerald M Mefferd |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356737985 PECOS PAC ID: 0244546547 Enrollment ID: I20190401002362 |
| Provider Name | Jill Howey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750598843 PECOS PAC ID: 8921131905 Enrollment ID: I20190405000796 |
| Provider Name | Charisse D Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134399025 PECOS PAC ID: 2860516440 Enrollment ID: I20190417002005 |
| Provider Name | Pauline M Rocha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275090508 PECOS PAC ID: 7911249123 Enrollment ID: I20190508001044 |
| Provider Name | Heather S Cook-sinden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154886919 PECOS PAC ID: 4082957279 Enrollment ID: I20190509001129 |
| Provider Name | Lisa Lobel |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1245494699 PECOS PAC ID: 9335472620 Enrollment ID: I20190530002369 |
| Provider Name | Maria E Dimusto-poortenga |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013940980 PECOS PAC ID: 4486987229 Enrollment ID: I20190610001554 |
| Provider Name | Emily A Mitchell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043537020 PECOS PAC ID: 0941519185 Enrollment ID: I20190626000574 |
| Provider Name | Mandeep S Randhawa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255562138 PECOS PAC ID: 3173783214 Enrollment ID: I20190703002789 |
| Provider Name | Cristopher Jonathan Kaps |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124413034 PECOS PAC ID: 0547562282 Enrollment ID: I20190801003526 |
| Provider Name | Julia Miladore |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386910263 PECOS PAC ID: 2264658111 Enrollment ID: I20190816002354 |
| Provider Name | Monica J Mann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952550329 PECOS PAC ID: 2062714207 Enrollment ID: I20190820000144 |
| Provider Name | Morgan Aleman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1326603424 PECOS PAC ID: 3779811286 Enrollment ID: I20190821004902 |
| Provider Name | Sarah L Spencer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295129633 PECOS PAC ID: 3971818303 Enrollment ID: I20190827000178 |
| Provider Name | Toni M Fedyski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205499902 PECOS PAC ID: 5597093799 Enrollment ID: I20190827000236 |
| Provider Name | Ambrose Soler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710915525 PECOS PAC ID: 2466713201 Enrollment ID: I20190909001774 |
| Provider Name | Christina Kemple-wascher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144880881 PECOS PAC ID: 4284066150 Enrollment ID: I20191114000691 |
| Provider Name | Marcus D Fazzari |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275067480 PECOS PAC ID: 8022389477 Enrollment ID: I20191120000957 |
| Provider Name | Taj Sahni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457900292 PECOS PAC ID: 6103259106 Enrollment ID: I20191205000932 |
| Provider Name | Amanda Maureen Rubley |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1952968307 PECOS PAC ID: 8729412010 Enrollment ID: I20191219000248 |
| Provider Name | Emily M Geldersma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528615630 PECOS PAC ID: 6305270265 Enrollment ID: I20191231000668 |
| Provider Name | Laurie A Townsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487204020 PECOS PAC ID: 6901112101 Enrollment ID: I20200121002403 |
| Provider Name | Brigette L Mast |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669932943 PECOS PAC ID: 4486089364 Enrollment ID: I20200123000445 |
| Provider Name | Albert Tang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689022253 PECOS PAC ID: 0840578613 Enrollment ID: I20200127001058 |
| Provider Name | Allison Elizabeth Davenport |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871943969 PECOS PAC ID: 4789977604 Enrollment ID: I20200130001898 |
| Provider Name | Zulfiqar Ali Qutrio Baloch |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982085106 PECOS PAC ID: 7911288832 Enrollment ID: I20200221000438 |
| Provider Name | Eric R Dejong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629619903 PECOS PAC ID: 1052748001 Enrollment ID: I20200304000066 |
| Provider Name | Jillian R Peyerk |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700370707 PECOS PAC ID: 3072940048 Enrollment ID: I20200304000895 |
| Provider Name | Theresa I Rinehart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881231090 PECOS PAC ID: 6608204235 Enrollment ID: I20200314000224 |
| Provider Name | Ferris Alkazir |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1053757849 PECOS PAC ID: 3476785213 Enrollment ID: I20200319002106 |
| Provider Name | Kelsey Lankford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114551777 PECOS PAC ID: 7618308362 Enrollment ID: I20200512003223 |
| Provider Name | Brandy L Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114551272 PECOS PAC ID: 2668893769 Enrollment ID: I20200527003251 |
| Provider Name | Karen Elizabeth Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669007944 PECOS PAC ID: 7911328026 Enrollment ID: I20200527003358 |
| Provider Name | Misty Rae Ledesma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154959591 PECOS PAC ID: 4587085329 Enrollment ID: I20200602002316 |
| Provider Name | Heather Nicole Merveldt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780221010 PECOS PAC ID: 7113348954 Enrollment ID: I20200602002322 |
| Provider Name | April Klavinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023642683 PECOS PAC ID: 9032530787 Enrollment ID: I20200604000878 |
| Provider Name | Nicole Marie Conway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467098202 PECOS PAC ID: 8426479122 Enrollment ID: I20200604003174 |
| Provider Name | Hussain Aboud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902046246 PECOS PAC ID: 5890965834 Enrollment ID: I20200616003320 |
| Provider Name | Brianne Nicole Deboer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982175741 PECOS PAC ID: 4385067875 Enrollment ID: I20200630002226 |
| Provider Name | Mohiman Saffar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952838138 PECOS PAC ID: 5193093904 Enrollment ID: I20200714002621 |
| Provider Name | Chassity Lee Stoneburgh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467989020 PECOS PAC ID: 9638593023 Enrollment ID: I20200717001522 |
| Provider Name | Dalal G. Kassir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477081685 PECOS PAC ID: 6608144365 Enrollment ID: I20200721003365 |
| Provider Name | James G Schaffhauser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295257558 PECOS PAC ID: 8921422049 Enrollment ID: I20200722002813 |
| Provider Name | Suzanne J Huberty |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154718237 PECOS PAC ID: 1557651692 Enrollment ID: I20200727001850 |
| Provider Name | Michelle Renee Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003441544 PECOS PAC ID: 6800211475 Enrollment ID: I20200730001996 |
| Provider Name | Zhigang Liu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689931693 PECOS PAC ID: 8426362609 Enrollment ID: I20200807000282 |
| Provider Name | Steven Z Lu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598179202 PECOS PAC ID: 4183840432 Enrollment ID: I20200811000781 |
| Provider Name | Sarina Sachdev |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972916278 PECOS PAC ID: 8123382777 Enrollment ID: I20200813000695 |
| Provider Name | Joseph F Prano |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124447347 PECOS PAC ID: 5193045151 Enrollment ID: I20200909001402 |
| Provider Name | Yashwant Agrawal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063850709 PECOS PAC ID: 9133350531 Enrollment ID: I20200928000097 |
| Provider Name | Emmaleigh Madeline Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487812889 PECOS PAC ID: 9537203302 Enrollment ID: I20201002001809 |
| Provider Name | William Charles Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730791484 PECOS PAC ID: 3971923996 Enrollment ID: I20201013002625 |
| Provider Name | Pauline U Boy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952908279 PECOS PAC ID: 0648680876 Enrollment ID: I20201029001189 |
| Provider Name | Jennifer Renee Hudson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184238602 PECOS PAC ID: 8123430899 Enrollment ID: I20201222001666 |
| Provider Name | Elizabeth Stuebing |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992924724 PECOS PAC ID: 6204085921 Enrollment ID: I20210114002963 |
| Provider Name | James Hull |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1548441827 PECOS PAC ID: 9133369556 Enrollment ID: I20210325002697 |
| Provider Name | Shannon Foster |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699755496 PECOS PAC ID: 9931150570 Enrollment ID: I20210511000715 |
| Provider Name | Mahmoud Hassan Kassir |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588154322 PECOS PAC ID: 2769747138 Enrollment ID: I20210616001091 |
| Provider Name | Muhammad A Zulqarnain |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033497888 PECOS PAC ID: 1951529957 Enrollment ID: I20210616002086 |
| Provider Name | Matthew B Shelnutt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053831818 PECOS PAC ID: 3375812134 Enrollment ID: I20210623001147 |
| Provider Name | William J C Palmer |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1710419783 PECOS PAC ID: 3274803267 Enrollment ID: I20210624001216 |
| Provider Name | Kameel Kassab |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760865596 PECOS PAC ID: 3274845888 Enrollment ID: I20210707003200 |
| Provider Name | Keri Kordie |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1093329740 PECOS PAC ID: 0749682888 Enrollment ID: I20210712002171 |
| Provider Name | Joshua Veenstra |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023498177 PECOS PAC ID: 7416262613 Enrollment ID: I20210803000163 |
| Provider Name | Lauren Ashley Hoskins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306418090 PECOS PAC ID: 1557765591 Enrollment ID: I20210812001389 |
| Provider Name | Brock A Hardin |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1639565583 PECOS PAC ID: 6800191354 Enrollment ID: I20210913002165 |
| Provider Name | Lori Kur |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1124611850 PECOS PAC ID: 2769889369 Enrollment ID: I20210924000203 |
| Provider Name | Colin T Fath |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811300817 PECOS PAC ID: 0345466009 Enrollment ID: I20210928002561 |
| Provider Name | Saud Alsubait |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1518341494 PECOS PAC ID: 1557759586 Enrollment ID: I20211025002501 |
| Provider Name | Ronak Soni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871978676 PECOS PAC ID: 2264726678 Enrollment ID: I20211118000711 |
| Provider Name | Alyssa Bethany Grace Tisdale |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1558949677 PECOS PAC ID: 5991196560 Enrollment ID: I20211216000429 |
| Provider Name | Janie Renee Pincumbe-gillaspie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801566385 PECOS PAC ID: 4284026832 Enrollment ID: I20220112000460 |
| Provider Name | Breanna E Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306422365 PECOS PAC ID: 6709278252 Enrollment ID: I20220113002116 |
| Provider Name | Katherine J Alizo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073108601 PECOS PAC ID: 7012309339 Enrollment ID: I20220119000983 |
| Provider Name | Jarrod Scott Brewer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508528217 PECOS PAC ID: 8729471529 Enrollment ID: I20220129000328 |
| Provider Name | Michael Adam Klein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588317432 PECOS PAC ID: 2860885845 Enrollment ID: I20220216000179 |
| Provider Name | Kimberly Lussier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306470729 PECOS PAC ID: 1658767587 Enrollment ID: I20220401001216 |
| Provider Name | Santhosh Koshy |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1124108493 PECOS PAC ID: 2264429539 Enrollment ID: I20220428001546 |
| Provider Name | Alicia Jean Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154982783 PECOS PAC ID: 1355728486 Enrollment ID: I20220511001644 |
| Provider Name | Khalid Najib |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1558626077 PECOS PAC ID: 4981918265 Enrollment ID: I20220601001160 |
| Provider Name | Anthony James-dyer Wilkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770154650 PECOS PAC ID: 3375921422 Enrollment ID: I20220602001296 |
| Provider Name | Raghuram Chava |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1477791390 PECOS PAC ID: 2062690555 Enrollment ID: I20220606000089 |
| Provider Name | Abhinav Sood |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508117888 PECOS PAC ID: 2668788878 Enrollment ID: I20220606001939 |
| Provider Name | Channan Marie Kositzke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831820356 PECOS PAC ID: 9739560145 Enrollment ID: I20220718000193 |
| Provider Name | George P Jolly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427504299 PECOS PAC ID: 4284015512 Enrollment ID: I20220719000430 |
| Provider Name | Laurel Tangalakis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104205921 PECOS PAC ID: 3779881263 Enrollment ID: I20220812002273 |
| Provider Name | Rachel Zito |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1245984749 PECOS PAC ID: 1658754114 Enrollment ID: I20220816001327 |
| Provider Name | Taylor Rimpel |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1144795113 PECOS PAC ID: 8123401585 Enrollment ID: I20220817002116 |
| Provider Name | Rebecca Spalo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003572199 PECOS PAC ID: 7517342306 Enrollment ID: I20220914003025 |
| Provider Name | Elizabeth Vermeulen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1083189278 PECOS PAC ID: 4183091309 Enrollment ID: I20221101001448 |
| Provider Name | Katherine Jennifer Kramer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992009955 PECOS PAC ID: 5193942613 Enrollment ID: I20221220000765 |
| Provider Name | James Koerten |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104870237 PECOS PAC ID: 3870623234 Enrollment ID: I20230109001037 |
| Provider Name | Susan Svientek |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023120227 PECOS PAC ID: 7810073186 Enrollment ID: I20230221000907 |
| Provider Name | Ashley Nicole Armbruster |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053762211 PECOS PAC ID: 8527342153 Enrollment ID: I20230222001435 |
| Provider Name | Christina Gale Robertson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1205560364 PECOS PAC ID: 0749656874 Enrollment ID: I20230301002445 |
| Provider Name | Cheryl J Roberts |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1427100098 PECOS PAC ID: 3971977885 Enrollment ID: I20230316000231 |
| Provider Name | Camie Jean Wisinski |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1033815469 PECOS PAC ID: 6608241096 Enrollment ID: I20230418000369 |
| Provider Name | Tra Pham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073045449 PECOS PAC ID: 6507136793 Enrollment ID: I20230508002409 |
| Provider Name | Fnu Zafrullah |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1255852687 PECOS PAC ID: 9234595307 Enrollment ID: I20230515003101 |
| Provider Name | Ashleigh Nichole Walter |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1982325569 PECOS PAC ID: 2466818513 Enrollment ID: I20230516003345 |
| Provider Name | Lashonda Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255541561 PECOS PAC ID: 6103999198 Enrollment ID: I20230707000210 |
| Provider Name | Ashraf A. Suliman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962852590 PECOS PAC ID: 6305265448 Enrollment ID: I20230824002029 |
| Provider Name | Sarah Elizabeth Strozier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215616032 PECOS PAC ID: 1355704982 Enrollment ID: I20230830002741 |
| Provider Name | Jennifer Klump |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1003199951 PECOS PAC ID: 4880853175 Enrollment ID: I20231003002677 |
| Provider Name | Rachel Saeger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124706676 PECOS PAC ID: 6709234255 Enrollment ID: I20231122001950 |
| Provider Name | Kelli Renee Pound |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356113146 PECOS PAC ID: 7719335579 Enrollment ID: I20231205000717 |
| Provider Name | Stacy Marie Dalrymple |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1134821325 PECOS PAC ID: 7113376153 Enrollment ID: I20231215000990 |
| Provider Name | Paul Schenarts |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124019963 PECOS PAC ID: 4880739408 Enrollment ID: I20240311001681 |
Myndfull Care Michigan Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5930 Lovers Ln Ste L1, Portage, MI 49002 Phone: 855-839-8878 | |
Horizon Health Solutions Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 724 W Centre Ave Ste 105, Portage, MI 49024 Phone: 269-501-1753 | |
Progressive Eyecare Centre Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1612 E. Centre Ave., Portage, MI 49002 Phone: 269-329-1030 Fax: 269-329-0966 | |
James E. Hanlon Md, Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8145 Valleywood Ln, Suite B, Portage, MI 49024 Phone: 269-324-9162 Fax: 269-375-6078 | |
Fidamar Medical Llp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 451 W Milham Ave, Portage, MI 49024 Phone: 269-254-8400 Fax: 269-254-8350 | |
Ascension Medical Group Promed Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7775 Angling Rd, Portage, MI 49024 Phone: 269-324-8670 |