| Aspirus Gilman Clinic | |
|
320 East Main Gilman WI 54433 | |
| (715) 447-8293 | |
| (715) 447-8270 |
| Full Name | Aspirus Gilman Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 320 East Main, Gilman, Wisconsin |
| Authorized Official Name and Position | Lori Peck (SVP- CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7158472575 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspirus Gilman Clinic 135 S Gibson St Medford WI 54451-1622 Ph: (715) 748-8100 | Aspirus Gilman Clinic 320 East Main Gilman WI 54433 Ph: (715) 447-8293 |
| NPI Number | 1285703173 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 02/26/2026 |
| Certification Date | 02/26/2026 |
| Medicare PECOS PAC ID | 5799688602 |
|---|---|
| Medicare Enrollment ID | O20040129000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285703173 | NPI | - | NPPES |
| 21303800 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | () | Secondary |
| 261Q00000X | Clinic/center | () | Secondary |
| 261QR1300X | Clinic/center - Rural Health | () | Primary |
| Provider Name | Diane M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801875364 PECOS PAC ID: 9739087024 Enrollment ID: I20031223000559 |
| Provider Name | Michelle M Roiger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295762896 PECOS PAC ID: 4486555869 Enrollment ID: I20040119000188 |
| Provider Name | Randolph B Waskin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497780134 PECOS PAC ID: 2961390364 Enrollment ID: I20040308000878 |
| Provider Name | Stephen W. Hubbard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366434961 PECOS PAC ID: 6002705811 Enrollment ID: I20040311000344 |
| Provider Name | Joseph R. Lacy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598740599 PECOS PAC ID: 9335039130 Enrollment ID: I20040316001356 |
| Provider Name | Steven B Mccann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932165636 PECOS PAC ID: 9537153382 Enrollment ID: I20040417000245 |
| Provider Name | Susan J Frazier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184606469 PECOS PAC ID: 9032106232 Enrollment ID: I20040518000864 |
| Provider Name | Julie a Rayburn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184654899 PECOS PAC ID: 3678564804 Enrollment ID: I20040518001212 |
| Provider Name | Christopher L Younker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528001716 PECOS PAC ID: 5092706168 Enrollment ID: I20040519000620 |
| Provider Name | Scott J Rotar |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376586099 PECOS PAC ID: 2365433364 Enrollment ID: I20040519000877 |
| Provider Name | Gene E Walker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740207349 PECOS PAC ID: 9234121120 Enrollment ID: I20040525000556 |
| Provider Name | Bryan K Hudson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073600508 PECOS PAC ID: 4587569124 Enrollment ID: I20040616001046 |
| Provider Name | Richard J Mayrer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023047859 PECOS PAC ID: 7810977717 Enrollment ID: I20040721001565 |
| Provider Name | Theodore J Shinners |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902981160 PECOS PAC ID: 9931173598 Enrollment ID: I20040820000643 |
| Provider Name | Pavel Guigauri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801874094 PECOS PAC ID: 5496729683 Enrollment ID: I20040824000133 |
| Provider Name | Cary G Tauchman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891800389 PECOS PAC ID: 7719954197 Enrollment ID: I20040915000028 |
| Provider Name | Mary Elizabeth Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487662060 PECOS PAC ID: 1052210762 Enrollment ID: I20040927000962 |
| Provider Name | Ellyn M Meshel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205875242 PECOS PAC ID: 9335114024 Enrollment ID: I20041008000009 |
| Provider Name | Heather R Gruszynski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386664423 PECOS PAC ID: 3870550890 Enrollment ID: I20041211000006 |
| Provider Name | David D Vanderkin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962407197 PECOS PAC ID: 3779486030 Enrollment ID: I20050106000937 |
| Provider Name | Renee M Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750310900 PECOS PAC ID: 9537117296 Enrollment ID: I20050110000337 |
| Provider Name | German Larrain |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1508845090 PECOS PAC ID: 9638129588 Enrollment ID: I20050127000832 |
| Provider Name | Steven a Hadlock |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497842157 PECOS PAC ID: 8325098056 Enrollment ID: I20050131000092 |
| Provider Name | Cynthia Pangallo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710946132 PECOS PAC ID: 5890746069 Enrollment ID: I20050204000267 |
| Provider Name | David J Sell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902833700 PECOS PAC ID: 9931154515 Enrollment ID: I20050316000709 |
| Provider Name | Thomas R Silbernagel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922097351 PECOS PAC ID: 8426098997 Enrollment ID: I20050504000992 |
| Provider Name | Rebecca Reim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043211766 PECOS PAC ID: 2668416744 Enrollment ID: I20050620000605 |
| Provider Name | Mark T Hoffmann |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1356342034 PECOS PAC ID: 8527966803 Enrollment ID: I20050706000135 |
| Provider Name | Timothy N Logemann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184626053 PECOS PAC ID: 2163320441 Enrollment ID: I20050706000159 |
| Provider Name | Paul a Luetmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689675332 PECOS PAC ID: 9133027410 Enrollment ID: I20050706000179 |
| Provider Name | Christopher Gary Peterson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700897535 PECOS PAC ID: 8820024474 Enrollment ID: I20050714000500 |
| Provider Name | Troy D Sennholz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861410110 PECOS PAC ID: 5395773030 Enrollment ID: I20050803000054 |
| Provider Name | Odessa M Gallett |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1245241272 PECOS PAC ID: 3870522253 Enrollment ID: I20050805000443 |
| Provider Name | Susan O Messerly |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447261706 PECOS PAC ID: 9931139771 Enrollment ID: I20050822000214 |
| Provider Name | Steven R Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861576597 PECOS PAC ID: 1759308034 Enrollment ID: I20051026000496 |
| Provider Name | David E Lange |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255449567 PECOS PAC ID: 6608895909 Enrollment ID: I20051116000340 |
| Provider Name | Marjorie S. Miller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487687604 PECOS PAC ID: 3577583418 Enrollment ID: I20051207000376 |
| Provider Name | Haresh B Modi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780699660 PECOS PAC ID: 3870497480 Enrollment ID: I20060111000418 |
| Provider Name | Bradley J Schwager |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265497598 PECOS PAC ID: 1951315761 Enrollment ID: I20060201000194 |
| Provider Name | Ronald J Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396799615 PECOS PAC ID: 8022026392 Enrollment ID: I20060328000534 |
| Provider Name | Shana M Gliniecki |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730112814 PECOS PAC ID: 0042214470 Enrollment ID: I20060828000072 |
| Provider Name | Lisa C Olson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891724365 PECOS PAC ID: 4688678386 Enrollment ID: I20060912000317 |
| Provider Name | Jennifer S Pantely |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871699132 PECOS PAC ID: 3476550690 Enrollment ID: I20061101000366 |
| Provider Name | Sarah Ann Sewall |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1447215736 PECOS PAC ID: 1153328166 Enrollment ID: I20061106000338 |
| Provider Name | Linda R Frahm |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104881317 PECOS PAC ID: 3779582986 Enrollment ID: I20061218000243 |
| Provider Name | Jody L Wilkins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114989050 PECOS PAC ID: 3375552615 Enrollment ID: I20070604000487 |
| Provider Name | Rebecca L England |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457360869 PECOS PAC ID: 7214035500 Enrollment ID: I20070611000307 |
| Provider Name | Gregory C Tyler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871695452 PECOS PAC ID: 3971603176 Enrollment ID: I20070717000010 |
| Provider Name | Claudio F Nunes |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053445411 PECOS PAC ID: 9537260963 Enrollment ID: I20070728000214 |
| Provider Name | Robyn a Schertz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043410673 PECOS PAC ID: 4688767023 Enrollment ID: I20070830000630 |
| Provider Name | Peter Scott Dahlberg |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750318218 PECOS PAC ID: 4880789205 Enrollment ID: I20071001000383 |
| Provider Name | Peter M Mccool |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306044847 PECOS PAC ID: 3274620133 Enrollment ID: I20071025000076 |
| Provider Name | Michael a Umland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518920578 PECOS PAC ID: 2062593023 Enrollment ID: I20080115000827 |
| Provider Name | Rachel a Dixon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912180555 PECOS PAC ID: 6103907803 Enrollment ID: I20080119000114 |
| Provider Name | Mitchell L Lewis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912956137 PECOS PAC ID: 3870686462 Enrollment ID: I20080222000358 |
| Provider Name | Sean M Cashin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558564203 PECOS PAC ID: 2961588595 Enrollment ID: I20080324000607 |
| Provider Name | Steven John Gasper |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043238405 PECOS PAC ID: 3870667785 Enrollment ID: I20080811000108 |
| Provider Name | Ludmil V Lazarov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285826404 PECOS PAC ID: 1254407729 Enrollment ID: I20080906000160 |
| Provider Name | Reed J Davis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720259112 PECOS PAC ID: 5193892446 Enrollment ID: I20080929000204 |
| Provider Name | Vickie J Woelfel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144337999 PECOS PAC ID: 6103985460 Enrollment ID: I20081101000119 |
| Provider Name | James E Dunn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962446351 PECOS PAC ID: 4284653965 Enrollment ID: I20081202000561 |
| Provider Name | Anthony J Rutkowski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740223445 PECOS PAC ID: 0042374597 Enrollment ID: I20090127000654 |
| Provider Name | Michael P Bellino |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780670950 PECOS PAC ID: 1153224431 Enrollment ID: I20090602000566 |
| Provider Name | Christian Zuver |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194843367 PECOS PAC ID: 5890887830 Enrollment ID: I20090624000126 |
| Provider Name | Brad Rogowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932365947 PECOS PAC ID: 9032272141 Enrollment ID: I20090707000681 |
| Provider Name | Sandip R Ghuge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770727083 PECOS PAC ID: 9537211362 Enrollment ID: I20090709000030 |
| Provider Name | Philip M Bovet |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912118308 PECOS PAC ID: 7810040532 Enrollment ID: I20090728000814 |
| Provider Name | Clint Grant Semrau |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346465739 PECOS PAC ID: 1254484835 Enrollment ID: I20090729000504 |
| Provider Name | Jennifer a Mikulich |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1831128669 PECOS PAC ID: 2163575283 Enrollment ID: I20090806000244 |
| Provider Name | Pamela S Rahmer |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134350754 PECOS PAC ID: 3375689839 Enrollment ID: I20091014000213 |
| Provider Name | Michael D Repplinger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154521425 PECOS PAC ID: 5294872693 Enrollment ID: I20091016000136 |
| Provider Name | Michael D Polka |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144242223 PECOS PAC ID: 3072654425 Enrollment ID: I20100106000782 |
| Provider Name | Amit Aneja |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487891560 PECOS PAC ID: 7012059843 Enrollment ID: I20100116000250 |
| Provider Name | Thomas a Koepke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912068982 PECOS PAC ID: 6901794817 Enrollment ID: I20100202000500 |
| Provider Name | Jonathan Currie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477743649 PECOS PAC ID: 1557406279 Enrollment ID: I20100305000685 |
| Provider Name | Katharine D Van Fossen |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1356316483 PECOS PAC ID: 5698854180 Enrollment ID: I20100421000892 |
| Provider Name | Jonathan T Ketzler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275509754 PECOS PAC ID: 3375672397 Enrollment ID: I20100528000524 |
| Provider Name | James E Svenson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700847183 PECOS PAC ID: 5698805455 Enrollment ID: I20100604001133 |
| Provider Name | Matthew P Doering |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255439543 PECOS PAC ID: 9234269481 Enrollment ID: I20100614000875 |
| Provider Name | Susan M Schneider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447264098 PECOS PAC ID: 3577644970 Enrollment ID: I20100618000833 |
| Provider Name | Michael C Walters |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063473973 PECOS PAC ID: 1456482017 Enrollment ID: I20100625000120 |
| Provider Name | Mary M Schultz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265414676 PECOS PAC ID: 6305977430 Enrollment ID: I20100706000347 |
| Provider Name | Anwar Hamami |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962405019 PECOS PAC ID: 4284537093 Enrollment ID: I20100713000080 |
| Provider Name | Ngozi Jacqueline Ekwueme |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548271984 PECOS PAC ID: 6800928201 Enrollment ID: I20100721000282 |
| Provider Name | Kevin E Rist |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1497734750 PECOS PAC ID: 7618864075 Enrollment ID: I20100724000181 |
| Provider Name | Fushen Xu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1376513036 PECOS PAC ID: 6608873617 Enrollment ID: I20100914001138 |
| Provider Name | Tracy L Cousins |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1679543383 PECOS PAC ID: 7517964521 Enrollment ID: I20100916000531 |
| Provider Name | Laura M Sova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891707881 PECOS PAC ID: 2860517331 Enrollment ID: I20100921000804 |
| Provider Name | Dennis Mcfadden |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184758237 PECOS PAC ID: 2961580717 Enrollment ID: I20101004000991 |
| Provider Name | Roberta L Herrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386958676 PECOS PAC ID: 9638188824 Enrollment ID: I20101008001275 |
| Provider Name | Jaren G Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164645164 PECOS PAC ID: 2567654106 Enrollment ID: I20101014000263 |
| Provider Name | Duwayne L Shelley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760798151 PECOS PAC ID: 2062605744 Enrollment ID: I20101026001134 |
| Provider Name | Andrew Mykytsey |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1750547378 PECOS PAC ID: 0648465310 Enrollment ID: I20101109000220 |
| Provider Name | Kurt J Dekiep |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114058294 PECOS PAC ID: 6709830490 Enrollment ID: I20101117001128 |
| Provider Name | Jonathan Parisi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659455970 PECOS PAC ID: 3971790981 Enrollment ID: I20101202001153 |
| Provider Name | Tina M Schulist |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689994196 PECOS PAC ID: 1355539578 Enrollment ID: I20110103000417 |
| Provider Name | Scott L Gradberg |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528152287 PECOS PAC ID: 0345439410 Enrollment ID: I20110105001189 |
| Provider Name | Sammy U Rehman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558372706 PECOS PAC ID: 7315904661 Enrollment ID: I20110112000028 |
| Provider Name | Jeffrey a Klein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174796478 PECOS PAC ID: 8224212469 Enrollment ID: I20110412000708 |
| Provider Name | John P Jarocki |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972525368 PECOS PAC ID: 7315078623 Enrollment ID: I20110526000790 |
| Provider Name | Ganesh L Pawar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568623999 PECOS PAC ID: 0042406753 Enrollment ID: I20110623000696 |
| Provider Name | Steven P Phillipson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023034105 PECOS PAC ID: 0345141313 Enrollment ID: I20110923000055 |
| Provider Name | Michael E Traktman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356325740 PECOS PAC ID: 6406820513 Enrollment ID: I20111004000296 |
| Provider Name | Nikki a Bonitz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396026266 PECOS PAC ID: 2567634199 Enrollment ID: I20111004000353 |
| Provider Name | Jean E Erdman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922388925 PECOS PAC ID: 3173795515 Enrollment ID: I20111007000460 |
| Provider Name | Amber N Petersen-kuemmel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598042285 PECOS PAC ID: 8729247861 Enrollment ID: I20120309000372 |
| Provider Name | Vimarsh Raina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508177841 PECOS PAC ID: 9537315064 Enrollment ID: I20120815000587 |
| Provider Name | Niaz M Haque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871783407 PECOS PAC ID: 9234271107 Enrollment ID: I20120917000455 |
| Provider Name | Glenda K Way |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437404811 PECOS PAC ID: 7012165780 Enrollment ID: I20120921000404 |
| Provider Name | Michael T Landis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558624908 PECOS PAC ID: 2668621731 Enrollment ID: I20121004000573 |
| Provider Name | Premraj Makkuni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730395740 PECOS PAC ID: 5092857532 Enrollment ID: I20121004000837 |
| Provider Name | Timothy E Wasano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982959391 PECOS PAC ID: 1658356175 Enrollment ID: I20121012000317 |
| Provider Name | Thomas D Boostrom |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164773685 PECOS PAC ID: 7810147931 Enrollment ID: I20121026000450 |
| Provider Name | Sarah J Staff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881944858 PECOS PAC ID: 0345492724 Enrollment ID: I20121228000191 |
| Provider Name | Raymond a Watts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972533263 PECOS PAC ID: 4981651809 Enrollment ID: I20130110000105 |
| Provider Name | Jodi L Space |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518217280 PECOS PAC ID: 3971758962 Enrollment ID: I20130222000413 |
| Provider Name | Michael J Olson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891062592 PECOS PAC ID: 0941466585 Enrollment ID: I20130806000324 |
| Provider Name | Stacie M Valukas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477995876 PECOS PAC ID: 6103060595 Enrollment ID: I20130925000696 |
| Provider Name | Liova E Rivera-garcia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790712610 PECOS PAC ID: 2062420318 Enrollment ID: I20131009000994 |
| Provider Name | Rachael L Kolaske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609202779 PECOS PAC ID: 2163658584 Enrollment ID: I20131113001073 |
| Provider Name | Adam G Clements |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033477997 PECOS PAC ID: 0749419778 Enrollment ID: I20140214000951 |
| Provider Name | Tahnee R Siewert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013265966 PECOS PAC ID: 2264670124 Enrollment ID: I20140507001308 |
| Provider Name | Samantha J Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225457526 PECOS PAC ID: 3173746047 Enrollment ID: I20140521001749 |
| Provider Name | Lindsey C Graff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467871525 PECOS PAC ID: 2860615440 Enrollment ID: I20140529000998 |
| Provider Name | Tristin Allan Suhonen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720393689 PECOS PAC ID: 8123243607 Enrollment ID: I20140626001077 |
| Provider Name | Scott Kantola |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1326211384 PECOS PAC ID: 4880840362 Enrollment ID: I20140709002100 |
| Provider Name | Elizabeth Harbison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699822551 PECOS PAC ID: 9830384411 Enrollment ID: I20141103000289 |
| Provider Name | Erin C Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194129353 PECOS PAC ID: 4486876349 Enrollment ID: I20141107001369 |
| Provider Name | Kimberly J Haycraft-schmotter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306800107 PECOS PAC ID: 7810073855 Enrollment ID: I20150210000658 |
| Provider Name | Kaitlin a Eichman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174878631 PECOS PAC ID: 6103142419 Enrollment ID: I20150304001406 |
| Provider Name | Jennifer Jean Delaney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992733166 PECOS PAC ID: 2365493061 Enrollment ID: I20150320001396 |
| Provider Name | Kelly M Orysen |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1497937957 PECOS PAC ID: 1456679794 Enrollment ID: I20150416000547 |
| Provider Name | Nicole K Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831582436 PECOS PAC ID: 3476872896 Enrollment ID: I20150507000572 |
| Provider Name | Jon C Bowersox |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164488946 PECOS PAC ID: 3971500778 Enrollment ID: I20150513002557 |
| Provider Name | Gregory L Werner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003297581 PECOS PAC ID: 0345552063 Enrollment ID: I20150708002012 |
| Provider Name | Kyle J Dembowiak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235499815 PECOS PAC ID: 7517271539 Enrollment ID: I20150805006698 |
| Provider Name | Keith J Bratulich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750646295 PECOS PAC ID: 9133372436 Enrollment ID: I20150807014727 |
| Provider Name | Craig D Destree |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154732063 PECOS PAC ID: 2062722895 Enrollment ID: I20151106002246 |
| Provider Name | Stacie R Leahy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1750748646 PECOS PAC ID: 2365746427 Enrollment ID: I20160210000713 |
| Provider Name | Jason D Randall |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235550955 PECOS PAC ID: 2466760095 Enrollment ID: I20160211000035 |
| Provider Name | Adam D Corrado |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992769715 PECOS PAC ID: 9830118637 Enrollment ID: I20160610000086 |
| Provider Name | Joseph Sullivan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295022903 PECOS PAC ID: 4284923327 Enrollment ID: I20160720002703 |
| Provider Name | Derek Hoyme |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245469808 PECOS PAC ID: 2062657372 Enrollment ID: I20160808002817 |
| Provider Name | Margaret Mary Greco |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760686414 PECOS PAC ID: 9739251703 Enrollment ID: I20160817003183 |
| Provider Name | Catherine Cooch Allen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265673164 PECOS PAC ID: 5991090110 Enrollment ID: I20160825002781 |
| Provider Name | Jessalyn N Rashid |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235680877 PECOS PAC ID: 4789963349 Enrollment ID: I20161122002387 |
| Provider Name | John P Berlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689117004 PECOS PAC ID: 1456635333 Enrollment ID: I20170222000802 |
| Provider Name | Michael a Ward |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316279433 PECOS PAC ID: 5294901526 Enrollment ID: I20170706000889 |
| Provider Name | Michael J Kuklinski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821383407 PECOS PAC ID: 1850520289 Enrollment ID: I20170706001162 |
| Provider Name | Efe M Akpoigbe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023365152 PECOS PAC ID: 9032334891 Enrollment ID: I20170719003840 |
| Provider Name | James K Harris |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346768009 PECOS PAC ID: 7416222468 Enrollment ID: I20171002002021 |
| Provider Name | Benjamin K Mwai |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700302023 PECOS PAC ID: 6901171966 Enrollment ID: I20171002002958 |
| Provider Name | Laura R Toppen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326563495 PECOS PAC ID: 8729354360 Enrollment ID: I20171025002787 |
| Provider Name | Jappan J Bhatt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669594115 PECOS PAC ID: 2567562952 Enrollment ID: I20171026001437 |
| Provider Name | Pamela Lowry Burr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639227978 PECOS PAC ID: 0648369173 Enrollment ID: I20171120002450 |
| Provider Name | Frances Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134529076 PECOS PAC ID: 8921322652 Enrollment ID: I20171214001967 |
| Provider Name | Amanada J Gaccetta |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417219197 PECOS PAC ID: 8426311721 Enrollment ID: I20180419002269 |
| Provider Name | Susan Yankovich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942301718 PECOS PAC ID: 6103005046 Enrollment ID: I20180611001326 |
| Provider Name | Bret K Stysly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104188416 PECOS PAC ID: 8224344544 Enrollment ID: I20180702002370 |
| Provider Name | Jared a Scherr |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1912378522 PECOS PAC ID: 0446506521 Enrollment ID: I20180703000135 |
| Provider Name | Kevin P Quirke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417306911 PECOS PAC ID: 3870888738 Enrollment ID: I20180717003218 |
| Provider Name | Kimberly Hatch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619484532 PECOS PAC ID: 3870840754 Enrollment ID: I20180724001367 |
| Provider Name | Ronnie Ortiz |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1245474410 PECOS PAC ID: 8426195900 Enrollment ID: I20180724003178 |
| Provider Name | Ahmed F Mohammed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407231178 PECOS PAC ID: 1557619913 Enrollment ID: I20180801004049 |
| Provider Name | Carli M Winter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114418662 PECOS PAC ID: 2163770017 Enrollment ID: I20180808003424 |
| Provider Name | Katie E Vangoethem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760962393 PECOS PAC ID: 7012267958 Enrollment ID: I20180913002198 |
| Provider Name | Mary B Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356824098 PECOS PAC ID: 2163774910 Enrollment ID: I20181008000074 |
| Provider Name | Tammy G Buchanan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487627022 PECOS PAC ID: 9335108463 Enrollment ID: I20190104000721 |
| Provider Name | Kay Johnson-keys |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043247190 PECOS PAC ID: 4587621271 Enrollment ID: I20190312000165 |
| Provider Name | Richard Prokesch |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1427064583 PECOS PAC ID: 2668411570 Enrollment ID: I20190319000054 |
| Provider Name | Lisa M Werner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609340561 PECOS PAC ID: 6709127335 Enrollment ID: I20190409002427 |
| Provider Name | Shirin Sultana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053610691 PECOS PAC ID: 7416266846 Enrollment ID: I20190423001599 |
| Provider Name | Kerry a Lingen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942766407 PECOS PAC ID: 3971845645 Enrollment ID: I20190429001686 |
| Provider Name | Lance Matthew Orr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548230790 PECOS PAC ID: 7113919879 Enrollment ID: I20190502000904 |
| Provider Name | Christine M Baker |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508350521 PECOS PAC ID: 4688907710 Enrollment ID: I20190605000740 |
| Provider Name | Jamie Lynn Schneider |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801240858 PECOS PAC ID: 3072877364 Enrollment ID: I20190711002059 |
| Provider Name | Justin C Wright |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285891846 PECOS PAC ID: 9638404353 Enrollment ID: I20190717000993 |
| Provider Name | Hilary E Faust |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1669764817 PECOS PAC ID: 5698044816 Enrollment ID: I20190723001486 |
| Provider Name | Jason Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841850542 PECOS PAC ID: 2961739941 Enrollment ID: I20190814001110 |
| Provider Name | Bryan Kincaid Austin |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316997943 PECOS PAC ID: 3678511326 Enrollment ID: I20190819002635 |
| Provider Name | Abbey Hurtis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306407010 PECOS PAC ID: 3870821853 Enrollment ID: I20190829000648 |
| Provider Name | Andrew Harold Paplham Androshie |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750930301 PECOS PAC ID: 9739410424 Enrollment ID: I20191010001443 |
| Provider Name | Kayla J Palmeter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841841244 PECOS PAC ID: 0547592305 Enrollment ID: I20191028001376 |
| Provider Name | Hema Kamthamneni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417262932 PECOS PAC ID: 1254565872 Enrollment ID: I20191028003082 |
| Provider Name | Nathan D Mcparlan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073656955 PECOS PAC ID: 3173680089 Enrollment ID: I20200207000002 |
| Provider Name | James Matthew Tracey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1598102527 PECOS PAC ID: 9638487804 Enrollment ID: I20200213000878 |
| Provider Name | Hilary K Eggen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790291300 PECOS PAC ID: 1153680863 Enrollment ID: I20200218001016 |
| Provider Name | Thomas C Howard |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1932369584 PECOS PAC ID: 0749583706 Enrollment ID: I20200610001054 |
| Provider Name | Justin Teresinski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134615131 PECOS PAC ID: 1153679048 Enrollment ID: I20200618000908 |
| Provider Name | Nicole M Held |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477085652 PECOS PAC ID: 7214362185 Enrollment ID: I20200622001306 |
| Provider Name | Amy Jeanne Defranco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962045393 PECOS PAC ID: 2466697842 Enrollment ID: I20200713000588 |
| Provider Name | Johonna Asquith |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1730447400 PECOS PAC ID: 5395986848 Enrollment ID: I20200720000195 |
| Provider Name | Nicholas John Stabo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568817815 PECOS PAC ID: 5496048555 Enrollment ID: I20200812002868 |
| Provider Name | Colleen E Lane |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1659717312 PECOS PAC ID: 3779722251 Enrollment ID: I20200814002130 |
| Provider Name | Thomas E Mckenzie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629050448 PECOS PAC ID: 5597756841 Enrollment ID: I20200817002245 |
| Provider Name | Syed M Imam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699202408 PECOS PAC ID: 8527339514 Enrollment ID: I20200917001379 |
| Provider Name | Sarah Pergande |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700275500 PECOS PAC ID: 5496083412 Enrollment ID: I20200923000323 |
| Provider Name | Justin Asquith |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1699031138 PECOS PAC ID: 1052603636 Enrollment ID: I20200925001250 |
| Provider Name | Jahoon Koo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629554209 PECOS PAC ID: 1355692922 Enrollment ID: I20201028000989 |
| Provider Name | Jeffrey Morgan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043436132 PECOS PAC ID: 8921108366 Enrollment ID: I20201111001127 |
| Provider Name | Megan E Simmons |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063047637 PECOS PAC ID: 2264843507 Enrollment ID: I20201118000639 |
| Provider Name | Cally F Gordon-haessly |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831754381 PECOS PAC ID: 5698007094 Enrollment ID: I20201204000825 |
| Provider Name | Waleed Mansour |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043628589 PECOS PAC ID: 1557661980 Enrollment ID: I20201210002640 |
| Provider Name | Amy Lee Kurth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548869167 PECOS PAC ID: 9436561453 Enrollment ID: I20201216002270 |
| Provider Name | Bradley Brossard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457968687 PECOS PAC ID: 3577977057 Enrollment ID: I20210125000293 |
| Provider Name | Nancy Rihana |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982835237 PECOS PAC ID: 5294954699 Enrollment ID: I20210201000594 |
| Provider Name | Carl H Zondlo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215549852 PECOS PAC ID: 1052725066 Enrollment ID: I20210203001663 |
| Provider Name | Shannon I Pham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295321370 PECOS PAC ID: 9638585458 Enrollment ID: I20210302003045 |
| Provider Name | Jonathan Packard |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659968121 PECOS PAC ID: 1951717511 Enrollment ID: I20210316001212 |
| Provider Name | Srikar Karanam |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588034227 PECOS PAC ID: 5092074302 Enrollment ID: I20210615003299 |
| Provider Name | Heidi Warmbold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285886531 PECOS PAC ID: 8921167214 Enrollment ID: I20210618001932 |
| Provider Name | Ryan Check |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366947269 PECOS PAC ID: 2264783216 Enrollment ID: I20210810002979 |
| Provider Name | Angelica T Hon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144892464 PECOS PAC ID: 5799189742 Enrollment ID: I20210812001983 |
| Provider Name | Tom T Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922389048 PECOS PAC ID: 0941578736 Enrollment ID: I20210813001496 |
| Provider Name | Emmanuel a Trigenis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225011844 PECOS PAC ID: 7719074319 Enrollment ID: I20210831002964 |
| Provider Name | Garett G Krug |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689248247 PECOS PAC ID: 2860899572 Enrollment ID: I20210923000166 |
| Provider Name | Nathan J Walters |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730281312 PECOS PAC ID: 1254366933 Enrollment ID: I20211007003223 |
| Provider Name | Ashley M Klinner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760159172 PECOS PAC ID: 3577951136 Enrollment ID: I20211101001371 |
| Provider Name | Jennifer Gayle Polacek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508535360 PECOS PAC ID: 0941699938 Enrollment ID: I20211112001264 |
| Provider Name | Katie L Mccarty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164181665 PECOS PAC ID: 9931591401 Enrollment ID: I20220112001714 |
| Provider Name | Eric Hyun |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831450170 PECOS PAC ID: 8527374388 Enrollment ID: I20220316002891 |
| Provider Name | Alan Berger |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104861350 PECOS PAC ID: 6709887656 Enrollment ID: I20220321001036 |
| Provider Name | Aarti K Attreya-latuso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538514799 PECOS PAC ID: 9234422361 Enrollment ID: I20220406000856 |
| Provider Name | Karim R Saleeby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710322110 PECOS PAC ID: 7517264732 Enrollment ID: I20220407000495 |
| Provider Name | Melissa S Skoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700309796 PECOS PAC ID: 7719250869 Enrollment ID: I20220408000493 |
| Provider Name | Ashley Kleutsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932860244 PECOS PAC ID: 6103203450 Enrollment ID: I20220506001780 |
| Provider Name | Elizabeth Mathews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124084306 PECOS PAC ID: 6800849258 Enrollment ID: I20220512000939 |
| Provider Name | Stuart Babcock |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366463689 PECOS PAC ID: 4880756790 Enrollment ID: I20220519002656 |
| Provider Name | Korby J Wipf |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1225128010 PECOS PAC ID: 5991185233 Enrollment ID: I20220705002568 |
| Provider Name | Kimberly L Anderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053549873 PECOS PAC ID: 5294889853 Enrollment ID: I20220711003221 |
| Provider Name | Edward Mckenna |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1164884433 PECOS PAC ID: 6406111764 Enrollment ID: I20220809003475 |
| Provider Name | Salman Mandhai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639445166 PECOS PAC ID: 4981914538 Enrollment ID: I20220826002130 |
| Provider Name | Jessica L Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528797255 PECOS PAC ID: 5698159358 Enrollment ID: I20220829003265 |
| Provider Name | Tyler J Wimmer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972249696 PECOS PAC ID: 3173907896 Enrollment ID: I20220830002408 |
| Provider Name | Chimkama N Ibe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366606337 PECOS PAC ID: 1456525914 Enrollment ID: I20220909002742 |
| Provider Name | Haley Erl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770067357 PECOS PAC ID: 9234514829 Enrollment ID: I20220919000636 |
| Provider Name | April Marie Byers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720708803 PECOS PAC ID: 5597141069 Enrollment ID: I20221006001920 |
| Provider Name | Monica Cespedes Santana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114204161 PECOS PAC ID: 7214212653 Enrollment ID: I20221008000304 |
| Provider Name | Elias G Issa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053305888 PECOS PAC ID: 6002840584 Enrollment ID: I20221019001722 |
| Provider Name | Amy Jo Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912621822 PECOS PAC ID: 9931576337 Enrollment ID: I20221027001194 |
| Provider Name | Sherif M Latif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518167188 PECOS PAC ID: 9830221233 Enrollment ID: I20221031003119 |
| Provider Name | Omar M El-sheikh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760681225 PECOS PAC ID: 6901030097 Enrollment ID: I20221104002088 |
| Provider Name | Erin Meyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922265305 PECOS PAC ID: 0143396184 Enrollment ID: I20221108001327 |
| Provider Name | Jordan Abel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417273301 PECOS PAC ID: 4789806522 Enrollment ID: I20221111000425 |
| Provider Name | Katie Seybold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629793948 PECOS PAC ID: 5698143345 Enrollment ID: I20221130001676 |
| Provider Name | Jasdeep Dalawari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215986807 PECOS PAC ID: 1759275167 Enrollment ID: I20230206000761 |
| Provider Name | Manisha Shah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215012000 PECOS PAC ID: 7517120124 Enrollment ID: I20230208001789 |
| Provider Name | Nicole Marie Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487363594 PECOS PAC ID: 3072985241 Enrollment ID: I20230216001304 |
| Provider Name | Sarah Siekert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831802958 PECOS PAC ID: 0648643809 Enrollment ID: I20230309000095 |
| Provider Name | Makayla Lisa Meyer-moser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023727278 PECOS PAC ID: 3678947538 Enrollment ID: I20230316002079 |
| Provider Name | Katherine Renee Vosburg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326332040 PECOS PAC ID: 1850517269 Enrollment ID: I20230322001154 |
| Provider Name | Taylor Jean Ewert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265141378 PECOS PAC ID: 0941674352 Enrollment ID: I20230327002348 |
| Provider Name | Andrea Caballero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003173824 PECOS PAC ID: 3274841770 Enrollment ID: I20230428001880 |
| Provider Name | Elizabeth O Wendt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821784067 PECOS PAC ID: 3870959513 Enrollment ID: I20230522003253 |
| Provider Name | Tian Xia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437357423 PECOS PAC ID: 2961681713 Enrollment ID: I20230602002603 |
| Provider Name | Thomas Oliver |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083069470 PECOS PAC ID: 9739477324 Enrollment ID: I20230711001880 |
| Provider Name | Rachel Seiler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083110241 PECOS PAC ID: 7315294329 Enrollment ID: I20230712004357 |
| Provider Name | Daniel J Growney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659367936 PECOS PAC ID: 1355232166 Enrollment ID: I20230719001651 |
| Provider Name | Matthew Dombrowski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710610407 PECOS PAC ID: 5092176651 Enrollment ID: I20230728001529 |
| Provider Name | Richard Belt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275064263 PECOS PAC ID: 1850643115 Enrollment ID: I20230731000081 |
| Provider Name | Sophia Kim Marie Pernsteiner |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1184301129 PECOS PAC ID: 7911369277 Enrollment ID: I20230817003290 |
| Provider Name | Tatyana Bombard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255629861 PECOS PAC ID: 0941595748 Enrollment ID: I20230911001645 |
| Provider Name | Amier Ahmad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689061897 PECOS PAC ID: 8224359807 Enrollment ID: I20230921000790 |
| Provider Name | Katy Lynn Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295412815 PECOS PAC ID: 8527412295 Enrollment ID: I20230928002772 |
| Provider Name | Joshua C Dilday |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033591185 PECOS PAC ID: 6709230477 Enrollment ID: I20230928002810 |
| Provider Name | Sarah J Hoppe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871376194 PECOS PAC ID: 9234585761 Enrollment ID: I20231019002331 |
| Provider Name | Anthony Willis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972866911 PECOS PAC ID: 4688947120 Enrollment ID: I20231030001447 |
| Provider Name | Meghan Cantlon Hughes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346869476 PECOS PAC ID: 7214354968 Enrollment ID: I20231102002230 |
| Provider Name | William Rusnak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366854325 PECOS PAC ID: 9638450943 Enrollment ID: I20231103001194 |
| Provider Name | Bassem Mourad Samaan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679740302 PECOS PAC ID: 8224271945 Enrollment ID: I20231103001888 |
| Provider Name | Rachel L Rindt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912680588 PECOS PAC ID: 8426405556 Enrollment ID: I20231113000191 |
| Provider Name | Thomas Anthony Licata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427638659 PECOS PAC ID: 8123475258 Enrollment ID: I20231113000321 |
| Provider Name | Ayden D Zarkhah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487159091 PECOS PAC ID: 8022492982 Enrollment ID: I20231113001576 |
| Provider Name | Madeline Jean Oestreich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508489170 PECOS PAC ID: 2961850839 Enrollment ID: I20231204000709 |
| Provider Name | Melissa L Swihart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033623772 PECOS PAC ID: 8426315425 Enrollment ID: I20231208002395 |
| Provider Name | Brooke Elizabeth Kottke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104695246 PECOS PAC ID: 8820440365 Enrollment ID: I20240119002110 |
| Provider Name | Shayla Hesse |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1689931305 PECOS PAC ID: 4082017868 Enrollment ID: I20240130001374 |
| Provider Name | Ashley Mary Delanty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992412639 PECOS PAC ID: 2163866096 Enrollment ID: I20240220001141 |
| Provider Name | Elizabeth a Edinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548034408 PECOS PAC ID: 1254776925 Enrollment ID: I20240304003456 |
| Provider Name | Prunetta O Brunson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538662556 PECOS PAC ID: 8820353071 Enrollment ID: I20240314000164 |
| Provider Name | Michael Borgen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659039238 PECOS PAC ID: 8921487778 Enrollment ID: I20240315002759 |
| Provider Name | Angela L Arnold-ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548713191 PECOS PAC ID: 0941588693 Enrollment ID: I20240321000816 |
| Provider Name | Brett J. Guinn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083683783 PECOS PAC ID: 3375541568 Enrollment ID: I20240409003521 |
| Provider Name | Lauren Fiske |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952509796 PECOS PAC ID: 8426270018 Enrollment ID: I20240605002258 |
| Provider Name | Qi Xin Wei |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003264599 PECOS PAC ID: 4880982057 Enrollment ID: I20240613004162 |
| Provider Name | Michael Perez Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376915330 PECOS PAC ID: 1850834318 Enrollment ID: I20240625002031 |
| Provider Name | Joel Ryan Oney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235974197 PECOS PAC ID: 6305381187 Enrollment ID: I20240717000242 |
| Provider Name | Diana M Wilmoth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225609050 PECOS PAC ID: 1951846625 Enrollment ID: I20240717003724 |
| Provider Name | Kudirat Bukola Olatunde |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649845074 PECOS PAC ID: 6406249218 Enrollment ID: I20240719000603 |
| Provider Name | Jenna Lyn Jicinsky |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679273577 PECOS PAC ID: 2961948740 Enrollment ID: I20240729003223 |
| Provider Name | Christopher G Stiglets |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578964698 PECOS PAC ID: 2769705151 Enrollment ID: I20240816002127 |
| Provider Name | Haane Massarotti |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518194083 PECOS PAC ID: 9739326638 Enrollment ID: I20240903002815 |
| Provider Name | Tiffany a Stoddard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720114846 PECOS PAC ID: 1557517893 Enrollment ID: I20240905001432 |
| Provider Name | Cody K Fox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285214445 PECOS PAC ID: 8123568045 Enrollment ID: I20240906000471 |
| Provider Name | Cynthia Joy Bainbridge |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326876202 PECOS PAC ID: 8921548215 Enrollment ID: I20240913000347 |
| Provider Name | Oded Greenberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003892928 PECOS PAC ID: 0840341533 Enrollment ID: I20240913003062 |
| Provider Name | Alisha Marley Natzke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184459281 PECOS PAC ID: 6901337757 Enrollment ID: I20241003001342 |
| Provider Name | Mutaz Musa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720432115 PECOS PAC ID: 8527396795 Enrollment ID: I20241017000225 |
| Provider Name | Steven E Hall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265531651 PECOS PAC ID: 7618977364 Enrollment ID: I20241025002989 |
| Provider Name | Thomas Saadeh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891927752 PECOS PAC ID: 7618192287 Enrollment ID: I20241122003561 |
| Provider Name | Lance Allen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609188713 PECOS PAC ID: 2264604784 Enrollment ID: I20241204000239 |
| Provider Name | Natalie Lambie |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215142559 PECOS PAC ID: 8921150483 Enrollment ID: I20241204003273 |
| Provider Name | Macey Brandeberry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346702537 PECOS PAC ID: 4284960550 Enrollment ID: I20241205002599 |
| Provider Name | Danny Bourgeois |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285824334 PECOS PAC ID: 5193965473 Enrollment ID: I20241210001329 |
| Provider Name | Zakaria Abdulnabi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790135499 PECOS PAC ID: 0446542203 Enrollment ID: I20241226001945 |
| Provider Name | Kyle a Winger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821810805 PECOS PAC ID: 5698203701 Enrollment ID: I20250116001357 |
| Provider Name | Jolita Marie Auguste |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063772283 PECOS PAC ID: 9739442484 Enrollment ID: I20250122001241 |
| Provider Name | Saurabh Verma |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659785665 PECOS PAC ID: 8426396821 Enrollment ID: I20250304001685 |
| Provider Name | April R Lauer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861920027 PECOS PAC ID: 0345514824 Enrollment ID: I20250312003756 |
| Provider Name | Tejaswini Vasamsetty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588043426 PECOS PAC ID: 1254630213 Enrollment ID: I20250313002257 |
| Provider Name | Latonia J Moncur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508910142 PECOS PAC ID: 4880889427 Enrollment ID: I20250314000630 |
| Provider Name | Sameul Osama Hanif |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1417240102 PECOS PAC ID: 1052605250 Enrollment ID: I20250317001801 |
| Provider Name | Todd Severnak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790775393 PECOS PAC ID: 2567452410 Enrollment ID: I20250327000422 |
| Provider Name | Sarah J Kantharia |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1881039253 PECOS PAC ID: 6406192574 Enrollment ID: I20250408002976 |
| Provider Name | Jeremy Stupin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780883496 PECOS PAC ID: 3375676836 Enrollment ID: I20250411000215 |
| Provider Name | Sameer Mittal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861830739 PECOS PAC ID: 8628323474 Enrollment ID: I20250414000270 |
| Provider Name | Torbjorg a Holtestaul |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295275428 PECOS PAC ID: 3274059878 Enrollment ID: I20250428000991 |
| Provider Name | Abdul S Bangura |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386879310 PECOS PAC ID: 3274974688 Enrollment ID: I20250502000691 |
| Provider Name | Cameron S Page |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497067912 PECOS PAC ID: 0840486791 Enrollment ID: I20250603001963 |
| Provider Name | Scherly Leon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952627424 PECOS PAC ID: 4587899950 Enrollment ID: I20250616000385 |
| Provider Name | Lawton Delisser |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366499378 PECOS PAC ID: 1850205675 Enrollment ID: I20250708001524 |
| Provider Name | Deepak Sharma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922369396 PECOS PAC ID: 0143592584 Enrollment ID: I20250709001284 |
| Provider Name | Sean Whalen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043429152 PECOS PAC ID: 3779678073 Enrollment ID: I20250715000628 |
| Provider Name | Maria Del Pilar Valencia Velez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396865374 PECOS PAC ID: 7618041641 Enrollment ID: I20250716002306 |
| Provider Name | Lourdes Villasenor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215421433 PECOS PAC ID: 7416283536 Enrollment ID: I20250717001018 |
| Provider Name | Andrew M Hall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710182407 PECOS PAC ID: 9830339126 Enrollment ID: I20250807000370 |
| Provider Name | Jennie R Corey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780475657 PECOS PAC ID: 9436658556 Enrollment ID: I20250815003486 |
| Provider Name | Jennifer Schneidler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285826487 PECOS PAC ID: 4587712294 Enrollment ID: I20250828000297 |
| Provider Name | Jana M Binkley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750941811 PECOS PAC ID: 0840521001 Enrollment ID: I20250902002894 |
| Provider Name | Mitchell Pearce |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932555885 PECOS PAC ID: 8527469501 Enrollment ID: I20250903001084 |
| Provider Name | Rania Mae Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619168184 PECOS PAC ID: 0749782381 Enrollment ID: I20250904001064 |
| Provider Name | Seyedehbatol Aleali |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659404267 PECOS PAC ID: 8123164191 Enrollment ID: I20250904003213 |
| Provider Name | Daniel Portal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104358480 PECOS PAC ID: 3577808179 Enrollment ID: I20250910002386 |
| Provider Name | Ahmed M El-sabbagh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376917781 PECOS PAC ID: 0941502488 Enrollment ID: I20250912000124 |
| Provider Name | Navjit Dullet |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386149342 PECOS PAC ID: 5092043281 Enrollment ID: I20250916001565 |
| Provider Name | Anthony Sparks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952634651 PECOS PAC ID: 1456650795 Enrollment ID: I20250918003059 |
| Provider Name | Amy Schimke |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033346739 PECOS PAC ID: 7315254919 Enrollment ID: I20251013000679 |
| Provider Name | Kristen Koshalek |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073168019 PECOS PAC ID: 0648767376 Enrollment ID: I20251015003469 |
| Provider Name | David Kephart |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376906958 PECOS PAC ID: 0345532727 Enrollment ID: I20251023002027 |
| Provider Name | Christopher Hill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063670248 PECOS PAC ID: 3577697028 Enrollment ID: I20251028002117 |
| Provider Name | Jewell Denise Robinson Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275988289 PECOS PAC ID: 6103104161 Enrollment ID: I20251030002551 |
| Provider Name | Thomas Fleming Mattox |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437113537 PECOS PAC ID: 7911940408 Enrollment ID: I20251104003736 |
| Provider Name | Larry R Hromalik |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184288110 PECOS PAC ID: 2961941489 Enrollment ID: I20251105003799 |
| Provider Name | Melba Taylor |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225295116 PECOS PAC ID: 1153467295 Enrollment ID: I20251113003048 |
| Provider Name | Jason Dunn |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1194385096 PECOS PAC ID: 5597147017 Enrollment ID: I20251120000229 |
| Provider Name | Andrenita Haddad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417650201 PECOS PAC ID: 3476911371 Enrollment ID: I20251121001409 |
| Provider Name | Raul Sebastian Laines |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144512682 PECOS PAC ID: 7113208646 Enrollment ID: I20251205001342 |
| Provider Name | Jordan Singh Guraya |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295359909 PECOS PAC ID: 9436654423 Enrollment ID: I20251208001976 |
| Provider Name | Sandra Kay Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669346714 PECOS PAC ID: 2365937299 Enrollment ID: I20251218001995 |
| Provider Name | Brooke Ann Rocque |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851268098 PECOS PAC ID: 0244725919 Enrollment ID: I20251219001470 |
| Provider Name | Sandeep Garg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376989806 PECOS PAC ID: 2062742836 Enrollment ID: I20251224002371 |
| Provider Name | Ankit Upadhyay |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376934059 PECOS PAC ID: 3779977152 Enrollment ID: I20251230002193 |
| Provider Name | Nicholas Holwey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093143869 PECOS PAC ID: 3779711452 Enrollment ID: I20251231002534 |
| Provider Name | Benjamin Comora |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427555903 PECOS PAC ID: 6002169240 Enrollment ID: I20260122000603 |
| Provider Name | Robert John O'connell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629030135 PECOS PAC ID: 0547684060 Enrollment ID: I20260126001230 |
| Provider Name | Damon Jordan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033109707 PECOS PAC ID: 7416936877 Enrollment ID: I20260127002199 |
| Provider Name | Barbara Manchec |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922453216 PECOS PAC ID: 8426341629 Enrollment ID: I20260130000058 |
| Provider Name | Yong Leung |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659827491 PECOS PAC ID: 0648567693 Enrollment ID: I20260205002548 |
| Provider Name | Hema Korlakunta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174604789 PECOS PAC ID: 5799963914 Enrollment ID: I20260216000099 |
| Provider Name | Dhaval Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831151174 PECOS PAC ID: 3678658333 Enrollment ID: I20260216002292 |
| Provider Name | Cinthia P Wiebusch |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427007129 PECOS PAC ID: 0446730212 Enrollment ID: I20260219001841 |
| Provider Name | Daniel P Davis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548204423 PECOS PAC ID: 5799810974 Enrollment ID: I20260225001234 |
| Provider Name | Amir Fallahian |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164618278 PECOS PAC ID: 6901942093 Enrollment ID: I20260304002907 |
| Provider Name | Alexandra Janota Gaines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245123728 PECOS PAC ID: 2264916709 Enrollment ID: I20260323001355 |
| Provider Name | Jonathan Lehman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679595193 PECOS PAC ID: 1951341916 Enrollment ID: I20260323002976 |
| Provider Name | Sara Rhiannon Magerowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518825520 PECOS PAC ID: 8628553492 Enrollment ID: I20260330002323 |
| Provider Name | Dean Kolnick |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538477906 PECOS PAC ID: 2769794247 Enrollment ID: I20260407003021 |
| Provider Name | Balaji Shanmugam |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1851786164 PECOS PAC ID: 7315242260 Enrollment ID: I20260410001447 |
| Provider Name | Patricio Rossi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902834187 PECOS PAC ID: 5597721407 Enrollment ID: I20260413003041 |
| Provider Name | Hannah Jordan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215507512 PECOS PAC ID: 8224430848 Enrollment ID: I20260421002210 |
| Provider Name | Allen Weiss |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871989079 PECOS PAC ID: 4183979099 Enrollment ID: I20260423000715 |
| Provider Name | Valerie Lou |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023376001 PECOS PAC ID: 8628386372 Enrollment ID: I20260430003722 |
| Provider Name | Gavin Roache |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023425600 PECOS PAC ID: 3274962675 Enrollment ID: I20260504006096 |
| Provider Name | Archana Lucchesi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225108533 PECOS PAC ID: 6709871346 Enrollment ID: I20260508001632 |
| Provider Name | Stephanie Thomas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043520489 PECOS PAC ID: 4587819826 Enrollment ID: I20260512002195 |
| Provider Name | Sirisha Komakula |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295872562 PECOS PAC ID: 4880745900 Enrollment ID: I20260513000973 |
| Provider Name | Zimatu Chukumerije |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326324831 PECOS PAC ID: 0840502100 Enrollment ID: I20260513001829 |
| Provider Name | Eric Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831312099 PECOS PAC ID: 3375629587 Enrollment ID: I20260514001532 |
| Provider Name | Fnu Zafrullah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255852687 PECOS PAC ID: 9234595307 Enrollment ID: I20260518001594 |
| Provider Name | Melissa Bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780142653 PECOS PAC ID: 4486982808 Enrollment ID: I20260521000782 |
| Provider Name | Zenus Wilson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578941597 PECOS PAC ID: 1254672660 Enrollment ID: I20260521003686 |
| Provider Name | Kathleen Shaffer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912940834 PECOS PAC ID: 7012011265 Enrollment ID: I20260601002946 |
| Provider Name | Behnaz Goudarzi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962667139 PECOS PAC ID: 1557589371 Enrollment ID: I20260625000841 |