| Bend Memorial Clinic Pc | |
|
1501 Ne Medical Center Dr Bend OR 97701-6051 | |
| (541) 382-2811 | |
| Not Available |
| Full Name | Bend Memorial Clinic Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1501 Ne Medical Center Dr, Bend, Oregon |
| Authorized Official Name and Position | Jessie Dover (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 5417062495 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bend Memorial Clinic Pc 1501 Ne Medical Center Dr Bend OR 97701-6051 Ph: (541) 382-2811 | Bend Memorial Clinic Pc 1501 Ne Medical Center Dr Bend OR 97701-6051 Ph: (541) 382-2811 |
| NPI Number | 1699827477 |
|---|---|
| Provider Enumeration Date | 01/18/2007 |
| Last Update Date | 04/21/2023 |
| Medicare PECOS PAC ID | 7214936533 |
|---|---|
| Medicare Enrollment ID | O20061215000022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699827477 | NPI | - | NPPES |
| 213243 | Medicaid | OR |
| Provider Name | Michael C Widmer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124092051 PECOS PAC ID: 6406769496 Enrollment ID: I20031111000874 |
| Provider Name | Laurie D Ponte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215048129 PECOS PAC ID: 1456255736 Enrollment ID: I20040320000304 |
| Provider Name | Michael N Harris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023047503 PECOS PAC ID: 0749171890 Enrollment ID: I20040320000329 |
| Provider Name | Michael J Troychak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841252913 PECOS PAC ID: 0840286779 Enrollment ID: I20040423001425 |
| Provider Name | Seth M Hofstetter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851354419 PECOS PAC ID: 3476549338 Enrollment ID: I20040424000157 |
| Provider Name | Michael S Fennell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336101690 PECOS PAC ID: 9931195807 Enrollment ID: I20040424000212 |
| Provider Name | Mack K Bandler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609830199 PECOS PAC ID: 1355243155 Enrollment ID: I20040424000221 |
| Provider Name | Brian Patrick Desmond |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1356329809 PECOS PAC ID: 5890782593 Enrollment ID: I20040426001649 |
| Provider Name | Mayra E Dennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316925472 PECOS PAC ID: 7517955412 Enrollment ID: I20040430001077 |
| Provider Name | Craigan T Griffin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407839798 PECOS PAC ID: 1850389156 Enrollment ID: I20040505000276 |
| Provider Name | Khuelien Dretke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831130251 PECOS PAC ID: 4284624800 Enrollment ID: I20040515000329 |
| Provider Name | Stephen B Archer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699750307 PECOS PAC ID: 4789669854 Enrollment ID: I20040622001380 |
| Provider Name | Mark D Sternfeld |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023071792 PECOS PAC ID: 6507752391 Enrollment ID: I20040624000370 |
| Provider Name | Jennifer A Blechman |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1144209297 PECOS PAC ID: 5991782088 Enrollment ID: I20040707000276 |
| Provider Name | Timothy S Bollom |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639179930 PECOS PAC ID: 9739071994 Enrollment ID: I20040803001497 |
| Provider Name | Pamela L Tornay |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689778326 PECOS PAC ID: 1355312042 Enrollment ID: I20040805000119 |
| Provider Name | Jack E Berndt |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1467408682 PECOS PAC ID: 0345214193 Enrollment ID: I20040825001638 |
| Provider Name | Mary Fiona Carroll |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1821004599 PECOS PAC ID: 1658323217 Enrollment ID: I20050211000636 |
| Provider Name | Darren M Kowalski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598859076 PECOS PAC ID: 6305887654 Enrollment ID: I20050517000388 |
| Provider Name | James A Hall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285636290 PECOS PAC ID: 4880630185 Enrollment ID: I20050707000780 |
| Provider Name | Laurie A Martin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841273265 PECOS PAC ID: 7012944432 Enrollment ID: I20050718000666 |
| Provider Name | Patrick B Brown |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750364170 PECOS PAC ID: 8628005063 Enrollment ID: I20050718000862 |
| Provider Name | Steven D Kjobech |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073596219 PECOS PAC ID: 8820025273 Enrollment ID: I20050718000941 |
| Provider Name | Thomas F Koehler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982687307 PECOS PAC ID: 4688601909 Enrollment ID: I20050719000570 |
| Provider Name | Traci L Clautice Engle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114900438 PECOS PAC ID: 4981631215 Enrollment ID: I20050719000632 |
| Provider Name | Ertan Raif Esmer |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619069887 PECOS PAC ID: 8820071012 Enrollment ID: I20050808000852 |
| Provider Name | Brian T Ohollaren |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1629030523 PECOS PAC ID: 8325077472 Enrollment ID: I20050809000380 |
| Provider Name | Andrew T Chen |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1124081096 PECOS PAC ID: 9931131471 Enrollment ID: I20050906001073 |
| Provider Name | Vanessa K Vargas |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1417073115 PECOS PAC ID: 0345274619 Enrollment ID: I20050926000800 |
| Provider Name | Nora Takla |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1962464271 PECOS PAC ID: 8628093044 Enrollment ID: I20051018000249 |
| Provider Name | Joseph F Bachtold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437134582 PECOS PAC ID: 9537132816 Enrollment ID: I20051207000481 |
| Provider Name | Sanaz Warnock Askari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437248358 PECOS PAC ID: 4385531003 Enrollment ID: I20051229000303 |
| Provider Name | Maureen S Filipek |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780764787 PECOS PAC ID: 5294759874 Enrollment ID: I20060123000292 |
| Provider Name | Yvette M Gaynor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588721237 PECOS PAC ID: 6305851239 Enrollment ID: I20060214000715 |
| Provider Name | Mary P Manfredi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376567388 PECOS PAC ID: 0547278731 Enrollment ID: I20060329000766 |
| Provider Name | James Lee Ockner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366448821 PECOS PAC ID: 6507851656 Enrollment ID: I20060331000013 |
| Provider Name | Tonya I Koopman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013006931 PECOS PAC ID: 8022028687 Enrollment ID: I20060426000612 |
| Provider Name | Thomas D Fitzsimmons |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1275581365 PECOS PAC ID: 3577574672 Enrollment ID: I20060602000190 |
| Provider Name | Stephen M Shultz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619923943 PECOS PAC ID: 5092618439 Enrollment ID: I20060621000042 |
| Provider Name | Robert E Hogan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336195585 PECOS PAC ID: 3870505415 Enrollment ID: I20060622000092 |
| Provider Name | Peter Farkas |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215035639 PECOS PAC ID: 5193722940 Enrollment ID: I20061108000650 |
| Provider Name | Matthew R Lasala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619062114 PECOS PAC ID: 5799689980 Enrollment ID: I20061221000539 |
| Provider Name | Robert C Mathews |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1235167693 PECOS PAC ID: 6901700186 Enrollment ID: I20061222000034 |
| Provider Name | Nancy H Maloney |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1841385408 PECOS PAC ID: 2466452404 Enrollment ID: I20061222000072 |
| Provider Name | Thomas H Wendel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790720258 PECOS PAC ID: 0345240255 Enrollment ID: I20061227000213 |
| Provider Name | Robert V Pinnick |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1386691269 PECOS PAC ID: 4587568761 Enrollment ID: I20061227000353 |
| Provider Name | Kathleen Antolak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316975741 PECOS PAC ID: 2365346095 Enrollment ID: I20061227000355 |
| Provider Name | May S Fan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457462939 PECOS PAC ID: 5890699078 Enrollment ID: I20061228000045 |
| Provider Name | Jeffrey P Boggess |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215048715 PECOS PAC ID: 1254235443 Enrollment ID: I20061228000052 |
| Provider Name | John R Allen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043304462 PECOS PAC ID: 2062412992 Enrollment ID: I20061228000064 |
| Provider Name | Timothy L Beard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831200740 PECOS PAC ID: 4082643911 Enrollment ID: I20061228000087 |
| Provider Name | Thomas A Warlick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487765392 PECOS PAC ID: 7719987684 Enrollment ID: I20061228000356 |
| Provider Name | Patrick L Simning |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295761708 PECOS PAC ID: 5890699086 Enrollment ID: I20061228000379 |
| Provider Name | Richard Snider |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609884105 PECOS PAC ID: 7012916216 Enrollment ID: I20070118000337 |
| Provider Name | Hans G Russell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922037464 PECOS PAC ID: 9739180563 Enrollment ID: I20070123000307 |
| Provider Name | Michael E Feldman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1184618761 PECOS PAC ID: 6709867088 Enrollment ID: I20070606000483 |
| Provider Name | Kristina E Darlington Hansen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225047889 PECOS PAC ID: 1951302363 Enrollment ID: I20070726000686 |
| Provider Name | Russell E Massine |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1447329032 PECOS PAC ID: 9133210248 Enrollment ID: I20070803000282 |
| Provider Name | Meredith R Baker |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1316161680 PECOS PAC ID: 0143313346 Enrollment ID: I20070904000617 |
| Provider Name | Elana Fedor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639182769 PECOS PAC ID: 6709772148 Enrollment ID: I20070919000912 |
| Provider Name | Jennifer A Laughlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932188158 PECOS PAC ID: 1153300231 Enrollment ID: I20070921000536 |
| Provider Name | Matthew C Fedor |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1235225624 PECOS PAC ID: 0547294902 Enrollment ID: I20070927000662 |
| Provider Name | Hyon Soo Harold Kim |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1700924719 PECOS PAC ID: 7618065780 Enrollment ID: I20071127000213 |
| Provider Name | Debra G Wong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720074909 PECOS PAC ID: 9537114970 Enrollment ID: I20080310000007 |
| Provider Name | Josephine M Fitzsimons |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1740265453 PECOS PAC ID: 2062599103 Enrollment ID: I20080414000363 |
| Provider Name | Steven J Michel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841268729 PECOS PAC ID: 6608812532 Enrollment ID: I20080515000567 |
| Provider Name | Steven C Goins |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578634051 PECOS PAC ID: 7012918279 Enrollment ID: I20080519000798 |
| Provider Name | Danielle Anne Eigner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801989280 PECOS PAC ID: 9133290539 Enrollment ID: I20080612000224 |
| Provider Name | James L Mcanally |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891767968 PECOS PAC ID: 5496704876 Enrollment ID: I20080623000604 |
| Provider Name | Adam N Williams |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1265433445 PECOS PAC ID: 8123924594 Enrollment ID: I20080710000664 |
| Provider Name | Steven A Wahls |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467425629 PECOS PAC ID: 4284526559 Enrollment ID: I20080814000351 |
| Provider Name | Kirk W Walker |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922076546 PECOS PAC ID: 1456345834 Enrollment ID: I20081126000060 |
| Provider Name | Deona J Kasten-stubbs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023202314 PECOS PAC ID: 4183712789 Enrollment ID: I20090115000092 |
| Provider Name | James Ronald Hills |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487647905 PECOS PAC ID: 2961444179 Enrollment ID: I20090225000282 |
| Provider Name | William G Schmidt |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1467455386 PECOS PAC ID: 0345257390 Enrollment ID: I20090409000636 |
| Provider Name | Jon E Lutz |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1740385426 PECOS PAC ID: 4486736469 Enrollment ID: I20090513000012 |
| Provider Name | Charlotte Lin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396789574 PECOS PAC ID: 9335166438 Enrollment ID: I20090702000218 |
| Provider Name | Clover N Dill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144289505 PECOS PAC ID: 5395734123 Enrollment ID: I20090722000149 |
| Provider Name | Eric W Palmer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952515553 PECOS PAC ID: 3173677952 Enrollment ID: I20090812000857 |
| Provider Name | Michelle R Mills |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104972710 PECOS PAC ID: 7517011208 Enrollment ID: I20090814000213 |
| Provider Name | John M Stassen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134296726 PECOS PAC ID: 4688778012 Enrollment ID: I20090909000495 |
| Provider Name | Dana J Mann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962485995 PECOS PAC ID: 9335032416 Enrollment ID: I20091119000586 |
| Provider Name | Leslie M Brott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730184391 PECOS PAC ID: 3870633829 Enrollment ID: I20091222000741 |
| Provider Name | Kelly R Pettit |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659454544 PECOS PAC ID: 1254393002 Enrollment ID: I20100518000465 |
| Provider Name | Scott R Jacobson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730184201 PECOS PAC ID: 0345153433 Enrollment ID: I20100719000186 |
| Provider Name | Kathleen L S Broadman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801909791 PECOS PAC ID: 2961541149 Enrollment ID: I20100721000728 |
| Provider Name | Jonathan D Brewer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447226451 PECOS PAC ID: 3476686874 Enrollment ID: I20100805000797 |
| Provider Name | Jonathan A Mcfadyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003136334 PECOS PAC ID: 3678607496 Enrollment ID: I20100816000969 |
| Provider Name | Ginger Vaughn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558592360 PECOS PAC ID: 3173657848 Enrollment ID: I20100817000559 |
| Provider Name | Rod Lee Elliott-mullens |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1447271986 PECOS PAC ID: 2668383241 Enrollment ID: I20100818001061 |
| Provider Name | Joe Pastrano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619946563 PECOS PAC ID: 4587678438 Enrollment ID: I20100819001285 |
| Provider Name | Erin M Walling |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659304012 PECOS PAC ID: 3072504588 Enrollment ID: I20100916000309 |
| Provider Name | Mark G Belza |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1740284777 PECOS PAC ID: 3971416066 Enrollment ID: I20101012000594 |
| Provider Name | Ann L Clemens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669566030 PECOS PAC ID: 3274554100 Enrollment ID: I20101012000778 |
| Provider Name | Laurel H Hartwell |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265652531 PECOS PAC ID: 5698968436 Enrollment ID: I20101025000788 |
| Provider Name | Brant D Wommack |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023164613 PECOS PAC ID: 7911050877 Enrollment ID: I20101025001081 |
| Provider Name | Jennifer B Schroeder |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437279577 PECOS PAC ID: 8527252923 Enrollment ID: I20101029000844 |
| Provider Name | William H Wheir |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912046947 PECOS PAC ID: 2062606965 Enrollment ID: I20101104001079 |
| Provider Name | Michael Eugene Wettstein |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1245271303 PECOS PAC ID: 3779676432 Enrollment ID: I20101123001085 |
| Provider Name | David H Craig |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801982673 PECOS PAC ID: 4183810476 Enrollment ID: I20101129000825 |
| Provider Name | Megan R Chaffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760795827 PECOS PAC ID: 7416145032 Enrollment ID: I20101227000437 |
| Provider Name | Janey Mae Purvis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548379316 PECOS PAC ID: 6608056999 Enrollment ID: I20110203000267 |
| Provider Name | David E Greenberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487855938 PECOS PAC ID: 3971791898 Enrollment ID: I20110610000201 |
| Provider Name | Emily J Wommack |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265695803 PECOS PAC ID: 0648449447 Enrollment ID: I20110812000137 |
| Provider Name | Benjamin S English |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609922202 PECOS PAC ID: 5597880302 Enrollment ID: I20110818000854 |
| Provider Name | Jess A Campagna |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790831386 PECOS PAC ID: 5092831214 Enrollment ID: I20110824000915 |
| Provider Name | Charles F Hales |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629027784 PECOS PAC ID: 8426962994 Enrollment ID: I20111202000702 |
| Provider Name | John N Simmons |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124052618 PECOS PAC ID: 8820169469 Enrollment ID: I20120103000303 |
| Provider Name | Jeffrey R Mathisen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740200484 PECOS PAC ID: 7416992508 Enrollment ID: I20120110000835 |
| Provider Name | Robert L Roberts |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1649280371 PECOS PAC ID: 2961424932 Enrollment ID: I20120116000076 |
| Provider Name | Lacey R Sheppard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093979007 PECOS PAC ID: 0143489237 Enrollment ID: I20120308000781 |
| Provider Name | Garrett Pr Schroeder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487879870 PECOS PAC ID: 5294990388 Enrollment ID: I20120621000720 |
| Provider Name | Molly A. Tilley |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1285854653 PECOS PAC ID: 1456483437 Enrollment ID: I20120710000467 |
| Provider Name | Chad Micheal Ringger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134314537 PECOS PAC ID: 1052597556 Enrollment ID: I20120710000700 |
| Provider Name | Kevin E Sherer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1922097039 PECOS PAC ID: 7517913510 Enrollment ID: I20120717000001 |
| Provider Name | Louis M D'avignon |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1760583389 PECOS PAC ID: 9537232889 Enrollment ID: I20120822000161 |
| Provider Name | Matthew T Weed |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275726598 PECOS PAC ID: 7719134063 Enrollment ID: I20120822000188 |
| Provider Name | Laurie C D'avignon |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1700851433 PECOS PAC ID: 4880841147 Enrollment ID: I20120822000233 |
| Provider Name | Matthew J Davey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831323930 PECOS PAC ID: 3870740939 Enrollment ID: I20120823000805 |
| Provider Name | Kevin L Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992021505 PECOS PAC ID: 4688824857 Enrollment ID: I20121024000378 |
| Provider Name | Maria Cristina Hatara |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427217439 PECOS PAC ID: 3375794217 Enrollment ID: I20121127000209 |
| Provider Name | Mark Goodman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609018860 PECOS PAC ID: 2668643008 Enrollment ID: I20130215000251 |
| Provider Name | Brian Erickson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1730168972 PECOS PAC ID: 0547369035 Enrollment ID: I20130312000000 |
| Provider Name | Mattie E Towle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164643664 PECOS PAC ID: 0042356354 Enrollment ID: I20130516000640 |
| Provider Name | Michael J Grant |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265692917 PECOS PAC ID: 9234384033 Enrollment ID: I20130523000306 |
| Provider Name | Brent J Bose |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841435047 PECOS PAC ID: 4880835040 Enrollment ID: I20130731000009 |
| Provider Name | Benjamin Miriovsky |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1427234277 PECOS PAC ID: 9537301098 Enrollment ID: I20130813000097 |
| Provider Name | Christina M Bright |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1063684934 PECOS PAC ID: 5294980116 Enrollment ID: I20130827000591 |
| Provider Name | Brett Madison Young |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1255505368 PECOS PAC ID: 3779739594 Enrollment ID: I20130829000548 |
| Provider Name | Tamara A Everhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639497688 PECOS PAC ID: 5092940478 Enrollment ID: I20131022000378 |
| Provider Name | Jennifer S Griswold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245343870 PECOS PAC ID: 4880824135 Enrollment ID: I20140305002109 |
| Provider Name | Michael W Niedermeier |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558599209 PECOS PAC ID: 0446401947 Enrollment ID: I20140312001422 |
| Provider Name | Tammy A Bull |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689678278 PECOS PAC ID: 6103059852 Enrollment ID: I20140502001117 |
| Provider Name | Jennifer Rossi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386832442 PECOS PAC ID: 6709073224 Enrollment ID: I20140514001228 |
| Provider Name | Travis A Abele |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871792168 PECOS PAC ID: 9537300181 Enrollment ID: I20140521000770 |
| Provider Name | Matthew R. Bentz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689818619 PECOS PAC ID: 0143475327 Enrollment ID: I20140528000869 |
| Provider Name | Carolyn K Day |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619921350 PECOS PAC ID: 1557529229 Enrollment ID: I20140707001855 |
| Provider Name | Jennifer R Ashley |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699882993 PECOS PAC ID: 8820085137 Enrollment ID: I20140716002059 |
| Provider Name | Stephanie B Barss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033450234 PECOS PAC ID: 8426275009 Enrollment ID: I20140805001008 |
| Provider Name | Karen N Lynn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912111519 PECOS PAC ID: 9830377316 Enrollment ID: I20140814002762 |
| Provider Name | Brooks W Booker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376558429 PECOS PAC ID: 7012946940 Enrollment ID: I20140828000080 |
| Provider Name | Michael J Majerczyk |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1598911299 PECOS PAC ID: 9931267713 Enrollment ID: I20140923002290 |
| Provider Name | Jeffrey J Davis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942205752 PECOS PAC ID: 5991704413 Enrollment ID: I20140924000371 |
| Provider Name | Hayley M Mccoy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1972947133 PECOS PAC ID: 7618198821 Enrollment ID: I20141030002628 |
| Provider Name | Antonia L Mcclune |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1285923714 PECOS PAC ID: 2567784523 Enrollment ID: I20141202000028 |
| Provider Name | Zachary R Heeter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952543373 PECOS PAC ID: 0143461384 Enrollment ID: I20150512002672 |
| Provider Name | Kristi Anne Nix |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083740187 PECOS PAC ID: 4981595154 Enrollment ID: I20150615001538 |
| Provider Name | Ian C. Riddock |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669582870 PECOS PAC ID: 1759544356 Enrollment ID: I20150710000336 |
| Provider Name | Anthony J Fillmore |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982680518 PECOS PAC ID: 5496777252 Enrollment ID: I20150729006626 |
| Provider Name | Anthony M Kahr |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1558686352 PECOS PAC ID: 4789998709 Enrollment ID: I20150805006725 |
| Provider Name | Nicholas Cody Bjorn Branting |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114243490 PECOS PAC ID: 4789839515 Enrollment ID: I20150806012321 |
| Provider Name | Carey A Pulido |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811380157 PECOS PAC ID: 8224344072 Enrollment ID: I20150825003851 |
| Provider Name | Emily M Karben |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1174875413 PECOS PAC ID: 2769797737 Enrollment ID: I20150826002479 |
| Provider Name | Andrew Kleaveland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043571342 PECOS PAC ID: 2365676079 Enrollment ID: I20150903001749 |
| Provider Name | Tracy M Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427315704 PECOS PAC ID: 1355667031 Enrollment ID: I20151016000929 |
| Provider Name | Cameron David Mitchell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891733176 PECOS PAC ID: 0446283873 Enrollment ID: I20151020001320 |
| Provider Name | Jamie Henderson Paluck |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1952668659 PECOS PAC ID: 8022327576 Enrollment ID: I20151022002661 |
| Provider Name | Amy E Madison |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1699904912 PECOS PAC ID: 1355566647 Enrollment ID: I20151023001533 |
| Provider Name | Jennifer K Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053332593 PECOS PAC ID: 5799780961 Enrollment ID: I20151119000316 |
| Provider Name | Cassandra L Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598928558 PECOS PAC ID: 6305913054 Enrollment ID: I20151207000048 |
| Provider Name | Daymen S Tuscano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962606798 PECOS PAC ID: 1658535273 Enrollment ID: I20151210000724 |
| Provider Name | David G Ingraham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902892631 PECOS PAC ID: 3577468818 Enrollment ID: I20151221002357 |
| Provider Name | Kristin A Stratton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275775843 PECOS PAC ID: 7113229352 Enrollment ID: I20160106000011 |
| Provider Name | Monica M Wahls |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922071182 PECOS PAC ID: 9931404647 Enrollment ID: I20160217002239 |
| Provider Name | Lauren Andrus Tomeny |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497072433 PECOS PAC ID: 3274767603 Enrollment ID: I20160418002441 |
| Provider Name | Kelsey M Conklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801255120 PECOS PAC ID: 0840589651 Enrollment ID: I20160518001305 |
| Provider Name | Kallie A Schneider |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902168008 PECOS PAC ID: 5395978621 Enrollment ID: I20160519002338 |
| Provider Name | Leslie A Carey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699938340 PECOS PAC ID: 3779758297 Enrollment ID: I20160715002088 |
| Provider Name | Kristina E Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689010738 PECOS PAC ID: 1153644299 Enrollment ID: I20160819001977 |
| Provider Name | Courtney R Virgilio |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285753160 PECOS PAC ID: 5890840086 Enrollment ID: I20161018002878 |
| Provider Name | Renee Del Rio |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811053283 PECOS PAC ID: 7618049008 Enrollment ID: I20161221000540 |
| Provider Name | Victor A Nwanguma |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1366601387 PECOS PAC ID: 5496901688 Enrollment ID: I20170313000974 |
| Provider Name | Eric T Ory |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083657621 PECOS PAC ID: 1557335239 Enrollment ID: I20170320002382 |
| Provider Name | Dausen John Harker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922244128 PECOS PAC ID: 4981837929 Enrollment ID: I20170329002589 |
| Provider Name | Sandra V Hazra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215972195 PECOS PAC ID: 3577464346 Enrollment ID: I20170425000080 |
| Provider Name | Laura S Nicholson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578513552 PECOS PAC ID: 5193728384 Enrollment ID: I20170425000595 |
| Provider Name | Marco A Ugas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134410392 PECOS PAC ID: 7214165281 Enrollment ID: I20170615000128 |
| Provider Name | Matt S Ashley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013294941 PECOS PAC ID: 1658502851 Enrollment ID: I20170714000320 |
| Provider Name | Jill Olinger |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1396745303 PECOS PAC ID: 6204861131 Enrollment ID: I20170810000553 |
| Provider Name | Matthew R Lilley |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003166612 PECOS PAC ID: 7315219946 Enrollment ID: I20170816004556 |
| Provider Name | Priscilla Villarreal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144648031 PECOS PAC ID: 3678884525 Enrollment ID: I20170825003080 |
| Provider Name | Michael K Schlepp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831455377 PECOS PAC ID: 5395022610 Enrollment ID: I20180109001557 |
| Provider Name | Ekaterina Y Urch |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1548550890 PECOS PAC ID: 6709178072 Enrollment ID: I20180208001836 |
| Provider Name | Rebecca L Ferguson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396973087 PECOS PAC ID: 6709030281 Enrollment ID: I20180329000962 |
| Provider Name | Jeremiah W Lanford |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033230800 PECOS PAC ID: 6103926373 Enrollment ID: I20180419002700 |
| Provider Name | Mauricio E Vargas |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1871997502 PECOS PAC ID: 4880959501 Enrollment ID: I20180530002546 |
| Provider Name | Stephanie L Smith |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1487819017 PECOS PAC ID: 3678838091 Enrollment ID: I20180605002058 |
| Provider Name | Ryan Edward Berecky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104026772 PECOS PAC ID: 8628221777 Enrollment ID: I20180627003792 |
| Provider Name | Dennis N Hughes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215076468 PECOS PAC ID: 5193753242 Enrollment ID: I20180702003612 |
| Provider Name | Timothy M Preston |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457748196 PECOS PAC ID: 4385930338 Enrollment ID: I20180806000682 |
| Provider Name | Justin Stephan Roth |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306109954 PECOS PAC ID: 1850660531 Enrollment ID: I20180808003623 |
| Provider Name | Audrey Jacquette Eden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609247972 PECOS PAC ID: 9436454840 Enrollment ID: I20180904003259 |
| Provider Name | Linda A Steiner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285601823 PECOS PAC ID: 9830440163 Enrollment ID: I20180925002627 |
| Provider Name | Megan B Blunda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235424334 PECOS PAC ID: 2466673736 Enrollment ID: I20181031002996 |
| Provider Name | Elizabeth Chandy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437456159 PECOS PAC ID: 8022391549 Enrollment ID: I20181107002059 |
| Provider Name | Emily J Messmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962852723 PECOS PAC ID: 4688965411 Enrollment ID: I20181213001167 |
| Provider Name | Devon Hutton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518379080 PECOS PAC ID: 4284933581 Enrollment ID: I20190118002284 |
| Provider Name | Kai Zachary Kinder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548585086 PECOS PAC ID: 4486975299 Enrollment ID: I20190228001784 |
| Provider Name | Hagop Sarkissian |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1245473990 PECOS PAC ID: 0840505145 Enrollment ID: I20190319002510 |
| Provider Name | Jaclyn E Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013419530 PECOS PAC ID: 3678813748 Enrollment ID: I20190327002837 |
| Provider Name | Jennifer N Herr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003350505 PECOS PAC ID: 2567746787 Enrollment ID: I20190328000679 |
| Provider Name | Melina Maria Moran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871064493 PECOS PAC ID: 0547501587 Enrollment ID: I20190401001521 |
| Provider Name | Jade C Carboy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891286944 PECOS PAC ID: 9931458817 Enrollment ID: I20190521002676 |
| Provider Name | Sarah C. Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477749836 PECOS PAC ID: 5294820718 Enrollment ID: I20190530002658 |
| Provider Name | Julie E Chaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174042824 PECOS PAC ID: 7719210079 Enrollment ID: I20190531002097 |
| Provider Name | Casey George Curran |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013276070 PECOS PAC ID: 9436395357 Enrollment ID: I20190701001800 |
| Provider Name | Laith M Kadasi |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1174937163 PECOS PAC ID: 7012223571 Enrollment ID: I20190807003873 |
| Provider Name | Andrew O Jensen |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1285025478 PECOS PAC ID: 4981998010 Enrollment ID: I20190903003141 |
| Provider Name | Tamarind Marie Keating |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508012568 PECOS PAC ID: 5799851192 Enrollment ID: I20191105000263 |
| Provider Name | Christopher Martin Coleman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952691800 PECOS PAC ID: 6305089665 Enrollment ID: I20191111000145 |
| Provider Name | Melinda C Burns-williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710351341 PECOS PAC ID: 1456658327 Enrollment ID: I20191115000293 |
| Provider Name | David R Ludwig |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306805080 PECOS PAC ID: 4284601683 Enrollment ID: I20191204000189 |
| Provider Name | David James Oettel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144434820 PECOS PAC ID: 0840583894 Enrollment ID: I20191204000226 |
| Provider Name | Carl A Recine |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013979780 PECOS PAC ID: 1254245723 Enrollment ID: I20191204000248 |
| Provider Name | Lloyd Wagner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124161872 PECOS PAC ID: 3870517923 Enrollment ID: I20191204000308 |
| Provider Name | Paula Kay Shultz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407047103 PECOS PAC ID: 7618301078 Enrollment ID: I20191218002321 |
| Provider Name | Matthew Ryan Clark |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1194162230 PECOS PAC ID: 1153564380 Enrollment ID: I20191224000409 |
| Provider Name | Frederick B Steinberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225002702 PECOS PAC ID: 9638140239 Enrollment ID: I20191226000527 |
| Provider Name | Trisha D Alderson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1144552936 PECOS PAC ID: 6305974817 Enrollment ID: I20200205000500 |
| Provider Name | Christopher G Wladyka |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043452659 PECOS PAC ID: 8921131798 Enrollment ID: I20200206001552 |
| Provider Name | Daniel Lerner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740441898 PECOS PAC ID: 4789862202 Enrollment ID: I20200211000223 |
| Provider Name | Christina H Halter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134568157 PECOS PAC ID: 4284876319 Enrollment ID: I20200309002255 |
| Provider Name | Theodore Jennermann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073891735 PECOS PAC ID: 3173822673 Enrollment ID: I20200416003455 |
| Provider Name | Amber Faast |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316387251 PECOS PAC ID: 8921311564 Enrollment ID: I20200508000978 |
| Provider Name | Robert Andrews |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568805836 PECOS PAC ID: 2769610575 Enrollment ID: I20200609002868 |
| Provider Name | Michael S Mclaughlin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316205149 PECOS PAC ID: 2860624632 Enrollment ID: I20200610001367 |
| Provider Name | Walter Bogart |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1922084151 PECOS PAC ID: 1254485899 Enrollment ID: I20200708002425 |
| Provider Name | Jozef Brozyna |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508201336 PECOS PAC ID: 9032333760 Enrollment ID: I20200806001009 |
| Provider Name | Steven M Christiansen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1548603483 PECOS PAC ID: 9436390531 Enrollment ID: I20200814001891 |
| Provider Name | Katelyn Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245766856 PECOS PAC ID: 8820329907 Enrollment ID: I20200818003600 |
| Provider Name | David Gregory Downing |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649882671 PECOS PAC ID: 8729405485 Enrollment ID: I20200827000300 |
| Provider Name | David Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558517623 PECOS PAC ID: 3476731043 Enrollment ID: I20200914000807 |
| Provider Name | Maximilian Psolka |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1255441952 PECOS PAC ID: 6608921523 Enrollment ID: I20200922002515 |
| Provider Name | Lewis B Barnett |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1366856734 PECOS PAC ID: 6305134974 Enrollment ID: I20201015001828 |
| Provider Name | Adam J Pike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508358201 PECOS PAC ID: 9739437583 Enrollment ID: I20201210002520 |
| Provider Name | Evon J Praska |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1225685266 PECOS PAC ID: 3779919162 Enrollment ID: I20201215000182 |
| Provider Name | Nicole C Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568822864 PECOS PAC ID: 5496045338 Enrollment ID: I20201215001691 |
| Provider Name | Dennis M Willerford |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1316010804 PECOS PAC ID: 6406858265 Enrollment ID: I20210108001005 |
| Provider Name | Julie Ann Aldrich Whalen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740566306 PECOS PAC ID: 9537480868 Enrollment ID: I20210115001920 |
| Provider Name | Brooke Veer Sundermeier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649757436 PECOS PAC ID: 8729339619 Enrollment ID: I20210125002776 |
| Provider Name | Whitney Stalder Morgan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487016945 PECOS PAC ID: 7214341676 Enrollment ID: I20210126000560 |
| Provider Name | Erin J Morrow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770807232 PECOS PAC ID: 1951694355 Enrollment ID: I20210219000502 |
| Provider Name | Michael Amedeo Franzone |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1821589573 PECOS PAC ID: 9234463688 Enrollment ID: I20210329001439 |
| Provider Name | Kurt W Andreason |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1013990027 PECOS PAC ID: 3779683016 Enrollment ID: I20210427001624 |
| Provider Name | Alanna Mozena |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003201476 PECOS PAC ID: 4587964036 Enrollment ID: I20210517001285 |
| Provider Name | Ryan D Kearney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700105046 PECOS PAC ID: 0345556833 Enrollment ID: I20210608003320 |
| Provider Name | Bryden Thomas Considine |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356760839 PECOS PAC ID: 2668791716 Enrollment ID: I20210609003019 |
| Provider Name | Poornima Rao |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639346851 PECOS PAC ID: 5597836668 Enrollment ID: I20210611002147 |
| Provider Name | Tessa Maria Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700370087 PECOS PAC ID: 9739438656 Enrollment ID: I20210617001295 |
| Provider Name | Robert S Yee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497743116 PECOS PAC ID: 2062487176 Enrollment ID: I20210624003847 |
| Provider Name | Emma Considine |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447695226 PECOS PAC ID: 9537489372 Enrollment ID: I20210626000027 |
| Provider Name | Kathryn A Bacher |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1619330057 PECOS PAC ID: 6709178726 Enrollment ID: I20210706001796 |
| Provider Name | Spencer Pellicano Larson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508363045 PECOS PAC ID: 3678975257 Enrollment ID: I20210706002775 |
| Provider Name | Amber Marie Loredo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770166381 PECOS PAC ID: 3577966928 Enrollment ID: I20210723000359 |
| Provider Name | Connor A King |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1750761003 PECOS PAC ID: 6204138068 Enrollment ID: I20210804002080 |
| Provider Name | Ashley Michael |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1831553551 PECOS PAC ID: 2264855436 Enrollment ID: I20210920000230 |
| Provider Name | Joel Evan Schneider |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437157138 PECOS PAC ID: 0941382097 Enrollment ID: I20211007002238 |
| Provider Name | Tariq Salam |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1043294291 PECOS PAC ID: 2668413717 Enrollment ID: I20211019002811 |
| Provider Name | James Fredrick Ciomber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548932064 PECOS PAC ID: 8527459874 Enrollment ID: I20211222000665 |
| Provider Name | Hyung Chil Kang |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1992709471 PECOS PAC ID: 5294724514 Enrollment ID: I20211228002134 |
| Provider Name | Daniel Levi Willis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1023211547 PECOS PAC ID: 5496908840 Enrollment ID: I20220117000623 |
| Provider Name | Stephen Haltom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538208574 PECOS PAC ID: 5496889602 Enrollment ID: I20220121000900 |
| Provider Name | Jason L Davis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861502783 PECOS PAC ID: 7517063118 Enrollment ID: I20220126002276 |
| Provider Name | Benjamin Z Cooper |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568564300 PECOS PAC ID: 3577595370 Enrollment ID: I20220315002075 |
| Provider Name | Dana Barnett |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275947640 PECOS PAC ID: 7113206053 Enrollment ID: I20220325001932 |
| Provider Name | Heidi Rasmussen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982253506 PECOS PAC ID: 8921495920 Enrollment ID: I20220421000739 |
| Provider Name | Edmund Pennington Pillsbury |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871793380 PECOS PAC ID: 4789717125 Enrollment ID: I20220503001363 |
| Provider Name | Zizhen Feng |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1285096347 PECOS PAC ID: 7315281458 Enrollment ID: I20220505000979 |
| Provider Name | Kara M Prier |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164614632 PECOS PAC ID: 6608947890 Enrollment ID: I20220509001506 |
| Provider Name | Alexander Ochman |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316392970 PECOS PAC ID: 8628362894 Enrollment ID: I20220616002878 |
| Provider Name | Roman Raju |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104026681 PECOS PAC ID: 0648414185 Enrollment ID: I20220620001248 |
| Provider Name | Timothy Roos |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558855767 PECOS PAC ID: 2769732486 Enrollment ID: I20220714002285 |
| Provider Name | Sarah Catherine O'brien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801415138 PECOS PAC ID: 8628450483 Enrollment ID: I20220727000907 |
| Provider Name | Teresa G Straub |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891299020 PECOS PAC ID: 5294142816 Enrollment ID: I20220824002402 |
| Provider Name | Matthew Taylor |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1033123658 PECOS PAC ID: 8022922905 Enrollment ID: I20220908002482 |
| Provider Name | Jeremy Feldman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689681025 PECOS PAC ID: 5496749160 Enrollment ID: I20221018000339 |
| Provider Name | Lauren N Bartniski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134845811 PECOS PAC ID: 8628445699 Enrollment ID: I20221103001482 |
| Provider Name | Kid Jonathan Cabrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588386676 PECOS PAC ID: 4385012715 Enrollment ID: I20221116001232 |
| Provider Name | Terry Rolan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063479103 PECOS PAC ID: 7315831401 Enrollment ID: I20221118002398 |
| Provider Name | Ramin Sabahi |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1568569804 PECOS PAC ID: 8820991185 Enrollment ID: I20221209001808 |
| Provider Name | Alexa Erin Rawlins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770044901 PECOS PAC ID: 7810226693 Enrollment ID: I20230111002354 |
| Provider Name | Rachel Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952960387 PECOS PAC ID: 8426384785 Enrollment ID: I20230130001163 |
| Provider Name | Kerry Traugott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396118469 PECOS PAC ID: 3779885884 Enrollment ID: I20230214001218 |
| Provider Name | William M Newberry |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1629148762 PECOS PAC ID: 2567497803 Enrollment ID: I20230227002332 |
| Provider Name | Tawnyee Lynne Marzoeki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275229064 PECOS PAC ID: 1850756834 Enrollment ID: I20230426001357 |
| Provider Name | Sarah A Struthers |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154764066 PECOS PAC ID: 6103126677 Enrollment ID: I20230511002816 |
| Provider Name | Lindsey Sage Cabrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558084228 PECOS PAC ID: 6204292998 Enrollment ID: I20230523001411 |
| Provider Name | Mary Allegra Kelley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1720646862 PECOS PAC ID: 1052778552 Enrollment ID: I20230526000958 |
| Provider Name | Stephen Carroll |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669532008 PECOS PAC ID: 8224122551 Enrollment ID: I20230613003243 |
| Provider Name | Amber Marie Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851024582 PECOS PAC ID: 5991165839 Enrollment ID: I20230724002537 |
| Provider Name | Alyssa Leigh Mcnamara |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972034270 PECOS PAC ID: 3678846474 Enrollment ID: I20230821002546 |
| Provider Name | Steven R Plimpton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841731254 PECOS PAC ID: 0840629010 Enrollment ID: I20230821003148 |
| Provider Name | Nathan M Segerson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841303534 PECOS PAC ID: 2860566049 Enrollment ID: I20230829003800 |
| Provider Name | Rachel Elizabeth Delance |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275022311 PECOS PAC ID: 9032572615 Enrollment ID: I20230830000629 |
| Provider Name | Carolyn L Luppens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669868030 PECOS PAC ID: 6204116676 Enrollment ID: I20230901001306 |
| Provider Name | Darcy Dubuc Wynn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508216268 PECOS PAC ID: 8426308313 Enrollment ID: I20230912003781 |
| Provider Name | Kendra Michelle Caudle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427747054 PECOS PAC ID: 8921462573 Enrollment ID: I20230914002618 |
| Provider Name | Alice Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235768409 PECOS PAC ID: 8123449857 Enrollment ID: I20230918003915 |
| Provider Name | Jennifer Burtner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518903558 PECOS PAC ID: 8527080233 Enrollment ID: I20240109004175 |
| Provider Name | Katie Kahl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427824713 PECOS PAC ID: 4486006962 Enrollment ID: I20240119003219 |
| Provider Name | Mark R Burge |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1578579207 PECOS PAC ID: 3476633652 Enrollment ID: I20240219003340 |
| Provider Name | Debbi Mason |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1801202288 PECOS PAC ID: 2163868852 Enrollment ID: I20240316000531 |
| Provider Name | Alison Leigh Gardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821864554 PECOS PAC ID: 5698112332 Enrollment ID: I20240318002138 |
| Provider Name | Stefani Rocco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164036547 PECOS PAC ID: 0941611974 Enrollment ID: I20240327003214 |
| Provider Name | Katrina Suzanne Meynig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275257438 PECOS PAC ID: 0749629186 Enrollment ID: I20240417002900 |
| Provider Name | Joshua D Raines |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184057580 PECOS PAC ID: 0244503704 Enrollment ID: I20240508003382 |
| Provider Name | Anette Gail Santos Pe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194577320 PECOS PAC ID: 1052752482 Enrollment ID: I20240515003767 |
| Provider Name | Hannah S Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568219350 PECOS PAC ID: 6406298389 Enrollment ID: I20240523000975 |
| Provider Name | Arianna Kousari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194220889 PECOS PAC ID: 2668728783 Enrollment ID: I20240605004118 |
| Provider Name | Ryan D Lurtsema |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033645296 PECOS PAC ID: 3476823964 Enrollment ID: I20240614003554 |
| Provider Name | Nica Lurtsema |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558942383 PECOS PAC ID: 3375945652 Enrollment ID: I20240708000622 |
| Provider Name | Sierra R Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780261479 PECOS PAC ID: 5698178234 Enrollment ID: I20240708002521 |
| Provider Name | Walter Curtis Griffin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508212127 PECOS PAC ID: 6305181165 Enrollment ID: I20240710005260 |
| Provider Name | Emily Sauck |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942838164 PECOS PAC ID: 7618399478 Enrollment ID: I20240720000517 |
| Provider Name | Ryan Michael Masterson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1679035042 PECOS PAC ID: 9032449426 Enrollment ID: I20240729003221 |
| Provider Name | Michelle A Bender |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184625279 PECOS PAC ID: 6608055348 Enrollment ID: I20240901000032 |
| Provider Name | Matthew Ingrassia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700142122 PECOS PAC ID: 5294050258 Enrollment ID: I20240918002935 |
| Provider Name | Annalise Forsythe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336614247 PECOS PAC ID: 1658619713 Enrollment ID: I20241003002305 |
| Provider Name | Kiersten Leigh Sorensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679300628 PECOS PAC ID: 8820529563 Enrollment ID: I20241004001223 |
| Provider Name | Evan Smith |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1588157010 PECOS PAC ID: 4486989027 Enrollment ID: I20241120002912 |
| Provider Name | Lauren Shields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417572975 PECOS PAC ID: 4981015427 Enrollment ID: I20241217001305 |
Pine Springs Health Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 711 Ne Irving Ave, Bend, OR 97701 Phone: 541-330-9110 | |
St. Charles Health System, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2500 Ne Neff Rd, Bend, OR 97701 Phone: 541-382-4321 | |
Mosaic Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2577 Ne Courtney Dr Ste 100, Bend, OR 97701 Phone: 541-383-3005 | |
Adam Derr, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 528 Ne Greenwood Ave, Bend, OR 97701 Phone: 541-385-7890 Fax: 541-388-2606 | |
Driven Enterprises Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20700 Wandalea Dr, Bend, OR 97701 Phone: 435-669-2930 | |
Bend Plastic & Reconstructive Surgery, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1239 Ne Medical Center Dr Ste 240, Bend, OR 97701 Phone: 541-749-2282 Fax: 541-749-2283 | |
Neuro Speech Therapy Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1372 Ne Whisper Ridge Dr Apt 3, Bend, OR 97701 Phone: 541-204-1757 |