| Cayuga Medical Associates, PC | |
|
101 Dates Dr Ithaca NY 14850-1342 | |
| (607) 274-4011 | |
| Not Available |
| Full Name | Cayuga Medical Associates, PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 101 Dates Dr, Ithaca, New York |
| Authorized Official Name and Position | Elizabeth Smith (PRESIDENT) |
| Authorized Official Contact | 6072744011 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cayuga Medical Associates, PC Po Box 250 Ithaca NY 14851-0250 Ph: (607) 882-0010 | Cayuga Medical Associates, PC 101 Dates Dr Ithaca NY 14850-1342 Ph: (607) 274-4011 |
| NPI Number | 1679525455 |
|---|---|
| Provider Enumeration Date | 05/17/2006 |
| Last Update Date | 04/22/2026 |
| Certification Date | 04/22/2026 |
| Medicare PECOS PAC ID | 6709897960 |
|---|---|
| Medicare Enrollment ID | O20060601000199 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679525455 | NPI | - | NPPES |
| Provider Name | Ami Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518942127 PECOS PAC ID: 8921906157 Enrollment ID: I20031226000217 |
| Provider Name | Stefan Lucas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174541213 PECOS PAC ID: 0840199691 Enrollment ID: I20031231000365 |
| Provider Name | Ashutosh H Ruparelia |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1790771996 PECOS PAC ID: 3375435696 Enrollment ID: I20040329001765 |
| Provider Name | Mashelle M Jansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598744880 PECOS PAC ID: 1052304110 Enrollment ID: I20040405001404 |
| Provider Name | Andrew R Getzin |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1962458406 PECOS PAC ID: 4284626748 Enrollment ID: I20040407000108 |
| Provider Name | Amit K Singh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699799528 PECOS PAC ID: 8022001825 Enrollment ID: I20040407000295 |
| Provider Name | David S Dinhofer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770576589 PECOS PAC ID: 3971599226 Enrollment ID: I20040422000155 |
| Provider Name | Charles L Garbo |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1942363346 PECOS PAC ID: 4082601778 Enrollment ID: I20040426001582 |
| Provider Name | Elizabeth a Gaary |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447202684 PECOS PAC ID: 4183613714 Enrollment ID: I20040510000589 |
| Provider Name | Aruna Kode |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124012398 PECOS PAC ID: 9335130673 Enrollment ID: I20040524001074 |
| Provider Name | Suzamie J Farnsworth |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497761431 PECOS PAC ID: 3274524558 Enrollment ID: I20040524001377 |
| Provider Name | Emmanuel U Ekeke |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467503235 PECOS PAC ID: 7012993983 Enrollment ID: I20040629001615 |
| Provider Name | Chan M Ma |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1487642120 PECOS PAC ID: 8325026917 Enrollment ID: I20040709001296 |
| Provider Name | Biswarup Syam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1942299771 PECOS PAC ID: 5991783417 Enrollment ID: I20040712000416 |
| Provider Name | Mark N Moosikasuwan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1710994983 PECOS PAC ID: 7810968013 Enrollment ID: I20040802001621 |
| Provider Name | Francis J Mangiacapra |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386612216 PECOS PAC ID: 4183695638 Enrollment ID: I20040805001389 |
| Provider Name | Tamara J Stockwin |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1043326424 PECOS PAC ID: 1850363342 Enrollment ID: I20040806000034 |
| Provider Name | Jianming Ren |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093710899 PECOS PAC ID: 0547237513 Enrollment ID: I20040910000790 |
| Provider Name | Charbel Georges Moussallem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538268289 PECOS PAC ID: 1658334651 Enrollment ID: I20041110000906 |
| Provider Name | John-paul Daniel Mead |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1861498602 PECOS PAC ID: 4587628300 Enrollment ID: I20041112000094 |
| Provider Name | Katherine L Menera |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952301194 PECOS PAC ID: 6507820610 Enrollment ID: I20041118000275 |
| Provider Name | Sharon L Ziegler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083671325 PECOS PAC ID: 1850342171 Enrollment ID: I20050207000216 |
| Provider Name | Christina D Morse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972608990 PECOS PAC ID: 3971557711 Enrollment ID: I20050304000379 |
| Provider Name | Jose a Torrado |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528039864 PECOS PAC ID: 6406801471 Enrollment ID: I20050314000465 |
| Provider Name | Kelli a Hektor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407956980 PECOS PAC ID: 4981646411 Enrollment ID: I20050525000559 |
| Provider Name | Timothy E Bael |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1376605501 PECOS PAC ID: 2062449705 Enrollment ID: I20050725000894 |
| Provider Name | Jonathan E Cryer |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1407947351 PECOS PAC ID: 6305874173 Enrollment ID: I20050802000831 |
| Provider Name | Julie J Higgins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1073534590 PECOS PAC ID: 4486683877 Enrollment ID: I20050808000486 |
| Provider Name | David Halpert |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811913163 PECOS PAC ID: 4789614694 Enrollment ID: I20050823000108 |
| Provider Name | Meredith a Schledorn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265499651 PECOS PAC ID: 7315978566 Enrollment ID: I20050826000629 |
| Provider Name | James Malpeso |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1366440679 PECOS PAC ID: 2163455890 Enrollment ID: I20050920000788 |
| Provider Name | Beth S Hopkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720029382 PECOS PAC ID: 9830123603 Enrollment ID: I20050922000895 |
| Provider Name | Inna Malostovker |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1033189949 PECOS PAC ID: 5890716344 Enrollment ID: I20051212000561 |
| Provider Name | Andrea Amato |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992739510 PECOS PAC ID: 9739140880 Enrollment ID: I20051213000665 |
| Provider Name | Walter C Silbert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578591749 PECOS PAC ID: 1456366970 Enrollment ID: I20060220000348 |
| Provider Name | Steven Perlin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922083427 PECOS PAC ID: 5799740379 Enrollment ID: I20060316000504 |
| Provider Name | Michael D Beredo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033188990 PECOS PAC ID: 3870501034 Enrollment ID: I20060330000033 |
| Provider Name | Thomas M Toal |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1720054372 PECOS PAC ID: 2668426164 Enrollment ID: I20060407000057 |
| Provider Name | Mary F Howson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861447369 PECOS PAC ID: 3476562984 Enrollment ID: I20060412000103 |
| Provider Name | Jonathan Mauser |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417902958 PECOS PAC ID: 9133130644 Enrollment ID: I20060517000101 |
| Provider Name | Michael Stone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750359691 PECOS PAC ID: 6204848047 Enrollment ID: I20060619000267 |
| Provider Name | Serena H Yoon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477505279 PECOS PAC ID: 5092727644 Enrollment ID: I20060622000150 |
| Provider Name | Wade S Bollinger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730198136 PECOS PAC ID: 8325026727 Enrollment ID: I20070201000187 |
| Provider Name | James R Norton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679592224 PECOS PAC ID: 3779685607 Enrollment ID: I20070223000562 |
| Provider Name | Adrienne Salomon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881700177 PECOS PAC ID: 8123123148 Enrollment ID: I20070420000104 |
| Provider Name | Magdalena D Hohn |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285644260 PECOS PAC ID: 6709982226 Enrollment ID: I20070430000538 |
| Provider Name | Michael R Ronald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871507905 PECOS PAC ID: 4385743772 Enrollment ID: I20070626000484 |
| Provider Name | William C Shepherd |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821071499 PECOS PAC ID: 5294835336 Enrollment ID: I20070703000146 |
| Provider Name | Sandra Thananart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669527263 PECOS PAC ID: 5496855603 Enrollment ID: I20070717000146 |
| Provider Name | Walter Edward Margie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427033349 PECOS PAC ID: 5597723684 Enrollment ID: I20070719000431 |
| Provider Name | Suzanne KW Anderson |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1770571101 PECOS PAC ID: 3375644776 Enrollment ID: I20070730000652 |
| Provider Name | Joseph R Zuback |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447287354 PECOS PAC ID: 9638100068 Enrollment ID: I20070811000005 |
| Provider Name | Zafar J Bajwa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205848611 PECOS PAC ID: 9537255575 Enrollment ID: I20071022000536 |
| Provider Name | Melissa Franckowiak |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700077278 PECOS PAC ID: 1557457405 Enrollment ID: I20071023000687 |
| Provider Name | Aaron Sasson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366470049 PECOS PAC ID: 7517960420 Enrollment ID: I20071107000165 |
| Provider Name | Reilly W Coch |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1639394323 PECOS PAC ID: 2668561648 Enrollment ID: I20071128000402 |
| Provider Name | Karen M La Face |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982675765 PECOS PAC ID: 9335238252 Enrollment ID: I20071130000033 |
| Provider Name | Virginia Marie Signorelli |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992993448 PECOS PAC ID: 7618067109 Enrollment ID: I20071220000574 |
| Provider Name | Laurie Bitting |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235318247 PECOS PAC ID: 5496837288 Enrollment ID: I20080201000224 |
| Provider Name | Sorin Brener |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104930338 PECOS PAC ID: 4284690884 Enrollment ID: I20080320000181 |
| Provider Name | Stephanie Susan Debuck |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1285648469 PECOS PAC ID: 9931170057 Enrollment ID: I20080324000259 |
| Provider Name | Blake M Marson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205898772 PECOS PAC ID: 6002995461 Enrollment ID: I20080509000437 |
| Provider Name | Alan Ipson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285808824 PECOS PAC ID: 0941369615 Enrollment ID: I20081110000647 |
| Provider Name | Christopher Schaeffer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962688366 PECOS PAC ID: 5193890580 Enrollment ID: I20090508000048 |
| Provider Name | Paul L Marino |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1821096397 PECOS PAC ID: 2961506159 Enrollment ID: I20090601000357 |
| Provider Name | David M Landsberg |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1194721456 PECOS PAC ID: 9638229149 Enrollment ID: I20090603000642 |
| Provider Name | Martin Stallone |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295751782 PECOS PAC ID: 0941395073 Enrollment ID: I20090615000305 |
| Provider Name | Brian Bollo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992943153 PECOS PAC ID: 0345392536 Enrollment ID: I20090720000191 |
| Provider Name | Alon Yarkoni |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1912103052 PECOS PAC ID: 1153474572 Enrollment ID: I20090803000562 |
| Provider Name | Jillene M Brathwaite |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1174753743 PECOS PAC ID: 2365596525 Enrollment ID: I20090821000621 |
| Provider Name | Steven Lasker |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437261732 PECOS PAC ID: 7810913100 Enrollment ID: I20090824000614 |
| Provider Name | Emily C Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295962892 PECOS PAC ID: 0446305528 Enrollment ID: I20090826000652 |
| Provider Name | Elisabeth M Cotton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720049919 PECOS PAC ID: 9436205754 Enrollment ID: I20091020000690 |
| Provider Name | Duc T Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134363682 PECOS PAC ID: 7214074251 Enrollment ID: I20091026000006 |
| Provider Name | Dirk H Dugan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699854208 PECOS PAC ID: 2668511239 Enrollment ID: I20091120000558 |
| Provider Name | Kenneth P Subin |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1144333170 PECOS PAC ID: 5597805648 Enrollment ID: I20091221000502 |
| Provider Name | Andreia P De Lima |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376733329 PECOS PAC ID: 2365583192 Enrollment ID: I20091230000555 |
| Provider Name | Peter T Brennan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780655118 PECOS PAC ID: 1850309444 Enrollment ID: I20100224000019 |
| Provider Name | Amy Lynn Alvaro-hamilton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508194234 PECOS PAC ID: 9335274471 Enrollment ID: I20100316000000 |
| Provider Name | Howard Silcoff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730135963 PECOS PAC ID: 8921141797 Enrollment ID: I20100414000122 |
| Provider Name | Edwin R Acosta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255309985 PECOS PAC ID: 3476596453 Enrollment ID: I20100611000641 |
| Provider Name | Anthony Sanito |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1033189931 PECOS PAC ID: 8224161997 Enrollment ID: I20100802000333 |
| Provider Name | Stephen J Meyer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467422238 PECOS PAC ID: 9830222512 Enrollment ID: I20100802000377 |
| Provider Name | Donald G Bluh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619947660 PECOS PAC ID: 5991838674 Enrollment ID: I20100802000417 |
| Provider Name | Mattison a Burt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437129483 PECOS PAC ID: 8729112099 Enrollment ID: I20100823000668 |
| Provider Name | Kimberly P Kaffenbarger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790867794 PECOS PAC ID: 8325942758 Enrollment ID: I20100827000555 |
| Provider Name | David M Monacelli |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1003960881 PECOS PAC ID: 4981720281 Enrollment ID: I20100923001124 |
| Provider Name | Ellyn Purcell Sellers-selin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902827470 PECOS PAC ID: 4688869159 Enrollment ID: I20101110000094 |
| Provider Name | Lynn Bancroft Swisher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659392538 PECOS PAC ID: 7810981560 Enrollment ID: I20101213000133 |
| Provider Name | Dvorah Milner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376613836 PECOS PAC ID: 4789698127 Enrollment ID: I20101214001323 |
| Provider Name | James S Gaffney |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316949522 PECOS PAC ID: 4486747888 Enrollment ID: I20110112000533 |
| Provider Name | Christian H Mckeithen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508176280 PECOS PAC ID: 0840472908 Enrollment ID: I20110310000387 |
| Provider Name | Sara S Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831491596 PECOS PAC ID: 2769664689 Enrollment ID: I20110314000262 |
| Provider Name | Desiree L Long |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508167644 PECOS PAC ID: 7719160720 Enrollment ID: I20110330000049 |
| Provider Name | Megan G Turnbull |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629375167 PECOS PAC ID: 8325223100 Enrollment ID: I20110420000366 |
| Provider Name | Malcolm Brand |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770507683 PECOS PAC ID: 1759389158 Enrollment ID: I20110506000008 |
| Provider Name | Lloyd a Darlow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740376615 PECOS PAC ID: 9638152309 Enrollment ID: I20110524000058 |
| Provider Name | Jerry Robert Emmons |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528202462 PECOS PAC ID: 3476730573 Enrollment ID: I20110526000471 |
| Provider Name | Candice M Oliver |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932361656 PECOS PAC ID: 0648457127 Enrollment ID: I20110609000503 |
| Provider Name | David D Chung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588870042 PECOS PAC ID: 3971771155 Enrollment ID: I20110713000484 |
| Provider Name | Susan M Mckelvey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669760682 PECOS PAC ID: 6608045075 Enrollment ID: I20110802000220 |
| Provider Name | Shawn Mills |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326012329 PECOS PAC ID: 5991743528 Enrollment ID: I20110816000639 |
| Provider Name | Joshua E Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710272638 PECOS PAC ID: 0244401800 Enrollment ID: I20110913000128 |
| Provider Name | William N Ambrosini |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881662898 PECOS PAC ID: 5698947141 Enrollment ID: I20111006000044 |
| Provider Name | Humaira Hassan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023228996 PECOS PAC ID: 7113070194 Enrollment ID: I20111007000278 |
| Provider Name | Avery F Marzulla-dulfer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639453988 PECOS PAC ID: 3173796778 Enrollment ID: I20111026000705 |
| Provider Name | Lisa a Olson-gugerty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083902027 PECOS PAC ID: 6406029024 Enrollment ID: I20111027000058 |
| Provider Name | Christopher L Peck |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164424362 PECOS PAC ID: 5294908430 Enrollment ID: I20111103000008 |
| Provider Name | Jenny E Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538443114 PECOS PAC ID: 3375717192 Enrollment ID: I20111114000130 |
| Provider Name | John Mecenas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821090036 PECOS PAC ID: 8224202098 Enrollment ID: I20111114000727 |
| Provider Name | Kim S Hwang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235130279 PECOS PAC ID: 1951577170 Enrollment ID: I20120110000140 |
| Provider Name | Suzanne M Langtry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821379710 PECOS PAC ID: 5496913857 Enrollment ID: I20120215000326 |
| Provider Name | Nathan D Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770865115 PECOS PAC ID: 0244491397 Enrollment ID: I20120417000212 |
| Provider Name | Donna L Pierre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770638652 PECOS PAC ID: 4688836505 Enrollment ID: I20120510000017 |
| Provider Name | Douglas D Macqueen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1427129543 PECOS PAC ID: 0648323667 Enrollment ID: I20120628000462 |
| Provider Name | Piotr Sadej |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730384512 PECOS PAC ID: 9537325048 Enrollment ID: I20120730000001 |
| Provider Name | Scott Biter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417980392 PECOS PAC ID: 1759322233 Enrollment ID: I20120917000050 |
| Provider Name | Rebecca Reeves |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1902064793 PECOS PAC ID: 3870742935 Enrollment ID: I20121004000429 |
| Provider Name | Kathryn M Rooth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578798922 PECOS PAC ID: 1557512258 Enrollment ID: I20121106000066 |
| Provider Name | Judith A. Munson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528334026 PECOS PAC ID: 9032360797 Enrollment ID: I20121107000035 |
| Provider Name | Mark B. Forsti |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396095725 PECOS PAC ID: 5890947642 Enrollment ID: I20121201000002 |
| Provider Name | Elizabeth H Gebhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871838920 PECOS PAC ID: 7113162892 Enrollment ID: I20130329000043 |
| Provider Name | Anthony P Randazzo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548598154 PECOS PAC ID: 5991957904 Enrollment ID: I20130808000059 |
| Provider Name | Mason M Sopchak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679808885 PECOS PAC ID: 0749424893 Enrollment ID: I20130911000835 |
| Provider Name | Deborah S Harris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740285337 PECOS PAC ID: 8325062755 Enrollment ID: I20130926000475 |
| Provider Name | James C Metcalf |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1184696965 PECOS PAC ID: 8325025919 Enrollment ID: I20130927000625 |
| Provider Name | Angela Hei-ning Chang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679776199 PECOS PAC ID: 5496887507 Enrollment ID: I20130930000515 |
| Provider Name | Mary Conroy |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1982957577 PECOS PAC ID: 3870727050 Enrollment ID: I20131001000007 |
| Provider Name | Erin M Lovejoy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417264623 PECOS PAC ID: 0547449373 Enrollment ID: I20131028000356 |
| Provider Name | Deidre M Blake |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336157015 PECOS PAC ID: 6103096870 Enrollment ID: I20131203000260 |
| Provider Name | Cameron R Saber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164607578 PECOS PAC ID: 8224100995 Enrollment ID: I20140305001842 |
| Provider Name | Sarah P Elfstrom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235566183 PECOS PAC ID: 4587887443 Enrollment ID: I20140521001569 |
| Provider Name | Carol T Berlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568742914 PECOS PAC ID: 0648495846 Enrollment ID: I20140701002558 |
| Provider Name | Christopher J Cataldi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952721268 PECOS PAC ID: 5799900866 Enrollment ID: I20140703000149 |
| Provider Name | Michael L Berlin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619276375 PECOS PAC ID: 8820213838 Enrollment ID: I20140708001027 |
| Provider Name | Gina M Darpino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316354418 PECOS PAC ID: 4284854803 Enrollment ID: I20141002002093 |
| Provider Name | Ralph J Zinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740696616 PECOS PAC ID: 3072733310 Enrollment ID: I20141008001128 |
| Provider Name | Seemant Singh |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1649435025 PECOS PAC ID: 6103052451 Enrollment ID: I20141010000490 |
| Provider Name | Lavanya Kodali |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114172038 PECOS PAC ID: 8426278698 Enrollment ID: I20141010000831 |
| Provider Name | Qi Zhang |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1720220734 PECOS PAC ID: 8921228099 Enrollment ID: I20141013002355 |
| Provider Name | Roman G Politi |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1508067745 PECOS PAC ID: 9133375488 Enrollment ID: I20141014001251 |
| Provider Name | Marie a Harkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558437640 PECOS PAC ID: 1951376045 Enrollment ID: I20141119001682 |
| Provider Name | Jenna Rae Wilkens |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336543297 PECOS PAC ID: 6406170976 Enrollment ID: I20150112001094 |
| Provider Name | Monica Margaret Wellings |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609953231 PECOS PAC ID: 0345381927 Enrollment ID: I20150312000084 |
| Provider Name | Jeremiah Depta |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1548453939 PECOS PAC ID: 2264573807 Enrollment ID: I20150721000523 |
| Provider Name | Brian S Marino |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750523700 PECOS PAC ID: 4284947011 Enrollment ID: I20150722004388 |
| Provider Name | William David Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124409099 PECOS PAC ID: 1153635602 Enrollment ID: I20150729007012 |
| Provider Name | Farhad Abtahian |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1518166925 PECOS PAC ID: 8224295084 Enrollment ID: I20150812006318 |
| Provider Name | Sarah M Slocum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063896728 PECOS PAC ID: 1557676707 Enrollment ID: I20150817002056 |
| Provider Name | Akbar K Ahmed |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1699908921 PECOS PAC ID: 6204142870 Enrollment ID: I20150827000076 |
| Provider Name | Hannah L Potts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932581063 PECOS PAC ID: 6103133400 Enrollment ID: I20150918002062 |
| Provider Name | Marybeth Zazzera |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962498808 PECOS PAC ID: 2961588736 Enrollment ID: I20151110000111 |
| Provider Name | Robert J Meador |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1891725396 PECOS PAC ID: 5890750749 Enrollment ID: I20160114000270 |
| Provider Name | Dennis Dylan Demeria |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356717599 PECOS PAC ID: 7113234329 Enrollment ID: I20160222002663 |
| Provider Name | Ryan N Dockery |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134305196 PECOS PAC ID: 0042515280 Enrollment ID: I20160225000808 |
| Provider Name | Kari a Winkleblack Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356707434 PECOS PAC ID: 7113224007 Enrollment ID: I20160321000387 |
| Provider Name | Samara Touchton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760842314 PECOS PAC ID: 2264722685 Enrollment ID: I20160526000264 |
| Provider Name | Erica a Lawlor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417319724 PECOS PAC ID: 4385936087 Enrollment ID: I20160715000808 |
| Provider Name | Fahed a Saada |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316223613 PECOS PAC ID: 8729371349 Enrollment ID: I20160720000313 |
| Provider Name | Gurinder S Rana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669776902 PECOS PAC ID: 9032411657 Enrollment ID: I20160726000497 |
| Provider Name | Gregory J Zablocki |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1538427455 PECOS PAC ID: 0840584058 Enrollment ID: I20160811000601 |
| Provider Name | Omotoke O Missih |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649533472 PECOS PAC ID: 2668767179 Enrollment ID: I20160823002136 |
| Provider Name | Benjamin F. Donohue |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558587204 PECOS PAC ID: 0749576569 Enrollment ID: I20160902001706 |
| Provider Name | Michael Waters |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1609194133 PECOS PAC ID: 9537455365 Enrollment ID: I20160906000038 |
| Provider Name | Douglas Sivers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275985558 PECOS PAC ID: 4284920471 Enrollment ID: I20160914002927 |
| Provider Name | Judith Louise Griffin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356629240 PECOS PAC ID: 4284852211 Enrollment ID: I20161005000967 |
| Provider Name | Tasia E Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407194145 PECOS PAC ID: 7911295613 Enrollment ID: I20161012002612 |
| Provider Name | Sarah B. Robinson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396078648 PECOS PAC ID: 6002048436 Enrollment ID: I20161025003110 |
| Provider Name | Marlee J Drumheller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114475365 PECOS PAC ID: 6608155734 Enrollment ID: I20161114001516 |
| Provider Name | Kyla B Edelman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134678576 PECOS PAC ID: 3274813068 Enrollment ID: I20161214000397 |
| Provider Name | Kristin Lee Swanstrom |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992035216 PECOS PAC ID: 7911188040 Enrollment ID: I20170315001143 |
| Provider Name | Martha Herrera-rojas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659670693 PECOS PAC ID: 9133497332 Enrollment ID: I20170612002215 |
| Provider Name | Mindy R Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598191991 PECOS PAC ID: 8729205950 Enrollment ID: I20170801002279 |
| Provider Name | Christopher M King |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043474844 PECOS PAC ID: 9133277916 Enrollment ID: I20170807003132 |
| Provider Name | Alec a Macaulay |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1184918179 PECOS PAC ID: 5698932929 Enrollment ID: I20170814000288 |
| Provider Name | Johannah Elizabeth Shortle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336664655 PECOS PAC ID: 8224301965 Enrollment ID: I20170831002264 |
| Provider Name | Jillian Senner |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477990430 PECOS PAC ID: 5193019727 Enrollment ID: I20170919000378 |
| Provider Name | Michael Artino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609395771 PECOS PAC ID: 5395010284 Enrollment ID: I20171003005012 |
| Provider Name | Annette C Mills |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841460714 PECOS PAC ID: 0042383564 Enrollment ID: I20171004002700 |
| Provider Name | Timothy Kujawski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750807319 PECOS PAC ID: 5698040152 Enrollment ID: I20171009003354 |
| Provider Name | Matthew Greenspan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063505568 PECOS PAC ID: 5395803795 Enrollment ID: I20171114000642 |
| Provider Name | Melissa a Pinckney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659890465 PECOS PAC ID: 5597022590 Enrollment ID: I20171129002795 |
| Provider Name | Cynthia MP Porter |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134502701 PECOS PAC ID: 4688988652 Enrollment ID: I20171206000626 |
| Provider Name | Jessica Barfield Doto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245630714 PECOS PAC ID: 8527289537 Enrollment ID: I20180103001171 |
| Provider Name | Monika Radloff |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1700858156 PECOS PAC ID: 0941196265 Enrollment ID: I20180126001100 |
| Provider Name | Benjamin P Kay |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184135865 PECOS PAC ID: 6608136171 Enrollment ID: I20180131001783 |
| Provider Name | Morgan L Boyce |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881017549 PECOS PAC ID: 2466682679 Enrollment ID: I20180309001111 |
| Provider Name | Anthony R Mato |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1053473983 PECOS PAC ID: 1254405996 Enrollment ID: I20180316001253 |
| Provider Name | Subah Gupta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578803227 PECOS PAC ID: 2668727140 Enrollment ID: I20180625002502 |
| Provider Name | Caitlin Louise Foor-pessin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215290846 PECOS PAC ID: 2769777655 Enrollment ID: I20180720000568 |
| Provider Name | Cynthia Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164918546 PECOS PAC ID: 1951659184 Enrollment ID: I20180806000173 |
| Provider Name | Ashlin M Thuman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366829327 PECOS PAC ID: 3375854631 Enrollment ID: I20180829000428 |
| Provider Name | Stacey Lin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194142026 PECOS PAC ID: 7517217177 Enrollment ID: I20180904000468 |
| Provider Name | Michael L Mcgrattan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366885634 PECOS PAC ID: 1850641317 Enrollment ID: I20180904000926 |
| Provider Name | Lydia Sutton Staiger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477047504 PECOS PAC ID: 7315297819 Enrollment ID: I20180904002672 |
| Provider Name | Stephanie L Meissner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669958948 PECOS PAC ID: 4587914080 Enrollment ID: I20180904002749 |
| Provider Name | Rachel E Ayers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265928436 PECOS PAC ID: 5193075299 Enrollment ID: I20180911003630 |
| Provider Name | Melissa J Doak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801382759 PECOS PAC ID: 4688924699 Enrollment ID: I20180912000442 |
| Provider Name | Ryan K Dean |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1679960751 PECOS PAC ID: 0244580264 Enrollment ID: I20180912000785 |
| Provider Name | Nauman Hamid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518146869 PECOS PAC ID: 1254524259 Enrollment ID: I20180918002431 |
| Provider Name | Brian K Clark |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821059403 PECOS PAC ID: 1658360441 Enrollment ID: I20180924000983 |
| Provider Name | Kanwal Ejaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396954178 PECOS PAC ID: 7113026154 Enrollment ID: I20180928001304 |
| Provider Name | Lori a Hill |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649219700 PECOS PAC ID: 8527163484 Enrollment ID: I20181009000014 |
| Provider Name | Jillian Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649753898 PECOS PAC ID: 3274886841 Enrollment ID: I20181029001325 |
| Provider Name | Caelyn Bellerose |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1124482179 PECOS PAC ID: 3870846355 Enrollment ID: I20181031000166 |
| Provider Name | Eric J Knaake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952840241 PECOS PAC ID: 5597041855 Enrollment ID: I20181116000477 |
| Provider Name | Peter Dvorak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518209675 PECOS PAC ID: 7214177385 Enrollment ID: I20190125002524 |
| Provider Name | Carly C Linick |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780148668 PECOS PAC ID: 2769721505 Enrollment ID: I20190222000424 |
| Provider Name | Rebecca O'keefe |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912471947 PECOS PAC ID: 0547509176 Enrollment ID: I20190226003083 |
| Provider Name | William L Mcgill |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083075154 PECOS PAC ID: 8820383813 Enrollment ID: I20190418000754 |
| Provider Name | Mohammad a Samih |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1750539367 PECOS PAC ID: 7810157872 Enrollment ID: I20190807001703 |
| Provider Name | Anthony Paul Sidari |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1942569322 PECOS PAC ID: 1052530474 Enrollment ID: I20190906000353 |
| Provider Name | Emily R Dvorak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700448503 PECOS PAC ID: 9335478437 Enrollment ID: I20190916002221 |
| Provider Name | Bashar Sharma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124472782 PECOS PAC ID: 1951648583 Enrollment ID: I20190923001742 |
| Provider Name | Shamanthy Ratnasingam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184076507 PECOS PAC ID: 7113257643 Enrollment ID: I20190926002012 |
| Provider Name | Lyndsey Armstrong |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205496908 PECOS PAC ID: 4880924109 Enrollment ID: I20190927003014 |
| Provider Name | Suzy H Lin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407290422 PECOS PAC ID: 9931453818 Enrollment ID: I20191107000357 |
| Provider Name | Kristine M. Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336799899 PECOS PAC ID: 8022440205 Enrollment ID: I20191108000269 |
| Provider Name | Bradley Dewitt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346891900 PECOS PAC ID: 8729413653 Enrollment ID: I20200122002208 |
| Provider Name | Malissa M Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821645789 PECOS PAC ID: 7012342900 Enrollment ID: I20200123000891 |
| Provider Name | Tonusri Nag |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1235587551 PECOS PAC ID: 3870915218 Enrollment ID: I20200612000811 |
| Provider Name | Sapan M Shah |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1922493097 PECOS PAC ID: 9537581020 Enrollment ID: I20200630001779 |
| Provider Name | Carl Juers |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841686714 PECOS PAC ID: 9931522430 Enrollment ID: I20200630002592 |
| Provider Name | Amelia Ann Poplawski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831676444 PECOS PAC ID: 6305190646 Enrollment ID: I20200730001352 |
| Provider Name | Tran Tu Huynh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679977417 PECOS PAC ID: 2961739016 Enrollment ID: I20200804001719 |
| Provider Name | Tyler Kelly |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689100935 PECOS PAC ID: 7214270123 Enrollment ID: I20200811002183 |
| Provider Name | Micah Gabriel Katz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912324955 PECOS PAC ID: 4284934282 Enrollment ID: I20200917001255 |
| Provider Name | Christina M Bellefeuille |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215549456 PECOS PAC ID: 8426478629 Enrollment ID: I20201008001824 |
| Provider Name | Suzanne M Dozoretz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033744891 PECOS PAC ID: 2062832561 Enrollment ID: I20201022001931 |
| Provider Name | Ashley H. Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922269638 PECOS PAC ID: 0143522755 Enrollment ID: I20201023000672 |
| Provider Name | Emily Hidalgo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245881473 PECOS PAC ID: 8022428010 Enrollment ID: I20201103000715 |
| Provider Name | H. Hans Salamanca |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023464252 PECOS PAC ID: 9931519758 Enrollment ID: I20201106001257 |
| Provider Name | Jessica L Austin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285244012 PECOS PAC ID: 0648680306 Enrollment ID: I20201109000533 |
| Provider Name | Casine A. Cummings |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780994632 PECOS PAC ID: 5395934657 Enrollment ID: I20201109001226 |
| Provider Name | Jennifer L Hatch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437301090 PECOS PAC ID: 5991869372 Enrollment ID: I20201116002034 |
| Provider Name | Luke J Byrnes |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1255660718 PECOS PAC ID: 5698808384 Enrollment ID: I20201202002192 |
| Provider Name | Heather M Dirienzo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760010169 PECOS PAC ID: 9739591447 Enrollment ID: I20201221002243 |
| Provider Name | Sarah D Batschelet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114537065 PECOS PAC ID: 1951713619 Enrollment ID: I20201222001560 |
| Provider Name | Shanise P Thomas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023647013 PECOS PAC ID: 4789097221 Enrollment ID: I20201230002204 |
| Provider Name | Bryan R Gibb |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063014413 PECOS PAC ID: 3678986056 Enrollment ID: I20201231001481 |
| Provider Name | Ryan R Dirienzo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205464344 PECOS PAC ID: 2769895911 Enrollment ID: I20210106002547 |
| Provider Name | Laura E Taylor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225642580 PECOS PAC ID: 6204249089 Enrollment ID: I20210115002211 |
| Provider Name | Elaine R Abdulky |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396335881 PECOS PAC ID: 5698189413 Enrollment ID: I20210205001084 |
| Provider Name | Laura T Sidari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881950665 PECOS PAC ID: 6709138498 Enrollment ID: I20210226000747 |
| Provider Name | Paul S Patane |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003812512 PECOS PAC ID: 2163435330 Enrollment ID: I20210319000436 |
| Provider Name | Courtney E Kingston |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821680828 PECOS PAC ID: 3375951965 Enrollment ID: I20210420002282 |
| Provider Name | Robert D Petrocelli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730566415 PECOS PAC ID: 0840608261 Enrollment ID: I20210422002361 |
| Provider Name | Kaitlin R Lilienthal |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710494620 PECOS PAC ID: 0042629230 Enrollment ID: I20210428002645 |
| Provider Name | Robert W Horowitz |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1578667960 PECOS PAC ID: 1850328477 Enrollment ID: I20210510000827 |
| Provider Name | Alicia Christine Shaikh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609020791 PECOS PAC ID: 1557424579 Enrollment ID: I20210517000498 |
| Provider Name | David J Maldow |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750762795 PECOS PAC ID: 1355636481 Enrollment ID: I20210525003207 |
| Provider Name | Heidi a Lee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417140146 PECOS PAC ID: 9931294329 Enrollment ID: I20210610002910 |
| Provider Name | Trisha M Patrician |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1720450059 PECOS PAC ID: 0648671040 Enrollment ID: I20210623000555 |
| Provider Name | Toby Hawkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447552559 PECOS PAC ID: 4880095017 Enrollment ID: I20210625001370 |
| Provider Name | Lucas D Knewstub |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083103642 PECOS PAC ID: 6204238306 Enrollment ID: I20210713000162 |
| Provider Name | Brian R Shaw |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1578890570 PECOS PAC ID: 1052551934 Enrollment ID: I20210727000347 |
| Provider Name | Ali Akram |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285123752 PECOS PAC ID: 2668877143 Enrollment ID: I20210820002789 |
| Provider Name | Melissa a Bresenhan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629572870 PECOS PAC ID: 1557626215 Enrollment ID: I20210820002864 |
| Provider Name | Muhammad a Jaffari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497374086 PECOS PAC ID: 4385040476 Enrollment ID: I20210915002751 |
| Provider Name | Bridgette Heath-isigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932872231 PECOS PAC ID: 8921405895 Enrollment ID: I20210920001271 |
| Provider Name | Jessica D Carr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164199428 PECOS PAC ID: 0840697785 Enrollment ID: I20210921000349 |
| Provider Name | Samuel Edwin Donovan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215433230 PECOS PAC ID: 0244588549 Enrollment ID: I20211006002006 |
| Provider Name | Nicholas a Smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851069082 PECOS PAC ID: 6002206182 Enrollment ID: I20211203000872 |
| Provider Name | Raphael Bochent |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275808008 PECOS PAC ID: 7113183070 Enrollment ID: I20211213002248 |
| Provider Name | Zoey Elizabeth Doney Wallenbeck |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316544505 PECOS PAC ID: 2769873314 Enrollment ID: I20211215002420 |
| Provider Name | Meredith Breann Zembiec |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679189039 PECOS PAC ID: 9638562853 Enrollment ID: I20220211001158 |
| Provider Name | Kristen Canzler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124781877 PECOS PAC ID: 2668865650 Enrollment ID: I20220216000652 |
| Provider Name | Elisabeth Corbett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669123089 PECOS PAC ID: 7315332228 Enrollment ID: I20220311000211 |
| Provider Name | Victoria E Shevchuk |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326628546 PECOS PAC ID: 5890180764 Enrollment ID: I20220312000159 |
| Provider Name | Nidhi Simlote Villanueva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649629916 PECOS PAC ID: 6709272867 Enrollment ID: I20220330000910 |
| Provider Name | Mary Ngaleu Nkamany |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083009278 PECOS PAC ID: 1951651488 Enrollment ID: I20220428002483 |
| Provider Name | Phoebe S Hurd |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316693674 PECOS PAC ID: 3678950565 Enrollment ID: I20220516000511 |
| Provider Name | Matthew Thomas Williams |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891392643 PECOS PAC ID: 8022438316 Enrollment ID: I20220601001124 |
| Provider Name | Hendel Jorge Villamizar |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871065094 PECOS PAC ID: 3678814845 Enrollment ID: I20220708000155 |
| Provider Name | Sujithraj Dommaraju |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497310031 PECOS PAC ID: 3678800778 Enrollment ID: I20220823000491 |
| Provider Name | Eli Finkelsztein |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1932632171 PECOS PAC ID: 7416331053 Enrollment ID: I20220831002879 |
| Provider Name | Andrea Marie Khlevnoy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689234718 PECOS PAC ID: 0749517613 Enrollment ID: I20220907001514 |
| Provider Name | Sristee Niraula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396308367 PECOS PAC ID: 7012392111 Enrollment ID: I20220909001230 |
| Provider Name | Irine Siraj |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528589421 PECOS PAC ID: 1759628373 Enrollment ID: I20220915001910 |
| Provider Name | Asim H Maher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619215167 PECOS PAC ID: 1557616968 Enrollment ID: I20220925000016 |
| Provider Name | Manish Thakur |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669034641 PECOS PAC ID: 1052643657 Enrollment ID: I20220928002350 |
| Provider Name | Kaili Du |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316500473 PECOS PAC ID: 2365828605 Enrollment ID: I20221010002773 |
| Provider Name | Andrew C Schutrumpf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104889740 PECOS PAC ID: 0244366672 Enrollment ID: I20221012002793 |
| Provider Name | Christina F Siau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245601574 PECOS PAC ID: 9931401023 Enrollment ID: I20221020002785 |
| Provider Name | Akshaar Brahmbhatt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033564356 PECOS PAC ID: 6103179924 Enrollment ID: I20221031002458 |
| Provider Name | Sharinne Sukhnanand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508585019 PECOS PAC ID: 2466829056 Enrollment ID: I20221111000401 |
| Provider Name | Marvette West-williams |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083902548 PECOS PAC ID: 9032380951 Enrollment ID: I20221202002853 |
| Provider Name | Katharine L Bills Woods |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386896546 PECOS PAC ID: 3971663683 Enrollment ID: I20230112001731 |
| Provider Name | Lee a Witherow |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205802253 PECOS PAC ID: 0042407892 Enrollment ID: I20230113000922 |
| Provider Name | Melissa Faith Alt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487397055 PECOS PAC ID: 5395116065 Enrollment ID: I20230118000371 |
| Provider Name | Rachel Postel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477015402 PECOS PAC ID: 6103297742 Enrollment ID: I20230119000354 |
| Provider Name | Mohammad Hussain |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801328414 PECOS PAC ID: 0244581569 Enrollment ID: I20230119001554 |
| Provider Name | Linda E Wieselquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609583749 PECOS PAC ID: 4688045131 Enrollment ID: I20230120001971 |
| Provider Name | Cynthia M Correll |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609036482 PECOS PAC ID: 4981821170 Enrollment ID: I20230120002214 |
| Provider Name | Jonathan Ed Harris |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1720499981 PECOS PAC ID: 3173850211 Enrollment ID: I20230123002563 |
| Provider Name | Christine L Monacelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619689973 PECOS PAC ID: 9234501040 Enrollment ID: I20230203001636 |
| Provider Name | Sarah E. Roach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245908052 PECOS PAC ID: 9234503756 Enrollment ID: I20230324001050 |
| Provider Name | Turker Dalkilic |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1366141160 PECOS PAC ID: 0244604593 Enrollment ID: I20230328001414 |
| Provider Name | Aarti Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598926651 PECOS PAC ID: 7618127960 Enrollment ID: I20230329002504 |
| Provider Name | Garret Joseph Garofolo-gonzalez |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1710332689 PECOS PAC ID: 3173877263 Enrollment ID: I20230428000472 |
| Provider Name | Jaspreet S. Johal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457845877 PECOS PAC ID: 9931455961 Enrollment ID: I20230525001571 |
| Provider Name | Elizabeth A. Davenport |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073141859 PECOS PAC ID: 9335506815 Enrollment ID: I20230530001014 |
| Provider Name | Shane Robert Thorp |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821599952 PECOS PAC ID: 5193182921 Enrollment ID: I20230608003132 |
| Provider Name | Ashley J Choe |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1083060651 PECOS PAC ID: 9032403373 Enrollment ID: I20230621002872 |
| Provider Name | Adam R Hall |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679714620 PECOS PAC ID: 4183764285 Enrollment ID: I20230627001131 |
| Provider Name | Mohammad Ali Shahab |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447745864 PECOS PAC ID: 1355700246 Enrollment ID: I20230711000753 |
| Provider Name | Caleb S Baxter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780063727 PECOS PAC ID: 5698196434 Enrollment ID: I20230801001956 |
| Provider Name | Jonathan P Edelman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508433780 PECOS PAC ID: 5991171258 Enrollment ID: I20230808001449 |
| Provider Name | Anurag Aryal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699399873 PECOS PAC ID: 1850753039 Enrollment ID: I20230821001280 |
| Provider Name | Mashhood A. Bodla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669092805 PECOS PAC ID: 8921460098 Enrollment ID: I20230822001476 |
| Provider Name | Samuel P Francis |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1316478050 PECOS PAC ID: 6709121189 Enrollment ID: I20230825000850 |
| Provider Name | Tandy M Agostini |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134642135 PECOS PAC ID: 8628496239 Enrollment ID: I20230829002214 |
| Provider Name | Hannah Armstrong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417633843 PECOS PAC ID: 5991168452 Enrollment ID: I20230830003866 |
| Provider Name | Amna Riaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871113019 PECOS PAC ID: 1759745953 Enrollment ID: I20230906002807 |
| Provider Name | Sameer Acharya |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518581701 PECOS PAC ID: 1557725645 Enrollment ID: I20230907002615 |
| Provider Name | Candace Beth Donley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356627517 PECOS PAC ID: 9638344971 Enrollment ID: I20230908000344 |
| Provider Name | Munu Napit |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831710193 PECOS PAC ID: 7911361910 Enrollment ID: I20230908002734 |
| Provider Name | Ruthanne M Parsons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356011241 PECOS PAC ID: 0648624114 Enrollment ID: I20231003000059 |
| Provider Name | Tariq Alfarra |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1447757018 PECOS PAC ID: 7719367382 Enrollment ID: I20231102002355 |
| Provider Name | Stephanie J Luca |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952844136 PECOS PAC ID: 1456748045 Enrollment ID: I20231106001282 |
| Provider Name | Rebecca Gorsak |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346920972 PECOS PAC ID: 4789031212 Enrollment ID: I20231106001707 |
| Provider Name | Ashley Beaujon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659864825 PECOS PAC ID: 1254687445 Enrollment ID: I20231116000748 |
| Provider Name | Emilee Mackey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962178079 PECOS PAC ID: 2365890407 Enrollment ID: I20231129002491 |
| Provider Name | Heather Bolduc Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659158616 PECOS PAC ID: 6103274147 Enrollment ID: I20231130003129 |
| Provider Name | Kathryn Lynn Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861272817 PECOS PAC ID: 7012366222 Enrollment ID: I20231213003262 |
| Provider Name | Maria C Morog |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245011790 PECOS PAC ID: 0749639839 Enrollment ID: I20231214002546 |
| Provider Name | Ingrid I Vaughan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124089958 PECOS PAC ID: 9335151257 Enrollment ID: I20240119003653 |
| Provider Name | Rodger J. Lantz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033986146 PECOS PAC ID: 4688010515 Enrollment ID: I20240313002682 |
| Provider Name | Emily Williams |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598300618 PECOS PAC ID: 3870928708 Enrollment ID: I20240402003770 |
| Provider Name | Paul V Soper |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679071377 PECOS PAC ID: 3072954841 Enrollment ID: I20240510000296 |
| Provider Name | Kelsey Pierce |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184490559 PECOS PAC ID: 4880137645 Enrollment ID: I20240620003727 |
| Provider Name | Emre Oto |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881221711 PECOS PAC ID: 4486064128 Enrollment ID: I20240718001722 |
| Provider Name | Brandon M Bilka |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316300304 PECOS PAC ID: 6002208147 Enrollment ID: I20240729000102 |
| Provider Name | Jashvin Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1164983623 PECOS PAC ID: 4385019017 Enrollment ID: I20240730003216 |
| Provider Name | Stephanie a Bates |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467033985 PECOS PAC ID: 3173060092 Enrollment ID: I20240808002829 |
| Provider Name | William Supplee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972009785 PECOS PAC ID: 7315485125 Enrollment ID: I20240812002213 |
| Provider Name | Jeri Charlotte Albano |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003301722 PECOS PAC ID: 5991243719 Enrollment ID: I20240812002533 |
| Provider Name | Josephine Tapper |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235905613 PECOS PAC ID: 9032657770 Enrollment ID: I20240813003251 |
| Provider Name | Farla Jean-louis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386120657 PECOS PAC ID: 3971042318 Enrollment ID: I20240828005145 |
| Provider Name | Navalok Sharma Ghimire |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841863040 PECOS PAC ID: 3476093162 Enrollment ID: I20240909002945 |
| Provider Name | Maneesha Nandimandalam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154901080 PECOS PAC ID: 6103366695 Enrollment ID: I20240911001520 |
| Provider Name | Felipe Centellas Montano |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144800160 PECOS PAC ID: 7315488475 Enrollment ID: I20240917003299 |
| Provider Name | Graham James Gorsline |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033860911 PECOS PAC ID: 9335524958 Enrollment ID: I20241022005307 |
| Provider Name | Madeline G Bush |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720785041 PECOS PAC ID: 5698209914 Enrollment ID: I20241108003602 |
| Provider Name | Sarah E. Rudman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568820066 PECOS PAC ID: 4789119835 Enrollment ID: I20241126001394 |
| Provider Name | Lacey Netti |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780402776 PECOS PAC ID: 8527593474 Enrollment ID: I20241202001009 |
| Provider Name | Eric T Choi |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1306863865 PECOS PAC ID: 3971632431 Enrollment ID: I20250206001569 |
| Provider Name | Lisa M Bodzio |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356548069 PECOS PAC ID: 8325228364 Enrollment ID: I20250307002864 |
| Provider Name | Lindsey Sullivan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992511505 PECOS PAC ID: 4183147911 Enrollment ID: I20250402000387 |
| Provider Name | Ellie Lockhart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639995673 PECOS PAC ID: 9931623832 Enrollment ID: I20250414000404 |
| Provider Name | David Gossat |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1295718153 PECOS PAC ID: 0345216941 Enrollment ID: I20250414000832 |
| Provider Name | Colleen Selner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679399695 PECOS PAC ID: 9739606476 Enrollment ID: I20250507000354 |
| Provider Name | Azka S. Zergham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457924474 PECOS PAC ID: 7517486145 Enrollment ID: I20250527002617 |
| Provider Name | Irfon Bhatti |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033777818 PECOS PAC ID: 0143554618 Enrollment ID: I20250624001515 |
| Provider Name | Abinash Subedi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619539798 PECOS PAC ID: 5991218372 Enrollment ID: I20250630001013 |
| Provider Name | Miluska Mejia Trebejo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134613805 PECOS PAC ID: 1759633878 Enrollment ID: I20250708002570 |
| Provider Name | Wesley Harl Adams |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184809956 PECOS PAC ID: 1052490679 Enrollment ID: I20250716000534 |
| Provider Name | Rachele E Curtis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1174325138 PECOS PAC ID: 1658886890 Enrollment ID: I20250716000681 |
| Provider Name | Carlo M Dangcalan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356956270 PECOS PAC ID: 2163939448 Enrollment ID: I20250730002917 |
| Provider Name | Michael Riskalla |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538628631 PECOS PAC ID: 2264817428 Enrollment ID: I20250730003396 |
| Provider Name | Matthew Negrey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285054056 PECOS PAC ID: 5991921306 Enrollment ID: I20250731001847 |
| Provider Name | Kandace O Tulk |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487080222 PECOS PAC ID: 0840428439 Enrollment ID: I20250814001211 |
| Provider Name | Ndubuisi D Ahuruonye |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467959494 PECOS PAC ID: 7911258264 Enrollment ID: I20250828001059 |
| Provider Name | Seneca Harberger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316332562 PECOS PAC ID: 5193016186 Enrollment ID: I20250909000033 |
| Provider Name | Kajal Vachharajani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043958812 PECOS PAC ID: 7618345869 Enrollment ID: I20250909002825 |
| Provider Name | Kartik a Moza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437894557 PECOS PAC ID: 0042688384 Enrollment ID: I20250909002913 |
| Provider Name | Joseph Stein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477940070 PECOS PAC ID: 8022439108 Enrollment ID: I20251003001623 |
| Provider Name | Farrukh Abid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477290682 PECOS PAC ID: 0345618534 Enrollment ID: I20251008000714 |
| Provider Name | Jasmit K Heera |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1386311660 PECOS PAC ID: 4183121866 Enrollment ID: I20251008002566 |
| Provider Name | Dibyata Rana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154069193 PECOS PAC ID: 4880191576 Enrollment ID: I20251008003132 |
| Provider Name | Brian Gillette |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437983996 PECOS PAC ID: 1850828476 Enrollment ID: I20251016002030 |
| Provider Name | Eric Elzinga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710621164 PECOS PAC ID: 0749778587 Enrollment ID: I20251023000339 |
| Provider Name | Robert F Searles |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689611808 PECOS PAC ID: 1355379272 Enrollment ID: I20251110001388 |
| Provider Name | Alexander Conlon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851967442 PECOS PAC ID: 9436685781 Enrollment ID: I20251208001114 |
| Provider Name | Lauren Chmielewski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063388221 PECOS PAC ID: 2365938909 Enrollment ID: I20260102001010 |
| Provider Name | Malavika B Bhalla |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447546403 PECOS PAC ID: 2365757895 Enrollment ID: I20260310000925 |
| Provider Name | Gary A. Simpson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1063668747 PECOS PAC ID: 2961642871 Enrollment ID: I20260310002166 |
| Provider Name | Santosh N Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841440021 PECOS PAC ID: 2668612342 Enrollment ID: I20260313000474 |
| Provider Name | Brittany Griffin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831525153 PECOS PAC ID: 0446735666 Enrollment ID: I20260326000252 |
| Provider Name | Rusina S Karia |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508531567 PECOS PAC ID: 3072054162 Enrollment ID: I20260407003904 |
Primary Care Internal Medicine of Ithaca, PLLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 217 N Aurora St, Ithaca, NY 14850 Phone: 607-273-2811 Fax: 607-273-1170 |
New York Em-iii Medical Services, PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 101 Dates Dr., Ithaca, NY 14850 Phone: 214-712-2400 |
Cornell Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 Ho Plaza, Ithaca, NY 14853 Phone: 607-255-5155 Fax: 607-255-0269 |
Marne Oshae MD PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 402 N Cayuga St, Ithaca, NY 14850 Phone: 607-273-5551 Fax: 607-275-0313 |
Reach Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 402 N Cayuga St, Ithaca, NY 14850 Phone: 607-273-7000 Fax: 607-273-7001 |
Kory Marsland Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 422 Taylor Place, Ithaca, NY 14850 Phone: 608-400-0141 Fax: 608-561-8745 |