| Chi St Alexius Health Dickinson Medical Clinic | |
|
2500 Fairway St Dickinson ND 58601 | |
| (701) 456-4200 | |
| (701) 456-4849 |
| Full Name | Chi St Alexius Health Dickinson Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2500 Fairway St, Dickinson, North Dakota |
| Authorized Official Name and Position | Reed Reyman (PRESIDENT) |
| Authorized Official Contact | 7014564000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chi St Alexius Health Dickinson Medical Clinic 2500 Fairway St Dickinson ND 58601 Ph: (701) 456-4200 | Chi St Alexius Health Dickinson Medical Clinic 2500 Fairway St Dickinson ND 58601 Ph: (701) 456-4200 |
| NPI Number | 1730464108 |
|---|---|
| Provider Enumeration Date | 10/18/2011 |
| Last Update Date | 03/30/2017 |
| Medicare PECOS PAC ID | 0547177560 |
|---|---|
| Medicare Enrollment ID | O20031107000651 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730464108 | NPI | - | NPPES |
| 12842 | Medicaid | ND |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Brent Bruderer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821055138 PECOS PAC ID: 2860398039 Enrollment ID: I20031209000539 |
| Provider Name | Sarah J. Mccullough |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659393734 PECOS PAC ID: 7214833441 Enrollment ID: I20031209000835 |
| Provider Name | Mary Jo Wicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407952542 PECOS PAC ID: 2769388313 Enrollment ID: I20031212000291 |
| Provider Name | Thomas F Arnold |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235237918 PECOS PAC ID: 4183521792 Enrollment ID: I20031212000611 |
| Provider Name | Robert M Bathurst |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821001447 PECOS PAC ID: 4385542422 Enrollment ID: I20031226000322 |
| Provider Name | Debra J Lukenbill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265456370 PECOS PAC ID: 5294622569 Enrollment ID: I20040302000284 |
| Provider Name | Sheldon L Swenson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104830298 PECOS PAC ID: 2769372408 Enrollment ID: I20040317000778 |
| Provider Name | Susan M Truman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356320105 PECOS PAC ID: 6507859840 Enrollment ID: I20040405000540 |
| Provider Name | Dominic F Frecentese |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144209008 PECOS PAC ID: 8022922798 Enrollment ID: I20040426000862 |
| Provider Name | Jeffrey M Barkmeier |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871571083 PECOS PAC ID: 4385558311 Enrollment ID: I20040506001704 |
| Provider Name | Anuradha K Tummala |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972582732 PECOS PAC ID: 2567376270 Enrollment ID: I20040510001262 |
| Provider Name | Hugh S Carlson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093837197 PECOS PAC ID: 5597754747 Enrollment ID: I20040511001551 |
| Provider Name | Lea Marie Floberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881673119 PECOS PAC ID: 0648260380 Enrollment ID: I20040514000928 |
| Provider Name | Michael A Schirado |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104852185 PECOS PAC ID: 4789661026 Enrollment ID: I20040702001193 |
| Provider Name | Peter B Wold |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861471633 PECOS PAC ID: 0749260404 Enrollment ID: I20040722001100 |
| Provider Name | Alexandra L Muschenheim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184603607 PECOS PAC ID: 2668452335 Enrollment ID: I20040722001150 |
| Provider Name | Mark W Berger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962481747 PECOS PAC ID: 0749194777 Enrollment ID: I20040803001283 |
| Provider Name | John M Caspers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750369989 PECOS PAC ID: 2567376221 Enrollment ID: I20040804000318 |
| Provider Name | Joseph J Baraga |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730167073 PECOS PAC ID: 8022922053 Enrollment ID: I20040804000350 |
| Provider Name | Todd M Arsenault |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902890726 PECOS PAC ID: 4688588619 Enrollment ID: I20040804000373 |
| Provider Name | Blake A Carlson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548249956 PECOS PAC ID: 8022922780 Enrollment ID: I20040804000482 |
| Provider Name | Steven C Hommeyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356329593 PECOS PAC ID: 8325952005 Enrollment ID: I20040804000586 |
| Provider Name | Paul F Mulcahy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467431262 PECOS PAC ID: 9234043928 Enrollment ID: I20040804001525 |
| Provider Name | Keith H Wittenberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154300929 PECOS PAC ID: 3173437886 Enrollment ID: I20040804001860 |
| Provider Name | Matthew T Baldwin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487632725 PECOS PAC ID: 5496669426 Enrollment ID: I20040810000544 |
| Provider Name | Ronald D Isackson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134111404 PECOS PAC ID: 8325013501 Enrollment ID: I20040831001130 |
| Provider Name | Charles R Gasser |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1023105020 PECOS PAC ID: 9335100403 Enrollment ID: I20041021000872 |
| Provider Name | Nathan D Block |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871571125 PECOS PAC ID: 0648174334 Enrollment ID: I20050308000173 |
| Provider Name | Vladimir Savcenko |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861471658 PECOS PAC ID: 4183519119 Enrollment ID: I20050308000206 |
| Provider Name | Martin J Asis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598743833 PECOS PAC ID: 3678477353 Enrollment ID: I20050308000239 |
| Provider Name | Jennifer A Tinkler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982790242 PECOS PAC ID: 4183671779 Enrollment ID: I20050406000108 |
| Provider Name | Glenn R Lefor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619991973 PECOS PAC ID: 7012922412 Enrollment ID: I20060207000118 |
| Provider Name | Jeffrey S Phelan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497734123 PECOS PAC ID: 1254245954 Enrollment ID: I20060411000154 |
| Provider Name | Heather A Freitag |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063457000 PECOS PAC ID: 3870598097 Enrollment ID: I20060921000641 |
| Provider Name | David P Lambert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154384527 PECOS PAC ID: 9436162120 Enrollment ID: I20061005000435 |
| Provider Name | Eltayeb Elshiekh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245325257 PECOS PAC ID: 7810994803 Enrollment ID: I20061106000212 |
| Provider Name | Suzanne S Parrino |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730113671 PECOS PAC ID: 1658341870 Enrollment ID: I20061212000709 |
| Provider Name | David A Kuylen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275732455 PECOS PAC ID: 6406947613 Enrollment ID: I20070802000160 |
| Provider Name | Craig D Smith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275602740 PECOS PAC ID: 7214021864 Enrollment ID: I20070913000533 |
| Provider Name | David Javier Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275629719 PECOS PAC ID: 0648241232 Enrollment ID: I20071009000104 |
| Provider Name | Tammy J Grosulak |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083892095 PECOS PAC ID: 2163505058 Enrollment ID: I20080226000260 |
| Provider Name | Michael L Cassidy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558381939 PECOS PAC ID: 8527143411 Enrollment ID: I20080318000121 |
| Provider Name | Attas N Boutrous |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346362423 PECOS PAC ID: 9335138023 Enrollment ID: I20080521000404 |
| Provider Name | Thomas B Matheson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558365106 PECOS PAC ID: 8921035213 Enrollment ID: I20080527000709 |
| Provider Name | Anne M Reddy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659340180 PECOS PAC ID: 9335040633 Enrollment ID: I20080611000719 |
| Provider Name | Penny M Wilkie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861557977 PECOS PAC ID: 9234217936 Enrollment ID: I20080818000620 |
| Provider Name | Ronald M Knutson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649392739 PECOS PAC ID: 7517956204 Enrollment ID: I20080925000515 |
| Provider Name | Heidi Warmbold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285886531 PECOS PAC ID: 8921167214 Enrollment ID: I20081031000050 |
| Provider Name | Don E Wiese |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114908159 PECOS PAC ID: 7810971843 Enrollment ID: I20081205000501 |
| Provider Name | Lorrissa L Bohlman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518111558 PECOS PAC ID: 8628130028 Enrollment ID: I20081218000543 |
| Provider Name | David Ness |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1700012739 PECOS PAC ID: 9234280785 Enrollment ID: I20090624000227 |
| Provider Name | Brenda Reems |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548400260 PECOS PAC ID: 6204988892 Enrollment ID: I20090713000205 |
| Provider Name | Scott Harris |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740402858 PECOS PAC ID: 5890835334 Enrollment ID: I20091215000186 |
| Provider Name | Nasser Saffarian |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1073684122 PECOS PAC ID: 7517009459 Enrollment ID: I20100115000223 |
| Provider Name | Benjamin J May |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710172960 PECOS PAC ID: 0547313918 Enrollment ID: I20100122000680 |
| Provider Name | Gregory A Rathmann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891990404 PECOS PAC ID: 9739270182 Enrollment ID: I20100122000693 |
| Provider Name | Ronald W Schmitz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770501892 PECOS PAC ID: 6507857646 Enrollment ID: I20100312000121 |
| Provider Name | Michelle M Hardy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871513259 PECOS PAC ID: 2567597537 Enrollment ID: I20100316000381 |
| Provider Name | Azhar T Ali |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538187786 PECOS PAC ID: 0143228809 Enrollment ID: I20100318001011 |
| Provider Name | Brian E Ohara |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568459113 PECOS PAC ID: 3577469071 Enrollment ID: I20100726000445 |
| Provider Name | Mark P Hinrichs |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922095363 PECOS PAC ID: 9335045830 Enrollment ID: I20100726000465 |
| Provider Name | Wesley A Ellison |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1740391044 PECOS PAC ID: 7416978333 Enrollment ID: I20101110001264 |
| Provider Name | Michael J Laszewski |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1801907118 PECOS PAC ID: 7517988439 Enrollment ID: I20101110001409 |
| Provider Name | Laura J Tooz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538296751 PECOS PAC ID: 8224211750 Enrollment ID: I20110322000137 |
| Provider Name | Joan M Connell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306888623 PECOS PAC ID: 3476737206 Enrollment ID: I20110401000814 |
| Provider Name | Mary O Aaland |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568463321 PECOS PAC ID: 8729078480 Enrollment ID: I20110615000678 |
| Provider Name | Marshall S Jones |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285821645 PECOS PAC ID: 5092848838 Enrollment ID: I20110620000307 |
| Provider Name | Jared L Schmidt |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1154475101 PECOS PAC ID: 4688706807 Enrollment ID: I20110926000018 |
| Provider Name | Jennifer M Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972528040 PECOS PAC ID: 3971522574 Enrollment ID: I20111004000895 |
| Provider Name | Arlys M Jorda |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073533139 PECOS PAC ID: 6406020569 Enrollment ID: I20111130000015 |
| Provider Name | Austin J Mccoy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508092933 PECOS PAC ID: 6406003466 Enrollment ID: I20120827000180 |
| Provider Name | Benji Kitagawa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770685265 PECOS PAC ID: 8022061605 Enrollment ID: I20120904000603 |
| Provider Name | Kjirsten A Swenson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346482569 PECOS PAC ID: 0941458004 Enrollment ID: I20121026000706 |
| Provider Name | Angela W Tai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336212810 PECOS PAC ID: 8022161819 Enrollment ID: I20121203000097 |
| Provider Name | Lucas B Ludeman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205080744 PECOS PAC ID: 2668537069 Enrollment ID: I20121203000117 |
| Provider Name | Matthew J Loe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861419293 PECOS PAC ID: 2769486117 Enrollment ID: I20121218000333 |
| Provider Name | Paul R Carolan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144427055 PECOS PAC ID: 3971695214 Enrollment ID: I20121227000128 |
| Provider Name | Michael Grogan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518015627 PECOS PAC ID: 6608044334 Enrollment ID: I20121227000158 |
| Provider Name | Benjamin A Gilloon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902919376 PECOS PAC ID: 5597880989 Enrollment ID: I20121228000432 |
| Provider Name | Amy Bakke |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750340360 PECOS PAC ID: 6709891534 Enrollment ID: I20130529000932 |
| Provider Name | Ronald J Beare |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508895954 PECOS PAC ID: 8426049792 Enrollment ID: I20130827000224 |
| Provider Name | Nida Zehra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578853008 PECOS PAC ID: 0345484358 Enrollment ID: I20130912000742 |
| Provider Name | Robert J Lotstein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851337554 PECOS PAC ID: 8426043696 Enrollment ID: I20131031001695 |
| Provider Name | William Matt Lowe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912069337 PECOS PAC ID: 4284799826 Enrollment ID: I20131105000002 |
| Provider Name | Rebecca Ann Kiecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043599277 PECOS PAC ID: 2466623673 Enrollment ID: I20140414000436 |
| Provider Name | Erich N Bryan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740459551 PECOS PAC ID: 5799932489 Enrollment ID: I20140505002316 |
| Provider Name | Thomas C Bryson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811101116 PECOS PAC ID: 0749436491 Enrollment ID: I20140505002318 |
| Provider Name | Trisha R Prescott |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487895660 PECOS PAC ID: 8123205655 Enrollment ID: I20140609000977 |
| Provider Name | Brandon L Roller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295158020 PECOS PAC ID: 2567686751 Enrollment ID: I20140609001849 |
| Provider Name | David Saxon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689607418 PECOS PAC ID: 6800843848 Enrollment ID: I20140818002695 |
| Provider Name | James Joseph Heffele |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326145228 PECOS PAC ID: 2668560152 Enrollment ID: I20141120000040 |
| Provider Name | Sugata Sensarma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083604748 PECOS PAC ID: 7416985635 Enrollment ID: I20150116001256 |
| Provider Name | John M Clair |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427232354 PECOS PAC ID: 7113073594 Enrollment ID: I20150320000976 |
| Provider Name | Ifeanyichukwu N Nwobodo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497922074 PECOS PAC ID: 2163669458 Enrollment ID: I20150331001413 |
| Provider Name | Paul Mchenry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962422923 PECOS PAC ID: 3072590348 Enrollment ID: I20150331001511 |
| Provider Name | Quyen T Lee |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538550512 PECOS PAC ID: 2163740150 Enrollment ID: I20150423002203 |
| Provider Name | Asher Zelikson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306239066 PECOS PAC ID: 4284955915 Enrollment ID: I20150608000569 |
| Provider Name | Lashonda W Soma |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831330851 PECOS PAC ID: 7214155076 Enrollment ID: I20150723008189 |
| Provider Name | Craig Jones |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043501349 PECOS PAC ID: 1052625035 Enrollment ID: I20150804005792 |
| Provider Name | Carrie J Haar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437532132 PECOS PAC ID: 6507171121 Enrollment ID: I20150811005954 |
| Provider Name | Jeannette Y Martello |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1245452424 PECOS PAC ID: 2365507860 Enrollment ID: I20150821014576 |
| Provider Name | Kashyap Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033476189 PECOS PAC ID: 4981854544 Enrollment ID: I20150831000450 |
| Provider Name | Daniel F Merges |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376621185 PECOS PAC ID: 2062460504 Enrollment ID: I20151003000139 |
| Provider Name | Stephen A Coulson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1841292778 PECOS PAC ID: 9032111505 Enrollment ID: I20151211000742 |
| Provider Name | Engelbert Tito Ranada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063770063 PECOS PAC ID: 2365742814 Enrollment ID: I20160104002337 |
| Provider Name | Preston W Huber |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629433982 PECOS PAC ID: 8123322500 Enrollment ID: I20160204001511 |
| Provider Name | Harry D Elshire |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376618389 PECOS PAC ID: 2163410721 Enrollment ID: I20160322002870 |
| Provider Name | Jacqueline Materi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881088383 PECOS PAC ID: 8820319833 Enrollment ID: I20160715001578 |
| Provider Name | Neil S Karjalainen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679831424 PECOS PAC ID: 6608199336 Enrollment ID: I20160802001174 |
| Provider Name | Shannon J Sauter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265872030 PECOS PAC ID: 0648592782 Enrollment ID: I20160907001926 |
| Provider Name | Volney Willett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912964966 PECOS PAC ID: 9234157215 Enrollment ID: I20161013001669 |
| Provider Name | Kelsey Kuylen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477007367 PECOS PAC ID: 3173811411 Enrollment ID: I20161019001480 |
| Provider Name | Kevin Q Nguyen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407090632 PECOS PAC ID: 2668793514 Enrollment ID: I20170801000334 |
| Provider Name | Kyle R Shipley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841408200 PECOS PAC ID: 6507995339 Enrollment ID: I20170809002161 |
| Provider Name | John F Brunner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740423870 PECOS PAC ID: 2365680204 Enrollment ID: I20170809003623 |
| Provider Name | Ryan T Whitesell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245465301 PECOS PAC ID: 2466690540 Enrollment ID: I20170809004143 |
| Provider Name | Craig Wolf |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033558523 PECOS PAC ID: 0143592402 Enrollment ID: I20170821003051 |
| Provider Name | Troy Howard |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1164788667 PECOS PAC ID: 6608003876 Enrollment ID: I20170824003192 |
| Provider Name | Shawna L Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679524896 PECOS PAC ID: 6901091438 Enrollment ID: I20170912000040 |
| Provider Name | Kevin Curtis Sullivan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750523775 PECOS PAC ID: 7618242389 Enrollment ID: I20171005001017 |
| Provider Name | Danielle L Kiedrowski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205337888 PECOS PAC ID: 2860754538 Enrollment ID: I20180315002149 |
| Provider Name | Carolyn Waldo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447266234 PECOS PAC ID: 0345209888 Enrollment ID: I20180416000922 |
| Provider Name | Ronald Lee Burinsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497775100 PECOS PAC ID: 8820092828 Enrollment ID: I20180530002466 |
| Provider Name | Addison Chan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568791994 PECOS PAC ID: 8729272216 Enrollment ID: I20180727001151 |
| Provider Name | Damon Lee Nelson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184731952 PECOS PAC ID: 7911905856 Enrollment ID: I20180731002893 |
| Provider Name | John Lewis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083637086 PECOS PAC ID: 8325043938 Enrollment ID: I20180912001008 |
| Provider Name | Caroline L Ho |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689664534 PECOS PAC ID: 0446277016 Enrollment ID: I20180917001171 |
| Provider Name | Megan T Elgethun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558785311 PECOS PAC ID: 9931324654 Enrollment ID: I20180920001583 |
| Provider Name | Zachary James Hernandez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831577550 PECOS PAC ID: 3870806672 Enrollment ID: I20181022003271 |
| Provider Name | Jigarkumar Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316485592 PECOS PAC ID: 6608144613 Enrollment ID: I20181108001037 |
| Provider Name | Shiquan Liu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104182757 PECOS PAC ID: 1850664210 Enrollment ID: I20181108002157 |
| Provider Name | Olexandr S Krinochkin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1912971318 PECOS PAC ID: 8527074129 Enrollment ID: I20181211000260 |
| Provider Name | Samantha L Kiedrowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467814954 PECOS PAC ID: 7618264516 Enrollment ID: I20190118002023 |
| Provider Name | David Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104910306 PECOS PAC ID: 3971501891 Enrollment ID: I20190123003680 |
| Provider Name | M Bergman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972517977 PECOS PAC ID: 7810998135 Enrollment ID: I20190222002215 |
| Provider Name | Charles R Wilson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295933471 PECOS PAC ID: 4486722840 Enrollment ID: I20190225001720 |
| Provider Name | Kerry L Bayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275927923 PECOS PAC ID: 1153632757 Enrollment ID: I20190319002007 |
| Provider Name | Parveen Kumar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558522003 PECOS PAC ID: 0143498550 Enrollment ID: I20190325001334 |
| Provider Name | Jeffrey Desmidt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689056111 PECOS PAC ID: 8921301474 Enrollment ID: I20190407000001 |
| Provider Name | Jeffery Schultz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255650610 PECOS PAC ID: 3375667538 Enrollment ID: I20190529000250 |
| Provider Name | Lorant Divald |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275859670 PECOS PAC ID: 7719111020 Enrollment ID: I20190603001716 |
| Provider Name | Michael Ryan Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336419969 PECOS PAC ID: 1557522687 Enrollment ID: I20190627003324 |
| Provider Name | Nana Oforiwaa Boateng-holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093219685 PECOS PAC ID: 8123354792 Enrollment ID: I20190719002949 |
| Provider Name | Richard Edward Thompson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174962559 PECOS PAC ID: 6002032034 Enrollment ID: I20190801002531 |
| Provider Name | Maria Hernandez Azmitia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952750127 PECOS PAC ID: 5991090581 Enrollment ID: I20190812003754 |
| Provider Name | David M Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750721593 PECOS PAC ID: 5597075135 Enrollment ID: I20190829003149 |
| Provider Name | Amy J Guzman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306495072 PECOS PAC ID: 7517298086 Enrollment ID: I20191015000256 |
| Provider Name | Nicholas J Lange |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285650952 PECOS PAC ID: 3971780701 Enrollment ID: I20191023001481 |
| Provider Name | Susan N Moruri |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306006861 PECOS PAC ID: 4981621059 Enrollment ID: I20191118000256 |
| Provider Name | John M Sherwood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821121088 PECOS PAC ID: 6800988700 Enrollment ID: I20191231001107 |
| Provider Name | Nicholas John Canion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629008768 PECOS PAC ID: 2769403823 Enrollment ID: I20200107002814 |
| Provider Name | Brendan M O'shea |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396972584 PECOS PAC ID: 4385888130 Enrollment ID: I20200109000252 |
| Provider Name | Matthew S Manganaro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609118710 PECOS PAC ID: 9234431321 Enrollment ID: I20200121000162 |
| Provider Name | Leslie L Teng |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679916423 PECOS PAC ID: 7012262579 Enrollment ID: I20200123002483 |
| Provider Name | Dana M Glasser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447897038 PECOS PAC ID: 8628403318 Enrollment ID: I20200128001056 |
| Provider Name | Crystal Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033752530 PECOS PAC ID: 7214363993 Enrollment ID: I20200129001827 |
| Provider Name | Leif E Jensen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205053832 PECOS PAC ID: 3678602992 Enrollment ID: I20200214002332 |
| Provider Name | Jaime Louise Dougherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124669221 PECOS PAC ID: 4880022656 Enrollment ID: I20200310002918 |
| Provider Name | Evelyn L Slomka |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437388378 PECOS PAC ID: 3577689629 Enrollment ID: I20200318002692 |
| Provider Name | Robert Hosker |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023338282 PECOS PAC ID: 1153624051 Enrollment ID: I20200323002253 |
| Provider Name | Brian A Conley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831394402 PECOS PAC ID: 6002076825 Enrollment ID: I20200327000424 |
| Provider Name | Kendall J Strand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518987668 PECOS PAC ID: 3577468222 Enrollment ID: I20200403002728 |
| Provider Name | Matthew M Schaar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790765600 PECOS PAC ID: 5698678944 Enrollment ID: I20200406000689 |
| Provider Name | Dean P J Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104841501 PECOS PAC ID: 6103721758 Enrollment ID: I20200411000296 |
| Provider Name | Whitney Lea Finke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134404908 PECOS PAC ID: 2062659345 Enrollment ID: I20200413003444 |
| Provider Name | Andrey A Ilyasov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972575587 PECOS PAC ID: 3971525809 Enrollment ID: I20200423003554 |
| Provider Name | Deann Schaefer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497372965 PECOS PAC ID: 8022432657 Enrollment ID: I20200715003161 |
| Provider Name | Amanda Marie Kleppe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336678689 PECOS PAC ID: 7416226477 Enrollment ID: I20200721004289 |
| Provider Name | Casey A Kramer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568998607 PECOS PAC ID: 6608136361 Enrollment ID: I20200806003016 |
| Provider Name | Jonathan K Wood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932143583 PECOS PAC ID: 8022007392 Enrollment ID: I20201210003032 |
| Provider Name | Jacob Hodge |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811158256 PECOS PAC ID: 3072668193 Enrollment ID: I20201211000633 |
| Provider Name | Scott S Nielsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902824238 PECOS PAC ID: 0143217034 Enrollment ID: I20201211000975 |
| Provider Name | Kevin P Henseler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952358129 PECOS PAC ID: 6800977810 Enrollment ID: I20201211001195 |
| Provider Name | Gregory M Phelan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427090133 PECOS PAC ID: 2860397510 Enrollment ID: I20201211001424 |
| Provider Name | Michael D Heaney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245287549 PECOS PAC ID: 7416991880 Enrollment ID: I20201211001695 |
| Provider Name | Matthew Adam Rischall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750607248 PECOS PAC ID: 5890006415 Enrollment ID: I20201211001831 |
| Provider Name | Ryan C Cusic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699091686 PECOS PAC ID: 2264667443 Enrollment ID: I20201214002133 |
| Provider Name | Veena R Iyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932426004 PECOS PAC ID: 0941511141 Enrollment ID: I20201214002481 |
| Provider Name | Steven G Thiel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427229541 PECOS PAC ID: 1456411735 Enrollment ID: I20201214002846 |
| Provider Name | Thomas R Frerichs |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629028329 PECOS PAC ID: 9436114634 Enrollment ID: I20201214003014 |
| Provider Name | John A Coburn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205273083 PECOS PAC ID: 3476797317 Enrollment ID: I20201214003166 |
| Provider Name | Torrey Bergman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861442493 PECOS PAC ID: 5890762124 Enrollment ID: I20201215001745 |
| Provider Name | Jennifer M Williams |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194917302 PECOS PAC ID: 1355467507 Enrollment ID: I20201217000912 |
| Provider Name | John T Olsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801814132 PECOS PAC ID: 8224933973 Enrollment ID: I20201217001355 |
| Provider Name | Justin M Nelson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326455239 PECOS PAC ID: 7810114527 Enrollment ID: I20201217001906 |
| Provider Name | Brian S Martell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689991432 PECOS PAC ID: 9931419793 Enrollment ID: I20201217002874 |
| Provider Name | Jeffrey R Brace |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619905924 PECOS PAC ID: 7618933326 Enrollment ID: I20201218001686 |
| Provider Name | Lee Kiedrowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962997338 PECOS PAC ID: 5890107429 Enrollment ID: I20201223001300 |
| Provider Name | Brian F Decesare |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194871798 PECOS PAC ID: 5395811863 Enrollment ID: I20201223002554 |
| Provider Name | Eric Jonathan Hartman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104172782 PECOS PAC ID: 3870716343 Enrollment ID: I20201230002125 |
| Provider Name | Bryan M Donald |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396064465 PECOS PAC ID: 5698089555 Enrollment ID: I20210113001545 |
| Provider Name | Adam B Jeffers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255539748 PECOS PAC ID: 8325293038 Enrollment ID: I20210310002411 |
| Provider Name | Nihar S Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245218759 PECOS PAC ID: 4688667645 Enrollment ID: I20210311001070 |
| Provider Name | Brian T Sullivan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780604835 PECOS PAC ID: 9436193802 Enrollment ID: I20210311002315 |
| Provider Name | Deidre A Mccann |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1821031618 PECOS PAC ID: 1557359601 Enrollment ID: I20210325002585 |
| Provider Name | Kyle O'boyle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922530575 PECOS PAC ID: 9436568508 Enrollment ID: I20210503001450 |
| Provider Name | Roland K Kafuuma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962615732 PECOS PAC ID: 3072681709 Enrollment ID: I20210603001057 |
| Provider Name | Kyle Hirsh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356778161 PECOS PAC ID: 4981823580 Enrollment ID: I20210608001459 |
| Provider Name | Kushal Parikh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518233642 PECOS PAC ID: 6305127390 Enrollment ID: I20210716002571 |
| Provider Name | Jacob Waxman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972946937 PECOS PAC ID: 8820238322 Enrollment ID: I20210720001954 |
| Provider Name | Mark D Mcmillan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508884826 PECOS PAC ID: 4981785995 Enrollment ID: I20210723000787 |
| Provider Name | Assefa M Ayalew |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912240235 PECOS PAC ID: 5597985358 Enrollment ID: I20210723003155 |
| Provider Name | Thomas J Giannaccini |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861814238 PECOS PAC ID: 1052535382 Enrollment ID: I20210729000824 |
| Provider Name | Franklin Liu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265540405 PECOS PAC ID: 1951454644 Enrollment ID: I20210729002199 |
| Provider Name | Andrew T Babcock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609134436 PECOS PAC ID: 3870898992 Enrollment ID: I20210803003582 |
| Provider Name | David Aamodt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578876496 PECOS PAC ID: 0244401461 Enrollment ID: I20210804001088 |
| Provider Name | Nolan Michael Kleinjan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386131100 PECOS PAC ID: 9931456159 Enrollment ID: I20210917002399 |
| Provider Name | Megan Beth Thiel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053087056 PECOS PAC ID: 6507264785 Enrollment ID: I20211004000728 |
| Provider Name | Fareed A Siddiqui |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235236530 PECOS PAC ID: 8921031535 Enrollment ID: I20211103000791 |
| Provider Name | Pegah Entezari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639517881 PECOS PAC ID: 7214156702 Enrollment ID: I20211103002376 |
| Provider Name | Suzanne C Moffit |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487687406 PECOS PAC ID: 7214926120 Enrollment ID: I20211103002521 |
| Provider Name | Christopher Mone |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902193428 PECOS PAC ID: 6507083870 Enrollment ID: I20211124001959 |
| Provider Name | William Hayes |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760433098 PECOS PAC ID: 9638143373 Enrollment ID: I20220118001976 |
| Provider Name | Mehdi Dastrange |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982967139 PECOS PAC ID: 4880906734 Enrollment ID: I20220202000723 |
| Provider Name | Brandon W Welsh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467730143 PECOS PAC ID: 3274830856 Enrollment ID: I20220308002817 |
| Provider Name | Aaron Binstock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891744280 PECOS PAC ID: 4284689985 Enrollment ID: I20220311000970 |
| Provider Name | Sharon Falke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578591947 PECOS PAC ID: 8527024264 Enrollment ID: I20220322001709 |
| Provider Name | Sanjay Saluja |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053374462 PECOS PAC ID: 0840241279 Enrollment ID: I20220613001239 |
| Provider Name | Brian P Flemming |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093000747 PECOS PAC ID: 7214226422 Enrollment ID: I20220614001384 |
| Provider Name | Everett H Gu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588004535 PECOS PAC ID: 5395055396 Enrollment ID: I20220629003647 |
| Provider Name | Kevin Mcelroy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184151110 PECOS PAC ID: 6204106644 Enrollment ID: I20220701002495 |
| Provider Name | Lina M Ricketts |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508527755 PECOS PAC ID: 3375937816 Enrollment ID: I20220728000747 |
| Provider Name | Ahmad R Hatem Al Samaraee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447593173 PECOS PAC ID: 7810292828 Enrollment ID: I20220822002988 |
| Provider Name | Mohamed Abdihalim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912141243 PECOS PAC ID: 6204010994 Enrollment ID: I20220822003374 |
| Provider Name | David Asinger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205886819 PECOS PAC ID: 8426953142 Enrollment ID: I20220823003870 |
| Provider Name | Amanjit Baadh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003061367 PECOS PAC ID: 3870750029 Enrollment ID: I20220824000670 |
| Provider Name | Curt Behrns |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801869227 PECOS PAC ID: 1850318379 Enrollment ID: I20220824002798 |
| Provider Name | Andrew Bunney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114246113 PECOS PAC ID: 5597998096 Enrollment ID: I20220826001525 |
| Provider Name | Jason Carroll |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033417571 PECOS PAC ID: 4789843285 Enrollment ID: I20220829000788 |
| Provider Name | Eric Carolan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679899389 PECOS PAC ID: 6800037623 Enrollment ID: I20220829000851 |
| Provider Name | Lester Fahrner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295995900 PECOS PAC ID: 7618115981 Enrollment ID: I20220829002720 |
| Provider Name | David Drake |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528046612 PECOS PAC ID: 7517871288 Enrollment ID: I20220830002750 |
| Provider Name | Jamie Fort |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568589083 PECOS PAC ID: 3375711542 Enrollment ID: I20220831000777 |
| Provider Name | Laurent Grignon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538366752 PECOS PAC ID: 9638301849 Enrollment ID: I20220831001342 |
| Provider Name | Timothy Goertzen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821076068 PECOS PAC ID: 3577477256 Enrollment ID: I20220831001763 |
| Provider Name | Justin Gross |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558676817 PECOS PAC ID: 1355573643 Enrollment ID: I20220901000278 |
| Provider Name | Andrew Hartigan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093793234 PECOS PAC ID: 5294649976 Enrollment ID: I20220901002689 |
| Provider Name | James Goddard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770562639 PECOS PAC ID: 0749279214 Enrollment ID: I20220901003041 |
| Provider Name | Jorge Leon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013996065 PECOS PAC ID: 2860394210 Enrollment ID: I20220901003353 |
| Provider Name | Joshua Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811127905 PECOS PAC ID: 7416081591 Enrollment ID: I20220902001294 |
| Provider Name | Cory Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699092445 PECOS PAC ID: 1355580671 Enrollment ID: I20220902001744 |
| Provider Name | Scott Hunter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700930344 PECOS PAC ID: 2062681059 Enrollment ID: I20220902002200 |
| Provider Name | Cory Nordman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679771521 PECOS PAC ID: 2961689427 Enrollment ID: I20220902002231 |
| Provider Name | Kristin Lieberman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053413708 PECOS PAC ID: 0648267682 Enrollment ID: I20220902002525 |
| Provider Name | Timothy Meehan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558686030 PECOS PAC ID: 4486811395 Enrollment ID: I20220902002623 |
| Provider Name | Sameer Nevile |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447556584 PECOS PAC ID: 5991957425 Enrollment ID: I20220906002317 |
| Provider Name | Michael Powell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700027166 PECOS PAC ID: 9234262148 Enrollment ID: I20220907002632 |
| Provider Name | Jonathan Phelan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437323128 PECOS PAC ID: 4183866353 Enrollment ID: I20220907002879 |
| Provider Name | Zachary Royce |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326307760 PECOS PAC ID: 8325340938 Enrollment ID: I20220909001611 |
| Provider Name | Douglas Sheafor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669438610 PECOS PAC ID: 7517970148 Enrollment ID: I20220909002532 |
| Provider Name | Collin Torok |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558523944 PECOS PAC ID: 7911156948 Enrollment ID: I20220912000453 |
| Provider Name | Andrew Sundblad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447411772 PECOS PAC ID: 3375781487 Enrollment ID: I20220915002928 |
| Provider Name | Mathew So |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215126503 PECOS PAC ID: 1254597487 Enrollment ID: I20220915003748 |
| Provider Name | Deepak Somashekar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710116918 PECOS PAC ID: 6901118843 Enrollment ID: I20220916000544 |
| Provider Name | Craig Rodriguez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467667774 PECOS PAC ID: 7618021429 Enrollment ID: I20220916001065 |
| Provider Name | Anne Weisensee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992784755 PECOS PAC ID: 8729992433 Enrollment ID: I20220916002894 |
| Provider Name | Jeff Werner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417152885 PECOS PAC ID: 7113180258 Enrollment ID: I20220916002966 |
| Provider Name | Sean K Johnston |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609052000 PECOS PAC ID: 7416088489 Enrollment ID: I20220919000744 |
| Provider Name | Mark Veldman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538188511 PECOS PAC ID: 6305889478 Enrollment ID: I20220919002792 |
| Provider Name | Michael H Wittmer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427029859 PECOS PAC ID: 1658275094 Enrollment ID: I20220920000390 |
| Provider Name | Jonathan P Williams |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003079112 PECOS PAC ID: 1153569710 Enrollment ID: I20220920002917 |
| Provider Name | Patrick Hackler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205282746 PECOS PAC ID: 0345531091 Enrollment ID: I20220922000569 |
| Provider Name | Ashley C Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770938607 PECOS PAC ID: 6305242959 Enrollment ID: I20220922002577 |
| Provider Name | Timothy K Ho |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063874808 PECOS PAC ID: 8820497779 Enrollment ID: I20220923001590 |
| Provider Name | Bilal Alturkmani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649627621 PECOS PAC ID: 2264723105 Enrollment ID: I20220923001659 |
| Provider Name | Jennifer Laroy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942654983 PECOS PAC ID: 3870885254 Enrollment ID: I20220927000576 |
| Provider Name | Glen C Gross |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467814467 PECOS PAC ID: 4880986884 Enrollment ID: I20220928003273 |
| Provider Name | Benjamin D Meyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619324043 PECOS PAC ID: 2264726397 Enrollment ID: I20220929002272 |
| Provider Name | Mark D Kovacs |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437385507 PECOS PAC ID: 3072738285 Enrollment ID: I20220929002712 |
| Provider Name | Kerri Harting |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487674040 PECOS PAC ID: 8022016906 Enrollment ID: I20220930002819 |
| Provider Name | John D Millet |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922444355 PECOS PAC ID: 3375845472 Enrollment ID: I20220930002850 |
| Provider Name | Ryan B O'malley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174729131 PECOS PAC ID: 3870759707 Enrollment ID: I20221003001309 |
| Provider Name | Robert Talbert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700172905 PECOS PAC ID: 3274762422 Enrollment ID: I20221003002838 |
| Provider Name | Michael A Koning |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285893990 PECOS PAC ID: 9133015878 Enrollment ID: I20221019001333 |
| Provider Name | Jeffrey Nathan Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285959213 PECOS PAC ID: 7214174101 Enrollment ID: I20221020001864 |
| Provider Name | Jonathan Perry |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427497254 PECOS PAC ID: 1658512496 Enrollment ID: I20221101002534 |
| Provider Name | Thomas E Crosslin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376779934 PECOS PAC ID: 5890913891 Enrollment ID: I20221104001298 |
| Provider Name | Andrew Scarano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356607725 PECOS PAC ID: 0446473177 Enrollment ID: I20221115001221 |
| Provider Name | Phillip Lee Van |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639330533 PECOS PAC ID: 9335380161 Enrollment ID: I20221115001945 |
| Provider Name | Carly Harvey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194067660 PECOS PAC ID: 7618197005 Enrollment ID: I20221123001995 |
| Provider Name | Adam T Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306078191 PECOS PAC ID: 3779890546 Enrollment ID: I20230113002176 |
| Provider Name | Amy Nielsen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356736995 PECOS PAC ID: 5496057655 Enrollment ID: I20230201002727 |
| Provider Name | Paige Hood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184338501 PECOS PAC ID: 8628440393 Enrollment ID: I20230206001144 |
| Provider Name | Mark E Wilson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134161128 PECOS PAC ID: 2163485178 Enrollment ID: I20230216002926 |
| Provider Name | Jessica Ann Axmacher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912148867 PECOS PAC ID: 6305023839 Enrollment ID: I20230309002660 |
| Provider Name | David Strang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851366025 PECOS PAC ID: 1254373848 Enrollment ID: I20230329001429 |
| Provider Name | Gianluca Cerri |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922157627 PECOS PAC ID: 5395642193 Enrollment ID: I20230331000652 |
| Provider Name | Monroe C Whitman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346248861 PECOS PAC ID: 0143416354 Enrollment ID: I20230403001004 |
| Provider Name | Michael Skulski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801871876 PECOS PAC ID: 8921058108 Enrollment ID: I20230405002271 |
| Provider Name | Tristan R Lawson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295260552 PECOS PAC ID: 4082986385 Enrollment ID: I20230503003040 |
| Provider Name | Kimberley Farmer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326008400 PECOS PAC ID: 9830182096 Enrollment ID: I20230512001455 |
| Provider Name | Michael Fu-yen Lin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245250802 PECOS PAC ID: 7113922030 Enrollment ID: I20230516003318 |
| Provider Name | Gabrielle K Hartze |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1083187348 PECOS PAC ID: 7911363965 Enrollment ID: I20230517000068 |
| Provider Name | Subba Alapati |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487642039 PECOS PAC ID: 7012974686 Enrollment ID: I20230524000117 |
| Provider Name | Maarten L Galantowicz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194257899 PECOS PAC ID: 6608146063 Enrollment ID: I20230524003401 |
| Provider Name | Stephanie Thomas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043520489 PECOS PAC ID: 4587819826 Enrollment ID: I20230608002689 |
| Provider Name | Andrew Deh-an Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124070883 PECOS PAC ID: 2769581578 Enrollment ID: I20230613001836 |
| Provider Name | Sonia Lucille Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104804343 PECOS PAC ID: 1557323136 Enrollment ID: I20230705000108 |
| Provider Name | Curtis Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548209133 PECOS PAC ID: 0749269991 Enrollment ID: I20230706001285 |
| Provider Name | James Arthur Erickson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306378344 PECOS PAC ID: 1850660705 Enrollment ID: I20230710000967 |
| Provider Name | Michael Thomas Madison |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821077876 PECOS PAC ID: 5890609580 Enrollment ID: I20230712003198 |
| Provider Name | Monika M Banach |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396042263 PECOS PAC ID: 7911183686 Enrollment ID: I20230718002750 |
| Provider Name | Nissar Vahora |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407299423 PECOS PAC ID: 4183864168 Enrollment ID: I20230719002875 |
| Provider Name | Matthew Charles Mcvay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336593300 PECOS PAC ID: 3971903352 Enrollment ID: I20230728002848 |
| Provider Name | James Austin Campbell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437687167 PECOS PAC ID: 3476823915 Enrollment ID: I20230801002537 |
| Provider Name | Adam S Nygard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871021816 PECOS PAC ID: 3173895232 Enrollment ID: I20230802003395 |
| Provider Name | Molly A Wingfield |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649709411 PECOS PAC ID: 1052683133 Enrollment ID: I20230803002511 |
| Provider Name | Wade Bollinger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730198136 PECOS PAC ID: 8325026727 Enrollment ID: I20230804001064 |
| Provider Name | Justin Edward Vranic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336551993 PECOS PAC ID: 7416260955 Enrollment ID: I20230804001316 |
| Provider Name | Joshua Theodore Olson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992237754 PECOS PAC ID: 1850649674 Enrollment ID: I20230809002977 |
| Provider Name | Scott Mauch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598290272 PECOS PAC ID: 3173893104 Enrollment ID: I20230810000940 |
| Provider Name | Anand Rao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629102918 PECOS PAC ID: 9436217858 Enrollment ID: I20230810002983 |
| Provider Name | Benjamin Scott Levy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053745273 PECOS PAC ID: 9638421050 Enrollment ID: I20230811000945 |
| Provider Name | Trevor Everett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134654908 PECOS PAC ID: 0446520654 Enrollment ID: I20230814000916 |
| Provider Name | Jack Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104356500 PECOS PAC ID: 2668744426 Enrollment ID: I20230815000620 |
| Provider Name | Jeffrey Paul Lassig |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558459032 PECOS PAC ID: 6507896578 Enrollment ID: I20230815001210 |
| Provider Name | Eric T Torkelson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1902468978 PECOS PAC ID: 4789914946 Enrollment ID: I20230822003299 |
| Provider Name | Dennis Heaton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144453978 PECOS PAC ID: 6901944669 Enrollment ID: I20230919001122 |
| Provider Name | John William Colford |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164575411 PECOS PAC ID: 1254426141 Enrollment ID: I20230922002797 |
| Provider Name | Chike Onyejekwe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891775565 PECOS PAC ID: 6103914429 Enrollment ID: I20230927000362 |
| Provider Name | Kari Ann Kudrna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528747763 PECOS PAC ID: 8729433867 Enrollment ID: I20231010003510 |
| Provider Name | Mehmet Gencturk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134508054 PECOS PAC ID: 9335444520 Enrollment ID: I20231117002570 |
| Provider Name | Thomas Maxwell Geddings |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1184845026 PECOS PAC ID: 9032233796 Enrollment ID: I20231120003663 |
| Provider Name | Orlando Ricci |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063440006 PECOS PAC ID: 5597659441 Enrollment ID: I20231205002235 |
| Provider Name | George Vernon Chesteen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083053573 PECOS PAC ID: 8729333646 Enrollment ID: I20231229002125 |
| Provider Name | John Daniel Rothpletz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740220409 PECOS PAC ID: 3971496142 Enrollment ID: I20240105002059 |
| Provider Name | Danielle Leigh Sanchez |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689024549 PECOS PAC ID: 7315270832 Enrollment ID: I20240119001681 |
| Provider Name | Douglas Spencer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215496195 PECOS PAC ID: 7416314265 Enrollment ID: I20240206000817 |
| Provider Name | Cascillas Guy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215391545 PECOS PAC ID: 0648613398 Enrollment ID: I20240208004690 |
| Provider Name | Wayne Tse |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609222967 PECOS PAC ID: 0547554883 Enrollment ID: I20240223001509 |
| Provider Name | Clifford Jean |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285788570 PECOS PAC ID: 5597661603 Enrollment ID: I20240304000854 |
| Provider Name | Andrew Ward |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356452056 PECOS PAC ID: 6305746694 Enrollment ID: I20240311002704 |
Ideal Option, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 44 24th St E, Dickinson, ND 58601 Phone: 877-522-1275 Fax: 509-491-3031 | |
Medcenter One Health Systems Dickinson Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 938 2nd Ave W, Dickinson, ND 58601 Phone: 701-456-6000 Fax: 701-323-5709 | |
Ideal Option, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1260 W Villard St Unit 1, Dickinson, ND 58601 Phone: 877-522-1275 Fax: 509-491-3031 | |
Family Planning Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 202 E Villard St, Dickinson, ND 58601 Phone: 701-227-0131 Fax: 701-227-4750 | |
West River Foot And Ankle Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 683 State Ave, Suite E, Dickinson, ND 58601 Phone: 701-483-4561 | |
Sanford Health East Dickinson Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 33 9th St W, Dickinson, ND 58601 Phone: 701-483-6017 Fax: 701-483-5018 |