| Fairview Heights Medical Group SC | |
|
670 Mason Ridge Center Dr Ste 300 Saint Louis MO 63141-8573 | |
| (314) 996-7644 | |
| (314) 996-7658 |
| Full Name | Fairview Heights Medical Group SC |
|---|---|
| Speciality | Clinic/Center |
| Location | 670 Mason Ridge Center Dr Ste 300, Saint Louis, Missouri |
| Authorized Official Name and Position | Karen Canter-koester (VP OPERATIONS AND STRATEGY) |
| Authorized Official Contact | 3149967610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairview Heights Medical Group SC 670 Mason Ridge Center Dr Ste 300 Saint Louis MO 63141-8573 Ph: (314) 996-7644 | Fairview Heights Medical Group SC 670 Mason Ridge Center Dr Ste 300 Saint Louis MO 63141-8573 Ph: (314) 996-7644 |
| NPI Number | 1679503668 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 09/17/2025 |
| Certification Date | 09/17/2025 |
| Medicare PECOS PAC ID | 6800784083 |
|---|---|
| Medicare Enrollment ID | O20040309000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679503668 | NPI | - | NPPES |
| 500720107 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | () | Primary |
| 261QM2500X | Clinic/center - Medical Specialty | () | Secondary |
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| Provider Name | Syed M Ala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235233792 PECOS PAC ID: 7214836469 Enrollment ID: I20040107000216 |
| Provider Name | Mark Kovach |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1336128222 PECOS PAC ID: 1850293366 Enrollment ID: I20040124000148 |
| Provider Name | Gregory Simmons |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194729871 PECOS PAC ID: 9830092865 Enrollment ID: I20040129000064 |
| Provider Name | Erik C Stabell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609868108 PECOS PAC ID: 6608779350 Enrollment ID: I20040129000845 |
| Provider Name | John a Hoelscher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447267810 PECOS PAC ID: 7517868003 Enrollment ID: I20040329000799 |
| Provider Name | Christine M Taylor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942223409 PECOS PAC ID: 0042202053 Enrollment ID: I20040331000810 |
| Provider Name | Joseph Mark Talsky |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629026208 PECOS PAC ID: 2668465303 Enrollment ID: I20040407000686 |
| Provider Name | Sekou K Kelsey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982661567 PECOS PAC ID: 8628062221 Enrollment ID: I20040414000908 |
| Provider Name | Benedict Painter |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154314839 PECOS PAC ID: 6305831769 Enrollment ID: I20040419001147 |
| Provider Name | Lance L Lane |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023088655 PECOS PAC ID: 8628064979 Enrollment ID: I20040422000144 |
| Provider Name | William a Chadwick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568454775 PECOS PAC ID: 2365349172 Enrollment ID: I20040510000876 |
| Provider Name | Nidal Shawahin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245236884 PECOS PAC ID: 0244213379 Enrollment ID: I20040610000436 |
| Provider Name | Courtney M Mcfarlin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831183334 PECOS PAC ID: 7911894142 Enrollment ID: I20040628000605 |
| Provider Name | Tori R Sutton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528088051 PECOS PAC ID: 0345226668 Enrollment ID: I20040628000668 |
| Provider Name | William R Bartley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134112097 PECOS PAC ID: 7012811987 Enrollment ID: I20040717000055 |
| Provider Name | Kashif S Bhutto |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083791651 PECOS PAC ID: 3971578204 Enrollment ID: I20040831000598 |
| Provider Name | Craig K Harms |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598878373 PECOS PAC ID: 7012976871 Enrollment ID: I20041007000178 |
| Provider Name | Christopher L Schenewerk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154328722 PECOS PAC ID: 0941262109 Enrollment ID: I20041029000782 |
| Provider Name | Steven R Horner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932154051 PECOS PAC ID: 6709848997 Enrollment ID: I20041030000054 |
| Provider Name | Erica L Uppstrom |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366441339 PECOS PAC ID: 8628970134 Enrollment ID: I20041101000599 |
| Provider Name | Kristen M Stabell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689667529 PECOS PAC ID: 0042114951 Enrollment ID: I20041217000483 |
| Provider Name | Indu M Vence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992805808 PECOS PAC ID: 1456309053 Enrollment ID: I20050111000256 |
| Provider Name | Tariq L Quadri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275525271 PECOS PAC ID: 1254387392 Enrollment ID: I20050322001081 |
| Provider Name | Omer M Badahman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1851371231 PECOS PAC ID: 5991751489 Enrollment ID: I20050331001195 |
| Provider Name | Rafael M De La Cruz |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1669460655 PECOS PAC ID: 6204873292 Enrollment ID: I20050412000220 |
| Provider Name | Michele D Brannan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083621452 PECOS PAC ID: 8022057066 Enrollment ID: I20050428000599 |
| Provider Name | Carlos M Yu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417934894 PECOS PAC ID: 6901845817 Enrollment ID: I20050510000438 |
| Provider Name | Shadi Adel Altwal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417992520 PECOS PAC ID: 2365486552 Enrollment ID: I20050617000984 |
| Provider Name | Charlotte Albinson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366400608 PECOS PAC ID: 4688605058 Enrollment ID: I20050825000333 |
| Provider Name | Douglas W Dothager |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871599738 PECOS PAC ID: 2769441153 Enrollment ID: I20050920000931 |
| Provider Name | Beatriz C Pardo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780670844 PECOS PAC ID: 3779517081 Enrollment ID: I20050926000222 |
| Provider Name | Robert Walton Garner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285612242 PECOS PAC ID: 2264467364 Enrollment ID: I20050928000030 |
| Provider Name | Donna Lynn Koenig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871564898 PECOS PAC ID: 2264457696 Enrollment ID: I20051013000932 |
| Provider Name | Keith a Moss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588601819 PECOS PAC ID: 4587680137 Enrollment ID: I20051026000380 |
| Provider Name | Irina Yurievna Polansky |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801866462 PECOS PAC ID: 3779503669 Enrollment ID: I20051207000340 |
| Provider Name | Hans H Moosa |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1194768432 PECOS PAC ID: 1658393020 Enrollment ID: I20051229000366 |
| Provider Name | Deborah F D Bross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487692430 PECOS PAC ID: 1557383809 Enrollment ID: I20051229000600 |
| Provider Name | Hatim a Mahmood |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174556583 PECOS PAC ID: 9830112101 Enrollment ID: I20060112000619 |
| Provider Name | Prasad V Kandula |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164518460 PECOS PAC ID: 9234152505 Enrollment ID: I20060112000662 |
| Provider Name | Michele M Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326020041 PECOS PAC ID: 6800833138 Enrollment ID: I20060112000733 |
| Provider Name | Karen a Ham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629285515 PECOS PAC ID: 2466476957 Enrollment ID: I20060124000262 |
| Provider Name | Samir Kanainalal Shah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427072768 PECOS PAC ID: 3779591185 Enrollment ID: I20060328000253 |
| Provider Name | Mei Huang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417972597 PECOS PAC ID: 2163459546 Enrollment ID: I20060914000413 |
| Provider Name | James M Hitchcock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295725174 PECOS PAC ID: 8123023298 Enrollment ID: I20060925000595 |
| Provider Name | Richard J Hehmann |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1215922067 PECOS PAC ID: 9436155942 Enrollment ID: I20061005000526 |
| Provider Name | Ajitesh Rai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205883097 PECOS PAC ID: 1456358548 Enrollment ID: I20061102000488 |
| Provider Name | Mary R Hoffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316984057 PECOS PAC ID: 1850357526 Enrollment ID: I20061116000374 |
| Provider Name | David J Nyquist |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114966611 PECOS PAC ID: 2163423807 Enrollment ID: I20070124000326 |
| Provider Name | Kim C Wrigley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013070440 PECOS PAC ID: 0547262008 Enrollment ID: I20070213000149 |
| Provider Name | Gregory S Churchill |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1053390237 PECOS PAC ID: 4880798057 Enrollment ID: I20070327000675 |
| Provider Name | Ahmad a Karadaghy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619963063 PECOS PAC ID: 0244285781 Enrollment ID: I20070620000347 |
| Provider Name | Eileen Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083668750 PECOS PAC ID: 2668485277 Enrollment ID: I20070621000379 |
| Provider Name | Niraja Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346275724 PECOS PAC ID: 4183723448 Enrollment ID: I20070627000304 |
| Provider Name | Hollie a Yoder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548476922 PECOS PAC ID: 9234221615 Enrollment ID: I20070815000863 |
| Provider Name | Wael F Girgis |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1508053802 PECOS PAC ID: 5991891046 Enrollment ID: I20071019000509 |
| Provider Name | David Andrew O'neill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922092394 PECOS PAC ID: 4284723271 Enrollment ID: I20071128000570 |
| Provider Name | Robert J Dizes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871686790 PECOS PAC ID: 8123109527 Enrollment ID: I20080111000732 |
| Provider Name | Satyen Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154482131 PECOS PAC ID: 8527142777 Enrollment ID: I20080226000675 |
| Provider Name | Kirby Klostermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285829572 PECOS PAC ID: 7517041437 Enrollment ID: I20080229000493 |
| Provider Name | Pathanjali Saravanan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639284862 PECOS PAC ID: 6002991833 Enrollment ID: I20080304000584 |
| Provider Name | Julia J Wiegers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891899209 PECOS PAC ID: 9830196104 Enrollment ID: I20080318000417 |
| Provider Name | Pamela Van Bevern |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407970395 PECOS PAC ID: 6103902325 Enrollment ID: I20080327000453 |
| Provider Name | Laura S Bird |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295720993 PECOS PAC ID: 6709786072 Enrollment ID: I20080707000215 |
| Provider Name | Vibhu Dhawan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033315965 PECOS PAC ID: 6901979111 Enrollment ID: I20080722000262 |
| Provider Name | Mohammad Sajed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396785127 PECOS PAC ID: 3577567528 Enrollment ID: I20080804000521 |
| Provider Name | Ahsan Usman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215016571 PECOS PAC ID: 6507864998 Enrollment ID: I20080823000101 |
| Provider Name | Ann T Laney |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1497904213 PECOS PAC ID: 8426116922 Enrollment ID: I20081028000560 |
| Provider Name | Abdulsalam Jamous |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891778221 PECOS PAC ID: 4587607809 Enrollment ID: I20081103000126 |
| Provider Name | James M Goldring |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992715775 PECOS PAC ID: 6507933157 Enrollment ID: I20090127000135 |
| Provider Name | Rhonda Lyn Pulver |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932147592 PECOS PAC ID: 6608882915 Enrollment ID: I20090204000634 |
| Provider Name | David a Harmon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033175633 PECOS PAC ID: 2860383098 Enrollment ID: I20090211000074 |
| Provider Name | Matthew J Koch |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1962420448 PECOS PAC ID: 0042292765 Enrollment ID: I20090216000389 |
| Provider Name | Jeffrey D Parks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215044367 PECOS PAC ID: 1153210596 Enrollment ID: I20090324000319 |
| Provider Name | Walter a Dimmitt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467532267 PECOS PAC ID: 6709892888 Enrollment ID: I20090810000440 |
| Provider Name | Michael X Liu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851402721 PECOS PAC ID: 0547314452 Enrollment ID: I20090812000094 |
| Provider Name | Matthew Alan Fraley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326187352 PECOS PAC ID: 5092766824 Enrollment ID: I20090812000126 |
| Provider Name | David R Riedel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073505004 PECOS PAC ID: 7911811146 Enrollment ID: I20091118000600 |
| Provider Name | Tina Ann Cloin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902916851 PECOS PAC ID: 0648311803 Enrollment ID: I20100109000301 |
| Provider Name | Mark T Klucka |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1801902432 PECOS PAC ID: 3678608353 Enrollment ID: I20100319000401 |
| Provider Name | Blake C Rodgers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366501140 PECOS PAC ID: 6507992419 Enrollment ID: I20100331000230 |
| Provider Name | Craig Lotz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194879288 PECOS PAC ID: 9436288677 Enrollment ID: I20100526000154 |
| Provider Name | Christina Dothager |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508067596 PECOS PAC ID: 9133251614 Enrollment ID: I20100719000863 |
| Provider Name | Matthew D Hageman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376540930 PECOS PAC ID: 7214957109 Enrollment ID: I20100819000968 |
| Provider Name | Steven P Zenker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861485708 PECOS PAC ID: 3779487657 Enrollment ID: I20100825000991 |
| Provider Name | Muhammad Farooq Asghar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447416342 PECOS PAC ID: 3678697737 Enrollment ID: I20100826000946 |
| Provider Name | Kelly J Lindsey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225021165 PECOS PAC ID: 9931003829 Enrollment ID: I20101005001309 |
| Provider Name | Sultan a Hayat |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548248453 PECOS PAC ID: 3577598713 Enrollment ID: I20101027001543 |
| Provider Name | Douglas Anthony Kruse |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194830661 PECOS PAC ID: 5294929444 Enrollment ID: I20101101001357 |
| Provider Name | Aaron P Omotola |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841461134 PECOS PAC ID: 8325232465 Enrollment ID: I20101102000931 |
| Provider Name | David P Rawdon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376549139 PECOS PAC ID: 6406041235 Enrollment ID: I20101105001260 |
| Provider Name | Christopher Wagoner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750583506 PECOS PAC ID: 1456546944 Enrollment ID: I20101110000298 |
| Provider Name | Ibrahim B Elayyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023207115 PECOS PAC ID: 6507051943 Enrollment ID: I20101111000738 |
| Provider Name | Rehan M Rafiq |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407924954 PECOS PAC ID: 2062467756 Enrollment ID: I20101116000116 |
| Provider Name | Michael J Fleissner |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1942289459 PECOS PAC ID: 5395755110 Enrollment ID: I20101124000698 |
| Provider Name | Salma Mannan-hilaly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699772251 PECOS PAC ID: 9537357587 Enrollment ID: I20110104001233 |
| Provider Name | Lisa R Reno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306871538 PECOS PAC ID: 3779763743 Enrollment ID: I20110208000621 |
| Provider Name | Farid Roman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1851366355 PECOS PAC ID: 3870574585 Enrollment ID: I20110511000511 |
| Provider Name | Carol Marie Kadonsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124326145 PECOS PAC ID: 4880871326 Enrollment ID: I20110609000042 |
| Provider Name | Kellie D Hughes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699071266 PECOS PAC ID: 3072790351 Enrollment ID: I20110614000703 |
| Provider Name | Robert Piotrowski |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134382898 PECOS PAC ID: 0547442212 Enrollment ID: I20110617000557 |
| Provider Name | Deepak Koul |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1417155672 PECOS PAC ID: 6709910649 Enrollment ID: I20110628000319 |
| Provider Name | Jacqueline Sue Baalman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912236183 PECOS PAC ID: 0244418861 Enrollment ID: I20110630000529 |
| Provider Name | Narine Sargsyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609032598 PECOS PAC ID: 2769651587 Enrollment ID: I20110812000374 |
| Provider Name | Cynthia Whitcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275827917 PECOS PAC ID: 4789842808 Enrollment ID: I20120221000759 |
| Provider Name | Donald G Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508842352 PECOS PAC ID: 6901864230 Enrollment ID: I20120224000459 |
| Provider Name | Jaclyn N Sneed |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962642744 PECOS PAC ID: 8325199144 Enrollment ID: I20120411000825 |
| Provider Name | Akhil Chapagain |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346525235 PECOS PAC ID: 6002078276 Enrollment ID: I20120504000098 |
| Provider Name | Vikram Patney |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1699744235 PECOS PAC ID: 4981680394 Enrollment ID: I20120514000729 |
| Provider Name | Sara E Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881951648 PECOS PAC ID: 7618130162 Enrollment ID: I20120518000521 |
| Provider Name | Michael S Hughes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558470617 PECOS PAC ID: 6406011543 Enrollment ID: I20120622000510 |
| Provider Name | Ron Oren |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1366422438 PECOS PAC ID: 5395761134 Enrollment ID: I20120806000746 |
| Provider Name | Alfreda Shields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497021810 PECOS PAC ID: 7810145133 Enrollment ID: I20120911000818 |
| Provider Name | Christopher R Aldridge |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104026707 PECOS PAC ID: 0941459713 Enrollment ID: I20121011000439 |
| Provider Name | Hannah B Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649526013 PECOS PAC ID: 8628228269 Enrollment ID: I20121017000433 |
| Provider Name | Ahmad Osama Rez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356537179 PECOS PAC ID: 1951435510 Enrollment ID: I20130107000025 |
| Provider Name | Pankaj Kaul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376771105 PECOS PAC ID: 8123211919 Enrollment ID: I20130110000495 |
| Provider Name | Melissa a Kershaw |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518178730 PECOS PAC ID: 9133372378 Enrollment ID: I20130121000088 |
| Provider Name | Casey a Newgent |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386989549 PECOS PAC ID: 3678718905 Enrollment ID: I20130314000362 |
| Provider Name | Sumbul Meraj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285931261 PECOS PAC ID: 9436394228 Enrollment ID: I20130327000332 |
| Provider Name | Amanda N Ventimiglia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972845998 PECOS PAC ID: 5395982060 Enrollment ID: I20130516000616 |
| Provider Name | Puja Gurung |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1063727832 PECOS PAC ID: 1355580648 Enrollment ID: I20130618000142 |
| Provider Name | Philip S Dudak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720067051 PECOS PAC ID: 7911946421 Enrollment ID: I20130620000254 |
| Provider Name | Kristen N Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003159450 PECOS PAC ID: 1355581158 Enrollment ID: I20130627000605 |
| Provider Name | Shawna R Swinigan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932391687 PECOS PAC ID: 9032396023 Enrollment ID: I20130627000666 |
| Provider Name | Vicki K Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518179654 PECOS PAC ID: 9638310246 Enrollment ID: I20130724000601 |
| Provider Name | Olayiwola C Olagbegi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912011255 PECOS PAC ID: 1355347741 Enrollment ID: I20130731000366 |
| Provider Name | Charles L Lehmann |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033371992 PECOS PAC ID: 2264673300 Enrollment ID: I20130801000124 |
| Provider Name | Rachel E Durham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730318890 PECOS PAC ID: 3577705771 Enrollment ID: I20130819000592 |
| Provider Name | Niraj Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134440969 PECOS PAC ID: 9830332741 Enrollment ID: I20130826000017 |
| Provider Name | John W Stirton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851598429 PECOS PAC ID: 4587899372 Enrollment ID: I20131104000046 |
| Provider Name | Lyndsi K Sievers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750716726 PECOS PAC ID: 5698901783 Enrollment ID: I20131120000155 |
| Provider Name | Thomas H Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306070636 PECOS PAC ID: 6103082227 Enrollment ID: I20140130000530 |
| Provider Name | Mary K Stuart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417372772 PECOS PAC ID: 5799918975 Enrollment ID: I20140424001196 |
| Provider Name | Denise R Schleeper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144642539 PECOS PAC ID: 1557594439 Enrollment ID: I20140429002133 |
| Provider Name | Patrick M Neville |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1588959548 PECOS PAC ID: 0244454411 Enrollment ID: I20140609000674 |
| Provider Name | Jennifer L Neville |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528292299 PECOS PAC ID: 6901053933 Enrollment ID: I20140626001878 |
| Provider Name | Brandy Michele Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902217540 PECOS PAC ID: 6305061904 Enrollment ID: I20140715000496 |
| Provider Name | Umesh I Gandhi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205056660 PECOS PAC ID: 8527111384 Enrollment ID: I20140828001007 |
| Provider Name | Dana M Grosch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447651708 PECOS PAC ID: 4284855099 Enrollment ID: I20141021000034 |
| Provider Name | Jennifer D Szalkowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275524290 PECOS PAC ID: 2163556002 Enrollment ID: I20141031000129 |
| Provider Name | Michael J Sullivan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881097236 PECOS PAC ID: 9335361930 Enrollment ID: I20141115000347 |
| Provider Name | Mary L Schinkel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1386892172 PECOS PAC ID: 2860663630 Enrollment ID: I20141118001359 |
| Provider Name | Steven Lock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629409644 PECOS PAC ID: 6901026392 Enrollment ID: I20141124000822 |
| Provider Name | Frederick D Turpin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376536029 PECOS PAC ID: 8224110754 Enrollment ID: I20141223000635 |
| Provider Name | Mahmud Al Furgani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528369782 PECOS PAC ID: 2365670809 Enrollment ID: I20141231000517 |
| Provider Name | Briana R Waldeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477952067 PECOS PAC ID: 7618290180 Enrollment ID: I20150108002144 |
| Provider Name | Anne Leslie Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326441478 PECOS PAC ID: 0345564787 Enrollment ID: I20150113002191 |
| Provider Name | Bethany I Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609293372 PECOS PAC ID: 9335464361 Enrollment ID: I20150213000546 |
| Provider Name | Christopher Louis Beuer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144482563 PECOS PAC ID: 0345498143 Enrollment ID: I20150415000313 |
| Provider Name | Srinivasarao C Yaganti |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245252972 PECOS PAC ID: 7012004351 Enrollment ID: I20150519000257 |
| Provider Name | Jessica M Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588057848 PECOS PAC ID: 5991025108 Enrollment ID: I20150528002171 |
| Provider Name | Farhanaz Chowdhury |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518253160 PECOS PAC ID: 9931327947 Enrollment ID: I20150617000700 |
| Provider Name | Ranita R Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083096895 PECOS PAC ID: 5890007900 Enrollment ID: I20150702000564 |
| Provider Name | Siddharth Munsif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184926040 PECOS PAC ID: 0648414375 Enrollment ID: I20150710001156 |
| Provider Name | Lori a Mccullough |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336312693 PECOS PAC ID: 7810021136 Enrollment ID: I20150825003477 |
| Provider Name | Huzaifa Quaizar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326334343 PECOS PAC ID: 7416198486 Enrollment ID: I20150825003517 |
| Provider Name | Supriya Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245593201 PECOS PAC ID: 3274849435 Enrollment ID: I20150902001447 |
| Provider Name | Timothy J Leeburton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104823574 PECOS PAC ID: 4183695364 Enrollment ID: I20150902001876 |
| Provider Name | Christina L Moore |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558738237 PECOS PAC ID: 2365759883 Enrollment ID: I20150916001692 |
| Provider Name | Mattison Perez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003285560 PECOS PAC ID: 2860700820 Enrollment ID: I20150924003010 |
| Provider Name | Rouba G Ghoussoub |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1396964599 PECOS PAC ID: 5092883686 Enrollment ID: I20151005002948 |
| Provider Name | Marianne Torbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982017976 PECOS PAC ID: 4981913688 Enrollment ID: I20151020002348 |
| Provider Name | Amy E Witkus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710355565 PECOS PAC ID: 1951610278 Enrollment ID: I20151027001331 |
| Provider Name | Beth a Jacobs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508110776 PECOS PAC ID: 7416258447 Enrollment ID: I20151217000134 |
| Provider Name | Julie a Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922492271 PECOS PAC ID: 9133449846 Enrollment ID: I20160107001313 |
| Provider Name | Krista N Ludwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437523677 PECOS PAC ID: 2264736826 Enrollment ID: I20160203000028 |
| Provider Name | Lucy Broaddus |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114299419 PECOS PAC ID: 3971732355 Enrollment ID: I20160219001522 |
| Provider Name | John J Lehman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568480374 PECOS PAC ID: 3779616156 Enrollment ID: I20160405000468 |
| Provider Name | Kristine M Costello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922469402 PECOS PAC ID: 5496053183 Enrollment ID: I20160413001232 |
| Provider Name | Kiley M Faires |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366806838 PECOS PAC ID: 6800186297 Enrollment ID: I20160525002708 |
| Provider Name | Angie Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972694685 PECOS PAC ID: 5193621233 Enrollment ID: I20160620000759 |
| Provider Name | Arjun Singh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780619957 PECOS PAC ID: 5991829400 Enrollment ID: I20160627001217 |
| Provider Name | Ahmad Zabad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780021774 PECOS PAC ID: 9638460306 Enrollment ID: I20160628000951 |
| Provider Name | Amanda Sue Schmitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912361411 PECOS PAC ID: 7618268392 Enrollment ID: I20160628001372 |
| Provider Name | Michael G Guignon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942542931 PECOS PAC ID: 3779886791 Enrollment ID: I20160630001414 |
| Provider Name | Megha Manek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841446473 PECOS PAC ID: 4385812007 Enrollment ID: I20160831001535 |
| Provider Name | Catherine F Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427504042 PECOS PAC ID: 2365738507 Enrollment ID: I20160914000933 |
| Provider Name | Adnan Y Siddiqui |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1134194327 PECOS PAC ID: 7810910460 Enrollment ID: I20161012002016 |
| Provider Name | Zandra N Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528496437 PECOS PAC ID: 9739319120 Enrollment ID: I20161110001828 |
| Provider Name | Angela Marie Kage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881145159 PECOS PAC ID: 4385923408 Enrollment ID: I20161114000895 |
| Provider Name | Christine a Testa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013121383 PECOS PAC ID: 7113012931 Enrollment ID: I20161118000605 |
| Provider Name | Supraja Reddy Reddy |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1134432479 PECOS PAC ID: 5597903583 Enrollment ID: I20161202000543 |
| Provider Name | Melissa K Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679920052 PECOS PAC ID: 6406135656 Enrollment ID: I20170201000169 |
| Provider Name | Veronica O Abegunde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740500826 PECOS PAC ID: 5294960357 Enrollment ID: I20170213000242 |
| Provider Name | Stephanie E King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053860320 PECOS PAC ID: 0941580476 Enrollment ID: I20170301000059 |
| Provider Name | Jareer Farah |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073784583 PECOS PAC ID: 6002977246 Enrollment ID: I20170320001619 |
| Provider Name | Timothy Michael Kamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932633443 PECOS PAC ID: 9638456809 Enrollment ID: I20170426001946 |
| Provider Name | Imtiaz Bangash |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003216953 PECOS PAC ID: 4688951288 Enrollment ID: I20170509001464 |
| Provider Name | Ashley N Altman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457882417 PECOS PAC ID: 6901174960 Enrollment ID: I20170615000045 |
| Provider Name | Jared M Hu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770023608 PECOS PAC ID: 5597042382 Enrollment ID: I20170615000201 |
| Provider Name | Emily M Cottrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295262459 PECOS PAC ID: 5193093946 Enrollment ID: I20170620000286 |
| Provider Name | Kaycee M Eyers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750818522 PECOS PAC ID: 4981972445 Enrollment ID: I20170626000861 |
| Provider Name | Kathy L Liefer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013439777 PECOS PAC ID: 3870865116 Enrollment ID: I20170821002126 |
| Provider Name | Aftab Awan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316971880 PECOS PAC ID: 2860473998 Enrollment ID: I20171018003682 |
| Provider Name | Omar Ali Mohammad Mahasneh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124361746 PECOS PAC ID: 3274831417 Enrollment ID: I20171101000858 |
| Provider Name | Leah M Trower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306365556 PECOS PAC ID: 8123384252 Enrollment ID: I20171106003208 |
| Provider Name | Molly Clare Wade |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093224768 PECOS PAC ID: 2163788084 Enrollment ID: I20171109001852 |
| Provider Name | Juletta Avagyan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013278944 PECOS PAC ID: 4789821323 Enrollment ID: I20171229001093 |
| Provider Name | Shazia Abbas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205086998 PECOS PAC ID: 3779751086 Enrollment ID: I20180102000080 |
| Provider Name | Courtney M Guebert |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679091474 PECOS PAC ID: 6406116474 Enrollment ID: I20180213000511 |
| Provider Name | Adrienne B Kinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710489349 PECOS PAC ID: 7012271554 Enrollment ID: I20180508002788 |
| Provider Name | Kimberly Janean King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508306952 PECOS PAC ID: 9830464551 Enrollment ID: I20180621000212 |
| Provider Name | Asikhame Ahonkhai Oikeh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720444110 PECOS PAC ID: 2163779273 Enrollment ID: I20180720000949 |
| Provider Name | Nilupa Sewwandi Gaspe Mudiyanselage |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598147407 PECOS PAC ID: 8729336367 Enrollment ID: I20180730002679 |
| Provider Name | Daniel P Berg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164817722 PECOS PAC ID: 1557663903 Enrollment ID: I20180813000944 |
| Provider Name | Amanda Willane Michaels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275027344 PECOS PAC ID: 1850641481 Enrollment ID: I20180831001973 |
| Provider Name | Karen Michelle Bertels |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548657737 PECOS PAC ID: 7618289612 Enrollment ID: I20180906003380 |
| Provider Name | Nizar Charafeddine |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912090317 PECOS PAC ID: 3870503188 Enrollment ID: I20180911003771 |
| Provider Name | Stephanie Gabathuler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457647927 PECOS PAC ID: 0941458541 Enrollment ID: I20180924003685 |
| Provider Name | Mohammed Ismail Al Hamati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851779920 PECOS PAC ID: 3375845886 Enrollment ID: I20181002003280 |
| Provider Name | Sarah E Nangle |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487940961 PECOS PAC ID: 3375846827 Enrollment ID: I20181015002079 |
| Provider Name | Tracie Lynn Eilerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619456472 PECOS PAC ID: 8325392459 Enrollment ID: I20181108001411 |
| Provider Name | Katherine Ruth Richards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942599808 PECOS PAC ID: 6204057391 Enrollment ID: I20181201000083 |
| Provider Name | Cedric Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356534994 PECOS PAC ID: 9931243128 Enrollment ID: I20181226000001 |
| Provider Name | Kelly S Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508341181 PECOS PAC ID: 4688910672 Enrollment ID: I20190111002367 |
| Provider Name | Elizabeth J Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164832705 PECOS PAC ID: 9537054622 Enrollment ID: I20190226001626 |
| Provider Name | Erica Card |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275006488 PECOS PAC ID: 3779822275 Enrollment ID: I20190227003078 |
| Provider Name | Andrea Volkerding |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922412717 PECOS PAC ID: 8527364819 Enrollment ID: I20190305001298 |
| Provider Name | Amy M Maher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639679756 PECOS PAC ID: 5890035695 Enrollment ID: I20190313002742 |
| Provider Name | Mindy Marie Faraone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336619782 PECOS PAC ID: 6608116124 Enrollment ID: I20190401000354 |
| Provider Name | Manuel Emilio Lopez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437158052 PECOS PAC ID: 0143224212 Enrollment ID: I20190401000615 |
| Provider Name | Kimberly L Tiller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467930883 PECOS PAC ID: 2567703853 Enrollment ID: I20190415002402 |
| Provider Name | Kelsey Koenig |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962973982 PECOS PAC ID: 4486996253 Enrollment ID: I20190426000016 |
| Provider Name | Kristin Anne Childers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801359575 PECOS PAC ID: 4486997079 Enrollment ID: I20190522003179 |
| Provider Name | Bindu Finnell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851327340 PECOS PAC ID: 8729180245 Enrollment ID: I20190523001415 |
| Provider Name | John a Richards |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508276288 PECOS PAC ID: 2163724642 Enrollment ID: I20190808001274 |
| Provider Name | Kaitlin Mcclenahan Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376989186 PECOS PAC ID: 5890062111 Enrollment ID: I20190809001071 |
| Provider Name | Tracie Leigh Placher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831757103 PECOS PAC ID: 4082943436 Enrollment ID: I20190910001454 |
| Provider Name | Stephanie L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467005009 PECOS PAC ID: 4284965930 Enrollment ID: I20191010000046 |
| Provider Name | Bryson Thomas Whalen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255727301 PECOS PAC ID: 9436468428 Enrollment ID: I20191011000682 |
| Provider Name | Matthew C Musielak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477781177 PECOS PAC ID: 2062720436 Enrollment ID: I20191014000115 |
| Provider Name | Gillian Long |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790345726 PECOS PAC ID: 9133450653 Enrollment ID: I20191015002525 |
| Provider Name | Danielle Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164809737 PECOS PAC ID: 9335421791 Enrollment ID: I20191105001405 |
| Provider Name | Sarah J Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457911810 PECOS PAC ID: 3971935289 Enrollment ID: I20191107000084 |
| Provider Name | Monica Marie Magowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114493723 PECOS PAC ID: 4981036092 Enrollment ID: I20191111002953 |
| Provider Name | Darcee Bair Schmitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477198596 PECOS PAC ID: 8628400033 Enrollment ID: I20191122000695 |
| Provider Name | Jennifer a Rademacher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346887106 PECOS PAC ID: 6103250113 Enrollment ID: I20191230000491 |
| Provider Name | Jason Wiechert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235545971 PECOS PAC ID: 3678829132 Enrollment ID: I20200115002232 |
| Provider Name | Linda Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770121980 PECOS PAC ID: 9931535333 Enrollment ID: I20200203002067 |
| Provider Name | Elsayed Abo-salem |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1629207477 PECOS PAC ID: 7719116490 Enrollment ID: I20200211001246 |
| Provider Name | Lisa K James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083253413 PECOS PAC ID: 4981032653 Enrollment ID: I20200311000341 |
| Provider Name | Ashley N Mehochko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861048605 PECOS PAC ID: 9234567686 Enrollment ID: I20200317002353 |
| Provider Name | Concepcion Esteban Santillan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083647408 PECOS PAC ID: 2567402100 Enrollment ID: I20200326002163 |
| Provider Name | Daniel Duelm |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023099314 PECOS PAC ID: 2062459803 Enrollment ID: I20200330002293 |
| Provider Name | Megan M Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326504135 PECOS PAC ID: 5193066793 Enrollment ID: I20200330002459 |
| Provider Name | Shannon Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942712310 PECOS PAC ID: 7113356932 Enrollment ID: I20200330003677 |
| Provider Name | Shadab Muhammad Bhutto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396753018 PECOS PAC ID: 1557389970 Enrollment ID: I20200403001128 |
| Provider Name | James Christopher Tanner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194107532 PECOS PAC ID: 5597077792 Enrollment ID: I20200408000148 |
| Provider Name | Salik Choudhary |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386986578 PECOS PAC ID: 1951603422 Enrollment ID: I20200413001552 |
| Provider Name | Jessica N Stricklin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124650353 PECOS PAC ID: 7012347958 Enrollment ID: I20200417000109 |
| Provider Name | Kimberly a Spano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750927182 PECOS PAC ID: 1850721291 Enrollment ID: I20200425000161 |
| Provider Name | Maureen Julia Dunajcik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407304728 PECOS PAC ID: 3173811270 Enrollment ID: I20200520000078 |
| Provider Name | Yaimet V Bucknor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902030836 PECOS PAC ID: 4880745470 Enrollment ID: I20200528003290 |
| Provider Name | Jenny M Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346783230 PECOS PAC ID: 1456638048 Enrollment ID: I20200623000225 |
| Provider Name | Claire M Vargo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831712835 PECOS PAC ID: 1355766098 Enrollment ID: I20200729000845 |
| Provider Name | Chandni Sinha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265960058 PECOS PAC ID: 4385069830 Enrollment ID: I20200731000859 |
| Provider Name | Sumit Tiwari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215048574 PECOS PAC ID: 5597909952 Enrollment ID: I20200803000994 |
| Provider Name | Sisay Michael Abraham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184088312 PECOS PAC ID: 6800182759 Enrollment ID: I20200812002963 |
| Provider Name | Dany Jose Saturno Arias |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275052318 PECOS PAC ID: 6204253586 Enrollment ID: I20200901002039 |
| Provider Name | Elissa Davis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629496203 PECOS PAC ID: 7214238898 Enrollment ID: I20200909003465 |
| Provider Name | Omar a Al-abboud |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740693449 PECOS PAC ID: 9638471493 Enrollment ID: I20200910002352 |
| Provider Name | Vanessa D Pratt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164462172 PECOS PAC ID: 1052378742 Enrollment ID: I20200929001361 |
| Provider Name | James Edward Alonso |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063506566 PECOS PAC ID: 8325214562 Enrollment ID: I20201002002044 |
| Provider Name | Roohi Siraj |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1760885693 PECOS PAC ID: 2961834908 Enrollment ID: I20201019000250 |
| Provider Name | Adam Arnold Shpigel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1417223447 PECOS PAC ID: 2567612161 Enrollment ID: I20201118003044 |
| Provider Name | Eric Colton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790723492 PECOS PAC ID: 0244271245 Enrollment ID: I20201214002071 |
| Provider Name | Garri Priyampolskiy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659760833 PECOS PAC ID: 6406129212 Enrollment ID: I20201224000209 |
| Provider Name | Jared Wayne Schiefer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548881196 PECOS PAC ID: 6305259664 Enrollment ID: I20210105001137 |
| Provider Name | Kathryn F Mckenna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902416134 PECOS PAC ID: 3072926120 Enrollment ID: I20210108001182 |
| Provider Name | Lauren T Flavan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750983045 PECOS PAC ID: 8921411836 Enrollment ID: I20210114001910 |
| Provider Name | Cody E Bilderback |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467890657 PECOS PAC ID: 5092949537 Enrollment ID: I20210122002485 |
| Provider Name | Karra Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194366401 PECOS PAC ID: 8729411020 Enrollment ID: I20210205002471 |
| Provider Name | Elizabeth M Kemper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043802754 PECOS PAC ID: 0446667398 Enrollment ID: I20210322001438 |
| Provider Name | Christy Anne Kay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487209045 PECOS PAC ID: 5193132546 Enrollment ID: I20210401000062 |
| Provider Name | Mary E Maloney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710592175 PECOS PAC ID: 6608285234 Enrollment ID: I20210511001054 |
| Provider Name | Francis Le |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1134236508 PECOS PAC ID: 3476596925 Enrollment ID: I20210517001509 |
| Provider Name | Mari Jane Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659974764 PECOS PAC ID: 6103225693 Enrollment ID: I20210603002259 |
| Provider Name | Alicia M Whorton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508490806 PECOS PAC ID: 4486082740 Enrollment ID: I20210622001508 |
| Provider Name | Mena Metias |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295229573 PECOS PAC ID: 6406102128 Enrollment ID: I20210713000720 |
| Provider Name | Kenechukwu Olufemi Chudy-onwugaje |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861749780 PECOS PAC ID: 1355632233 Enrollment ID: I20210713000932 |
| Provider Name | Natasha D Bancroft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679153456 PECOS PAC ID: 0143622191 Enrollment ID: I20210713002351 |
| Provider Name | Paul Michael Eckerle |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1215317409 PECOS PAC ID: 6103138540 Enrollment ID: I20210714003763 |
| Provider Name | Evan Neville |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1245694538 PECOS PAC ID: 0749682649 Enrollment ID: I20210715000562 |
| Provider Name | Andrew M Gaillardetz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548764236 PECOS PAC ID: 5799035499 Enrollment ID: I20210719002568 |
| Provider Name | Megan E Sauer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144753237 PECOS PAC ID: 7517232267 Enrollment ID: I20210723000102 |
| Provider Name | Ashley Danielle Versluys |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417531930 PECOS PAC ID: 7810390879 Enrollment ID: I20210728001771 |
| Provider Name | Stacey Ann Williamson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457667891 PECOS PAC ID: 5698960763 Enrollment ID: I20210730001813 |
| Provider Name | Sohaib Sajjad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578057873 PECOS PAC ID: 2860740214 Enrollment ID: I20210802000088 |
| Provider Name | Timothy R. Isakson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487790168 PECOS PAC ID: 9335128388 Enrollment ID: I20210802003062 |
| Provider Name | Megan J Land |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053981423 PECOS PAC ID: 1658775390 Enrollment ID: I20210803002308 |
| Provider Name | Jelena Nikolic |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689174682 PECOS PAC ID: 5991109985 Enrollment ID: I20210813000016 |
| Provider Name | Yu Lun |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740771823 PECOS PAC ID: 5193071322 Enrollment ID: I20210830000200 |
| Provider Name | Jaleesa Gilbert-gortman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710484332 PECOS PAC ID: 0648514877 Enrollment ID: I20210830001246 |
| Provider Name | Shereece N Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104338318 PECOS PAC ID: 1557627049 Enrollment ID: I20210830003376 |
| Provider Name | Deepa Elizabeth Kalapurayil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760976328 PECOS PAC ID: 2860898509 Enrollment ID: I20210907000238 |
| Provider Name | Tiffany Marie Hostert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467128363 PECOS PAC ID: 7618374513 Enrollment ID: I20210920002364 |
| Provider Name | Kristen Kustermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396312419 PECOS PAC ID: 3072911106 Enrollment ID: I20211004003372 |
| Provider Name | Kevin K Pham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144754607 PECOS PAC ID: 9830460286 Enrollment ID: I20211005000169 |
| Provider Name | Caren Pauline Schaecher |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326067711 PECOS PAC ID: 6800911033 Enrollment ID: I20211005001053 |
| Provider Name | Sergiy Georgiyev |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821324831 PECOS PAC ID: 2163670241 Enrollment ID: I20211007002171 |
| Provider Name | Carly Galli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669145686 PECOS PAC ID: 6305244807 Enrollment ID: I20211014000722 |
| Provider Name | Bertram Drury |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366822918 PECOS PAC ID: 7113239591 Enrollment ID: I20211015001491 |
| Provider Name | Shabreen Abdul Sharief |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992025118 PECOS PAC ID: 5991921215 Enrollment ID: I20211029000257 |
| Provider Name | Amy Zeller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326539859 PECOS PAC ID: 6608123385 Enrollment ID: I20211221000820 |
| Provider Name | Mathew Kalapurayil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295182459 PECOS PAC ID: 6800210188 Enrollment ID: I20220107001095 |
| Provider Name | Yolanda L Hoag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053815423 PECOS PAC ID: 5799032207 Enrollment ID: I20220118002698 |
| Provider Name | Mohamad a Albsheri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447508874 PECOS PAC ID: 3779891379 Enrollment ID: I20220125002720 |
| Provider Name | Ashirf Al-ghanoudi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1316289564 PECOS PAC ID: 9830401223 Enrollment ID: I20220223002304 |
| Provider Name | Jonathan Yu Xia |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578094918 PECOS PAC ID: 9830434463 Enrollment ID: I20220307000756 |
| Provider Name | Chiedozie K Anokwute |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811272438 PECOS PAC ID: 9133432362 Enrollment ID: I20220321000484 |
| Provider Name | Christopher M Chambers |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1184831869 PECOS PAC ID: 8628141785 Enrollment ID: I20220505001950 |
| Provider Name | Abraham D Bezuneh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508238130 PECOS PAC ID: 4385990183 Enrollment ID: I20220603001120 |
| Provider Name | Kayla Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457977274 PECOS PAC ID: 9931587896 Enrollment ID: I20220606000204 |
| Provider Name | Anuj Sharma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932420957 PECOS PAC ID: 6204075450 Enrollment ID: I20220628003402 |
| Provider Name | Kari Leanne Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760131957 PECOS PAC ID: 8022498054 Enrollment ID: I20220707002406 |
| Provider Name | Blakelyn Busse |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093238230 PECOS PAC ID: 9436531407 Enrollment ID: I20220808002024 |
| Provider Name | Manideep Duttuluri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164912341 PECOS PAC ID: 8224410220 Enrollment ID: I20220808003093 |
| Provider Name | Sai Si Thu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063875722 PECOS PAC ID: 1254678386 Enrollment ID: I20220823002502 |
| Provider Name | Colleen R Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285966739 PECOS PAC ID: 9335554310 Enrollment ID: I20220826000490 |
| Provider Name | Susannah K Koch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063906352 PECOS PAC ID: 4183008014 Enrollment ID: I20220826000828 |
| Provider Name | Parth Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548722713 PECOS PAC ID: 7012241763 Enrollment ID: I20220829001814 |
| Provider Name | Jordyn M Hoemmen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649916875 PECOS PAC ID: 3870977622 Enrollment ID: I20220829002298 |
| Provider Name | Ripa K Patel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1811372980 PECOS PAC ID: 3577815612 Enrollment ID: I20220830001661 |
| Provider Name | Anand P Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043503972 PECOS PAC ID: 3779883723 Enrollment ID: I20220906003396 |
| Provider Name | Ekanga Sunday Petters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144751827 PECOS PAC ID: 8527331321 Enrollment ID: I20220907001693 |
| Provider Name | Mckenzie R Youngblood |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063010924 PECOS PAC ID: 2567876865 Enrollment ID: I20220920000276 |
| Provider Name | Margaret C Hoester |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740870492 PECOS PAC ID: 4183009509 Enrollment ID: I20220920003570 |
| Provider Name | Jennine M Beckmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649932559 PECOS PAC ID: 5991180267 Enrollment ID: I20220922002409 |
| Provider Name | Emily C Klein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740934629 PECOS PAC ID: 7012393234 Enrollment ID: I20220926001463 |
| Provider Name | Daniel Elizondo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366002362 PECOS PAC ID: 1456687672 Enrollment ID: I20220927002210 |
| Provider Name | Jayne Lee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740444751 PECOS PAC ID: 5698842094 Enrollment ID: I20220927003070 |
| Provider Name | Mohammed Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932691672 PECOS PAC ID: 1052718574 Enrollment ID: I20220930001742 |
| Provider Name | Nicole L Garner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881321107 PECOS PAC ID: 5395121800 Enrollment ID: I20221007000033 |
| Provider Name | Kashif Janjua |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558522730 PECOS PAC ID: 5597938282 Enrollment ID: I20221017000820 |
| Provider Name | Kourtney Cecelia Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932799400 PECOS PAC ID: 3072980259 Enrollment ID: I20221031002752 |
| Provider Name | Ashley Liou |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1023402229 PECOS PAC ID: 8123336070 Enrollment ID: I20221103001722 |
| Provider Name | Karley Christopher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881321651 PECOS PAC ID: 1759758550 Enrollment ID: I20221108002239 |
| Provider Name | Taylor D Reno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366192908 PECOS PAC ID: 1658749965 Enrollment ID: I20221117001216 |
| Provider Name | Christian G Caceres |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255787628 PECOS PAC ID: 6002194701 Enrollment ID: I20221121002651 |
| Provider Name | Kaylee Anne Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043927957 PECOS PAC ID: 1153799150 Enrollment ID: I20221123000712 |
| Provider Name | Alyssa M Branson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245953470 PECOS PAC ID: 8123497575 Enrollment ID: I20221207002096 |
| Provider Name | Melissa Armstead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326599911 PECOS PAC ID: 5294114773 Enrollment ID: I20221208001755 |
| Provider Name | Crista L Jamous |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710535794 PECOS PAC ID: 4082083258 Enrollment ID: I20221209001046 |
| Provider Name | Meaghan E Baumgardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760020531 PECOS PAC ID: 7810304631 Enrollment ID: I20221213001862 |
| Provider Name | Sunil K Darbari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932197290 PECOS PAC ID: 3678475308 Enrollment ID: I20221223000679 |
| Provider Name | Holly L Steiner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083907844 PECOS PAC ID: 0446494967 Enrollment ID: I20230105002304 |
| Provider Name | Jennifer Feder |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669109971 PECOS PAC ID: 7416327440 Enrollment ID: I20230106002485 |
| Provider Name | Christina Marie Zagorski |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154058493 PECOS PAC ID: 3476923400 Enrollment ID: I20230106002737 |
| Provider Name | Fazillah Faiz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093359150 PECOS PAC ID: 3971975939 Enrollment ID: I20230221001704 |
| Provider Name | Takeysha L Lowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174007868 PECOS PAC ID: 4183977689 Enrollment ID: I20230222000484 |
| Provider Name | Uzma Kothawala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083069819 PECOS PAC ID: 7214225127 Enrollment ID: I20230309000393 |
| Provider Name | Asim Ayaz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144509563 PECOS PAC ID: 7416279807 Enrollment ID: I20230322000034 |
| Provider Name | Brandon Chase Kruse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386148872 PECOS PAC ID: 1456780170 Enrollment ID: I20230324002320 |
| Provider Name | Sherrywin Saner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114630886 PECOS PAC ID: 7315302882 Enrollment ID: I20230505001141 |
| Provider Name | Umair J Ashraf |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255773396 PECOS PAC ID: 4284914326 Enrollment ID: I20230508001087 |
| Provider Name | Nnenna Louisa Uzodi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386272169 PECOS PAC ID: 5496110835 Enrollment ID: I20230508001998 |
| Provider Name | Jessica R Therien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164122974 PECOS PAC ID: 5799141396 Enrollment ID: I20230524002960 |
| Provider Name | Adnan S Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558865097 PECOS PAC ID: 8628324852 Enrollment ID: I20230606002178 |
| Provider Name | Hanna Jo Liljegren |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598426140 PECOS PAC ID: 7618334400 Enrollment ID: I20230609002074 |
| Provider Name | Lito T Rufin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003431560 PECOS PAC ID: 6709245491 Enrollment ID: I20230628002541 |
| Provider Name | Matthew a Nations |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073017638 PECOS PAC ID: 3476809542 Enrollment ID: I20230710001819 |
| Provider Name | Jaime Shoemaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861108185 PECOS PAC ID: 0648630558 Enrollment ID: I20230724001488 |
| Provider Name | Saim Mustafa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952939308 PECOS PAC ID: 9638592389 Enrollment ID: I20230809001735 |
| Provider Name | Hardikkumar M Patel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1790165736 PECOS PAC ID: 4486997616 Enrollment ID: I20230814003346 |
| Provider Name | Samuel M Lindner |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1831517051 PECOS PAC ID: 3678831112 Enrollment ID: I20230829000266 |
| Provider Name | Joya a Keys |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982199287 PECOS PAC ID: 2961759980 Enrollment ID: I20230906002953 |
| Provider Name | Lainey Jean Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265182786 PECOS PAC ID: 9234593112 Enrollment ID: I20230911002922 |
| Provider Name | Sobhana Potluri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801419304 PECOS PAC ID: 3072938513 Enrollment ID: I20230913002260 |
| Provider Name | Cesar Abraham Santillana |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063974889 PECOS PAC ID: 9133508146 Enrollment ID: I20230914000155 |
| Provider Name | Kemuel E Telemaque |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437770690 PECOS PAC ID: 3274954037 Enrollment ID: I20230915002846 |
| Provider Name | Melissa K Whitworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871295188 PECOS PAC ID: 9830543024 Enrollment ID: I20230921001779 |
| Provider Name | MD S Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376163261 PECOS PAC ID: 0941654974 Enrollment ID: I20230926000367 |
| Provider Name | Atul Medavaram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487215638 PECOS PAC ID: 0749690501 Enrollment ID: I20231002002371 |
| Provider Name | Randi Lynne Moreland |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891213658 PECOS PAC ID: 2567716855 Enrollment ID: I20231024000407 |
| Provider Name | Neil S Shachter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942336516 PECOS PAC ID: 2860576980 Enrollment ID: I20231107002060 |
| Provider Name | Henry M Ogbuagu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992029987 PECOS PAC ID: 6507288032 Enrollment ID: I20231114000232 |
| Provider Name | Emily Vanuytven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295490159 PECOS PAC ID: 8022495621 Enrollment ID: I20231219002684 |
| Provider Name | Hannah Hanebrink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689455024 PECOS PAC ID: 3375994965 Enrollment ID: I20240108005422 |
| Provider Name | Toni Sue Baldwin-dufour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255343349 PECOS PAC ID: 8820194509 Enrollment ID: I20240109001180 |
| Provider Name | Joanna M Lindauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396320271 PECOS PAC ID: 1153701248 Enrollment ID: I20240118001531 |
| Provider Name | Elisha Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649895038 PECOS PAC ID: 2264875376 Enrollment ID: I20240206001719 |
| Provider Name | Collins a Kwarteng |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598943516 PECOS PAC ID: 0143407890 Enrollment ID: I20240221003860 |
| Provider Name | Russ Arjal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1821144403 PECOS PAC ID: 5294807301 Enrollment ID: I20240223001834 |
| Provider Name | Naveen Bondalapati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104147214 PECOS PAC ID: 3779724406 Enrollment ID: I20240409004603 |
| Provider Name | Howard Epstein |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1306818182 PECOS PAC ID: 5092845230 Enrollment ID: I20240415001472 |
| Provider Name | Tarek Alansari |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063776771 PECOS PAC ID: 2264740885 Enrollment ID: I20240416001651 |
| Provider Name | Margaret Louise Goetten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629845045 PECOS PAC ID: 9931548179 Enrollment ID: I20240419002599 |
| Provider Name | Olufemi Abiodun |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1821199464 PECOS PAC ID: 0749255362 Enrollment ID: I20240423001330 |
| Provider Name | Ganan Hahn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184337032 PECOS PAC ID: 6103265202 Enrollment ID: I20240423001585 |
| Provider Name | Stephanie Marie Hardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942078068 PECOS PAC ID: 5294175238 Enrollment ID: I20240424003096 |
| Provider Name | Jatinder Goyal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760772925 PECOS PAC ID: 1850538695 Enrollment ID: I20240503001939 |
| Provider Name | Kathryn L Davis |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1871791301 PECOS PAC ID: 7618290719 Enrollment ID: I20240521000397 |
| Provider Name | Salman Saeed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497106983 PECOS PAC ID: 9032401989 Enrollment ID: I20240531000635 |
| Provider Name | Ishaan Vohra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1477048130 PECOS PAC ID: 5193078913 Enrollment ID: I20240531001777 |
| Provider Name | Ayodele Osowo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1063552479 PECOS PAC ID: 8628161833 Enrollment ID: I20240618001080 |
| Provider Name | Shilpkumar Arora |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1699194365 PECOS PAC ID: 8921379264 Enrollment ID: I20240624004741 |
| Provider Name | Danielle Rae Hughes |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1114414935 PECOS PAC ID: 0244649952 Enrollment ID: I20240705000559 |
| Provider Name | Chase Andrew Baxter |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1487145264 PECOS PAC ID: 4385999192 Enrollment ID: I20240716000196 |
| Provider Name | Nahayo Esperant-hilaire |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235766148 PECOS PAC ID: 6800210071 Enrollment ID: I20240718002426 |
| Provider Name | Michael Messmer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538300561 PECOS PAC ID: 4587834502 Enrollment ID: I20240726003875 |
| Provider Name | Kahmalia-kalee Sada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376129460 PECOS PAC ID: 9537568431 Enrollment ID: I20240731003891 |
| Provider Name | Mary Pagano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962980979 PECOS PAC ID: 5991058463 Enrollment ID: I20240808000584 |
| Provider Name | Courtney M Dulworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679941546 PECOS PAC ID: 1850691031 Enrollment ID: I20240822001884 |
| Provider Name | Parishi Patel |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1649733353 PECOS PAC ID: 8022343862 Enrollment ID: I20240826002539 |
| Provider Name | Sandeep Walia |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467763607 PECOS PAC ID: 2264665751 Enrollment ID: I20240826002596 |
| Provider Name | Kiet Huynh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831769637 PECOS PAC ID: 2769884345 Enrollment ID: I20240826003176 |
| Provider Name | Willis Ko |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1215465307 PECOS PAC ID: 3375806102 Enrollment ID: I20240827001851 |
| Provider Name | Kasiemobi Bernice Okonkwo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891365391 PECOS PAC ID: 8628516036 Enrollment ID: I20240827001988 |
| Provider Name | Lindsey Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083352389 PECOS PAC ID: 3971982703 Enrollment ID: I20240909003255 |
| Provider Name | Eyob Berihun |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891359949 PECOS PAC ID: 5991181182 Enrollment ID: I20240913002706 |
| Provider Name | Mark T Klucka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801902432 PECOS PAC ID: 3678608353 Enrollment ID: I20240917002110 |
| Provider Name | Abdur Khan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1700132750 PECOS PAC ID: 5092043489 Enrollment ID: I20240917003359 |
| Provider Name | Anjanya Devendra Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639757339 PECOS PAC ID: 9830630771 Enrollment ID: I20240919001206 |
| Provider Name | Victoria Fasick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518372036 PECOS PAC ID: 2860798899 Enrollment ID: I20240927001623 |
| Provider Name | Omobosola Akinsete |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1891749214 PECOS PAC ID: 8224000120 Enrollment ID: I20241014002001 |
| Provider Name | Michele Brother |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033153598 PECOS PAC ID: 6204866882 Enrollment ID: I20241016004020 |
| Provider Name | Zachary Witges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801639596 PECOS PAC ID: 3971035528 Enrollment ID: I20241021002024 |
| Provider Name | Stacy Davis Baur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962232215 PECOS PAC ID: 9537692173 Enrollment ID: I20241104002664 |
| Provider Name | Tharun Paruchuri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376047886 PECOS PAC ID: 0446582860 Enrollment ID: I20241202002698 |
| Provider Name | Poonam Velagapudi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1861655144 PECOS PAC ID: 9436328838 Enrollment ID: I20241209000781 |
| Provider Name | Amit B Mori |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1053548891 PECOS PAC ID: 7719135706 Enrollment ID: I20241223003246 |
| Provider Name | Nazanin Kheirkhahan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811568504 PECOS PAC ID: 7315340999 Enrollment ID: I20250103001170 |
| Provider Name | Shalini Chiravuri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457880007 PECOS PAC ID: 7618204090 Enrollment ID: I20250108002932 |
| Provider Name | Marion Dessalines |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548082647 PECOS PAC ID: 8325576937 Enrollment ID: I20250110000508 |
| Provider Name | Yussuf Ismail |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841796745 PECOS PAC ID: 9638577604 Enrollment ID: I20250114003575 |
| Provider Name | Tyler Kimball Wright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679140891 PECOS PAC ID: 6608277488 Enrollment ID: I20250123003007 |
| Provider Name | Ann Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033460324 PECOS PAC ID: 5597910299 Enrollment ID: I20250213002803 |
| Provider Name | Adenike Oke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932742442 PECOS PAC ID: 2466883657 Enrollment ID: I20250214001671 |
| Provider Name | Smita I Negi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447446844 PECOS PAC ID: 0446515589 Enrollment ID: I20250219001570 |
| Provider Name | Paige Huette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427648203 PECOS PAC ID: 1153739131 Enrollment ID: I20250220001766 |
| Provider Name | Gabriel T Faz |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1285936625 PECOS PAC ID: 1850682477 Enrollment ID: I20250220003277 |
| Provider Name | Hannah Brewer Delong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265186290 PECOS PAC ID: 7810380979 Enrollment ID: I20250307002970 |
| Provider Name | Michael Opoku |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578520235 PECOS PAC ID: 2769445741 Enrollment ID: I20250321003107 |
| Provider Name | Dorian Shimotani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407344393 PECOS PAC ID: 5496001042 Enrollment ID: I20250408002827 |
| Provider Name | Chikezie Amadi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1487616918 PECOS PAC ID: 5799729638 Enrollment ID: I20250409003835 |
| Provider Name | Valerie Ann Fretz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720885270 PECOS PAC ID: 5597280115 Enrollment ID: I20250416001907 |
| Provider Name | Muhammad H Bashir |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881027662 PECOS PAC ID: 6103050703 Enrollment ID: I20250423000312 |
| Provider Name | Rupinderjit Dhillon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619167483 PECOS PAC ID: 6002940822 Enrollment ID: I20250502000822 |
| Provider Name | Elton Y Li |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144844564 PECOS PAC ID: 9830511252 Enrollment ID: I20250515001601 |
| Provider Name | Miranda Henson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952013849 PECOS PAC ID: 6709250962 Enrollment ID: I20250528001681 |
| Provider Name | Peter Rao |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1932250339 PECOS PAC ID: 7810048667 Enrollment ID: I20250530000281 |
| Provider Name | Faye Rao |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508883133 PECOS PAC ID: 7618909755 Enrollment ID: I20250530000729 |
| Provider Name | Ahmad Hasan Rimawi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902545783 PECOS PAC ID: 7618358482 Enrollment ID: I20250609002546 |
| Provider Name | Pramod Menon |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1588620611 PECOS PAC ID: 8426032590 Enrollment ID: I20250611001865 |
| Provider Name | Sarah a Durnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235568700 PECOS PAC ID: 7012148984 Enrollment ID: I20250612000018 |
| Provider Name | Lubasi Akombelwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811489479 PECOS PAC ID: 5193060135 Enrollment ID: I20250612002375 |
| Provider Name | Dean a Bramlet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164536488 PECOS PAC ID: 5597758961 Enrollment ID: I20250702003341 |
| Provider Name | Haley St Peters |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1417771536 PECOS PAC ID: 6608380506 Enrollment ID: I20250710002306 |
| Provider Name | Umair Sohail |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376879940 PECOS PAC ID: 0143468066 Enrollment ID: I20250714001546 |
| Provider Name | Atul Kukar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1225054984 PECOS PAC ID: 9133199110 Enrollment ID: I20250715002759 |
| Provider Name | Andy Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912649021 PECOS PAC ID: 5496134645 Enrollment ID: I20250716001786 |
| Provider Name | Jonathan Burt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215421805 PECOS PAC ID: 1951650373 Enrollment ID: I20250722001116 |
| Provider Name | Rohan Bhandari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558744474 PECOS PAC ID: 7810203890 Enrollment ID: I20250722001507 |
| Provider Name | Landry Crabtree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164224606 PECOS PAC ID: 1153838123 Enrollment ID: I20250725002188 |
| Provider Name | Jonathan Murphy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790103364 PECOS PAC ID: 8022490143 Enrollment ID: I20250728000419 |
| Provider Name | Akash Venkataramanan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902544356 PECOS PAC ID: 7517340672 Enrollment ID: I20250729002551 |
| Provider Name | Ahmed Hussein |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1104294685 PECOS PAC ID: 3678820669 Enrollment ID: I20250805002719 |
| Provider Name | Pooja Sethi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639458987 PECOS PAC ID: 1052661071 Enrollment ID: I20250806000756 |
| Provider Name | Danielle Paige Melnek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922992858 PECOS PAC ID: 5496253130 Enrollment ID: I20250812000971 |
| Provider Name | Sewuese Akuse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528702016 PECOS PAC ID: 9537668785 Enrollment ID: I20250815001880 |
| Provider Name | Morgan a Delozier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801537840 PECOS PAC ID: 6608257845 Enrollment ID: I20250905001651 |
| Provider Name | Ahmed Javed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114346657 PECOS PAC ID: 1951609239 Enrollment ID: I20250908000039 |
| Provider Name | Richard Kenechukwu Okeke |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649911645 PECOS PAC ID: 6608378435 Enrollment ID: I20250909002227 |
| Provider Name | Sumanth Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457091910 PECOS PAC ID: 8426437997 Enrollment ID: I20250910003287 |
| Provider Name | Winnie Shaba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275276156 PECOS PAC ID: 0941703532 Enrollment ID: I20250910003313 |
| Provider Name | Anitha Rajamanickam |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1225126600 PECOS PAC ID: 4587600960 Enrollment ID: I20250910004229 |
| Provider Name | Olufemi Osikoya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619557774 PECOS PAC ID: 9638557754 Enrollment ID: I20250917000510 |
| Provider Name | Thomas Young |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083694665 PECOS PAC ID: 3072558683 Enrollment ID: I20250919000190 |
| Provider Name | Brienna Milleson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336888643 PECOS PAC ID: 1850772906 Enrollment ID: I20250923000841 |
| Provider Name | Farah Sharieh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154070605 PECOS PAC ID: 2163927898 Enrollment ID: I20250924002839 |
| Provider Name | David Lotsoff |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205807328 PECOS PAC ID: 0749221646 Enrollment ID: I20250925003605 |
| Provider Name | Khadija Siddiqui |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831394295 PECOS PAC ID: 5193949089 Enrollment ID: I20251007001766 |
| Provider Name | Faith Maduka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285373548 PECOS PAC ID: 5890174379 Enrollment ID: I20251007003491 |
| Provider Name | Richard Decurtis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881324465 PECOS PAC ID: 3678953205 Enrollment ID: I20251013002715 |
| Provider Name | Ritesh Gandhi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396109880 PECOS PAC ID: 9931493426 Enrollment ID: I20251016004467 |
| Provider Name | Bethany Kette |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225666118 PECOS PAC ID: 9032630710 Enrollment ID: I20251021002234 |
| Provider Name | Michael Lam |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336190883 PECOS PAC ID: 2062492390 Enrollment ID: I20251022004654 |
| Provider Name | Ashley Osborn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194454983 PECOS PAC ID: 3678952983 Enrollment ID: I20251023001935 |
| Provider Name | Henry Tsang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184298523 PECOS PAC ID: 3870997398 Enrollment ID: I20251027000740 |
| Provider Name | David a Janssen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1700995339 PECOS PAC ID: 3173622339 Enrollment ID: I20251031003877 |
| Provider Name | Balaji Shanmugam |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1851786164 PECOS PAC ID: 7315242260 Enrollment ID: I20251103002875 |
| Provider Name | Ijeoma Gloria Okeke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326780073 PECOS PAC ID: 6507356029 Enrollment ID: I20251104002124 |
| Provider Name | Nancy Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699134346 PECOS PAC ID: 8921391970 Enrollment ID: I20251106001424 |
| Provider Name | Osama Hallak |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154852614 PECOS PAC ID: 9234400268 Enrollment ID: I20251113001430 |
| Provider Name | Abigail Lynn Kenney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679103782 PECOS PAC ID: 6204246226 Enrollment ID: I20251117000112 |
| Provider Name | Aditya Mangla |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1548453285 PECOS PAC ID: 4486834512 Enrollment ID: I20251119001824 |
| Provider Name | Aymen Bukannan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700179983 PECOS PAC ID: 3779700091 Enrollment ID: I20251119002814 |
| Provider Name | Kamaal Abdul-raheem Hicks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184354169 PECOS PAC ID: 5294114146 Enrollment ID: I20251203003571 |
| Provider Name | Stephanie Lynn Haynes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871480376 PECOS PAC ID: 7911491212 Enrollment ID: I20251215000605 |
| Provider Name | Hadiatou Barry |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225565880 PECOS PAC ID: 5698045540 Enrollment ID: I20251218003705 |
| Provider Name | Ashish Kabra |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639373798 PECOS PAC ID: 9436286135 Enrollment ID: I20251223001096 |
| Provider Name | Syed Zaidi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1972503878 PECOS PAC ID: 6305896077 Enrollment ID: I20251224000532 |
| Provider Name | Mark Pankonin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356509947 PECOS PAC ID: 3072732882 Enrollment ID: I20251224002611 |
| Provider Name | Balraj Singh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508097452 PECOS PAC ID: 9436303476 Enrollment ID: I20251230002374 |
| Provider Name | Lydia Noel Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215817481 PECOS PAC ID: 1951897008 Enrollment ID: I20260105002366 |
| Provider Name | Thomas Schwartz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104718352 PECOS PAC ID: 8729564182 Enrollment ID: I20260115002067 |
| Provider Name | Brian Borg |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902916778 PECOS PAC ID: 8224183124 Enrollment ID: I20260116000564 |
| Provider Name | Lauren Kruse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649916248 PECOS PAC ID: 3173964004 Enrollment ID: I20260202001549 |
| Provider Name | Tahreem Aziz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962847129 PECOS PAC ID: 6002058666 Enrollment ID: I20260205001462 |
| Provider Name | Mollie Wetstein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710479761 PECOS PAC ID: 9133475452 Enrollment ID: I20260209001390 |
| Provider Name | Julien Feghaly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356847651 PECOS PAC ID: 6103173976 Enrollment ID: I20260212001278 |
| Provider Name | Khushdeep Singh Chahal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013292622 PECOS PAC ID: 6901051341 Enrollment ID: I20260217003548 |
| Provider Name | Shabnam Darbari |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1225026016 PECOS PAC ID: 2062431539 Enrollment ID: I20260218000258 |
| Provider Name | Young Kim |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1700207941 PECOS PAC ID: 9133446990 Enrollment ID: I20260219001429 |
| Provider Name | Julian M Santos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982197067 PECOS PAC ID: 7911303250 Enrollment ID: I20260220001873 |
| Provider Name | Neel Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659730281 PECOS PAC ID: 4183902927 Enrollment ID: I20260220002083 |
| Provider Name | Sheetal H Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124132642 PECOS PAC ID: 7911969076 Enrollment ID: I20260220002747 |
| Provider Name | Jennifer S Real |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598779191 PECOS PAC ID: 6608884267 Enrollment ID: I20260220002767 |
| Provider Name | Abhijeet Waghray |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073878351 PECOS PAC ID: 7416190483 Enrollment ID: I20260223002259 |
| Provider Name | Christopher Walker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114230323 PECOS PAC ID: 0941444798 Enrollment ID: I20260223002535 |
| Provider Name | Athanasios Desalermos |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1982961066 PECOS PAC ID: 5092932830 Enrollment ID: I20260312002007 |
| Provider Name | Sorin Brener |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104930338 PECOS PAC ID: 4284690884 Enrollment ID: I20260316001577 |
| Provider Name | Tarika Chowdhary |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013440775 PECOS PAC ID: 1052656683 Enrollment ID: I20260317000852 |
| Provider Name | Micah Ritt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730047283 PECOS PAC ID: 0547744161 Enrollment ID: I20260323000551 |
| Provider Name | Zerihun Gebremichael |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427553460 PECOS PAC ID: 0244631638 Enrollment ID: I20260323000759 |
| Provider Name | Diego Lim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699038505 PECOS PAC ID: 1951611516 Enrollment ID: I20260323001177 |
| Provider Name | Zachary R Williams |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134372584 PECOS PAC ID: 4688860422 Enrollment ID: I20260324000353 |
| Provider Name | Ashley Primus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548558000 PECOS PAC ID: 4587882113 Enrollment ID: I20260325001889 |
| Provider Name | Amanda Boone |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760649800 PECOS PAC ID: 6800929480 Enrollment ID: I20260403001284 |
| Provider Name | Sami Elamin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932549987 PECOS PAC ID: 7517246770 Enrollment ID: I20260403001524 |
| Provider Name | Nitin Malhotra |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1407007982 PECOS PAC ID: 2769674563 Enrollment ID: I20260409000234 |
| Provider Name | Catherine Ash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861874059 PECOS PAC ID: 4284942806 Enrollment ID: I20260415001953 |
| Provider Name | Qi Zheng |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1518281542 PECOS PAC ID: 4880982362 Enrollment ID: I20260423000852 |
| Provider Name | Asif Rehman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1992813190 PECOS PAC ID: 9234112558 Enrollment ID: I20260429002829 |
| Provider Name | Richard Fikes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235176686 PECOS PAC ID: 0648295782 Enrollment ID: I20260504005215 |
| Provider Name | Stephanie Gabathuler |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1457647927 PECOS PAC ID: 0941458541 Enrollment ID: I20260511000024 |
St. Louis Center for Preventive and Longevity Medicine, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 777 S New Ballas Rd, Suite 200 E, Saint Louis, MO 63141 Phone: 314-994-1536 Fax: 314-692-0241 |
Town and Country Primary Care LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3009 N Ballas Rd, Suite 300a, Saint Louis, MO 63131 Phone: 314-872-8999 |
Family Care Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Lynch St, Saint Louis, MO 63118 Phone: 314-531-5444 Fax: 314-531-0063 |
Wusm Bjc Aco Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Campus Box 8081, Saint Louis, MO 63110 Phone: 314-273-0770 |
Victus Physician Services, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12607 Olive Blvd, Saint Louis, MO 63141 Phone: 314-327-8070 |
Salvation Army Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2900 Washington Ave, Saint Louis, MO 63103 Phone: 314-898-1700 Fax: 314-814-8542 |