| Genesis Eldercare Physician Services Llc | |
|
9 Haywood Ave Mountain View Center Rutland VT 05701 | |
| (802) 775-0007 | |
| (802) 775-6895 |
| Full Name | Genesis Eldercare Physician Services Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 9 Haywood Ave, Rutland, Vermont |
| Authorized Official Name and Position | Eric Shapiro (VP, CONTROLLER) |
| Authorized Official Contact | 4108327790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Genesis Eldercare Physician Services Llc Po Box 62946 Baltimore MD 21264-2946 Ph: (410) 494-7607 | Genesis Eldercare Physician Services Llc 9 Haywood Ave Mountain View Center Rutland VT 05701 Ph: (802) 775-0007 |
| NPI Number | 1477576304 |
|---|---|
| Provider Enumeration Date | 07/25/2006 |
| Last Update Date | 08/05/2019 |
| Medicare PECOS PAC ID | 9830002534 |
|---|---|
| Medicare Enrollment ID | O20040722000327 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477576304 | NPI | - | NPPES |
| 1104819259 | Medicaid | VT |
| Provider Name | Jesper Brickley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194081737 PECOS PAC ID: 3375770225 Enrollment ID: I20150804004969 |
| Provider Name | Jessica K Andrews |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043501372 PECOS PAC ID: 4082914171 Enrollment ID: I20151120001887 |
| Provider Name | Kasra Djalayer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093816761 PECOS PAC ID: 4789789983 Enrollment ID: I20151201001129 |
| Provider Name | Janet L Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992755219 PECOS PAC ID: 7810932290 Enrollment ID: I20190319000627 |
| Provider Name | Zabi Hayati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558926097 PECOS PAC ID: 5991139040 Enrollment ID: I20220823002025 |
| Provider Name | Joan Twombly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073890562 PECOS PAC ID: 4587823596 Enrollment ID: I20230125000814 |
| Provider Name | Stephanie Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215642400 PECOS PAC ID: 3476925959 Enrollment ID: I20230906002639 |
| Provider Name | Lauren Anna Fedorka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700669215 PECOS PAC ID: 4981068517 Enrollment ID: I20230914001423 |
| Provider Name | Falon Blessing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699124560 PECOS PAC ID: 8325320500 Enrollment ID: I20230929003212 |
| Provider Name | Shannon Murphy-miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740807114 PECOS PAC ID: 5890180434 Enrollment ID: I20231206000978 |
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