| Iu Health Medical Group, Llc | |
|
1701 N Senate Blvd Indianapolis IN 46202-1239 | |
| (317) 962-2000 | |
| Not Available |
| Full Name | Iu Health Medical Group, Llc |
|---|---|
| Speciality | General Practice |
| Location | 1701 N Senate Blvd, Indianapolis, Indiana |
| Authorized Official Name and Position | Todd Williams (CFO) |
| Authorized Official Contact | 3179483525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iu Health Medical Group, Llc 250 N Shadeland Ave Indianapolis IN 46219-4959 Ph: () - | Iu Health Medical Group, Llc 1701 N Senate Blvd Indianapolis IN 46202-1239 Ph: (317) 962-2000 |
| NPI Number | 1326893777 |
|---|---|
| Provider Enumeration Date | 04/19/2024 |
| Last Update Date | 04/17/2025 |
| Medicare PECOS PAC ID | 9638617913 |
|---|---|
| Medicare Enrollment ID | O20240817000533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326893777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | Minati D Swofford |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1346237476 PECOS PAC ID: 6305743220 Enrollment ID: I20040303000826 |
| Provider Name | Dana M Brock |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811952096 PECOS PAC ID: 6204725211 Enrollment ID: I20040315000966 |
| Provider Name | Fernando B Perez Majul |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1700841442 PECOS PAC ID: 3274513999 Enrollment ID: I20040722001390 |
| Provider Name | Bradley A Stalter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477543924 PECOS PAC ID: 5193795292 Enrollment ID: I20040727001177 |
| Provider Name | Scott Terence Cunningham |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841220787 PECOS PAC ID: 5698763266 Enrollment ID: I20040802001416 |
| Provider Name | Michael A Moorman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396760641 PECOS PAC ID: 2860451440 Enrollment ID: I20041008000310 |
| Provider Name | Leighan S Bye |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669422168 PECOS PAC ID: 4385604537 Enrollment ID: I20041013000297 |
| Provider Name | John V Hasewinkel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1134182397 PECOS PAC ID: 9830173319 Enrollment ID: I20041020001294 |
| Provider Name | Hardeep K Dhadha |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1902861784 PECOS PAC ID: 5597726240 Enrollment ID: I20041026000078 |
| Provider Name | Avonelle A Dorant |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578593414 PECOS PAC ID: 4284696709 Enrollment ID: I20041027001133 |
| Provider Name | Michael D Croner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548225725 PECOS PAC ID: 1759343494 Enrollment ID: I20041103001052 |
| Provider Name | Michael J Lisch |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669497020 PECOS PAC ID: 5698738508 Enrollment ID: I20041110001023 |
| Provider Name | Larry A Hopkins |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740211580 PECOS PAC ID: 6204899115 Enrollment ID: I20041110001045 |
| Provider Name | Jon P Kuzmic |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871558056 PECOS PAC ID: 8921062787 Enrollment ID: I20041112000348 |
| Provider Name | Jerry V Young |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760458871 PECOS PAC ID: 8022003912 Enrollment ID: I20041113000113 |
| Provider Name | James Q Mitchell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497718670 PECOS PAC ID: 9739163213 Enrollment ID: I20041117000269 |
| Provider Name | Bruce H Matt |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1013941558 PECOS PAC ID: 2365338431 Enrollment ID: I20050125000821 |
| Provider Name | Shahla N Hasnat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740255009 PECOS PAC ID: 3375596778 Enrollment ID: I20050225000212 |
| Provider Name | Alexander Zemtsov |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1811901184 PECOS PAC ID: 1759332570 Enrollment ID: I20050329000487 |
| Provider Name | Andrew J Smith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487697025 PECOS PAC ID: 2567407711 Enrollment ID: I20050628000358 |
| Provider Name | Ryan J Mcquillan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245255645 PECOS PAC ID: 2668417841 Enrollment ID: I20050628000641 |
| Provider Name | Ricky Cottrell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1962462648 PECOS PAC ID: 4284679473 Enrollment ID: I20050628000751 |
| Provider Name | Sean E Gardner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689605453 PECOS PAC ID: 2769418672 Enrollment ID: I20050712000996 |
| Provider Name | Ginat W Mirowski |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1750380275 PECOS PAC ID: 3072540350 Enrollment ID: I20050720000148 |
| Provider Name | Darryl W Dixon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497771299 PECOS PAC ID: 4284654831 Enrollment ID: I20051129000311 |
| Provider Name | Ali Hamza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306811195 PECOS PAC ID: 2769413871 Enrollment ID: I20051129000977 |
| Provider Name | Stacey L Halum |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1275569592 PECOS PAC ID: 9133106248 Enrollment ID: I20060127000483 |
| Provider Name | Lawrence A Mark |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1720025372 PECOS PAC ID: 5597778423 Enrollment ID: I20060719000220 |
| Provider Name | Kurt Andrew Riegner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689643280 PECOS PAC ID: 3577576131 Enrollment ID: I20060726000367 |
| Provider Name | Jerome M Adams |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568402659 PECOS PAC ID: 7214933357 Enrollment ID: I20061012000087 |
| Provider Name | Shane Leonard Guffey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922035278 PECOS PAC ID: 8325045610 Enrollment ID: I20061030000373 |
| Provider Name | Woo Joo Yi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881632594 PECOS PAC ID: 1850398983 Enrollment ID: I20061101000560 |
| Provider Name | John T Callaghan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700825064 PECOS PAC ID: 5092714204 Enrollment ID: I20061218000286 |
| Provider Name | Anita N Haggstrom |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1639288723 PECOS PAC ID: 3971579251 Enrollment ID: I20070112000199 |
| Provider Name | Karen S Stumpf |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184600868 PECOS PAC ID: 5799889010 Enrollment ID: I20070327000200 |
| Provider Name | Ahmed Ibrahim Elsahy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407805690 PECOS PAC ID: 5294830477 Enrollment ID: I20070417000286 |
| Provider Name | Marc L Frost |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1295733624 PECOS PAC ID: 3274638077 Enrollment ID: I20070424000508 |
| Provider Name | Min Zhao |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245360312 PECOS PAC ID: 4688773930 Enrollment ID: I20070627000253 |
| Provider Name | David M Stark |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326253212 PECOS PAC ID: 3678673522 Enrollment ID: I20070709000069 |
| Provider Name | John W Wolfe |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083882948 PECOS PAC ID: 6901979566 Enrollment ID: I20080716000176 |
| Provider Name | Amy L Mccutchan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487845475 PECOS PAC ID: 5395838403 Enrollment ID: I20080716000203 |
| Provider Name | Yar L Yeap |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447418637 PECOS PAC ID: 9931275658 Enrollment ID: I20080904000047 |
| Provider Name | Laurie A Miranda |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1346269016 PECOS PAC ID: 6608942297 Enrollment ID: I20080905000055 |
| Provider Name | Rebecca J Trepcos-klinger |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1154535714 PECOS PAC ID: 4385637529 Enrollment ID: I20080905000065 |
| Provider Name | Michael G Moore |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1851427900 PECOS PAC ID: 0941392310 Enrollment ID: I20080908000204 |
| Provider Name | Abideen O Yekinni |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1710904164 PECOS PAC ID: 2668539743 Enrollment ID: I20090317000016 |
| Provider Name | Ingrida I Ozols |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1710068796 PECOS PAC ID: 4587711643 Enrollment ID: I20090408000089 |
| Provider Name | Grant L Mcbride |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619130366 PECOS PAC ID: 0840340089 Enrollment ID: I20090610000443 |
| Provider Name | Alison S Klenk |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1205900800 PECOS PAC ID: 4082708474 Enrollment ID: I20090908000357 |
| Provider Name | Leilani S Mullis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669639084 PECOS PAC ID: 6305982265 Enrollment ID: I20091006000627 |
| Provider Name | Nasser H Hanna |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1316903883 PECOS PAC ID: 5597891135 Enrollment ID: I20100407000348 |
| Provider Name | Michael W Sanford |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659535227 PECOS PAC ID: 1658401161 Enrollment ID: I20100610000043 |
| Provider Name | Amy L Dorwart |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245488352 PECOS PAC ID: 4981734282 Enrollment ID: I20100614000217 |
| Provider Name | Patricia A Treadwell |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1508892613 PECOS PAC ID: 3577696319 Enrollment ID: I20100730000856 |
| Provider Name | Charles W Yates |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1275709958 PECOS PAC ID: 7618001041 Enrollment ID: I20100819001139 |
| Provider Name | Taha Z Shipchandler |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1023288230 PECOS PAC ID: 7719037597 Enrollment ID: I20100827000030 |
| Provider Name | Elliot J Androphy |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1740261478 PECOS PAC ID: 0446297055 Enrollment ID: I20101007000142 |
| Provider Name | Mark D Tasch |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447203195 PECOS PAC ID: 9133314693 Enrollment ID: I20101109001548 |
| Provider Name | David A Nakata |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659324754 PECOS PAC ID: 0941495097 Enrollment ID: I20101115000640 |
| Provider Name | Robert J Laviolette |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689609893 PECOS PAC ID: 9436344330 Enrollment ID: I20101117000095 |
| Provider Name | Douglas Groswald |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215967070 PECOS PAC ID: 5698961456 Enrollment ID: I20101119000356 |
| Provider Name | Rajesh K Pai |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1134145816 PECOS PAC ID: 8022204700 Enrollment ID: I20101119000749 |
| Provider Name | Janet L Wendeln |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174561518 PECOS PAC ID: 5799971735 Enrollment ID: I20101202000168 |
| Provider Name | Galina N Klimek |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609833318 PECOS PAC ID: 9931396959 Enrollment ID: I20101202001315 |
| Provider Name | Jodie M Greenwood |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497785257 PECOS PAC ID: 8820285851 Enrollment ID: I20101202001342 |
| Provider Name | Beth A Traylor |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457399891 PECOS PAC ID: 6002003076 Enrollment ID: I20101203000568 |
| Provider Name | Marla L Slough |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841238581 PECOS PAC ID: 3678760469 Enrollment ID: I20101206000826 |
| Provider Name | Pamela S Bryan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790715159 PECOS PAC ID: 0244427706 Enrollment ID: I20101209000404 |
| Provider Name | Douglas A Berebitsky |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811935232 PECOS PAC ID: 0840487161 Enrollment ID: I20101211000181 |
| Provider Name | Henry C Kim |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073548277 PECOS PAC ID: 4789872417 Enrollment ID: I20101222000674 |
| Provider Name | Thomas Mote |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205851557 PECOS PAC ID: 9537231394 Enrollment ID: I20101229000340 |
| Provider Name | Xiaotao F Qian |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295760692 PECOS PAC ID: 3870781230 Enrollment ID: I20101229000531 |
| Provider Name | Christian N Beaton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003854423 PECOS PAC ID: 9335337732 Enrollment ID: I20101229000924 |
| Provider Name | Stephen H Rosenfeld |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417900762 PECOS PAC ID: 4880883438 Enrollment ID: I20110112000753 |
| Provider Name | Elizabeth A Kroepfl |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508817511 PECOS PAC ID: 9739368200 Enrollment ID: I20110131000151 |
| Provider Name | Mark E Nielson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942407838 PECOS PAC ID: 2668658808 Enrollment ID: I20110524000071 |
| Provider Name | Adam J Lemmon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043474562 PECOS PAC ID: 9830375096 Enrollment ID: I20110524000248 |
| Provider Name | Christopher S Eddy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174782163 PECOS PAC ID: 1052598174 Enrollment ID: I20110526000684 |
| Provider Name | Matthew D Warner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679771919 PECOS PAC ID: 2163600305 Enrollment ID: I20110617000185 |
| Provider Name | Christiane Machado |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1790925618 PECOS PAC ID: 9234308453 Enrollment ID: I20110804000426 |
| Provider Name | Rebecca M Risser |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1598909061 PECOS PAC ID: 1456510452 Enrollment ID: I20120312000250 |
| Provider Name | Bradley S Destefano |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275706384 PECOS PAC ID: 8022272053 Enrollment ID: I20120604000140 |
| Provider Name | Matthew J Turner |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1033308275 PECOS PAC ID: 6204090145 Enrollment ID: I20120606000006 |
| Provider Name | Evan T Miller |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982839296 PECOS PAC ID: 2264696103 Enrollment ID: I20120606000044 |
| Provider Name | Lindsey C Hansen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174770788 PECOS PAC ID: 9335303270 Enrollment ID: I20120606000063 |
| Provider Name | Joanna Hwang Watkins |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1124079496 PECOS PAC ID: 3274681192 Enrollment ID: I20120720000016 |
| Provider Name | Takashi Hato |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043421209 PECOS PAC ID: 8325204985 Enrollment ID: I20120725000978 |
| Provider Name | Ryan D Nagy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558538546 PECOS PAC ID: 2769652536 Enrollment ID: I20120730000381 |
| Provider Name | Jonathan Y Ting |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1609034651 PECOS PAC ID: 3274780820 Enrollment ID: I20120904000465 |
| Provider Name | Joshua B Brewster |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700048709 PECOS PAC ID: 7911156179 Enrollment ID: I20130509000251 |
| Provider Name | Jennifer L Stewart |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124253513 PECOS PAC ID: 9436399714 Enrollment ID: I20130710000193 |
| Provider Name | Joseph B Hinton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023279130 PECOS PAC ID: 5890951909 Enrollment ID: I20130717000836 |
| Provider Name | Kristin E Hoffmann |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1710150214 PECOS PAC ID: 6507008216 Enrollment ID: I20130808000857 |
| Provider Name | Kevin M Backfish |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1962638916 PECOS PAC ID: 2567608144 Enrollment ID: I20130816000009 |
| Provider Name | Christopher Eric Grindle |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437384690 PECOS PAC ID: 2668618166 Enrollment ID: I20130828000035 |
| Provider Name | Elizabeth Bryant |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1598914657 PECOS PAC ID: 6204076953 Enrollment ID: I20130927000262 |
| Provider Name | Daniel J Shirley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669473740 PECOS PAC ID: 8628173523 Enrollment ID: I20131014001454 |
| Provider Name | Melissa H Stanton |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1255676730 PECOS PAC ID: 0941435242 Enrollment ID: I20131022001268 |
| Provider Name | Jacqueline H Wylam |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1972946713 PECOS PAC ID: 4789819038 Enrollment ID: I20131023000420 |
| Provider Name | Avinash V Mantravadi |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174789564 PECOS PAC ID: 3971768474 Enrollment ID: I20140113000495 |
| Provider Name | Steffanie A Standish |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1629401385 PECOS PAC ID: 1951531854 Enrollment ID: I20140219002110 |
| Provider Name | Michael N Kuria |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154765725 PECOS PAC ID: 3971744590 Enrollment ID: I20140414001601 |
| Provider Name | Noah P Parker |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1215100706 PECOS PAC ID: 7315175692 Enrollment ID: I20140602000644 |
| Provider Name | Michael Andrew Sherrill |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952621120 PECOS PAC ID: 1951548445 Enrollment ID: I20140604002266 |
| Provider Name | David W Harvey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083848550 PECOS PAC ID: 3870739717 Enrollment ID: I20140708002051 |
| Provider Name | Nidhi Avashia-khemka |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1306145792 PECOS PAC ID: 1951527555 Enrollment ID: I20140716001765 |
| Provider Name | Grant A Carson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407175763 PECOS PAC ID: 1153567789 Enrollment ID: I20140731001356 |
| Provider Name | Rick F Nelson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1720287139 PECOS PAC ID: 9931333481 Enrollment ID: I20140821000320 |
| Provider Name | Wei Shen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639305733 PECOS PAC ID: 6709022023 Enrollment ID: I20141027000971 |
| Provider Name | Timothy T Webb |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689994808 PECOS PAC ID: 8628215233 Enrollment ID: I20150615000086 |
| Provider Name | Diane N Turvy |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1952695744 PECOS PAC ID: 6406097278 Enrollment ID: I20150617001719 |
| Provider Name | Christopher Anthony Gentile |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952691909 PECOS PAC ID: 6002052834 Enrollment ID: I20150630000647 |
| Provider Name | Trent G Gray |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1730524893 PECOS PAC ID: 7719111095 Enrollment ID: I20160229001915 |
| Provider Name | Tejinder S Soi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467719591 PECOS PAC ID: 7810122306 Enrollment ID: I20160411000300 |
| Provider Name | Jamie A Harrison |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275897688 PECOS PAC ID: 9234364068 Enrollment ID: I20160524000440 |
| Provider Name | Adam M Mchenry |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659647857 PECOS PAC ID: 9830335025 Enrollment ID: I20160602000325 |
| Provider Name | Sarah E Schilling |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407119415 PECOS PAC ID: 9537310982 Enrollment ID: I20160701000367 |
| Provider Name | Benjamin P Anthony |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1457666943 PECOS PAC ID: 5496076978 Enrollment ID: I20160713000716 |
| Provider Name | Katherine A Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396197950 PECOS PAC ID: 0143515924 Enrollment ID: I20160817002669 |
| Provider Name | Stephen D Peretin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1689930679 PECOS PAC ID: 8426280306 Enrollment ID: I20160818000849 |
| Provider Name | Sahand Rahnama-moghadam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215257480 PECOS PAC ID: 9133415763 Enrollment ID: I20160908001271 |
| Provider Name | Elisa A Illing |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1851619845 PECOS PAC ID: 8921244609 Enrollment ID: I20160915000082 |
| Provider Name | Michael Tyler King |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306112669 PECOS PAC ID: 5799070264 Enrollment ID: I20160916001873 |
| Provider Name | Michael W Sim |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1730408493 PECOS PAC ID: 7719299528 Enrollment ID: I20160921000866 |
| Provider Name | Richard P Bassi |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1508829409 PECOS PAC ID: 3072532696 Enrollment ID: I20161017000457 |
| Provider Name | Jessamyn R Ambler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881144715 PECOS PAC ID: 7517245988 Enrollment ID: I20161107000725 |
| Provider Name | Nathan V Mcclelland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144575598 PECOS PAC ID: 7810146487 Enrollment ID: I20161116001506 |
| Provider Name | Nora Deenik |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649534934 PECOS PAC ID: 3476799222 Enrollment ID: I20170110001189 |
| Provider Name | David B Williams |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1124563556 PECOS PAC ID: 8820370604 Enrollment ID: I20170201000097 |
| Provider Name | Amanda S Weinzierl |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1801937248 PECOS PAC ID: 1557644465 Enrollment ID: I20170220000159 |
| Provider Name | Kathleen R Corbin |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1568479863 PECOS PAC ID: 1658654587 Enrollment ID: I20170220000530 |
| Provider Name | Kelsea M Ice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659805646 PECOS PAC ID: 7911284559 Enrollment ID: I20170508002033 |
| Provider Name | Ryan C Durk |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477992303 PECOS PAC ID: 9032486360 Enrollment ID: I20170517000878 |
| Provider Name | Philip M Stoller |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316385966 PECOS PAC ID: 7810113958 Enrollment ID: I20170518000280 |
| Provider Name | Zachary R Cohen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679894059 PECOS PAC ID: 3476782954 Enrollment ID: I20170518001261 |
| Provider Name | Chad Michael Solik |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255673752 PECOS PAC ID: 0143454041 Enrollment ID: I20170525001100 |
| Provider Name | Makato Kataoka |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013357474 PECOS PAC ID: 5193969400 Enrollment ID: I20170526000448 |
| Provider Name | Hishan Krish |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407168263 PECOS PAC ID: 6608091418 Enrollment ID: I20170606001913 |
| Provider Name | Jeffrey L Stutler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891133955 PECOS PAC ID: 7012150543 Enrollment ID: I20170606002060 |
| Provider Name | Patrick K Segeleon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427234236 PECOS PAC ID: 0547313553 Enrollment ID: I20170629000118 |
| Provider Name | Lindsey K Shine |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1881018745 PECOS PAC ID: 2163793142 Enrollment ID: I20170809003158 |
| Provider Name | Raheleh Rahimi Darabad |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1265791834 PECOS PAC ID: 5395035679 Enrollment ID: I20170815000156 |
| Provider Name | Ayman Hallab |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1982967022 PECOS PAC ID: 5991944159 Enrollment ID: I20170823002824 |
| Provider Name | Jennifer K Rush |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1821515784 PECOS PAC ID: 2961775390 Enrollment ID: I20170907001113 |
| Provider Name | Justin D Garrett |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1417473422 PECOS PAC ID: 8820361256 Enrollment ID: I20170907001252 |
| Provider Name | Katherine E Turk |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053557389 PECOS PAC ID: 6305119454 Enrollment ID: I20170912001271 |
| Provider Name | Rita R Patel |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1275598880 PECOS PAC ID: 5890061402 Enrollment ID: I20171026002562 |
| Provider Name | Stephen M Evankovich |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1710312301 PECOS PAC ID: 3577790104 Enrollment ID: I20180117001948 |
| Provider Name | Samantha A Evankovich |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1174931877 PECOS PAC ID: 3274752779 Enrollment ID: I20180119001371 |
| Provider Name | Matthew E Deburger |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1902289101 PECOS PAC ID: 1658660725 Enrollment ID: I20180316001040 |
| Provider Name | Christopher W Mueller |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568872760 PECOS PAC ID: 6204051881 Enrollment ID: I20180523002451 |
| Provider Name | Daniel Guillaud |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841617768 PECOS PAC ID: 0648495655 Enrollment ID: I20180524002596 |
| Provider Name | Peter T Zavislak |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588959530 PECOS PAC ID: 2062724446 Enrollment ID: I20180711002384 |
| Provider Name | Lindsey A Cunningham |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1831426444 PECOS PAC ID: 7618012477 Enrollment ID: I20180718001469 |
| Provider Name | Gulraj Chawla |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154664381 PECOS PAC ID: 3870719891 Enrollment ID: I20180802003499 |
| Provider Name | Danielle Christine Cummins |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801232558 PECOS PAC ID: 2961642038 Enrollment ID: I20180802003769 |
| Provider Name | Nikolajs J Perdue |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1639580152 PECOS PAC ID: 6002031465 Enrollment ID: I20180810001481 |
| Provider Name | Thomas J Willis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487896866 PECOS PAC ID: 8527208842 Enrollment ID: I20181204003479 |
| Provider Name | Syril Keena T Que |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1053672014 PECOS PAC ID: 0941502413 Enrollment ID: I20181211003461 |
| Provider Name | Jay Edward Wolverton |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1407291511 PECOS PAC ID: 2668692179 Enrollment ID: I20181228002471 |
| Provider Name | Benjamin Robert Cohen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558830646 PECOS PAC ID: 9436497823 Enrollment ID: I20190211000202 |
| Provider Name | Kristen Suzanne Scheffel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194298752 PECOS PAC ID: 3476892019 Enrollment ID: I20190226003471 |
| Provider Name | Kelsey M Murphy |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1992269112 PECOS PAC ID: 3375883010 Enrollment ID: I20190318000064 |
| Provider Name | Michael Arvin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891189841 PECOS PAC ID: 1759694920 Enrollment ID: I20190613000114 |
| Provider Name | Adam Michael Ellis |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1164836458 PECOS PAC ID: 2961793054 Enrollment ID: I20190618002364 |
| Provider Name | Krunal S Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407295777 PECOS PAC ID: 5799056230 Enrollment ID: I20190618003301 |
| Provider Name | Jenna L Streicher |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1619264660 PECOS PAC ID: 8820381627 Enrollment ID: I20190626003779 |
| Provider Name | Ross B Mirman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477966133 PECOS PAC ID: 6406071620 Enrollment ID: I20190723002011 |
| Provider Name | Shane A Hiatt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457627101 PECOS PAC ID: 4486980232 Enrollment ID: I20190731002598 |
| Provider Name | Erin R Dammann |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801273826 PECOS PAC ID: 0446563613 Enrollment ID: I20190806000467 |
| Provider Name | Clint W Riley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306233580 PECOS PAC ID: 6608103239 Enrollment ID: I20190806000591 |
| Provider Name | John M Sours |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245619790 PECOS PAC ID: 2163735424 Enrollment ID: I20190820002278 |
| Provider Name | Jessica Yesensky |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1043658818 PECOS PAC ID: 2264736255 Enrollment ID: I20190829000525 |
| Provider Name | Allison Rose Hammer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508191750 PECOS PAC ID: 1355584079 Enrollment ID: I20190829001282 |
| Provider Name | Dominic James Vernon |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1851737803 PECOS PAC ID: 5294976882 Enrollment ID: I20190829001372 |
| Provider Name | A Rum Kim |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174871743 PECOS PAC ID: 2567697394 Enrollment ID: I20190911002598 |
| Provider Name | Lisa Marie Clark |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1215998927 PECOS PAC ID: 6002709243 Enrollment ID: I20190918000703 |
| Provider Name | Tammy Jo Dukeshire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710441415 PECOS PAC ID: 0446581532 Enrollment ID: I20191003000907 |
| Provider Name | Kelly Lormore |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1851949820 PECOS PAC ID: 4082047022 Enrollment ID: I20191205002950 |
| Provider Name | Mark D Schamber |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1174083943 PECOS PAC ID: 0042644809 Enrollment ID: I20200102002472 |
| Provider Name | Gabrielle Clark |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1568092559 PECOS PAC ID: 3779919717 Enrollment ID: I20200211000429 |
| Provider Name | Emily F Fitzgerald |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1881224400 PECOS PAC ID: 1355770959 Enrollment ID: I20200402001680 |
| Provider Name | Taylor S Sim |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1891327219 PECOS PAC ID: 3678902293 Enrollment ID: I20200402002520 |
| Provider Name | Breeanna Wright |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1114576725 PECOS PAC ID: 2365872132 Enrollment ID: I20200417001949 |
| Provider Name | Wen Li Chen |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1225668841 PECOS PAC ID: 1153752050 Enrollment ID: I20200508002150 |
| Provider Name | Keegan M Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538797212 PECOS PAC ID: 9638500986 Enrollment ID: I20200520003149 |
| Provider Name | Wenhua Chen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1952795890 PECOS PAC ID: 2264862564 Enrollment ID: I20200521002063 |
| Provider Name | Christina L Becker |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1124027016 PECOS PAC ID: 2466427109 Enrollment ID: I20200604003097 |
| Provider Name | Emily P Ashby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518590504 PECOS PAC ID: 3173944535 Enrollment ID: I20200611000169 |
| Provider Name | Kristina A Vasnaik |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336764158 PECOS PAC ID: 7719309012 Enrollment ID: I20200615001212 |
| Provider Name | Yukako Suzuki |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982720009 PECOS PAC ID: 1759708357 Enrollment ID: I20200827001842 |
| Provider Name | Chakrapani Gupta |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578539474 PECOS PAC ID: 4385664382 Enrollment ID: I20200924003191 |
| Provider Name | Kathryn E Hull |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1720695752 PECOS PAC ID: 6406275981 Enrollment ID: I20201002000091 |
| Provider Name | Anahli Mayank Patel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689273849 PECOS PAC ID: 1951721398 Enrollment ID: I20201023000708 |
| Provider Name | Laura Katherine Durr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952900961 PECOS PAC ID: 7618389933 Enrollment ID: I20201210001077 |
| Provider Name | Maria Zaidi |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1871183095 PECOS PAC ID: 1355755711 Enrollment ID: I20210126000366 |
| Provider Name | David C Adams |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588608152 PECOS PAC ID: 9436109733 Enrollment ID: I20210128000704 |
| Provider Name | Sarangi Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1669062030 PECOS PAC ID: 3971917048 Enrollment ID: I20210201001881 |
| Provider Name | Quincy You |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1740616564 PECOS PAC ID: 3971825464 Enrollment ID: I20210204001983 |
| Provider Name | Michael Edward Ferrante |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1952745101 PECOS PAC ID: 2163665530 Enrollment ID: I20210304001962 |
| Provider Name | Baljit K Rehal |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1558696179 PECOS PAC ID: 5193131621 Enrollment ID: I20210309000980 |
| Provider Name | Stephanie Shapiro Wieczorek |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1992198527 PECOS PAC ID: 8729494166 Enrollment ID: I20210309001938 |
| Provider Name | Samantha L Dugan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033783543 PECOS PAC ID: 6305245515 Enrollment ID: I20210520000839 |
| Provider Name | Morgan A Griswold |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871169482 PECOS PAC ID: 3476952847 Enrollment ID: I20210604002120 |
| Provider Name | Kailee Dawn Petro |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336716802 PECOS PAC ID: 1153721576 Enrollment ID: I20210607001617 |
| Provider Name | Tracy Lyn Petree |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619544152 PECOS PAC ID: 6204236466 Enrollment ID: I20210610001110 |
| Provider Name | Trent P Wagoner |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1467058438 PECOS PAC ID: 8426461328 Enrollment ID: I20210622001903 |
| Provider Name | Yuk Wai Dominic Ng |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1871162933 PECOS PAC ID: 3072914241 Enrollment ID: I20210624003011 |
| Provider Name | Aaron Craig Miner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023548682 PECOS PAC ID: 8729357744 Enrollment ID: I20210723001499 |
| Provider Name | Lindsey Nikoa Grabek |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922530344 PECOS PAC ID: 5698044360 Enrollment ID: I20210727002329 |
| Provider Name | Tyler Witherspoon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497287627 PECOS PAC ID: 9830468503 Enrollment ID: I20210730001170 |
| Provider Name | John Patrick Haltom |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033793856 PECOS PAC ID: 6901201896 Enrollment ID: I20210816001276 |
| Provider Name | Brett M Barnes |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649701905 PECOS PAC ID: 4082982053 Enrollment ID: I20210817001846 |
| Provider Name | Yunpeng Yang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780117275 PECOS PAC ID: 6406104439 Enrollment ID: I20210823000090 |
| Provider Name | Elizabeth A Emhardt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578926903 PECOS PAC ID: 0446542898 Enrollment ID: I20210824000435 |
| Provider Name | Kevin R Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124791678 PECOS PAC ID: 8123423522 Enrollment ID: I20210824000508 |
| Provider Name | Megan E Carmony |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841672557 PECOS PAC ID: 9931413119 Enrollment ID: I20210824000566 |
| Provider Name | Adam Charles Murphy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1164953626 PECOS PAC ID: 9638447642 Enrollment ID: I20210824000968 |
| Provider Name | Wen Jia Chen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396071122 PECOS PAC ID: 7517109960 Enrollment ID: I20210824000984 |
| Provider Name | Sapna Ravindranath |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417253352 PECOS PAC ID: 7315264108 Enrollment ID: I20210825000962 |
| Provider Name | Satyan Sreenath |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1447638101 PECOS PAC ID: 7214240019 Enrollment ID: I20210825001310 |
| Provider Name | Jennifer L Lamb |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477087773 PECOS PAC ID: 6305183518 Enrollment ID: I20210825003082 |
| Provider Name | Janelle S Nassim |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1790212165 PECOS PAC ID: 9537431630 Enrollment ID: I20210825003113 |
| Provider Name | Lauren Sowa |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1811376593 PECOS PAC ID: 2163724733 Enrollment ID: I20210826000161 |
| Provider Name | Matthew Partain |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174917280 PECOS PAC ID: 4587940986 Enrollment ID: I20210826002078 |
| Provider Name | Sachin Vimal Bahadur |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023458999 PECOS PAC ID: 9830333517 Enrollment ID: I20210901000103 |
| Provider Name | Edwin L Becher |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497117931 PECOS PAC ID: 0749573699 Enrollment ID: I20210910000076 |
| Provider Name | Alexander J Service |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639563828 PECOS PAC ID: 7214210954 Enrollment ID: I20210914001878 |
| Provider Name | Yatish Siddapura Ranganath |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972861961 PECOS PAC ID: 9032374376 Enrollment ID: I20210922001489 |
| Provider Name | Megan A Deeb |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790214716 PECOS PAC ID: 9830469832 Enrollment ID: I20210923001859 |
| Provider Name | Alhasan N Elghouche |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1235585878 PECOS PAC ID: 4284926726 Enrollment ID: I20210924000456 |
| Provider Name | Priyanka H Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417480872 PECOS PAC ID: 7911279922 Enrollment ID: I20211115000152 |
| Provider Name | Ruqi Shi |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1316614779 PECOS PAC ID: 5698167906 Enrollment ID: I20220119000730 |
| Provider Name | Kelly Elizabeth Allison Foy |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1508412388 PECOS PAC ID: 3577957539 Enrollment ID: I20220308002317 |
| Provider Name | Rachel Hasewinkel |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1063164606 PECOS PAC ID: 0345635033 Enrollment ID: I20220316000266 |
| Provider Name | Jyoti P Dangle |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831451889 PECOS PAC ID: 8921391947 Enrollment ID: I20220324000143 |
| Provider Name | Vijay R Ramakrishnan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619014909 PECOS PAC ID: 4486704574 Enrollment ID: I20220504000246 |
| Provider Name | Madison Alexandra Plumer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790398824 PECOS PAC ID: 8921485673 Enrollment ID: I20220518001263 |
| Provider Name | Jie Xie |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1376923359 PECOS PAC ID: 6204147838 Enrollment ID: I20220524002044 |
| Provider Name | Evan Charles Cumpston |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1376905877 PECOS PAC ID: 9133426711 Enrollment ID: I20220526002759 |
| Provider Name | Grant W Hicks |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881199842 PECOS PAC ID: 4981959632 Enrollment ID: I20220607002234 |
| Provider Name | Michael Raymond Schneider |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1497027932 PECOS PAC ID: 9931368230 Enrollment ID: I20220608001797 |
| Provider Name | Sean J Dangelmajer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023513942 PECOS PAC ID: 1052744612 Enrollment ID: I20220622002321 |
| Provider Name | Allison C Malley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245658368 PECOS PAC ID: 7911205620 Enrollment ID: I20220706001357 |
| Provider Name | Osato Osato Urhiafe |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851824981 PECOS PAC ID: 6901200765 Enrollment ID: I20220707001331 |
| Provider Name | Callie Brook Burgin |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1073019980 PECOS PAC ID: 7315201530 Enrollment ID: I20220725001524 |
| Provider Name | Brandon Michael Tanner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043692478 PECOS PAC ID: 1052624533 Enrollment ID: I20220726003353 |
| Provider Name | John T Raduka |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790280022 PECOS PAC ID: 3971859604 Enrollment ID: I20220806000728 |
| Provider Name | Edita Maria Newton |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1952807364 PECOS PAC ID: 9234487893 Enrollment ID: I20220808001038 |
| Provider Name | David A Campbell |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1518329697 PECOS PAC ID: 2062774342 Enrollment ID: I20220812000600 |
| Provider Name | Jenna M Westwick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194450866 PECOS PAC ID: 6305221474 Enrollment ID: I20220912000254 |
| Provider Name | Brian Chulmin Shin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093247793 PECOS PAC ID: 2466838537 Enrollment ID: I20220928000655 |
| Provider Name | Margaret E Frith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1194293555 PECOS PAC ID: 5193064103 Enrollment ID: I20220930002087 |
| Provider Name | Tyler Jacob Reed |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1134798127 PECOS PAC ID: 3779975578 Enrollment ID: I20221015000087 |
| Provider Name | Sara E Miner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306338421 PECOS PAC ID: 8426307950 Enrollment ID: I20221019002390 |
| Provider Name | David Rosmarin |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1730353665 PECOS PAC ID: 7719031525 Enrollment ID: I20221118000836 |
| Provider Name | Mitesh J Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073527123 PECOS PAC ID: 7517937006 Enrollment ID: I20221121001901 |
| Provider Name | Brian Tien Tran |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1245947910 PECOS PAC ID: 1052780608 Enrollment ID: I20221205000318 |
| Provider Name | Michelle L Wagner-escobar |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1831464171 PECOS PAC ID: 9830568146 Enrollment ID: I20221208001477 |
| Provider Name | Joseph F Webb |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568449643 PECOS PAC ID: 8123062452 Enrollment ID: I20221209000221 |
| Provider Name | Johnathan S Brenia |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093212037 PECOS PAC ID: 4385991637 Enrollment ID: I20221214001942 |
| Provider Name | Anam Bashir |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1881311777 PECOS PAC ID: 8325419609 Enrollment ID: I20230124002897 |
| Provider Name | Blair Elizabeth Book |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1528789146 PECOS PAC ID: 8729459912 Enrollment ID: I20230126001199 |
| Provider Name | Chloe Drake |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1629787817 PECOS PAC ID: 2668844226 Enrollment ID: I20230207002906 |
| Provider Name | Corey Joseph Mitscher |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1982319505 PECOS PAC ID: 9335511930 Enrollment ID: I20230208000836 |
| Provider Name | Dmitriy S Tckachenko |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285645531 PECOS PAC ID: 9537165402 Enrollment ID: I20230208002965 |
| Provider Name | Shelby Lauren Ballard |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1720791940 PECOS PAC ID: 2668845017 Enrollment ID: I20230306000836 |
| Provider Name | Lingzhong Meng |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477724086 PECOS PAC ID: 3678647351 Enrollment ID: I20230307000511 |
| Provider Name | Tanner J Hulin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356097026 PECOS PAC ID: 8729473525 Enrollment ID: I20230315001561 |
| Provider Name | Adam Daniel Camp |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518107606 PECOS PAC ID: 0042453599 Enrollment ID: I20230317001161 |
| Provider Name | Tylor S Payne |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1538873807 PECOS PAC ID: 2062883275 Enrollment ID: I20230319000044 |
| Provider Name | William B Howard |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1891409116 PECOS PAC ID: 0648644971 Enrollment ID: I20230328000427 |
| Provider Name | Charles Connor Sorrells |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1508578220 PECOS PAC ID: 8527433309 Enrollment ID: I20230410000204 |
| Provider Name | Tyler Nicholas Thomas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326602699 PECOS PAC ID: 1557694999 Enrollment ID: I20230608002054 |
| Provider Name | Kelsea Lucas |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932774668 PECOS PAC ID: 9032514641 Enrollment ID: I20230620002114 |
| Provider Name | Carly A Smith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497250286 PECOS PAC ID: 9537415989 Enrollment ID: I20230630000803 |
| Provider Name | Zachary C Clark |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568025211 PECOS PAC ID: 1456680941 Enrollment ID: I20230710003428 |
| Provider Name | Janice Farlow |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1588010607 PECOS PAC ID: 9032487632 Enrollment ID: I20230731002061 |
| Provider Name | Carl R Christenson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699279000 PECOS PAC ID: 0143576967 Enrollment ID: I20230801002526 |
| Provider Name | Ryan G Hata |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750564217 PECOS PAC ID: 1153484936 Enrollment ID: I20230802002009 |
| Provider Name | Yuliang Ding |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1669153375 PECOS PAC ID: 0648633354 Enrollment ID: I20230829001583 |
| Provider Name | Cheryl Moreton |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1548814791 PECOS PAC ID: 4284050584 Enrollment ID: I20230831004470 |
| Provider Name | Catharina Daffre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023738242 PECOS PAC ID: 2769846807 Enrollment ID: I20230907004501 |
| Provider Name | Patrick R Carnes |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1629250162 PECOS PAC ID: 7416047758 Enrollment ID: I20230929000811 |
| Provider Name | Becky Q Chu |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1104466911 PECOS PAC ID: 9335579010 Enrollment ID: I20231013002752 |
| Provider Name | Robert D Denyer |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1457616518 PECOS PAC ID: 4789833278 Enrollment ID: I20231114002117 |
| Provider Name | Abena O Ofori |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1780727222 PECOS PAC ID: 9032211727 Enrollment ID: I20231205000695 |
| Provider Name | Jordan Szpak |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1063861854 PECOS PAC ID: 6608160239 Enrollment ID: I20231206000159 |
| Provider Name | Lia M Allen |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1982183596 PECOS PAC ID: 7810234408 Enrollment ID: I20231208001826 |
| Provider Name | Dana Renee Stoltz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851010169 PECOS PAC ID: 1557710803 Enrollment ID: I20231212001217 |
| Provider Name | Jonathon R Roullard |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1124556261 PECOS PAC ID: 8022363712 Enrollment ID: I20231213001680 |
| Provider Name | Sarah H Young |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1548654452 PECOS PAC ID: 3375879125 Enrollment ID: I20231222000999 |
| Provider Name | Paige M Victor |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1386262533 PECOS PAC ID: 2567873151 Enrollment ID: I20240109001590 |
| Provider Name | George Nicolas |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1124642509 PECOS PAC ID: 4880010446 Enrollment ID: I20240110002481 |
| Provider Name | Adam Edwards |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1467957829 PECOS PAC ID: 7911253182 Enrollment ID: I20240110003660 |
| Provider Name | Amira Zekan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124478904 PECOS PAC ID: 1052608189 Enrollment ID: I20240118003006 |
| Provider Name | Carey M Parker |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1306583844 PECOS PAC ID: 0547649998 Enrollment ID: I20240123000384 |
| Provider Name | Nuo Yang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013443357 PECOS PAC ID: 7618214966 Enrollment ID: I20240206002397 |
| Provider Name | Mikiel A Ewida |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1417726779 PECOS PAC ID: 9931542651 Enrollment ID: I20240209002450 |
| Provider Name | Gavin J Bowling |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1366219719 PECOS PAC ID: 8426492869 Enrollment ID: I20240214000608 |
| Provider Name | Robert Fiala |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316238694 PECOS PAC ID: 4789904111 Enrollment ID: I20240214002653 |
| Provider Name | David Edward Lee |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1023882016 PECOS PAC ID: 5890139034 Enrollment ID: I20240215003772 |
| Provider Name | Devon P Amos |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1689448805 PECOS PAC ID: 9638513880 Enrollment ID: I20240215004078 |
| Provider Name | Cameron Mitchell Knese |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1427811074 PECOS PAC ID: 8325482029 Enrollment ID: I20240221002877 |
| Provider Name | Bryan E Julian |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1689435349 PECOS PAC ID: 2163866724 Enrollment ID: I20240222001056 |
| Provider Name | Taylor J Merrill |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1376305474 PECOS PAC ID: 5799120119 Enrollment ID: I20240226001410 |
| Provider Name | Mary Elizabeth Combs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821868787 PECOS PAC ID: 2668818667 Enrollment ID: I20240313001153 |
| Provider Name | Ella Louise Funke |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1760245278 PECOS PAC ID: 2062858913 Enrollment ID: I20240313003347 |
| Provider Name | Kristen Leigh Taylor |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1568223139 PECOS PAC ID: 9931545738 Enrollment ID: I20240315000605 |
| Provider Name | Brittany Lynn Partain |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1851882906 PECOS PAC ID: 5496193070 Enrollment ID: I20240402000713 |
| Provider Name | Mohammed O Sadat |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548555345 PECOS PAC ID: 2769857879 Enrollment ID: I20240405003374 |
| Provider Name | Cristina Barboi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053394015 PECOS PAC ID: 4183804735 Enrollment ID: I20240423002637 |
| Provider Name | Weston Bertot |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558802801 PECOS PAC ID: 2264776970 Enrollment ID: I20240424001689 |
| Provider Name | Gaurav Chauhan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972979771 PECOS PAC ID: 9436482619 Enrollment ID: I20240501001832 |
| Provider Name | Hunter Luke Elms |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1225590359 PECOS PAC ID: 7517308265 Enrollment ID: I20240511000412 |
| Provider Name | John Francis Benecke |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023645819 PECOS PAC ID: 0345649968 Enrollment ID: I20240513000408 |
| Provider Name | Hunter Davis Archibald |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1629531801 PECOS PAC ID: 7618304593 Enrollment ID: I20240513002290 |
| Provider Name | Daniel A Benson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245850494 PECOS PAC ID: 8628499894 Enrollment ID: I20240514003122 |
| Provider Name | Toyin Daniel Ayodele |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881223030 PECOS PAC ID: 9537599782 Enrollment ID: I20240515001598 |
| Provider Name | Gregory J Aycock |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1215924527 PECOS PAC ID: 0547614059 Enrollment ID: I20240604000162 |
| Provider Name | Curtis D Groover |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497382154 PECOS PAC ID: 1557782794 Enrollment ID: I20240612001373 |
| Provider Name | Benjamin Mark Wahle |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1689194243 PECOS PAC ID: 0143762526 Enrollment ID: I20240613000768 |
| Provider Name | Christine Li Barron |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1588125413 PECOS PAC ID: 2062955461 Enrollment ID: I20240613001846 |
| Provider Name | Michelle R Axe |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013545540 PECOS PAC ID: 4688005325 Enrollment ID: I20240618002630 |
| Provider Name | Nicholas Robert Carter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174151567 PECOS PAC ID: 6709208671 Enrollment ID: I20240620000146 |
| Provider Name | Kari B Christie |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003060922 PECOS PAC ID: 1759538036 Enrollment ID: I20240620001737 |
| Provider Name | Bosi Zhang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295363158 PECOS PAC ID: 6608319439 Enrollment ID: I20240620002545 |
| Provider Name | Elise Porter |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386271393 PECOS PAC ID: 8426472945 Enrollment ID: I20240624000946 |
| Provider Name | Leah Elaine Moravec |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760001895 PECOS PAC ID: 3779904420 Enrollment ID: I20240625003352 |
| Provider Name | Christopher T Rud |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073141735 PECOS PAC ID: 3173947694 Enrollment ID: I20240702000322 |
| Provider Name | Michael J Frondorf |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639798804 PECOS PAC ID: 6204370844 Enrollment ID: I20240707000033 |
| Provider Name | Noah Shaikh |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1932603529 PECOS PAC ID: 9436494184 Enrollment ID: I20240715003805 |
| Provider Name | Michael Blessyn Nadutey Adjei |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1710516299 PECOS PAC ID: 1153866876 Enrollment ID: I20240717001943 |
| Provider Name | Courtney L Bledsoe |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1598429888 PECOS PAC ID: 3870980725 Enrollment ID: I20240723000885 |
| Provider Name | Gregory S Miller |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1710993662 PECOS PAC ID: 3779559265 Enrollment ID: I20240806003835 |
| Provider Name | Anne Marie Smith |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1639912587 PECOS PAC ID: 6709326465 Enrollment ID: I20240909001810 |
| Provider Name | Elham L Zayed |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1194450577 PECOS PAC ID: 3072984954 Enrollment ID: I20241018002546 |
| Provider Name | Shelby L Kubicki |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1043770746 PECOS PAC ID: 3577894245 Enrollment ID: I20241021001187 |
| Provider Name | Huynhvi Phan Nguyen |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1649007899 PECOS PAC ID: 2163955501 Enrollment ID: I20241029003848 |
| Provider Name | Merritt M Peterson |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1629895883 PECOS PAC ID: 9638603202 Enrollment ID: I20241106000415 |
| Provider Name | Mary Kleiman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407391253 PECOS PAC ID: 5294165932 Enrollment ID: I20241112000825 |
| Provider Name | Gerald T Kitchens |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104868629 PECOS PAC ID: 1254310899 Enrollment ID: I20241112002372 |
| Provider Name | Mikiyas Fitawok |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1447823075 PECOS PAC ID: 3274937230 Enrollment ID: I20241125001611 |
| Provider Name | Lindsey Bechtold |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1205582566 PECOS PAC ID: 0244765378 Enrollment ID: I20241126000467 |
| Provider Name | Melanie L Soloway |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1316675051 PECOS PAC ID: 1951771195 Enrollment ID: I20241203001360 |
| Provider Name | Anshika Kaushik |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1326437138 PECOS PAC ID: 0547691032 Enrollment ID: I20241203003906 |
| Provider Name | Joseph M Parrish |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1790204329 PECOS PAC ID: 4183980253 Enrollment ID: I20241205001922 |
| Provider Name | Yousef Al Ahwel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1093946576 PECOS PAC ID: 4385808609 Enrollment ID: I20241210001242 |
| Provider Name | Robert B Fujiki |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1871151837 PECOS PAC ID: 1658604160 Enrollment ID: I20241224000806 |
| Provider Name | Tiffany Pham |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306336540 PECOS PAC ID: 6507111267 Enrollment ID: I20250107003480 |
| Provider Name | Sejal Shah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770148892 PECOS PAC ID: 9537584586 Enrollment ID: I20250115002601 |
| Provider Name | Zoe N David |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1427868934 PECOS PAC ID: 4789113705 Enrollment ID: I20250121001845 |
| Provider Name | Valerie Jill Strother |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1992528061 PECOS PAC ID: 5890224380 Enrollment ID: I20250129000990 |
| Provider Name | Charisse F Shafer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659181592 PECOS PAC ID: 8628508165 Enrollment ID: I20250212002789 |
| Provider Name | Sean Kautz |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1679390603 PECOS PAC ID: 3678003076 Enrollment ID: I20250214001766 |
| Provider Name | Olivia K Rassel |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1851102578 PECOS PAC ID: 9830629161 Enrollment ID: I20250214003045 |
| Provider Name | Ricky L Miller |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1881405843 PECOS PAC ID: 8527588391 Enrollment ID: I20250224001718 |
| Provider Name | Dennis Viet Le |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1104635838 PECOS PAC ID: 1355861048 Enrollment ID: I20250225002477 |
| Provider Name | Brandon Matthew Haynes |
|---|---|
| Provider Type | Practitioner - Anesthesiology Assistant |
| Provider Identifiers | NPI Number: 1932911518 PECOS PAC ID: 9133649692 Enrollment ID: I20250227001283 |
Moazzam Habib Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9240 N Meridian St, Suite 240, Indianapolis, IN 46260 Phone: 317-571-0030 Fax: 317-571-0031 | |
Midwest Center For Pelvic Health Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 E 91st St Ste B, Indianapolis, IN 46240 Phone: 317-793-2819 | |
Franciscan Health Indianapolis & Mooresville Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5230a East Stop 11 Road, Suite 250, Indianapolis, IN 46237 Phone: 317-528-8921 Fax: 317-528-6916 | |
Evernorth Care Providers - Delaware Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8888 Keystone Xing Ste 1300, Indianapolis, IN 46240 Phone: 773-292-4800 Fax: 312-564-4059 | |
The Health And Hospital Corporation Of Marion County Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1434 Shelby St, Indianapolis, IN 46203 Phone: 317-655-3200 Fax: 317-655-3210 | |
Creative Rehab Strategies Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1040 E 86th St, Suite 48-a, Indianapolis, IN 46240 Phone: 317-569-1800 | |
Cadience Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5602 Caito Dr, Indianapolis, IN 46226 Phone: 901-235-2065 |