| Jefferson Physician Services, Pllc | |
|
2830 Calder St Beaumont TX 77702-1809 | |
| (409) 892-7171 | |
| Not Available |
| Full Name | Jefferson Physician Services, Pllc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2830 Calder St, Beaumont, Texas |
| Authorized Official Name and Position | Michael Pawlowski (OWNER/PRESIDENT) |
| Authorized Official Contact | 3376091221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jefferson Physician Services, Pllc 200 Corporate Blvd Lafayette LA 70508-3870 Ph: (800) 893-9698 | Jefferson Physician Services, Pllc 2830 Calder St Beaumont TX 77702-1809 Ph: (409) 892-7171 |
| NPI Number | 1598546764 |
|---|---|
| Provider Enumeration Date | 10/12/2023 |
| Last Update Date | 10/12/2023 |
| Medicare PECOS PAC ID | 0547610677 |
|---|---|
| Medicare Enrollment ID | O20240102001073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598546764 | NPI | - | NPPES |
| Provider Name | Mark R Rose |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427055102 PECOS PAC ID: 8729163233 Enrollment ID: I20080307000499 |
| Provider Name | Chinwe J Okafor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184869950 PECOS PAC ID: 3476686486 Enrollment ID: I20100728000161 |
| Provider Name | Damodharan Vaidyanathan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1376753087 PECOS PAC ID: 7719040278 Enrollment ID: I20100802000849 |
| Provider Name | Olayiwola Abdullateef Salmon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457585739 PECOS PAC ID: 7012062029 Enrollment ID: I20101124000352 |
| Provider Name | Anju Varanasi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407070162 PECOS PAC ID: 3971603622 Enrollment ID: I20121023000803 |
| Provider Name | Justin L Steward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619221934 PECOS PAC ID: 0547408668 Enrollment ID: I20130601000011 |
| Provider Name | Aaron Patrick Best |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013954320 PECOS PAC ID: 2668440918 Enrollment ID: I20140125000112 |
| Provider Name | Lynn Ann Crocker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558357947 PECOS PAC ID: 3577548791 Enrollment ID: I20140306000430 |
| Provider Name | Khris Randy Ramdeen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861652471 PECOS PAC ID: 2668628793 Enrollment ID: I20150604000079 |
| Provider Name | Michael E Sonier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912341579 PECOS PAC ID: 1850534173 Enrollment ID: I20161017000531 |
| Provider Name | Folashade M Bernard |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669817136 PECOS PAC ID: 6608178652 Enrollment ID: I20161114001742 |
| Provider Name | Olatunji Sarafadeen Olaoye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962668970 PECOS PAC ID: 2961690839 Enrollment ID: I20170201000371 |
| Provider Name | Sandra Tarapasade |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326461021 PECOS PAC ID: 9931482452 Enrollment ID: I20170208000223 |
| Provider Name | Belinda G Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356709810 PECOS PAC ID: 7416231774 Enrollment ID: I20170306000205 |
| Provider Name | Ruchita Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083034771 PECOS PAC ID: 1557683174 Enrollment ID: I20171010000972 |
| Provider Name | Rajender Agarwal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659687788 PECOS PAC ID: 8224270939 Enrollment ID: I20171019002975 |
| Provider Name | Chuang Xu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134540024 PECOS PAC ID: 7810276227 Enrollment ID: I20180122001711 |
| Provider Name | Herman Laroy Toliver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841481041 PECOS PAC ID: 3971756271 Enrollment ID: I20180208002735 |
| Provider Name | Danial A Soleja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770970451 PECOS PAC ID: 6002163631 Enrollment ID: I20180727000341 |
| Provider Name | Juliet Chinwe Nwokedi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235394198 PECOS PAC ID: 3173801487 Enrollment ID: I20180905003510 |
| Provider Name | Josef Atta Chemtob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376562132 PECOS PAC ID: 6002813938 Enrollment ID: I20181206000642 |
| Provider Name | Sheriffdeen Olalekan Ilo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184910382 PECOS PAC ID: 6305088766 Enrollment ID: I20190206002702 |
| Provider Name | Hesham Mohamed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174973937 PECOS PAC ID: 8123450038 Enrollment ID: I20191114002299 |
| Provider Name | Maliha Beg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790171643 PECOS PAC ID: 2668778929 Enrollment ID: I20200123000456 |
| Provider Name | Patrick Imonitie Igharosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336675032 PECOS PAC ID: 3678818663 Enrollment ID: I20200813003640 |
| Provider Name | Emelia Yeboah-sekyere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356980502 PECOS PAC ID: 6507278553 Enrollment ID: I20201215002652 |
| Provider Name | Hirenkumar Damjighai Italia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487815387 PECOS PAC ID: 7012164718 Enrollment ID: I20210112000942 |
| Provider Name | Joshua D Sifuentes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629425913 PECOS PAC ID: 7517251861 Enrollment ID: I20210217002681 |
| Provider Name | Anna M Gulik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801067590 PECOS PAC ID: 7416015250 Enrollment ID: I20210218000555 |
| Provider Name | Akaolisa Eziokwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265884100 PECOS PAC ID: 0547553570 Enrollment ID: I20210819002211 |
| Provider Name | Daniel S Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114493756 PECOS PAC ID: 1355686007 Enrollment ID: I20210921000574 |
| Provider Name | Lenita Hinkle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477948636 PECOS PAC ID: 0648599647 Enrollment ID: I20220203001218 |
| Provider Name | Akachi Azubuike |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467867762 PECOS PAC ID: 0941511471 Enrollment ID: I20220520001524 |
| Provider Name | Rama Krishna Yalamanchili |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487064895 PECOS PAC ID: 8426350976 Enrollment ID: I20220613003088 |
| Provider Name | Ernai Hernandez Sanchez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184115347 PECOS PAC ID: 4486046000 Enrollment ID: I20220706001296 |
| Provider Name | Linda Ekwealor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205399631 PECOS PAC ID: 4688917313 Enrollment ID: I20220926001894 |
| Provider Name | Muhammad Junaid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629428826 PECOS PAC ID: 6305197674 Enrollment ID: I20230718003693 |
| Provider Name | Amir Habibollah Ausef |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528046315 PECOS PAC ID: 3870517758 Enrollment ID: I20230814002096 |
| Provider Name | Chan Myae |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932717121 PECOS PAC ID: 3375961311 Enrollment ID: I20230828003952 |
| Provider Name | Byron Kendall Herpich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164629515 PECOS PAC ID: 6002931839 Enrollment ID: I20230907002146 |
| Provider Name | Thomas Kazecki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447677810 PECOS PAC ID: 2365744869 Enrollment ID: I20230913001924 |
| Provider Name | Justine Henao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902808645 PECOS PAC ID: 2769458561 Enrollment ID: I20230915000386 |
| Provider Name | Angel Rivera Castro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942721766 PECOS PAC ID: 5991128993 Enrollment ID: I20230919000643 |
| Provider Name | Urooj Shahid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780201152 PECOS PAC ID: 4981059755 Enrollment ID: I20231013002204 |
| Provider Name | Qasim Mahboob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548642127 PECOS PAC ID: 3678825718 Enrollment ID: I20231025002974 |
| Provider Name | Usha Bangalore Krishnappa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821300278 PECOS PAC ID: 8325282213 Enrollment ID: I20231026000810 |
| Provider Name | Catalin Perju |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578994984 PECOS PAC ID: 1658598552 Enrollment ID: I20240119002698 |
| Provider Name | Sudheer Konduru |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538727409 PECOS PAC ID: 1254708886 Enrollment ID: I20240219000846 |
| Provider Name | Neelam Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427021435 PECOS PAC ID: 0547274433 Enrollment ID: I20240301003738 |
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