| Jordan Physician Associates, Inc. | |
|
275 Sandwich St Plymouth MA 02360-2183 | |
| (508) 830-2401 | |
| (508) 830-1131 |
| Full Name | Jordan Physician Associates, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 275 Sandwich St, Plymouth, Massachusetts |
| Authorized Official Name and Position | Kevin Coughlin (PRESIDENT) |
| Authorized Official Contact | 5087462000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jordan Physician Associates, Inc. 36 Cordage Park Cir Suite 317 Plymouth MA 02360-7331 Ph: (508) 830-2428 | Jordan Physician Associates, Inc. 275 Sandwich St Plymouth MA 02360-2183 Ph: (508) 830-2401 |
| NPI Number | 1538145131 |
|---|---|
| Provider Enumeration Date | 12/16/2005 |
| Last Update Date | 12/15/2021 |
| Medicare PECOS PAC ID | 1254321086 |
|---|---|
| Medicare Enrollment ID | O20040514000167 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538145131 | NPI | - | NPPES |
| 110072193A | Medicaid | MA | |
| M15987 | Other | MA | BCBSMA |
| AA229234 | Other | MA | HARVARD PILGRIM HEALTHCARE |
| 602198 | Other | MA | TUFTS HEALTH PLAN |
| Provider Name | Dawn A Naylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871560367 PECOS PAC ID: 4284522491 Enrollment ID: I20040309000836 |
| Provider Name | Matthew Tierney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134105646 PECOS PAC ID: 1052308558 Enrollment ID: I20040427001304 |
| Provider Name | Donna M Golden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427116755 PECOS PAC ID: 8224015748 Enrollment ID: I20040702000139 |
| Provider Name | Marc L Schermerhorn |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1356391312 PECOS PAC ID: 2264412154 Enrollment ID: I20040721001494 |
| Provider Name | Alejandro Y Mendoza |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326086638 PECOS PAC ID: 2961482906 Enrollment ID: I20040727000370 |
| Provider Name | Bruce P Berlanstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962499277 PECOS PAC ID: 6002887197 Enrollment ID: I20040803000655 |
| Provider Name | Anit T Patel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1982682860 PECOS PAC ID: 4082685805 Enrollment ID: I20040804001544 |
| Provider Name | Raymond B Khawand |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952382558 PECOS PAC ID: 0749251429 Enrollment ID: I20040804001969 |
| Provider Name | Scott D James |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1922084458 PECOS PAC ID: 7719959048 Enrollment ID: I20040809000292 |
| Provider Name | Michelle M North |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669453981 PECOS PAC ID: 9133192644 Enrollment ID: I20040813000566 |
| Provider Name | Syed T Ali |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396733713 PECOS PAC ID: 6800786989 Enrollment ID: I20040816000634 |
| Provider Name | Debra White |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1457339335 PECOS PAC ID: 8224003587 Enrollment ID: I20040831000070 |
| Provider Name | Sushil K Singh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912955022 PECOS PAC ID: 4082681044 Enrollment ID: I20040910000699 |
| Provider Name | Michael G Mclaughlin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417929886 PECOS PAC ID: 8820065592 Enrollment ID: I20040913000725 |
| Provider Name | Susan James |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538276175 PECOS PAC ID: 6800863515 Enrollment ID: I20040913000977 |
| Provider Name | Jodi D Hoffman |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1871605360 PECOS PAC ID: 8527029321 Enrollment ID: I20041025000934 |
| Provider Name | Sherrie A Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770561953 PECOS PAC ID: 3870557622 Enrollment ID: I20041112000302 |
| Provider Name | Inad Joseph Bahhady |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285602052 PECOS PAC ID: 4688639263 Enrollment ID: I20041123000341 |
| Provider Name | Jay M Daly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083691240 PECOS PAC ID: 3173588712 Enrollment ID: I20041209000871 |
| Provider Name | Christian T Campos |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1235238882 PECOS PAC ID: 0446218697 Enrollment ID: I20041221000065 |
| Provider Name | Deborah Kylander |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528046372 PECOS PAC ID: 0547215493 Enrollment ID: I20050314001012 |
| Provider Name | Jonathan M Russo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184681892 PECOS PAC ID: 9335195064 Enrollment ID: I20050325000392 |
| Provider Name | Bernard J Durante |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1164400040 PECOS PAC ID: 8820064769 Enrollment ID: I20050331000184 |
| Provider Name | Giovanni A Ferrante |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1104818103 PECOS PAC ID: 2466409693 Enrollment ID: I20050331000273 |
| Provider Name | Lorenz B Cueni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265436208 PECOS PAC ID: 3971550740 Enrollment ID: I20050404000807 |
| Provider Name | Thomas A Browning |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528134210 PECOS PAC ID: 2567419229 Enrollment ID: I20050405000507 |
| Provider Name | Donald E Cutlip |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396777827 PECOS PAC ID: 4880632504 Enrollment ID: I20050421001393 |
| Provider Name | Robert A Scarlatelli |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205876737 PECOS PAC ID: 8527007756 Enrollment ID: I20050427001094 |
| Provider Name | Soroya M Rahaman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669448049 PECOS PAC ID: 7810964129 Enrollment ID: I20050503001184 |
| Provider Name | Todd W Sarge |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215969746 PECOS PAC ID: 1355387838 Enrollment ID: I20050706000866 |
| Provider Name | Wenliang Chen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275524456 PECOS PAC ID: 9335175710 Enrollment ID: I20050718000244 |
| Provider Name | Constance J Clarke |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1760490544 PECOS PAC ID: 4688602014 Enrollment ID: I20050727001141 |
| Provider Name | David M Kelly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184618910 PECOS PAC ID: 6204809817 Enrollment ID: I20050728000928 |
| Provider Name | Daniela Prodanovic |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1104859628 PECOS PAC ID: 9234167065 Enrollment ID: I20050802000510 |
| Provider Name | Thomas D Caughey |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1063419398 PECOS PAC ID: 9032147640 Enrollment ID: I20050803000609 |
| Provider Name | Stephan G Muhlebach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710965157 PECOS PAC ID: 4486685138 Enrollment ID: I20050823000613 |
| Provider Name | Maureen A Doyle |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1700804119 PECOS PAC ID: 8628000445 Enrollment ID: I20050901000136 |
| Provider Name | Eric E Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184610958 PECOS PAC ID: 4880503192 Enrollment ID: I20050926000261 |
| Provider Name | Kevin R Leblanc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770561037 PECOS PAC ID: 4981639556 Enrollment ID: I20051003000323 |
| Provider Name | Ian C Paskowski |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1497719280 PECOS PAC ID: 9032134366 Enrollment ID: I20051006000106 |
| Provider Name | Robyn A Sachs |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881662773 PECOS PAC ID: 4082674056 Enrollment ID: I20051128000702 |
| Provider Name | Lois M Bartels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811078868 PECOS PAC ID: 0547284614 Enrollment ID: I20060117000806 |
| Provider Name | Diane M Downing |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740331974 PECOS PAC ID: 6507871407 Enrollment ID: I20060214000553 |
| Provider Name | Hope D Bouldin Currier |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1336290550 PECOS PAC ID: 5193730737 Enrollment ID: I20060217000396 |
| Provider Name | Melanie A Baker |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1598894719 PECOS PAC ID: 7719993039 Enrollment ID: I20060223000676 |
| Provider Name | Agnes Densmore |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1033260252 PECOS PAC ID: 9830106442 Enrollment ID: I20060307000443 |
| Provider Name | Duane S Pinto |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1275521130 PECOS PAC ID: 8123036019 Enrollment ID: I20060404000537 |
| Provider Name | Steve G Massaquoi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811934813 PECOS PAC ID: 9436168143 Enrollment ID: I20060407000188 |
| Provider Name | David R Betteridge |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679553184 PECOS PAC ID: 0042229544 Enrollment ID: I20060411000650 |
| Provider Name | Jean-pierre Michel Geagea |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104884022 PECOS PAC ID: 7719885763 Enrollment ID: I20060419000552 |
| Provider Name | Pedro Bonilla |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215951934 PECOS PAC ID: 0244240927 Enrollment ID: I20060425000657 |
| Provider Name | Donna P Principato Sawyer |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1801867858 PECOS PAC ID: 6901816289 Enrollment ID: I20060502000041 |
| Provider Name | Roy Stillerman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1225077589 PECOS PAC ID: 5597664649 Enrollment ID: I20060504000606 |
| Provider Name | Lucyna Z Czarnota Dolliver |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982632006 PECOS PAC ID: 3678585205 Enrollment ID: I20060626000126 |
| Provider Name | Stephen E Nicolson |
|---|---|
| Provider Type | Practitioner - Geriatric Psychiatry |
| Provider Identifiers | NPI Number: 1497734461 PECOS PAC ID: 4082632898 Enrollment ID: I20060707000139 |
| Provider Name | Kelley J Travers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144252354 PECOS PAC ID: 7214930395 Enrollment ID: I20060809000488 |
| Provider Name | Laurence J Ufford |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063468171 PECOS PAC ID: 9436152337 Enrollment ID: I20060815000213 |
| Provider Name | Gregory V Mara |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1750425674 PECOS PAC ID: 7012010390 Enrollment ID: I20070306000552 |
| Provider Name | Mark P Finley |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1285766873 PECOS PAC ID: 3173629474 Enrollment ID: I20070503000048 |
| Provider Name | Glen D Garson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699746214 PECOS PAC ID: 4284662123 Enrollment ID: I20080205000130 |
| Provider Name | Louise Racine Bastarache |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1619975208 PECOS PAC ID: 1052357183 Enrollment ID: I20080208000524 |
| Provider Name | Mohammad A Rana |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861507956 PECOS PAC ID: 9335154582 Enrollment ID: I20080218000437 |
| Provider Name | Stephanie L Marglin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1124110556 PECOS PAC ID: 6204912538 Enrollment ID: I20080326000620 |
| Provider Name | Talia Fenoglietto |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1568630531 PECOS PAC ID: 5890874879 Enrollment ID: I20080501000387 |
| Provider Name | Mark C Wyers |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811909740 PECOS PAC ID: 7911801691 Enrollment ID: I20080602000076 |
| Provider Name | Padma Balasubramanian |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1649233933 PECOS PAC ID: 6305916388 Enrollment ID: I20080603000202 |
| Provider Name | Allen D Hamdan |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1164489217 PECOS PAC ID: 3779658596 Enrollment ID: I20080813000611 |
| Provider Name | Rebecca M Weaver |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1053312843 PECOS PAC ID: 7315014800 Enrollment ID: I20080925000199 |
| Provider Name | Richard M Hebert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801050190 PECOS PAC ID: 5890863468 Enrollment ID: I20081009000405 |
| Provider Name | Alexey Knyazhitskiy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942484092 PECOS PAC ID: 4183783335 Enrollment ID: I20081104000114 |
| Provider Name | Martha Fox Segal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619127453 PECOS PAC ID: 5597824300 Enrollment ID: I20081110000048 |
| Provider Name | Katherine K Parsons |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992833065 PECOS PAC ID: 3274694997 Enrollment ID: I20081212000236 |
| Provider Name | Eric A Osborn |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548445240 PECOS PAC ID: 0749346229 Enrollment ID: I20090309000144 |
| Provider Name | Umer Sayeed Shah |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1396966206 PECOS PAC ID: 3375446248 Enrollment ID: I20090622000665 |
| Provider Name | Daniel J Canaday |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1427042266 PECOS PAC ID: 4688725625 Enrollment ID: I20090702000121 |
| Provider Name | Mathews Thomas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1689790586 PECOS PAC ID: 1456404730 Enrollment ID: I20090804000451 |
| Provider Name | Justin L Massengale |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1003096736 PECOS PAC ID: 2769537042 Enrollment ID: I20090910000316 |
| Provider Name | Alex A Teixeira |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1700819224 PECOS PAC ID: 9931258746 Enrollment ID: I20100526000695 |
| Provider Name | Linda Mason |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518132356 PECOS PAC ID: 3274662366 Enrollment ID: I20100528000049 |
| Provider Name | Nathaniel G Clark |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1386687234 PECOS PAC ID: 7012949548 Enrollment ID: I20100627000014 |
| Provider Name | Russell P Atkin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871729178 PECOS PAC ID: 3577617836 Enrollment ID: I20101020000819 |
| Provider Name | Kathryn P Atkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275863201 PECOS PAC ID: 8224221163 Enrollment ID: I20101022001194 |
| Provider Name | Shane C Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689637902 PECOS PAC ID: 0345434551 Enrollment ID: I20101102000457 |
| Provider Name | Arthi Thangaraj |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1699939348 PECOS PAC ID: 1850577107 Enrollment ID: I20110520000502 |
| Provider Name | Caitlin J Marchenko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104114792 PECOS PAC ID: 0345410296 Enrollment ID: I20110831000738 |
| Provider Name | Erika Mello Souza |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245437342 PECOS PAC ID: 1759554322 Enrollment ID: I20111026000409 |
| Provider Name | Annika E Krystyna |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1437365319 PECOS PAC ID: 8022281195 Enrollment ID: I20111105000022 |
| Provider Name | Samuel K Staula |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1679883219 PECOS PAC ID: 2062685050 Enrollment ID: I20111108000559 |
| Provider Name | Joanna N Capparella |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538131479 PECOS PAC ID: 2769656057 Enrollment ID: I20111123000156 |
| Provider Name | Irina L Gurevich |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1013995992 PECOS PAC ID: 5890960793 Enrollment ID: I20111205000254 |
| Provider Name | James M Koomey |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1477531358 PECOS PAC ID: 0749455160 Enrollment ID: I20111214000430 |
| Provider Name | James M Galvin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417937939 PECOS PAC ID: 3971663451 Enrollment ID: I20111219000238 |
| Provider Name | Sallie Zanoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841506599 PECOS PAC ID: 1355517731 Enrollment ID: I20120106000194 |
| Provider Name | John M M Connell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528194156 PECOS PAC ID: 6800063215 Enrollment ID: I20120125000171 |
| Provider Name | Eugene Valsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255398475 PECOS PAC ID: 3173784998 Enrollment ID: I20120420000584 |
| Provider Name | Kristen L Staula |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1063712305 PECOS PAC ID: 4486801339 Enrollment ID: I20120828000414 |
| Provider Name | Colleen W Fine |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629244793 PECOS PAC ID: 4486805462 Enrollment ID: I20121126000150 |
| Provider Name | Christian H Corwin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427006097 PECOS PAC ID: 0345492773 Enrollment ID: I20121212000145 |
| Provider Name | John W Doney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861768178 PECOS PAC ID: 4880847300 Enrollment ID: I20130114000124 |
| Provider Name | Stephanie I Cody |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205098522 PECOS PAC ID: 6204986151 Enrollment ID: I20130311000311 |
| Provider Name | Lauren F Collier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720336977 PECOS PAC ID: 9739324419 Enrollment ID: I20130329000063 |
| Provider Name | Raul J Guzman |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1083713416 PECOS PAC ID: 8527116805 Enrollment ID: I20130403000201 |
| Provider Name | Adeeb Al-quthami |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245483965 PECOS PAC ID: 2567609100 Enrollment ID: I20130520000036 |
| Provider Name | Ying Geng |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174898118 PECOS PAC ID: 4183865439 Enrollment ID: I20130729000642 |
| Provider Name | Carrie Consalvi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952743841 PECOS PAC ID: 9133363161 Enrollment ID: I20130913000040 |
| Provider Name | Saba Khokhar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518133602 PECOS PAC ID: 3971656547 Enrollment ID: I20131206000345 |
| Provider Name | Sarah Van Der Veen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942478417 PECOS PAC ID: 0244468577 Enrollment ID: I20140114000415 |
| Provider Name | Carolyn M Early |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548516222 PECOS PAC ID: 3577793082 Enrollment ID: I20140303000323 |
| Provider Name | Erin L Cataen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912328675 PECOS PAC ID: 8628209426 Enrollment ID: I20140319002195 |
| Provider Name | Anne Marie Mingolelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063530970 PECOS PAC ID: 6204068158 Enrollment ID: I20140409000026 |
| Provider Name | Roy Sriwattanakomen |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1942594882 PECOS PAC ID: 2769607258 Enrollment ID: I20140625000386 |
| Provider Name | Osman Faheem |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1801073572 PECOS PAC ID: 7517012065 Enrollment ID: I20140729000291 |
| Provider Name | Regina J Chandler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639587611 PECOS PAC ID: 2163642463 Enrollment ID: I20141009000775 |
| Provider Name | Daria Marie Hanson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992865901 PECOS PAC ID: 8123012291 Enrollment ID: I20141124001752 |
| Provider Name | Akiva Leibowitz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215366935 PECOS PAC ID: 1355664707 Enrollment ID: I20141216001980 |
| Provider Name | Wendy S Dubin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285868398 PECOS PAC ID: 0244554525 Enrollment ID: I20150114001370 |
| Provider Name | Somnath Bose |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275775546 PECOS PAC ID: 0446574685 Enrollment ID: I20150119000547 |
| Provider Name | Brian Ogara |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609187608 PECOS PAC ID: 4385969252 Enrollment ID: I20150217001869 |
| Provider Name | John R Pettinato |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730277914 PECOS PAC ID: 0547284663 Enrollment ID: I20150407001161 |
| Provider Name | Amal A Kimawi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225323660 PECOS PAC ID: 3072814417 Enrollment ID: I20151209001074 |
| Provider Name | Junaid Y Malek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487769162 PECOS PAC ID: 1658538723 Enrollment ID: I20160302001744 |
| Provider Name | Reza Fazel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881795730 PECOS PAC ID: 9234106188 Enrollment ID: I20160321002075 |
| Provider Name | Edwin R Raffi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730444274 PECOS PAC ID: 5395044697 Enrollment ID: I20160506001777 |
| Provider Name | Stephanie J Curtis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548652233 PECOS PAC ID: 4082905633 Enrollment ID: I20160629000617 |
| Provider Name | Mary E Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245451814 PECOS PAC ID: 5799078200 Enrollment ID: I20160721000516 |
| Provider Name | Gale V Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104098508 PECOS PAC ID: 5991028318 Enrollment ID: I20161012000605 |
| Provider Name | Peter C Cohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215482518 PECOS PAC ID: 4587943949 Enrollment ID: I20161108001500 |
| Provider Name | Laura Francoeur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649671876 PECOS PAC ID: 6608194535 Enrollment ID: I20161125000082 |
| Provider Name | Cynthia M Lopes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245781400 PECOS PAC ID: 9032499413 Enrollment ID: I20161130001150 |
| Provider Name | Sarah Kugler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821440835 PECOS PAC ID: 5193005387 Enrollment ID: I20161205001542 |
| Provider Name | Elizabeth A Gruber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487041844 PECOS PAC ID: 5395027080 Enrollment ID: I20170112001054 |
| Provider Name | Martin B Abrams |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1073507851 PECOS PAC ID: 4789583170 Enrollment ID: I20170503002025 |
| Provider Name | Madhu Siddeswarappa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083948384 PECOS PAC ID: 3072835149 Enrollment ID: I20170616002129 |
| Provider Name | Robert E Gaudet |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1063706331 PECOS PAC ID: 0446559215 Enrollment ID: I20170622000190 |
| Provider Name | Jill Whelan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477848497 PECOS PAC ID: 9032489588 Enrollment ID: I20170717002399 |
| Provider Name | Diane White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588100796 PECOS PAC ID: 9739459785 Enrollment ID: I20170724002810 |
| Provider Name | Jessica Lawrence |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235591363 PECOS PAC ID: 4880993104 Enrollment ID: I20171006001406 |
| Provider Name | Maysaa El Zoghbi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043528250 PECOS PAC ID: 3577820984 Enrollment ID: I20171120001570 |
| Provider Name | Dhanviney Verma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932528668 PECOS PAC ID: 1355560772 Enrollment ID: I20171228001035 |
| Provider Name | Souheil Adra |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700049996 PECOS PAC ID: 5395974588 Enrollment ID: I20180119001169 |
| Provider Name | Daniel Patrick Walsh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841630407 PECOS PAC ID: 1355603747 Enrollment ID: I20180323000229 |
| Provider Name | Brian J Morse |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558388389 PECOS PAC ID: 2163425646 Enrollment ID: I20180717003282 |
| Provider Name | Vikram Rangan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124317235 PECOS PAC ID: 1052544079 Enrollment ID: I20180720000023 |
| Provider Name | Scott L Colello |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1225517733 PECOS PAC ID: 0143571562 Enrollment ID: I20180925001419 |
| Provider Name | Kushak Suchdev |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689806846 PECOS PAC ID: 0941515100 Enrollment ID: I20181127003105 |
| Provider Name | Sarah R Federoff |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1952883274 PECOS PAC ID: 2365786282 Enrollment ID: I20181204002492 |
| Provider Name | Edward Walter Malin |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1871751180 PECOS PAC ID: 6608034129 Enrollment ID: I20181210000901 |
| Provider Name | Vincent G Champion |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972728814 PECOS PAC ID: 6406001411 Enrollment ID: I20190114000686 |
| Provider Name | Rona Spector |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1831449909 PECOS PAC ID: 1759627441 Enrollment ID: I20190117001275 |
| Provider Name | Mackenzie K Miller |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1679037204 PECOS PAC ID: 2466792643 Enrollment ID: I20190326001595 |
| Provider Name | Abigail Dawn Mcdonough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881160562 PECOS PAC ID: 0446591465 Enrollment ID: I20190401000665 |
| Provider Name | Brittany E Ross |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1407314503 PECOS PAC ID: 8224379060 Enrollment ID: I20190404001824 |
| Provider Name | Molly M Valente |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699239129 PECOS PAC ID: 6608117445 Enrollment ID: I20190404002226 |
| Provider Name | Jessica Dacius |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679025258 PECOS PAC ID: 9739445941 Enrollment ID: I20190501002848 |
| Provider Name | Mark Tuttle |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194086900 PECOS PAC ID: 8123317351 Enrollment ID: I20190503001555 |
| Provider Name | Haley Govoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679031959 PECOS PAC ID: 2466785910 Enrollment ID: I20190614001880 |
| Provider Name | Amy E Pratt |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1538506100 PECOS PAC ID: 5193948594 Enrollment ID: I20190920000718 |
| Provider Name | Jessica Rose Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174006506 PECOS PAC ID: 6800126061 Enrollment ID: I20191001002658 |
| Provider Name | Isabelle H Eustice |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821021080 PECOS PAC ID: 1052446093 Enrollment ID: I20200114003612 |
| Provider Name | Bonnie Chung |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1487284972 PECOS PAC ID: 8123456837 Enrollment ID: I20200311002310 |
| Provider Name | Wally Omar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063823425 PECOS PAC ID: 9335471903 Enrollment ID: I20200526002639 |
| Provider Name | Ryan M Gardner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588195333 PECOS PAC ID: 4587080981 Enrollment ID: I20200817000830 |
| Provider Name | Samantha Mcvay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891158689 PECOS PAC ID: 1456645480 Enrollment ID: I20200824002698 |
| Provider Name | Brijal Desai |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1811282767 PECOS PAC ID: 2567743693 Enrollment ID: I20200908002694 |
| Provider Name | Kate Laura Latrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033743182 PECOS PAC ID: 2860810637 Enrollment ID: I20200910000766 |
| Provider Name | Michelle Dana Marella |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215290176 PECOS PAC ID: 0143509836 Enrollment ID: I20201016002349 |
| Provider Name | Angela Gaynor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639778996 PECOS PAC ID: 6406267509 Enrollment ID: I20201120002043 |
| Provider Name | Ritu Winders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861092793 PECOS PAC ID: 8224440698 Enrollment ID: I20201209002629 |
| Provider Name | Katelyn Tulp Mcnair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841838935 PECOS PAC ID: 5698188076 Enrollment ID: I20201231001401 |
| Provider Name | Ma Dolores Del Castillo |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1952741209 PECOS PAC ID: 2365671484 Enrollment ID: I20210113000318 |
| Provider Name | Erin J Senay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306477443 PECOS PAC ID: 1456764182 Enrollment ID: I20210119001336 |
| Provider Name | Alanna Rose Atkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497356893 PECOS PAC ID: 9739596768 Enrollment ID: I20210318001245 |
| Provider Name | Jazz Lesoleil Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255949939 PECOS PAC ID: 1355750324 Enrollment ID: I20210503001919 |
| Provider Name | Steven Milman |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1588821078 PECOS PAC ID: 4385799964 Enrollment ID: I20210507000331 |
| Provider Name | Lindsey Irene Schoener |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649730698 PECOS PAC ID: 4688083074 Enrollment ID: I20210517000025 |
| Provider Name | Kathleen Bentley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114513694 PECOS PAC ID: 9830598622 Enrollment ID: I20210527001552 |
| Provider Name | Angela Landerholm |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639605439 PECOS PAC ID: 6103157201 Enrollment ID: I20210617000787 |
| Provider Name | Philip Chan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023460482 PECOS PAC ID: 8426343625 Enrollment ID: I20210715001163 |
| Provider Name | Derek Michael Chicarilli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639532351 PECOS PAC ID: 6901191501 Enrollment ID: I20210723000374 |
| Provider Name | Mehida Rojas-alexandre |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083118293 PECOS PAC ID: 0446500235 Enrollment ID: I20210723001378 |
| Provider Name | Robert M Mayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154753457 PECOS PAC ID: 4082928320 Enrollment ID: I20210811001311 |
| Provider Name | Cortney Louise Ensor |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215512850 PECOS PAC ID: 2961806971 Enrollment ID: I20210812000195 |
| Provider Name | Danilo Rojas-velasquez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578094173 PECOS PAC ID: 4688947724 Enrollment ID: I20210816002250 |
| Provider Name | Alexander Friedman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205332079 PECOS PAC ID: 4688923287 Enrollment ID: I20210819003565 |
| Provider Name | Abigail Elizabeth Deangelis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740852110 PECOS PAC ID: 3678978988 Enrollment ID: I20210825001835 |
| Provider Name | Robert J Gapinski |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1407201817 PECOS PAC ID: 9537433503 Enrollment ID: I20210907001272 |
| Provider Name | Ghusn Al Sideiri |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1184243792 PECOS PAC ID: 9537590880 Enrollment ID: I20210921002805 |
| Provider Name | Itrat Zehra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275200271 PECOS PAC ID: 6608273966 Enrollment ID: I20210929001553 |
| Provider Name | Taylor Marie Leininger |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1356934236 PECOS PAC ID: 8325446701 Enrollment ID: I20211015000804 |
| Provider Name | Erin Marie Shekane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306508684 PECOS PAC ID: 6305235581 Enrollment ID: I20211109001747 |
| Provider Name | Stephanie Haden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922761238 PECOS PAC ID: 4183015142 Enrollment ID: I20211229002055 |
| Provider Name | Mairead Christina Wargovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487318994 PECOS PAC ID: 4082000963 Enrollment ID: I20220331002422 |
| Provider Name | Stanley Kim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801245535 PECOS PAC ID: 5193111904 Enrollment ID: I20220404002276 |
| Provider Name | Iskandar Barakat |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356624779 PECOS PAC ID: 4082978242 Enrollment ID: I20220517002608 |
| Provider Name | Charlie Alexandra Ball |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1689321788 PECOS PAC ID: 0840678207 Enrollment ID: I20220526000909 |
| Provider Name | Betsa Parsai Salehi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841642576 PECOS PAC ID: 0244610194 Enrollment ID: I20220708002643 |
| Provider Name | Jessica Lacroix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841727005 PECOS PAC ID: 6204211766 Enrollment ID: I20220920000485 |
| Provider Name | Nicole Barossi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316243322 PECOS PAC ID: 6204012149 Enrollment ID: I20221224000172 |
| Provider Name | Asad Ikram |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992219216 PECOS PAC ID: 0446508881 Enrollment ID: I20221227001184 |
| Provider Name | Samuel Russell Barnard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508588823 PECOS PAC ID: 3375914682 Enrollment ID: I20230125000588 |
| Provider Name | Shaheen Emmanuel Lakhan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649585944 PECOS PAC ID: 4082937255 Enrollment ID: I20230216002563 |
| Provider Name | Justin Lunderberg |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245725563 PECOS PAC ID: 6002163896 Enrollment ID: I20230502000839 |
| Provider Name | Theresa Feng |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891299202 PECOS PAC ID: 9335505304 Enrollment ID: I20230517000806 |
| Provider Name | Heather Hogan Foshey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063111714 PECOS PAC ID: 2567829823 Enrollment ID: I20230601002428 |
| Provider Name | Serge Korjian |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1235586850 PECOS PAC ID: 1951696145 Enrollment ID: I20230609002691 |
| Provider Name | Sean Phillip Curran |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235635491 PECOS PAC ID: 7719314483 Enrollment ID: I20230627002363 |
| Provider Name | Omkar U Vaidya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518117670 PECOS PAC ID: 0547483083 Enrollment ID: I20230629002383 |
| Provider Name | Kathryn A Schlosser |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629462833 PECOS PAC ID: 5395053391 Enrollment ID: I20230830003783 |
| Provider Name | Denetra Inell Barthell |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1437931870 PECOS PAC ID: 7012364649 Enrollment ID: I20231103001030 |
| Provider Name | Mackenzie Lee Garvey |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1932989118 PECOS PAC ID: 3678920329 Enrollment ID: I20231117000088 |
| Provider Name | Andis Bala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770154494 PECOS PAC ID: 8628427242 Enrollment ID: I20231207003834 |
| Provider Name | Stephen Laski |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1295269306 PECOS PAC ID: 7113281924 Enrollment ID: I20240111003154 |
Sergio Camargo,m.d. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Long Pond Rd, Suite 205, Plymouth, MA 02360 Phone: 508-726-2284 Fax: 508-747-5027 | |
Ask Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 118 Long Pond Rd Ste 101, Plymouth, MA 02360 Phone: 781-247-5500 Fax: 781-247-5215 | |
1620 Primary Care, Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 Long Pond Rd Ste 110, Plymouth, MA 02360 Phone: 508-591-3111 Fax: 774-283-9949 | |
Digestive Disease Associates Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 47 Obery St, Ste 201, Plymouth, MA 02360 Phone: 508-747-1560 Fax: 508-747-5155 | |
Housecall Physicians, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 31 Home Depot Drive, Suite 283, Plymouth, MA 02360 Phone: 774-343-2432 | |
Plymouth Carver Primary Care, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 110 Long Pond Rd, Suite 212, Plymouth, MA 02360 Phone: 508-746-7272 | |
Plymouth Carver Primary Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 110 Long Pond Rd, Suite 212, Plymouth, MA 02360 Phone: 508-746-7272 Fax: 508-746-0104 |