| Kennedy Krieger Associates | |
|
707 N Broadway Baltimore MD 21205-1832 | |
| (443) 923-1070 | |
| (443) 923-1875 |
| Full Name | Kennedy Krieger Associates |
|---|---|
| Speciality | Pediatrics |
| Location | 707 N Broadway, Baltimore, Maryland |
| Authorized Official Name and Position | Michael J Neuman (VICE PRESIDENT FINANCE) |
| Authorized Official Contact | 4439231810 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennedy Krieger Associates Po Box 744865 Atlanta GA 30374-4865 Ph: (443) 923-1886 | Kennedy Krieger Associates 707 N Broadway Baltimore MD 21205-1832 Ph: (443) 923-1070 |
| NPI Number | 1871515783 |
|---|---|
| Provider Enumeration Date | 07/24/2006 |
| Last Update Date | 04/03/2020 |
| Medicare PECOS PAC ID | 1759280597 |
|---|---|
| Medicare Enrollment ID | O20031231000300 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871515783 | NPI | - | NPPES |
| 168641100 | Medicaid | MD | |
| K631 | Other | MD | BLUE CROSS MARYLAND |
| F158 | Other | MD | BLUE CROSS FEDERAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
| 208000000X | Pediatrics | (* (Not Available)) | Primary |
| Provider Name | Lee E Wachtel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205864873 PECOS PAC ID: 2860391604 Enrollment ID: I20031231000350 |
| Provider Name | Carmelo Cuffari |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336184225 PECOS PAC ID: 4082515788 Enrollment ID: I20040115001092 |
| Provider Name | Maria M Oliva-hemker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306890801 PECOS PAC ID: 8527057546 Enrollment ID: I20040506000926 |
| Provider Name | Kristen Danzo Venuti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861437675 PECOS PAC ID: 8325020951 Enrollment ID: I20040607000302 |
| Provider Name | Mary L. Leppert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720136344 PECOS PAC ID: 9739168121 Enrollment ID: I20040719000826 |
| Provider Name | Elise Reinhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174687677 PECOS PAC ID: 3971582156 Enrollment ID: I20040720000696 |
| Provider Name | Susheel Patil |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1477500403 PECOS PAC ID: 1658334933 Enrollment ID: I20041108000728 |
| Provider Name | Paul Nyquist |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467408351 PECOS PAC ID: 5092772665 Enrollment ID: I20041215000352 |
| Provider Name | Emily L Germain-lee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619921046 PECOS PAC ID: 5698733194 Enrollment ID: I20041230000274 |
| Provider Name | Cristina L Sadowsky |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1619030749 PECOS PAC ID: 1658321278 Enrollment ID: I20050131000872 |
| Provider Name | Dejan B Budimirovic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851455380 PECOS PAC ID: 1557313962 Enrollment ID: I20050214000885 |
| Provider Name | Joyce N Harrison |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275583718 PECOS PAC ID: 9335186287 Enrollment ID: I20050412000752 |
| Provider Name | Carlin A Alleyne |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1376504514 PECOS PAC ID: 0244278174 Enrollment ID: I20050421000409 |
| Provider Name | Shauna P Reinblatt |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023047933 PECOS PAC ID: 0749229763 Enrollment ID: I20050428001169 |
| Provider Name | Elaine Tierney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1457382103 PECOS PAC ID: 8224078183 Enrollment ID: I20050510000731 |
| Provider Name | Roma A Vasa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194767491 PECOS PAC ID: 2466492335 Enrollment ID: I20050510000760 |
| Provider Name | Paul D Sponseller |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518994037 PECOS PAC ID: 5496797359 Enrollment ID: I20050601000719 |
| Provider Name | Joseph M Collaco |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1922144138 PECOS PAC ID: 7810939287 Enrollment ID: I20050613000373 |
| Provider Name | Anne Marie Comi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023062114 PECOS PAC ID: 1850320011 Enrollment ID: I20050808000816 |
| Provider Name | Sheryl Jefferson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811177488 PECOS PAC ID: 7315979689 Enrollment ID: I20050907001008 |
| Provider Name | William Baugher |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689637522 PECOS PAC ID: 5496772600 Enrollment ID: I20051027000419 |
| Provider Name | Marco A Grados |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316993207 PECOS PAC ID: 4789601683 Enrollment ID: I20051031000289 |
| Provider Name | Anna Maria L. Wilms Floet |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770519225 PECOS PAC ID: 0648293563 Enrollment ID: I20060106000153 |
| Provider Name | Samra S Blanchard |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1053423574 PECOS PAC ID: 8325024441 Enrollment ID: I20070207000656 |
| Provider Name | Suzanne M Prestwich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982750543 PECOS PAC ID: 8426150392 Enrollment ID: I20070223000067 |
| Provider Name | Eric Kossoff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861439721 PECOS PAC ID: 7012015225 Enrollment ID: I20070612000734 |
| Provider Name | Rajneesh Mahajan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558487355 PECOS PAC ID: 7719087675 Enrollment ID: I20070709000229 |
| Provider Name | Constance L Smith Hicks |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386866564 PECOS PAC ID: 1254422553 Enrollment ID: I20070801000526 |
| Provider Name | Janet Dean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811045495 PECOS PAC ID: 6002908688 Enrollment ID: I20070828000205 |
| Provider Name | Maria Del Carmen Lopez-arvizu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881742443 PECOS PAC ID: 9335232826 Enrollment ID: I20070829000272 |
| Provider Name | Jessica Ditto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659434736 PECOS PAC ID: 8123111549 Enrollment ID: I20070830000547 |
| Provider Name | Hilary E. Gwynn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710037247 PECOS PAC ID: 1456447556 Enrollment ID: I20071022000141 |
| Provider Name | Clifford Takemoto |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1033140777 PECOS PAC ID: 1850488735 Enrollment ID: I20071025000244 |
| Provider Name | Karen E Neal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104962976 PECOS PAC ID: 5991808388 Enrollment ID: I20071129000576 |
| Provider Name | Maria Cecilia S. Melendres |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881888592 PECOS PAC ID: 1759462336 Enrollment ID: I20080122000219 |
| Provider Name | Keith J Slifer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922127893 PECOS PAC ID: 4486738705 Enrollment ID: I20080226000365 |
| Provider Name | Seyed A Fatemi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124148341 PECOS PAC ID: 7810061603 Enrollment ID: I20080728000405 |
| Provider Name | Sybil Klaus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992848683 PECOS PAC ID: 4789780339 Enrollment ID: I20080813000117 |
| Provider Name | Leslie R Miller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518003615 PECOS PAC ID: 0648345413 Enrollment ID: I20080814000119 |
| Provider Name | Wikrom Karnsakul |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366522351 PECOS PAC ID: 1052398112 Enrollment ID: I20080909000462 |
| Provider Name | Melissa Hays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093832826 PECOS PAC ID: 7618039652 Enrollment ID: I20081229000318 |
| Provider Name | Joshua B Ewen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518013671 PECOS PAC ID: 8022173574 Enrollment ID: I20090217000144 |
| Provider Name | Stacy J Suskauer |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1528193091 PECOS PAC ID: 2365508231 Enrollment ID: I20090227000497 |
| Provider Name | Albert C Recio |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1598872814 PECOS PAC ID: 1052477791 Enrollment ID: I20090305000104 |
| Provider Name | Beth H Wieczorek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639232747 PECOS PAC ID: 7911052790 Enrollment ID: I20090831000262 |
| Provider Name | Harolyn M. Belcher |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134277718 PECOS PAC ID: 3870632581 Enrollment ID: I20091209000076 |
| Provider Name | Gerald V Raymond |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386686467 PECOS PAC ID: 8224171244 Enrollment ID: I20100129000568 |
| Provider Name | Harvey S Singer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396777108 PECOS PAC ID: 9830234830 Enrollment ID: I20100306000055 |
| Provider Name | William Thompson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326073131 PECOS PAC ID: 9335275098 Enrollment ID: I20100405000283 |
| Provider Name | George T. Capone |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962566471 PECOS PAC ID: 3274669833 Enrollment ID: I20100407000543 |
| Provider Name | David Tunkel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1447203765 PECOS PAC ID: 9739216524 Enrollment ID: I20100428000038 |
| Provider Name | Colleen M Lenz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083936397 PECOS PAC ID: 7810027018 Enrollment ID: I20100615000486 |
| Provider Name | Charles M Wiener |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1598700916 PECOS PAC ID: 7214069731 Enrollment ID: I20100720000279 |
| Provider Name | Elizabeth Cristofalo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770530859 PECOS PAC ID: 1951433390 Enrollment ID: I20100720000657 |
| Provider Name | Nancy Hutton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265485692 PECOS PAC ID: 2961535679 Enrollment ID: I20100802000818 |
| Provider Name | Eric B Levey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841234242 PECOS PAC ID: 5698968055 Enrollment ID: I20101019000456 |
| Provider Name | Doris Leung |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104013184 PECOS PAC ID: 0840487369 Enrollment ID: I20101209001173 |
| Provider Name | James Courtney Fackler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245262971 PECOS PAC ID: 3173567039 Enrollment ID: I20110107000210 |
| Provider Name | Tanjala T Gipson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528113602 PECOS PAC ID: 8628257789 Enrollment ID: I20110121000866 |
| Provider Name | Melissa K Trovato |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1366506990 PECOS PAC ID: 0840470845 Enrollment ID: I20110208000907 |
| Provider Name | Kristin W. Baranano |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063559268 PECOS PAC ID: 4183893399 Enrollment ID: I20110804000253 |
| Provider Name | Hilary Vernon |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1245380047 PECOS PAC ID: 9032382791 Enrollment ID: I20111026000107 |
| Provider Name | Alexander H Hoon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760578918 PECOS PAC ID: 1153597042 Enrollment ID: I20111227000064 |
| Provider Name | Sarah C Doerrer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730485988 PECOS PAC ID: 5092972000 Enrollment ID: I20120202000610 |
| Provider Name | Bruce Shapiro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750439477 PECOS PAC ID: 1355509365 Enrollment ID: I20120222000616 |
| Provider Name | Joyce Wong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598829186 PECOS PAC ID: 1658536792 Enrollment ID: I20120622000428 |
| Provider Name | Ryan Felling |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487851721 PECOS PAC ID: 7113183922 Enrollment ID: I20120724000131 |
| Provider Name | Alicia Dawn Cannon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316236326 PECOS PAC ID: 7618145434 Enrollment ID: I20120914000280 |
| Provider Name | Ranjit Varghese |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861700288 PECOS PAC ID: 1951550946 Enrollment ID: I20121008000325 |
| Provider Name | Mandeep S Jassal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194923458 PECOS PAC ID: 2860673761 Enrollment ID: I20121113000542 |
| Provider Name | Mihee J Bay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881814325 PECOS PAC ID: 7315190162 Enrollment ID: I20130104000085 |
| Provider Name | Karina M Yelin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598974701 PECOS PAC ID: 5496992729 Enrollment ID: I20130506000201 |
| Provider Name | Melanie Nies |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679776041 PECOS PAC ID: 8820233927 Enrollment ID: I20130730000124 |
| Provider Name | Sarah A Kelley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427109909 PECOS PAC ID: 9739338757 Enrollment ID: I20130820000008 |
| Provider Name | Julie S Pertman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487983953 PECOS PAC ID: 8820231103 Enrollment ID: I20130905000871 |
| Provider Name | Brenda D Harris |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427024975 PECOS PAC ID: 7416132386 Enrollment ID: I20131008000770 |
| Provider Name | Philippines G Cabahug |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1558501817 PECOS PAC ID: 0840439121 Enrollment ID: I20131015000035 |
| Provider Name | Gabrielle L Blackman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417913195 PECOS PAC ID: 6103051230 Enrollment ID: I20131028000539 |
| Provider Name | Janet L Crane |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1639342512 PECOS PAC ID: 5395990295 Enrollment ID: I20131121001443 |
| Provider Name | Sara Sadreameli |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407016264 PECOS PAC ID: 7517102122 Enrollment ID: I20140826000602 |
| Provider Name | Jessica Nance |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033376876 PECOS PAC ID: 5395993109 Enrollment ID: I20140917002918 |
| Provider Name | Vera J Burton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144489345 PECOS PAC ID: 0547419202 Enrollment ID: I20141002000302 |
| Provider Name | Jay A Salpekar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679663942 PECOS PAC ID: 5991719205 Enrollment ID: I20141016002201 |
| Provider Name | Carolina Vidal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861636771 PECOS PAC ID: 0244451003 Enrollment ID: I20141020000865 |
| Provider Name | Sneha P Jadhav |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780833582 PECOS PAC ID: 3971725250 Enrollment ID: I20141121000838 |
| Provider Name | Rachel Murray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457758070 PECOS PAC ID: 8527382563 Enrollment ID: I20150121001562 |
| Provider Name | Michelle E Melicosta |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558320010 PECOS PAC ID: 6800800459 Enrollment ID: I20150218001366 |
| Provider Name | Mari L Groves |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1598964439 PECOS PAC ID: 4486803541 Enrollment ID: I20150730010926 |
| Provider Name | Ekaterina Stepanova |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730359662 PECOS PAC ID: 9032331319 Enrollment ID: I20150911001510 |
| Provider Name | Bradley R Grant |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952625675 PECOS PAC ID: 5092943548 Enrollment ID: I20151019000211 |
| Provider Name | Sarah A Korth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578881983 PECOS PAC ID: 4284857954 Enrollment ID: I20151123001113 |
| Provider Name | Deepa Menon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336206291 PECOS PAC ID: 5890095459 Enrollment ID: I20151203001996 |
| Provider Name | Tanisha E Drummond |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063707024 PECOS PAC ID: 3870893340 Enrollment ID: I20151207000332 |
| Provider Name | M-irfan Suleman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396955795 PECOS PAC ID: 3173673191 Enrollment ID: I20160125000242 |
| Provider Name | Rebecca Lynn Ruebner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972776367 PECOS PAC ID: 2769543990 Enrollment ID: I20160406002376 |
| Provider Name | Amie E Bettencourt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851755250 PECOS PAC ID: 3375832892 Enrollment ID: I20160523000939 |
| Provider Name | Shenandoah Robinson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1134145006 PECOS PAC ID: 0941255376 Enrollment ID: I20160725001868 |
| Provider Name | Andreas Barth |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1689992190 PECOS PAC ID: 4183869274 Enrollment ID: I20160728000105 |
| Provider Name | Mahim Jain |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558660886 PECOS PAC ID: 3072800424 Enrollment ID: I20160928001656 |
| Provider Name | Jacqueline Harris |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083939326 PECOS PAC ID: 2062662216 Enrollment ID: I20161111000740 |
| Provider Name | Susan A Danielson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538476643 PECOS PAC ID: 7315218583 Enrollment ID: I20170807000839 |
| Provider Name | Hal Benjamin Kronsberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639437668 PECOS PAC ID: 7214242981 Enrollment ID: I20170824000368 |
| Provider Name | Ji Su Hong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801185558 PECOS PAC ID: 7315263001 Enrollment ID: I20171122000649 |
| Provider Name | Nancy Yeh |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1144581323 PECOS PAC ID: 9830404599 Enrollment ID: I20180108000974 |
| Provider Name | Matthew Taylor |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205193711 PECOS PAC ID: 4183873482 Enrollment ID: I20180716002021 |
| Provider Name | Steven David Miller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265799696 PECOS PAC ID: 2365692894 Enrollment ID: I20180724001833 |
| Provider Name | Brittany L Schwarz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780946483 PECOS PAC ID: 8123313558 Enrollment ID: I20180830000390 |
| Provider Name | Holly F Kosten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831682236 PECOS PAC ID: 3375896889 Enrollment ID: I20181031001317 |
| Provider Name | Souraya Torbey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639514870 PECOS PAC ID: 7911135793 Enrollment ID: I20181203000876 |
| Provider Name | Lara L Collender |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144695891 PECOS PAC ID: 9032450382 Enrollment ID: I20190415000751 |
| Provider Name | Michele C Mattson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184197303 PECOS PAC ID: 6608118310 Enrollment ID: I20190430000473 |
| Provider Name | Matthew Joseph Elrick |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609118090 PECOS PAC ID: 7517108137 Enrollment ID: I20190624002877 |
| Provider Name | Emily Southard Rao |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679919948 PECOS PAC ID: 1254699010 Enrollment ID: I20190730000488 |
| Provider Name | Sa Eun Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578979951 PECOS PAC ID: 3577842640 Enrollment ID: I20190820001059 |
| Provider Name | Sami Tuffaha |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1922398866 PECOS PAC ID: 7113176132 Enrollment ID: I20190824000265 |
| Provider Name | Juan Alfredo Caceres Noguera |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457798290 PECOS PAC ID: 2961710413 Enrollment ID: I20190826001522 |
| Provider Name | Amanda Kole Morrow |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1558603845 PECOS PAC ID: 7214153378 Enrollment ID: I20191003001090 |
| Provider Name | Laura W Lewallen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285951723 PECOS PAC ID: 5193981397 Enrollment ID: I20191003002305 |
| Provider Name | Daniel Sova |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1104230499 PECOS PAC ID: 7315251881 Enrollment ID: I20191009001360 |
| Provider Name | Christina G Kokorelis |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1679918841 PECOS PAC ID: 1759693823 Enrollment ID: I20191014000153 |
| Provider Name | Shannon L Dean |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376803577 PECOS PAC ID: 6507093150 Enrollment ID: I20191125002915 |
| Provider Name | Bradley L Schlaggar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144247685 PECOS PAC ID: 3274625710 Enrollment ID: I20191218000587 |
| Provider Name | Karin M Belsito |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1174591481 PECOS PAC ID: 6901934744 Enrollment ID: I20200103001884 |
| Provider Name | Joseph Mcguire |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1578089025 PECOS PAC ID: 0042647729 Enrollment ID: I20200218001856 |
| Provider Name | Christina B Keeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184257685 PECOS PAC ID: 0749618635 Enrollment ID: I20200306000732 |
| Provider Name | Jennifer Siu Hong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104244839 PECOS PAC ID: 4486953692 Enrollment ID: I20200505002916 |
| Provider Name | Laura A Malone |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578957130 PECOS PAC ID: 3072825264 Enrollment ID: I20200722003781 |
| Provider Name | Chana Richter |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982948543 PECOS PAC ID: 3577832112 Enrollment ID: I20200727001480 |
| Provider Name | Christopher Michael Carosella |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346501863 PECOS PAC ID: 1355690926 Enrollment ID: I20200804002556 |
| Provider Name | Dorian F Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073152807 PECOS PAC ID: 8921424185 Enrollment ID: I20200818002989 |
| Provider Name | Nadia Zaim |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336586353 PECOS PAC ID: 2567690704 Enrollment ID: I20200820000507 |
| Provider Name | Ryan Gill |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780084202 PECOS PAC ID: 0042525701 Enrollment ID: I20200909000591 |
| Provider Name | Melanie Brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881663060 PECOS PAC ID: 4183688765 Enrollment ID: I20201021000554 |
| Provider Name | Joseph Scafidi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740488667 PECOS PAC ID: 5597833418 Enrollment ID: I20201230001412 |
| Provider Name | April N Sharp |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275872947 PECOS PAC ID: 4486951225 Enrollment ID: I20210119002419 |
| Provider Name | Jacqueline E Mcpeek |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720432867 PECOS PAC ID: 0446541676 Enrollment ID: I20210526000081 |
| Provider Name | Eric Michael Chin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225444540 PECOS PAC ID: 4486946423 Enrollment ID: I20210722001230 |
| Provider Name | Miya R Asato |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548232937 PECOS PAC ID: 1759364581 Enrollment ID: I20210727002014 |
| Provider Name | Heather B Brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386007557 PECOS PAC ID: 7315239498 Enrollment ID: I20210728000741 |
| Provider Name | Aarya K Rajalakshmi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073962312 PECOS PAC ID: 8123358249 Enrollment ID: I20210730000464 |
| Provider Name | William W Ide |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1851528988 PECOS PAC ID: 7810315116 Enrollment ID: I20210802000023 |
| Provider Name | Aditya K Pawar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265881593 PECOS PAC ID: 6305176926 Enrollment ID: I20210802001523 |
| Provider Name | Malinda Wu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467871293 PECOS PAC ID: 5092938829 Enrollment ID: I20211012000687 |
| Provider Name | Clay E Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760862106 PECOS PAC ID: 0345550182 Enrollment ID: I20211027000832 |
| Provider Name | Kathryn Van Eck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437530383 PECOS PAC ID: 5890185557 Enrollment ID: I20211213000487 |
| Provider Name | Christina Morris-berry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811351489 PECOS PAC ID: 4880982784 Enrollment ID: I20211220001557 |
| Provider Name | Amir Miodovnik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437139227 PECOS PAC ID: 6406145200 Enrollment ID: I20220131001352 |
| Provider Name | Travis Lee Edmiston |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1689093023 PECOS PAC ID: 8729307814 Enrollment ID: I20220212000005 |
| Provider Name | Aaron J Hauptman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871869602 PECOS PAC ID: 0446522163 Enrollment ID: I20220407001022 |
| Provider Name | Babitha Haridas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447645478 PECOS PAC ID: 9739426180 Enrollment ID: I20220513001315 |
| Provider Name | Kevin Joseph Crow |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215496252 PECOS PAC ID: 2961737200 Enrollment ID: I20220614002588 |
| Provider Name | Melissa Golden |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558892265 PECOS PAC ID: 8527338623 Enrollment ID: I20220616000021 |
| Provider Name | Siddharth Swarup Gupta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083080543 PECOS PAC ID: 3870972409 Enrollment ID: I20220628001023 |
| Provider Name | Bushra Rizwan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295255131 PECOS PAC ID: 5698047132 Enrollment ID: I20220711003834 |
| Provider Name | Samieh Askari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629467386 PECOS PAC ID: 6204100910 Enrollment ID: I20221010001873 |
| Provider Name | Stephanie Morris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124315494 PECOS PAC ID: 7012146525 Enrollment ID: I20221013000089 |
| Provider Name | Brandon Newsome |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306208822 PECOS PAC ID: 8123313236 Enrollment ID: I20221025002727 |
| Provider Name | Wilfreda Lindsey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184078198 PECOS PAC ID: 9830566025 Enrollment ID: I20221101000379 |
| Provider Name | Erin Kenny Voelkel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518699719 PECOS PAC ID: 8820465966 Enrollment ID: I20221103000055 |
| Provider Name | Brooke Kimbrell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568969566 PECOS PAC ID: 8921432378 Enrollment ID: I20221201000253 |
| Provider Name | Laura Elizabeth Black |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1538504881 PECOS PAC ID: 4284932260 Enrollment ID: I20221208000969 |
| Provider Name | Anton Dietzen |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1063659076 PECOS PAC ID: 2163587924 Enrollment ID: I20221221001621 |
| Provider Name | Heather Riordan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568774131 PECOS PAC ID: 6406134667 Enrollment ID: I20221226000175 |
| Provider Name | Amena Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225370570 PECOS PAC ID: 2860634862 Enrollment ID: I20230105003030 |
| Provider Name | Katherine Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720707730 PECOS PAC ID: 9436520178 Enrollment ID: I20230117002434 |
| Provider Name | Khalid Elzamzamy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770164642 PECOS PAC ID: 6103214655 Enrollment ID: I20230419002675 |
| Provider Name | Phillip Sojka |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053804625 PECOS PAC ID: 5496001497 Enrollment ID: I20230509000858 |
| Provider Name | Cecilia Cordova |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1831675867 PECOS PAC ID: 5698011377 Enrollment ID: I20230823002936 |
| Provider Name | Joseph Timothy Woolcock |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1922567734 PECOS PAC ID: 5890118947 Enrollment ID: I20230922001180 |
| Provider Name | Megan Bone |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1902338338 PECOS PAC ID: 2264886183 Enrollment ID: I20230927000453 |
| Provider Name | Jodi Lindsey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801088638 PECOS PAC ID: 2668621046 Enrollment ID: I20231002003299 |
| Provider Name | William Silver |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1215424973 PECOS PAC ID: 2264783489 Enrollment ID: I20231009000236 |
| Provider Name | Meghna Rajaprakash |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467019034 PECOS PAC ID: 2264887975 Enrollment ID: I20231016003679 |
| Provider Name | Kyung Eun Paik |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1285130195 PECOS PAC ID: 6709287774 Enrollment ID: I20231020002871 |
| Provider Name | Gamze Ozsoy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538797824 PECOS PAC ID: 6608222955 Enrollment ID: I20231024000732 |
| Provider Name | Emily E Baron |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972984862 PECOS PAC ID: 9830545938 Enrollment ID: I20231025003794 |
| Provider Name | Mary R Coster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457438608 PECOS PAC ID: 4183070220 Enrollment ID: I20231026001841 |
| Provider Name | Stephanie Irene Brown |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437546918 PECOS PAC ID: 4183070139 Enrollment ID: I20231026002414 |
| Provider Name | Elgiz Bal Sener |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679901441 PECOS PAC ID: 1557717386 Enrollment ID: I20231030003221 |
| Provider Name | Valerie A Paasch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053615609 PECOS PAC ID: 1052767795 Enrollment ID: I20231101000099 |
| Provider Name | Nardos Zelleke Bellete |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780253708 PECOS PAC ID: 3870949530 Enrollment ID: I20231101001063 |
| Provider Name | Eric James Mallack |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730445180 PECOS PAC ID: 0143598235 Enrollment ID: I20231101001380 |
| Provider Name | Matthew Edelstein |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114306834 PECOS PAC ID: 6204282981 Enrollment ID: I20231101001661 |
| Provider Name | Rachel Peterson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922649706 PECOS PAC ID: 2567818172 Enrollment ID: I20231101003637 |
| Provider Name | Caitlin C Thompson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1013436872 PECOS PAC ID: 5092162602 Enrollment ID: I20231103000199 |
| Provider Name | Lyndsay Ann Fairchild |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1922552504 PECOS PAC ID: 2264889872 Enrollment ID: I20231103000218 |
| Provider Name | Angela Celano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750790028 PECOS PAC ID: 3274980891 Enrollment ID: I20231103000635 |
| Provider Name | Beth S Slomine |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831218700 PECOS PAC ID: 5698122273 Enrollment ID: I20231103003477 |
| Provider Name | Anna Ditkoff Dorsey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003150145 PECOS PAC ID: 8426405937 Enrollment ID: I20231106000793 |
| Provider Name | Mary Robinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316497316 PECOS PAC ID: 0042667412 Enrollment ID: I20231106003646 |
| Provider Name | Sarah Turgeon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346922382 PECOS PAC ID: 7719334101 Enrollment ID: I20231107000541 |
| Provider Name | Jaime L Benson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1326351008 PECOS PAC ID: 0345697736 Enrollment ID: I20231107000596 |
| Provider Name | Julia T O'connor |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023137999 PECOS PAC ID: 1658728068 Enrollment ID: I20231107001314 |
| Provider Name | Emily Grace Driscoll-roe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508193418 PECOS PAC ID: 9537516950 Enrollment ID: I20231107001952 |
| Provider Name | Lara Spiekermann |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083396865 PECOS PAC ID: 8426405754 Enrollment ID: I20231108002650 |
| Provider Name | Dorie Ellen Obertello |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1174973440 PECOS PAC ID: 6608223821 Enrollment ID: I20231109002740 |
| Provider Name | Patricia R Shepley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134240203 PECOS PAC ID: 2466809546 Enrollment ID: I20231110001632 |
| Provider Name | Betsy J Offermann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821119900 PECOS PAC ID: 6608223714 Enrollment ID: I20231111000421 |
| Provider Name | Caroline Elizabeth Guzi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063142230 PECOS PAC ID: 6406203520 Enrollment ID: I20231111000588 |
| Provider Name | Carolyn Theresa Caldwell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1679629117 PECOS PAC ID: 4486001500 Enrollment ID: I20231111000704 |
| Provider Name | Jennifer L Crockett |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1598884462 PECOS PAC ID: 8729435847 Enrollment ID: I20231113000049 |
| Provider Name | Roula Choueiri |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376644815 PECOS PAC ID: 9537188677 Enrollment ID: I20231113001074 |
| Provider Name | Laura V Costa |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659685840 PECOS PAC ID: 0648627604 Enrollment ID: I20231113002010 |
| Provider Name | Joshua Mellott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609444991 PECOS PAC ID: 9931556933 Enrollment ID: I20231113003652 |
| Provider Name | Kathryn Jane Davis |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487211744 PECOS PAC ID: 2163879164 Enrollment ID: I20231114000113 |
| Provider Name | Adrian James White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316463466 PECOS PAC ID: 5294182143 Enrollment ID: I20231114002356 |
| Provider Name | Atara Beilah Siegel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295360733 PECOS PAC ID: 9739536681 Enrollment ID: I20231114002372 |
| Provider Name | Emily Nadine Watts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619653771 PECOS PAC ID: 5799132676 Enrollment ID: I20231115000256 |
| Provider Name | Catherine Debus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578988127 PECOS PAC ID: 5890142780 Enrollment ID: I20231115000660 |
| Provider Name | Mary H Mueller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659492734 PECOS PAC ID: 0941657753 Enrollment ID: I20231115001753 |
| Provider Name | Andrea Heyman |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1821340555 PECOS PAC ID: 5193172971 Enrollment ID: I20231116000590 |
| Provider Name | Monica Beltran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982725065 PECOS PAC ID: 5890142673 Enrollment ID: I20231116000715 |
| Provider Name | Megan Elizabeth Kramer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447584404 PECOS PAC ID: 8224485966 Enrollment ID: I20231117000003 |
| Provider Name | Gwendolyn Gerner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730590241 PECOS PAC ID: 3971950650 Enrollment ID: I20231117001212 |
| Provider Name | Leanna Joy Herman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386842433 PECOS PAC ID: 6406204973 Enrollment ID: I20231121002812 |
| Provider Name | Tina R Fain |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720109895 PECOS PAC ID: 8921456419 Enrollment ID: I20231121003814 |
| Provider Name | Erica Carroll |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740837715 PECOS PAC ID: 0244688539 Enrollment ID: I20231127003453 |
| Provider Name | Jessica Belle Handelsman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1083066559 PECOS PAC ID: 5395193569 Enrollment ID: I20231128003644 |
| Provider Name | Emma Cole |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467804393 PECOS PAC ID: 2466800503 Enrollment ID: I20231129002899 |
| Provider Name | Hailey Mangano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750987012 PECOS PAC ID: 5193173268 Enrollment ID: I20231129003753 |
| Provider Name | Patricia Miller |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295856375 PECOS PAC ID: 2264880277 Enrollment ID: I20231201001880 |
| Provider Name | Terri L Bishoff |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790806875 PECOS PAC ID: 5092163972 Enrollment ID: I20231204001015 |
| Provider Name | Komila Brennan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285163378 PECOS PAC ID: 0749638526 Enrollment ID: I20231205001443 |
| Provider Name | Rowena Ng |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1811557960 PECOS PAC ID: 8426407206 Enrollment ID: I20231206001499 |
| Provider Name | Natalie Terese Delgado |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437814860 PECOS PAC ID: 0749639334 Enrollment ID: I20231207002758 |
| Provider Name | Lauren Bradstreet |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932757853 PECOS PAC ID: 4183073745 Enrollment ID: I20231208001051 |
| Provider Name | Ericka Lisle Wodka |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033256342 PECOS PAC ID: 6406205921 Enrollment ID: I20231209000149 |
| Provider Name | Michelle Bubnik-harrison |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1164898110 PECOS PAC ID: 1850740259 Enrollment ID: I20231211002284 |
| Provider Name | Dulce Mateo-burgos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619352747 PECOS PAC ID: 6608225024 Enrollment ID: I20231211003468 |
| Provider Name | Sarah Moore |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972381044 PECOS PAC ID: 3577912807 Enrollment ID: I20231212004032 |
| Provider Name | Aila Katrine Dommestrup |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740672906 PECOS PAC ID: 6002265907 Enrollment ID: I20231218000065 |
| Provider Name | Kirsten Denise Russo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790344760 PECOS PAC ID: 2062861974 Enrollment ID: I20231218000219 |
| Provider Name | Melanie H Pinkett-davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508941824 PECOS PAC ID: 1850741752 Enrollment ID: I20231219000179 |
| Provider Name | Kelly Anne Sheperd Riolo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902232291 PECOS PAC ID: 3870943780 Enrollment ID: I20231219000528 |
| Provider Name | Rebecca Wasserman Lieb |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407105596 PECOS PAC ID: 0941650626 Enrollment ID: I20231220003691 |
| Provider Name | Christina Eguizabal Love |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1710332697 PECOS PAC ID: 2567812027 Enrollment ID: I20231223000133 |
| Provider Name | Jennifer Lynn Horton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750535183 PECOS PAC ID: 8527418979 Enrollment ID: I20231227001028 |
| Provider Name | Keri Shiels Rosch |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255775284 PECOS PAC ID: 8022468115 Enrollment ID: I20240102003170 |
| Provider Name | Darius Stanley Sanders |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023561982 PECOS PAC ID: 7315397411 Enrollment ID: I20240102003525 |
| Provider Name | Latoya Gaines |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396201737 PECOS PAC ID: 3173973112 Enrollment ID: I20240103001193 |
| Provider Name | Eliana Sudikoff |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306322466 PECOS PAC ID: 0244640662 Enrollment ID: I20240103002128 |
| Provider Name | Nicole Christine D'adamo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962892075 PECOS PAC ID: 3577914266 Enrollment ID: I20240106000980 |
| Provider Name | Sarah Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700287174 PECOS PAC ID: 5698126217 Enrollment ID: I20240109000259 |
| Provider Name | Elizabeth Cross |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1053747451 PECOS PAC ID: 1254782725 Enrollment ID: I20240109002500 |
| Provider Name | Kelly Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063817401 PECOS PAC ID: 8224317870 Enrollment ID: I20240109003022 |
| Provider Name | Rashida Shani Barner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932581907 PECOS PAC ID: 2264883784 Enrollment ID: I20240109004493 |
| Provider Name | Eliezer Resnick Sollins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902113400 PECOS PAC ID: 9638520166 Enrollment ID: I20240109004882 |
| Provider Name | Christi Lanet Culpepper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1558640789 PECOS PAC ID: 2163873415 Enrollment ID: I20240110004930 |
| Provider Name | Eliot Louise Carney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083499917 PECOS PAC ID: 9032560388 Enrollment ID: I20240110005086 |
| Provider Name | Amy E Gaskin |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1801917976 PECOS PAC ID: 2769833045 Enrollment ID: I20240111000631 |
| Provider Name | Elizabeth Nicole Hunt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437721503 PECOS PAC ID: 0345691564 Enrollment ID: I20240111002490 |
| Provider Name | Danielle Wexler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356901102 PECOS PAC ID: 8022469261 Enrollment ID: I20240111003506 |
| Provider Name | Lara Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194170845 PECOS PAC ID: 4688025844 Enrollment ID: I20240111004303 |
| Provider Name | Holly Duncan |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1902215502 PECOS PAC ID: 3375939234 Enrollment ID: I20240112002819 |
| Provider Name | Erika Wesonga |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760153878 PECOS PAC ID: 2365893443 Enrollment ID: I20240112003570 |
| Provider Name | Megan Harrelson Cheung |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114536307 PECOS PAC ID: 0446601538 Enrollment ID: I20240112003931 |
| Provider Name | Sarah Hall Ellis |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1932620465 PECOS PAC ID: 9537426804 Enrollment ID: I20240115001794 |
| Provider Name | Sara Ronni Davis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750513669 PECOS PAC ID: 7315399300 Enrollment ID: I20240116000058 |
| Provider Name | Garland W Jones |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609150259 PECOS PAC ID: 6002268034 Enrollment ID: I20240116001291 |
| Provider Name | Lauren Danielle Holder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114595196 PECOS PAC ID: 8325490352 Enrollment ID: I20240116001403 |
| Provider Name | Michael S Goddard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861167413 PECOS PAC ID: 3476905373 Enrollment ID: I20240116003597 |
| Provider Name | Shalena Heard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982037156 PECOS PAC ID: 4385924075 Enrollment ID: I20240116004657 |
| Provider Name | Cynthia F Salorio |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295854164 PECOS PAC ID: 8022460518 Enrollment ID: I20240119003658 |
| Provider Name | Gabriela Frine Renderos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659722635 PECOS PAC ID: 6507218005 Enrollment ID: I20240119003992 |
| Provider Name | Andrea Young |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407234016 PECOS PAC ID: 7113379595 Enrollment ID: I20240122002368 |
| Provider Name | Joelle Krantz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205365442 PECOS PAC ID: 7012349632 Enrollment ID: I20240122003407 |
| Provider Name | Jennifer Shepard Payne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316145527 PECOS PAC ID: 2860845989 Enrollment ID: I20240125000690 |
| Provider Name | Jessica Woodward O'brien |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982263125 PECOS PAC ID: 5799138848 Enrollment ID: I20240125001785 |
| Provider Name | Claire-elizabeth Perkins Agbu |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396314696 PECOS PAC ID: 0840643714 Enrollment ID: I20240126001747 |
| Provider Name | Margaret Tunney |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205286630 PECOS PAC ID: 4981057866 Enrollment ID: I20240126002050 |
| Provider Name | Chandni Patel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942865472 PECOS PAC ID: 6901259761 Enrollment ID: I20240129000081 |
| Provider Name | Merideth Ann Wirstiuk |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760820187 PECOS PAC ID: 0648623272 Enrollment ID: I20240130002312 |
| Provider Name | Tasha Geiger |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609043108 PECOS PAC ID: 7517029879 Enrollment ID: I20240131002071 |
| Provider Name | Christine Reiner Hess |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609401280 PECOS PAC ID: 8123471539 Enrollment ID: I20240201000091 |
| Provider Name | Jamila Ray |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790109296 PECOS PAC ID: 8123471554 Enrollment ID: I20240201000820 |
| Provider Name | Dasal Jashar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1407257678 PECOS PAC ID: 7810340197 Enrollment ID: I20240202001812 |
| Provider Name | Tiffany Wen-ting Lin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003155540 PECOS PAC ID: 6002259355 Enrollment ID: I20240205000007 |
| Provider Name | Amanda Wagner Santanello |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346474400 PECOS PAC ID: 4981047115 Enrollment ID: I20240205003233 |
| Provider Name | Tana L Hope |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043339914 PECOS PAC ID: 1254774227 Enrollment ID: I20240206004149 |
| Provider Name | Ashley Zadrozny |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1467981407 PECOS PAC ID: 3476996034 Enrollment ID: I20240210000198 |
| Provider Name | Richard Boada |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356426001 PECOS PAC ID: 2466471826 Enrollment ID: I20240213001463 |
| Provider Name | Twanesha Nicole Wilcox |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639791742 PECOS PAC ID: 5294179628 Enrollment ID: I20240214000074 |
| Provider Name | Kathleen Hazel Parker |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1588145973 PECOS PAC ID: 9335583657 Enrollment ID: I20240214003627 |
| Provider Name | Kristi L.m. Phillips |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346404274 PECOS PAC ID: 8325482656 Enrollment ID: I20240214004137 |
| Provider Name | Stacy Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881107688 PECOS PAC ID: 8022452374 Enrollment ID: I20240215000123 |
| Provider Name | Steven Newton Morris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659035574 PECOS PAC ID: 7618311960 Enrollment ID: I20240215000287 |
| Provider Name | Ruiwen Zheng |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518532373 PECOS PAC ID: 3072957257 Enrollment ID: I20240215001420 |
| Provider Name | Natasha Ludwig |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1952824922 PECOS PAC ID: 6507200458 Enrollment ID: I20240219002164 |
| Provider Name | Helena Vaughan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1730756610 PECOS PAC ID: 6800230731 Enrollment ID: I20240220001479 |
| Provider Name | Yoreidy Vasquez Tavarez |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518402700 PECOS PAC ID: 6608143649 Enrollment ID: I20240220001488 |
| Provider Name | Amy Keefer Schreffler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689755803 PECOS PAC ID: 1052325016 Enrollment ID: I20240220003534 |
| Provider Name | Mariangely Melendez-torres |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114471968 PECOS PAC ID: 4284078924 Enrollment ID: I20240221000908 |
| Provider Name | Shijia Liu |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659712685 PECOS PAC ID: 4688018328 Enrollment ID: I20240221001096 |
| Provider Name | Ariana Whitney Zahn |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033442694 PECOS PAC ID: 5799129342 Enrollment ID: I20240222000735 |
| Provider Name | Christine Pho |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073138715 PECOS PAC ID: 7214372705 Enrollment ID: I20240223001919 |
| Provider Name | Shalom Shapiro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1255975306 PECOS PAC ID: 8123463692 Enrollment ID: I20240224000247 |
| Provider Name | Erin Pressman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902212210 PECOS PAC ID: 3476998485 Enrollment ID: I20240229002719 |
| Provider Name | Allison Gornik |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073137170 PECOS PAC ID: 2961847843 Enrollment ID: I20240301001028 |
| Provider Name | Lindsay Cirincione |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982049631 PECOS PAC ID: 9830534726 Enrollment ID: I20240301001184 |
| Provider Name | Danielle Sauro Virgadamo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043727928 PECOS PAC ID: 8729423553 Enrollment ID: I20240301002969 |
| Provider Name | Meg Claire Nicholl Snyder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174017669 PECOS PAC ID: 0446695233 Enrollment ID: I20240304000311 |
| Provider Name | Aerial Sheltry |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538698675 PECOS PAC ID: 7810332624 Enrollment ID: I20240304000989 |
| Provider Name | Miguel Eduardo Roberts |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073653044 PECOS PAC ID: 1557706298 Enrollment ID: I20240304002128 |
| Provider Name | Peter Anthony Girolami |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235327347 PECOS PAC ID: 2961848403 Enrollment ID: I20240307000583 |
| Provider Name | Vanessa Ramos Scarborough |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649588054 PECOS PAC ID: 7012353428 Enrollment ID: I20240307002958 |
| Provider Name | Alicia Lynn Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750760393 PECOS PAC ID: 2769828045 Enrollment ID: I20240308001465 |
| Provider Name | Jami C Pittman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1245001247 PECOS PAC ID: 3779929013 Enrollment ID: I20240309000005 |
| Provider Name | Jennifer Weeks |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1710365440 PECOS PAC ID: 2961848106 Enrollment ID: I20240311002963 |
| Provider Name | Gray Alexandra Vargas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689176927 PECOS PAC ID: 8123464096 Enrollment ID: I20240313003862 |
| Provider Name | Dorian Lanni |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295331544 PECOS PAC ID: 3678919321 Enrollment ID: I20240315002590 |
| Provider Name | Brian Jobe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992113690 PECOS PAC ID: 5698112118 Enrollment ID: I20240320001169 |
| Provider Name | Stacy Lynn Blasko |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1770964884 PECOS PAC ID: 8729426424 Enrollment ID: I20240401000795 |
| Provider Name | Katherine Lea Moore |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124401930 PECOS PAC ID: 6103264874 Enrollment ID: I20240402000012 |
| Provider Name | Jennifer Marie Serico |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447690557 PECOS PAC ID: 8022456078 Enrollment ID: I20240409004853 |
| Provider Name | Cherisse Rambarose |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1912521204 PECOS PAC ID: 5698114254 Enrollment ID: I20240415003712 |
| Provider Name | Danielle Marie Ploetz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669660999 PECOS PAC ID: 3971942558 Enrollment ID: I20240416000348 |
| Provider Name | Marilyn Camacho |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1407268832 PECOS PAC ID: 6507205036 Enrollment ID: I20240417001793 |
| Provider Name | Gina S Richman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487773354 PECOS PAC ID: 9436598513 Enrollment ID: I20240423000803 |
| Provider Name | Raghad Alkhafaji |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659932846 PECOS PAC ID: 8628306446 Enrollment ID: I20240528001075 |
| Provider Name | Sonum A Bharill |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346771367 PECOS PAC ID: 7719258706 Enrollment ID: I20240529001043 |
| Provider Name | Lauren Grace Burton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073073607 PECOS PAC ID: 1153863253 Enrollment ID: I20240604003666 |
| Provider Name | Nazli Kuter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780170878 PECOS PAC ID: 3779983283 Enrollment ID: I20240706000376 |
| Provider Name | Seungeun Lee |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1184249161 PECOS PAC ID: 4688111636 Enrollment ID: I20240808000045 |
| Provider Name | Loren Ketelsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245795434 PECOS PAC ID: 1557809472 Enrollment ID: I20240809002559 |
| Provider Name | Bruce B Mcclary |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053642157 PECOS PAC ID: 5597203901 Enrollment ID: I20240816001087 |
| Provider Name | Jessica Carpenter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134897994 PECOS PAC ID: 8224480728 Enrollment ID: I20240827000173 |
| Provider Name | Autumn Ivy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659638666 PECOS PAC ID: 1557631231 Enrollment ID: I20240829004511 |
| Provider Name | Ethan Hochheiser |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730744905 PECOS PAC ID: 2365773751 Enrollment ID: I20240911003891 |
| Provider Name | Jessica De Curtis Fernandez |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1013411784 PECOS PAC ID: 4082966874 Enrollment ID: I20240912000788 |
| Provider Name | Benjamin Schindel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417451113 PECOS PAC ID: 4880930874 Enrollment ID: I20240912001841 |
| Provider Name | Hala Katato |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487215083 PECOS PAC ID: 0648505305 Enrollment ID: I20240914000037 |
| Provider Name | Kavita Nadendla |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1386094886 PECOS PAC ID: 6406141852 Enrollment ID: I20240921000568 |
| Provider Name | Jonathan A Muniz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053978551 PECOS PAC ID: 6305377920 Enrollment ID: I20241007000714 |
| Provider Name | Kelsey Gnade Coulthard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124720222 PECOS PAC ID: 9335670868 Enrollment ID: I20241008001266 |
| Provider Name | Ashley Kniola |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1508506411 PECOS PAC ID: 4486185865 Enrollment ID: I20241009003380 |
| Provider Name | Heather Dano Burke |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487115879 PECOS PAC ID: 9638559834 Enrollment ID: I20241010002394 |
| Provider Name | Marisa Flavin |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1033558093 PECOS PAC ID: 5991004228 Enrollment ID: I20241013000052 |
| Provider Name | Samantha Marie Estacio |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689349979 PECOS PAC ID: 1153853213 Enrollment ID: I20241014002816 |
| Provider Name | Yvette F Bean |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619607298 PECOS PAC ID: 0547792129 Enrollment ID: I20241021003384 |
| Provider Name | Natario Couser |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1083822704 PECOS PAC ID: 5991820169 Enrollment ID: I20241031001152 |
| Provider Name | Margaret Johnson Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528746674 PECOS PAC ID: 2264966852 Enrollment ID: I20241105000807 |
| Provider Name | Bridget Elisabeth Payne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184237554 PECOS PAC ID: 7012441587 Enrollment ID: I20241107000608 |
| Provider Name | Robert Rudock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1215291653 PECOS PAC ID: 8224371349 Enrollment ID: I20241107003741 |
| Provider Name | Emma Hughes |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912742594 PECOS PAC ID: 4183158348 Enrollment ID: I20241111000850 |
| Provider Name | Mackenzie Tamblin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396469789 PECOS PAC ID: 6204360167 Enrollment ID: I20241114001884 |
| Provider Name | Madeline Kaplan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1740851344 PECOS PAC ID: 7012441827 Enrollment ID: I20241114004567 |
| Provider Name | Constance Austin Coates Quezada |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477241685 PECOS PAC ID: 0446784144 Enrollment ID: I20241115003673 |
| Provider Name | Brittany Nesbitt |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902314966 PECOS PAC ID: 3577097245 Enrollment ID: I20241118001709 |
| Provider Name | Gabrielle Sanchez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487138384 PECOS PAC ID: 8729513965 Enrollment ID: I20241125001010 |
| Provider Name | Roy Justin Boyd |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1376735266 PECOS PAC ID: 1951836014 Enrollment ID: I20241126002030 |
| Provider Name | Amanda Taboas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427748102 PECOS PAC ID: 1951836048 Enrollment ID: I20241126003105 |
| Provider Name | Catherine Stephan |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1205663929 PECOS PAC ID: 0547796278 Enrollment ID: I20241205000365 |
| Provider Name | Sydney Pippin Lenfestey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427788371 PECOS PAC ID: 0042746190 Enrollment ID: I20241212000826 |
| Provider Name | Savannah Sean Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447807417 PECOS PAC ID: 9638606973 Enrollment ID: I20241226002039 |
| Provider Name | Danielle Gordon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477087864 PECOS PAC ID: 2062836232 Enrollment ID: I20250129001363 |
Gbmc Health Partners At Helping Up Mission, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1017 E Baltimore St, Ground Floor, Baltimore, MD 21202 Phone: 410-826-0170 | |
Johns Hopkins University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2024 E Monument St Ste 2626, Baltimore, MD 21287 Phone: 410-933-6430 | |
Solutions Healthcare Services Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 W University Pkwy Apt 425, Baltimore, MD 21210 Phone: 786-451-5184 | |
Plume Health Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 200 E Pratt St, Baltimore, MD 21202 Phone: 720-248-4483 | |
Np Medical Solutions By Sheila Waller Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5119 Mcfaul Rd, Baltimore, MD 21206 Phone: 443-531-6248 | |
Health Care For The Homeless, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 421 Fallsway, Baltimore, MD 21202 Phone: 410-837-5533 Fax: 410-837-8020 | |
Maryland Medical First P.a. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8901 Clement Ave, Baltimore, MD 21234 Phone: 410-661-4670 Fax: 410-661-4671 |