| Corewell Health Medical Group South | |
|
1234 Napier Ave Saint Joseph MI 49085-2112 | |
| (269) 428-5007 | |
| (269) 428-2789 |
| Full Name | Corewell Health Medical Group South |
|---|---|
| Speciality | Internal Medicine |
| Location | 1234 Napier Ave, Saint Joseph, Michigan |
| Authorized Official Name and Position | Warren White (V.P. LAKELAND PHYSICIAN PRACTICES) |
| Authorized Official Contact | 2699838127 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corewell Health Medical Group South Po Box 708 Saint Joseph MI 49085-0708 Ph: (269) 428-5007 | Corewell Health Medical Group South 1234 Napier Ave Saint Joseph MI 49085-2112 Ph: (269) 428-5007 |
| NPI Number | 1538397120 |
|---|---|
| Provider Enumeration Date | 06/23/2009 |
| Last Update Date | 12/17/2023 |
| Medicare PECOS PAC ID | 1658427042 |
|---|---|
| Medicare Enrollment ID | O20090928000216 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538397120 | NPI | - | NPPES |
| OA10085 | Other | MI | CLINICAL PSYCHOLIGIST |
| OA10080 | Other | MI | NURSE MIDWIFE - BCBS |
| 1538397120 | Medicaid | MI | |
| 0A10021 | Other | MI | BLUE CROSS GROUP # |
| OA10065 | Other | MI | BCBS - NURSE PRACTIONER |
| OA10143 | Other | MI | AUDIOLOGIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Helene Johnson |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1215966528 PECOS PAC ID: 6406769785 Enrollment ID: I20031204000425 |
| Provider Name | Douglas Gregory Tacket |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790764868 PECOS PAC ID: 1658279625 Enrollment ID: I20040105000462 |
| Provider Name | John L Bard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154358331 PECOS PAC ID: 9830091115 Enrollment ID: I20040126000876 |
| Provider Name | James R Burczak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417936931 PECOS PAC ID: 2860385416 Enrollment ID: I20040210000088 |
| Provider Name | Daniel Sohn |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1710966254 PECOS PAC ID: 5698669877 Enrollment ID: I20040210000146 |
| Provider Name | Kenneth J Edwards |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447239967 PECOS PAC ID: 7315830965 Enrollment ID: I20040210000163 |
| Provider Name | Mark Dittenbir |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942249727 PECOS PAC ID: 0749192235 Enrollment ID: I20040308000355 |
| Provider Name | Ogubay T Mesmer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801856141 PECOS PAC ID: 0446243661 Enrollment ID: I20040405001084 |
| Provider Name | John R Gosling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851387302 PECOS PAC ID: 4789676487 Enrollment ID: I20040409000114 |
| Provider Name | Brian J Dykstra |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1346225752 PECOS PAC ID: 7113913807 Enrollment ID: I20040420001281 |
| Provider Name | Mohammad B Zalt |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1851331037 PECOS PAC ID: 6406843820 Enrollment ID: I20040428000467 |
| Provider Name | Aurora Madanguit |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619902855 PECOS PAC ID: 4789674193 Enrollment ID: I20040517001206 |
| Provider Name | Michael V Bergquist |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174570303 PECOS PAC ID: 1153312285 Enrollment ID: I20040519000316 |
| Provider Name | Katherine S Hayward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457388423 PECOS PAC ID: 2264410695 Enrollment ID: I20040712000518 |
| Provider Name | Satish B Salvi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275589509 PECOS PAC ID: 1951219989 Enrollment ID: I20040721000416 |
| Provider Name | Paul V Detrisac |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962506527 PECOS PAC ID: 8921070038 Enrollment ID: I20040810000308 |
| Provider Name | Paula Grimes Mceachen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174790646 PECOS PAC ID: 2567435159 Enrollment ID: I20040812001211 |
| Provider Name | Monika P Riedel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538174305 PECOS PAC ID: 9032182720 Enrollment ID: I20040819000934 |
| Provider Name | Sherry L Simpson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962819763 PECOS PAC ID: 4385617075 Enrollment ID: I20040819000947 |
| Provider Name | Sonya Lee Christensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649208786 PECOS PAC ID: 8729051412 Enrollment ID: I20040819000970 |
| Provider Name | Brian E Woodruff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215921432 PECOS PAC ID: 3476529066 Enrollment ID: I20040903001185 |
| Provider Name | Susan Hosana Dilan Szanto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871520460 PECOS PAC ID: 3375510985 Enrollment ID: I20040914000199 |
| Provider Name | James D Huggett |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962462200 PECOS PAC ID: 0840180998 Enrollment ID: I20040915000313 |
| Provider Name | Sherrell Anne Odonnell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699771725 PECOS PAC ID: 7113995010 Enrollment ID: I20040921000185 |
| Provider Name | Sabry Mansour |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1326009861 PECOS PAC ID: 0345134714 Enrollment ID: I20040930000725 |
| Provider Name | Pradeep Ramachandran |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528086295 PECOS PAC ID: 7113987264 Enrollment ID: I20041013001169 |
| Provider Name | Daniel Roger Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457389264 PECOS PAC ID: 3476515610 Enrollment ID: I20041101000238 |
| Provider Name | Robert Piasecki |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790854982 PECOS PAC ID: 6002873833 Enrollment ID: I20041214000374 |
| Provider Name | Donald Frederick Brooks |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790733293 PECOS PAC ID: 7214994052 Enrollment ID: I20041214000427 |
| Provider Name | Lisa Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760510366 PECOS PAC ID: 3274581327 Enrollment ID: I20050105001106 |
| Provider Name | Thomas K Pow |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174583199 PECOS PAC ID: 4385694504 Enrollment ID: I20050126000267 |
| Provider Name | Jerome L Kuhnlein |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619937315 PECOS PAC ID: 7012967235 Enrollment ID: I20050126000303 |
| Provider Name | Dilip S Arora |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225098114 PECOS PAC ID: 8921058231 Enrollment ID: I20050126000338 |
| Provider Name | Katherine Keith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104806116 PECOS PAC ID: 0345290987 Enrollment ID: I20050131001022 |
| Provider Name | Leonard C Vanderlinde |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235142548 PECOS PAC ID: 7113979865 Enrollment ID: I20050210000804 |
| Provider Name | Jonathan P Windeler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306890850 PECOS PAC ID: 7719931583 Enrollment ID: I20050304000644 |
| Provider Name | Steven T Deroos |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528033990 PECOS PAC ID: 2769436393 Enrollment ID: I20050308000171 |
| Provider Name | Seemab G Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851485882 PECOS PAC ID: 4587611173 Enrollment ID: I20050406000083 |
| Provider Name | John W Froggatt |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588691091 PECOS PAC ID: 8729025846 Enrollment ID: I20050411000867 |
| Provider Name | Andrew M Gurien |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629025408 PECOS PAC ID: 3173513553 Enrollment ID: I20050412001098 |
| Provider Name | Edmund B Paloyan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1972509081 PECOS PAC ID: 2062492721 Enrollment ID: I20050524001349 |
| Provider Name | Jason T Umfleet |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114993474 PECOS PAC ID: 1759326861 Enrollment ID: I20050620000983 |
| Provider Name | Yulam Chiu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104886704 PECOS PAC ID: 4082642251 Enrollment ID: I20050728001191 |
| Provider Name | Eyad Akhras |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710055231 PECOS PAC ID: 8123056876 Enrollment ID: I20050803000115 |
| Provider Name | Christopher J Harvey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265460489 PECOS PAC ID: 0941230080 Enrollment ID: I20050817001080 |
| Provider Name | Michele L Ashton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295763159 PECOS PAC ID: 8729018627 Enrollment ID: I20050820000018 |
| Provider Name | Jill S Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508800020 PECOS PAC ID: 5395776215 Enrollment ID: I20050830000607 |
| Provider Name | Samer A Zeayter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578543047 PECOS PAC ID: 5395777627 Enrollment ID: I20050907000661 |
| Provider Name | Sunil P John |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306953542 PECOS PAC ID: 3375576762 Enrollment ID: I20050915000926 |
| Provider Name | Rosa Lee Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003981176 PECOS PAC ID: 7012940422 Enrollment ID: I20050915001077 |
| Provider Name | Samraja Emerson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235165093 PECOS PAC ID: 0244256048 Enrollment ID: I20051020000948 |
| Provider Name | Leanne Marie Miller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326077744 PECOS PAC ID: 9931121670 Enrollment ID: I20051222000311 |
| Provider Name | Deborah Ann Vliet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881666501 PECOS PAC ID: 0244253383 Enrollment ID: I20060104000611 |
| Provider Name | Ian H Fox |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295743920 PECOS PAC ID: 8921021999 Enrollment ID: I20060105000651 |
| Provider Name | Daniel H Snyder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609803170 PECOS PAC ID: 3173546975 Enrollment ID: I20060106000794 |
| Provider Name | Bobbi L Jorkos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538160296 PECOS PAC ID: 1052335544 Enrollment ID: I20060124000213 |
| Provider Name | Barton L Comstock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437188877 PECOS PAC ID: 6103833546 Enrollment ID: I20060309000694 |
| Provider Name | Diane Marie Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861400426 PECOS PAC ID: 9931117876 Enrollment ID: I20060404000175 |
| Provider Name | Kathryn N Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275619801 PECOS PAC ID: 9638188998 Enrollment ID: I20060413000483 |
| Provider Name | Troy A Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477573962 PECOS PAC ID: 3870502008 Enrollment ID: I20060417000024 |
| Provider Name | Christian W Sikorski |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1629043930 PECOS PAC ID: 0941212260 Enrollment ID: I20060630000308 |
| Provider Name | John Grabowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1477517191 PECOS PAC ID: 8921011834 Enrollment ID: I20060719000073 |
| Provider Name | Mary P Mcmanmon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255363172 PECOS PAC ID: 8325937949 Enrollment ID: I20060804000290 |
| Provider Name | William H Nichols |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1285656017 PECOS PAC ID: 3375546906 Enrollment ID: I20060821000157 |
| Provider Name | Heather Ann Marten |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285670448 PECOS PAC ID: 7315940863 Enrollment ID: I20060823000123 |
| Provider Name | Heather Marie Adams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083692255 PECOS PAC ID: 7012911050 Enrollment ID: I20060906000499 |
| Provider Name | Michael S Wang |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1912913302 PECOS PAC ID: 9335118538 Enrollment ID: I20060914000097 |
| Provider Name | Rex Benjamin Guansing Cabaltica |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942221494 PECOS PAC ID: 7911903984 Enrollment ID: I20061013000568 |
| Provider Name | Kaled Bazzi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073522744 PECOS PAC ID: 6608874433 Enrollment ID: I20061110000063 |
| Provider Name | Tony E Pinson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1497764104 PECOS PAC ID: 2860491487 Enrollment ID: I20061208000440 |
| Provider Name | Jose E Gomez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447319975 PECOS PAC ID: 5092715169 Enrollment ID: I20070115000150 |
| Provider Name | David A Puzycki |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952478281 PECOS PAC ID: 2062413560 Enrollment ID: I20070126000103 |
| Provider Name | Barbara E Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518003029 PECOS PAC ID: 0648374959 Enrollment ID: I20070327000059 |
| Provider Name | Dennis Fred Thompson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1659373256 PECOS PAC ID: 2769589753 Enrollment ID: I20070529000104 |
| Provider Name | Barbara J Boyd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417981549 PECOS PAC ID: 7416055801 Enrollment ID: I20070608000155 |
| Provider Name | Richard W Douce |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952317976 PECOS PAC ID: 3375641517 Enrollment ID: I20070612000033 |
| Provider Name | Tracy J Tacket |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487775847 PECOS PAC ID: 6507965399 Enrollment ID: I20070619000683 |
| Provider Name | Frederick A Johansen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497784706 PECOS PAC ID: 8820193824 Enrollment ID: I20070720000822 |
| Provider Name | Alexander W Runowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154439339 PECOS PAC ID: 3779677851 Enrollment ID: I20070920000113 |
| Provider Name | Lana K Gagin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669693487 PECOS PAC ID: 6305931353 Enrollment ID: I20071005000024 |
| Provider Name | Matthew Ling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760419246 PECOS PAC ID: 7719073568 Enrollment ID: I20071010000221 |
| Provider Name | Mark Harrison |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346278108 PECOS PAC ID: 4789597055 Enrollment ID: I20071023000328 |
| Provider Name | David M Sabato |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1992795447 PECOS PAC ID: 1052408903 Enrollment ID: I20071025000030 |
| Provider Name | Patrick C Mckillion |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1114998804 PECOS PAC ID: 8921064601 Enrollment ID: I20071105000470 |
| Provider Name | Lowell H Hamel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881674232 PECOS PAC ID: 7214018555 Enrollment ID: I20080114000026 |
| Provider Name | Jane J Yin |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1457372484 PECOS PAC ID: 7315988458 Enrollment ID: I20080114000839 |
| Provider Name | Ewanah Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841282456 PECOS PAC ID: 4284717364 Enrollment ID: I20080213000042 |
| Provider Name | Dale G Leffler |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1346463254 PECOS PAC ID: 7810074655 Enrollment ID: I20080404000075 |
| Provider Name | Frederick W. Born |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295735751 PECOS PAC ID: 1254418999 Enrollment ID: I20080407000044 |
| Provider Name | Laurence E Habenicht |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851363618 PECOS PAC ID: 7618054180 Enrollment ID: I20080408000494 |
| Provider Name | Deborah D Habenicht |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1467424218 PECOS PAC ID: 6608953070 Enrollment ID: I20080409000459 |
| Provider Name | Sachchidanand Jha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295709863 PECOS PAC ID: 5092893958 Enrollment ID: I20080418000102 |
| Provider Name | Robert C Ward |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598762379 PECOS PAC ID: 0143284398 Enrollment ID: I20080421000021 |
| Provider Name | Georg C Schultz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386672046 PECOS PAC ID: 2860576592 Enrollment ID: I20080508000403 |
| Provider Name | Muhammad H Al-midani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366527160 PECOS PAC ID: 3678643970 Enrollment ID: I20080529000286 |
| Provider Name | Kenneth Oneill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447266341 PECOS PAC ID: 0244143519 Enrollment ID: I20080530000614 |
| Provider Name | Jennifer L Zizzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780675140 PECOS PAC ID: 3375613383 Enrollment ID: I20080603000413 |
| Provider Name | Daniel L Hayward |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285679365 PECOS PAC ID: 4082798715 Enrollment ID: I20080625000731 |
| Provider Name | Marcia K Wiinamaki |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942215553 PECOS PAC ID: 1153493689 Enrollment ID: I20080627000578 |
| Provider Name | Stephen Dale Bovenkerk |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1760503171 PECOS PAC ID: 7315010410 Enrollment ID: I20080723000279 |
| Provider Name | Ted M Sugimoto |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578579595 PECOS PAC ID: 0941384671 Enrollment ID: I20080725000423 |
| Provider Name | Paul G Wasielewski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164402772 PECOS PAC ID: 6608941182 Enrollment ID: I20080818000703 |
| Provider Name | Charity Tumangday |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386706323 PECOS PAC ID: 3870685035 Enrollment ID: I20080820000642 |
| Provider Name | Joy F Ling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922142561 PECOS PAC ID: 1850467739 Enrollment ID: I20080828000353 |
| Provider Name | Tracy M Mcintyre Anderson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1801056726 PECOS PAC ID: 9032285812 Enrollment ID: I20080904000201 |
| Provider Name | John R Spriegel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235146721 PECOS PAC ID: 5496839128 Enrollment ID: I20080915000560 |
| Provider Name | Sunny S Tumangday |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386805778 PECOS PAC ID: 2466529375 Enrollment ID: I20080918000331 |
| Provider Name | Nancy J Nixon |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1346309606 PECOS PAC ID: 5395805931 Enrollment ID: I20081126000583 |
| Provider Name | Frederick A Kosinski |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386717593 PECOS PAC ID: 3173684065 Enrollment ID: I20081210000769 |
| Provider Name | George Abraham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396735791 PECOS PAC ID: 1658323985 Enrollment ID: I20081229000210 |
| Provider Name | Lisa C Bury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346495355 PECOS PAC ID: 1254495401 Enrollment ID: I20090203000128 |
| Provider Name | Michael E Mayle |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1851403307 PECOS PAC ID: 1254496979 Enrollment ID: I20090213000319 |
| Provider Name | Mark A Smalley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477512168 PECOS PAC ID: 9133183015 Enrollment ID: I20090224000224 |
| Provider Name | Jennifer T Hoffman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306812854 PECOS PAC ID: 2365469186 Enrollment ID: I20090325000571 |
| Provider Name | Brandi Ross-douglas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1588779904 PECOS PAC ID: 0941205876 Enrollment ID: I20090415000079 |
| Provider Name | Bruce A Jones |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275526675 PECOS PAC ID: 6901907500 Enrollment ID: I20090415000628 |
| Provider Name | Cathleen A Burns |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1699945493 PECOS PAC ID: 4981752888 Enrollment ID: I20090504000247 |
| Provider Name | Rickey L Snipes |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1477546869 PECOS PAC ID: 4183725781 Enrollment ID: I20090514000346 |
| Provider Name | Suresh Potluri |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1871757708 PECOS PAC ID: 0244382034 Enrollment ID: I20090708000457 |
| Provider Name | Kimberly J Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700993441 PECOS PAC ID: 5799837597 Enrollment ID: I20090708000546 |
| Provider Name | Lokesh K Kebbehundi Marigowda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174730188 PECOS PAC ID: 6406900521 Enrollment ID: I20090824000492 |
| Provider Name | Muhammad U Farooq |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598945156 PECOS PAC ID: 8729132857 Enrollment ID: I20090824000545 |
| Provider Name | Lorie A Hamel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285767095 PECOS PAC ID: 6608937636 Enrollment ID: I20090831000232 |
| Provider Name | Inga Sriubiene |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1639373095 PECOS PAC ID: 2163578550 Enrollment ID: I20090928000243 |
| Provider Name | Shannon K Twiddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386899292 PECOS PAC ID: 9830235738 Enrollment ID: I20091007000190 |
| Provider Name | Brad S Ferrari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518995828 PECOS PAC ID: 2961545942 Enrollment ID: I20100130000358 |
| Provider Name | Daniel M Metzger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265478192 PECOS PAC ID: 1052495785 Enrollment ID: I20100205000471 |
| Provider Name | David E Burdette |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679648315 PECOS PAC ID: 2264577451 Enrollment ID: I20100226000069 |
| Provider Name | Joseph S Mashni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265424527 PECOS PAC ID: 1759439441 Enrollment ID: I20100521000384 |
| Provider Name | Madhavi Kanneganti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881768075 PECOS PAC ID: 0042285728 Enrollment ID: I20100521000661 |
| Provider Name | Edward D Lanigan |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1255444907 PECOS PAC ID: 3870623093 Enrollment ID: I20100615000699 |
| Provider Name | Daniel R Fain |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922088491 PECOS PAC ID: 4486784329 Enrollment ID: I20100618000793 |
| Provider Name | Amritpal Anand |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770701716 PECOS PAC ID: 3274625678 Enrollment ID: I20100715000463 |
| Provider Name | James A Kroeze |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275562696 PECOS PAC ID: 8628152352 Enrollment ID: I20100717000139 |
| Provider Name | Jonathan F Osburn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265468862 PECOS PAC ID: 9537291141 Enrollment ID: I20100717000148 |
| Provider Name | Gerald F Kozuh |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700835295 PECOS PAC ID: 0345142857 Enrollment ID: I20100724000169 |
| Provider Name | Julie J Sommerfield Ronek |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902955214 PECOS PAC ID: 5597899237 Enrollment ID: I20100817000152 |
| Provider Name | Stephen J Bachmeyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134114754 PECOS PAC ID: 5092860924 Enrollment ID: I20100818000214 |
| Provider Name | Roy Eugene Winslow |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467488932 PECOS PAC ID: 9032293774 Enrollment ID: I20100818000850 |
| Provider Name | Stephen L Hempel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1851329601 PECOS PAC ID: 6800970534 Enrollment ID: I20100820001078 |
| Provider Name | David Terhune |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1639157308 PECOS PAC ID: 8426140500 Enrollment ID: I20100827000970 |
| Provider Name | Peter B Spencer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669479432 PECOS PAC ID: 9032234794 Enrollment ID: I20100917000767 |
| Provider Name | Robert M Allen |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1073540647 PECOS PAC ID: 5890879522 Enrollment ID: I20100929000432 |
| Provider Name | Teri S Peak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700836699 PECOS PAC ID: 9537170055 Enrollment ID: I20101101001453 |
| Provider Name | Dennis A Rasbach |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386600526 PECOS PAC ID: 7214070275 Enrollment ID: I20101103000590 |
| Provider Name | Glen H Hastings |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669439550 PECOS PAC ID: 4587707542 Enrollment ID: I20101103000620 |
| Provider Name | James Clancy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679539811 PECOS PAC ID: 0042353005 Enrollment ID: I20101103000783 |
| Provider Name | Justin T Sybesma |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376732016 PECOS PAC ID: 4082808936 Enrollment ID: I20101104000502 |
| Provider Name | Subramaniam R Shastri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821057183 PECOS PAC ID: 5698739571 Enrollment ID: I20101209001065 |
| Provider Name | Kathleen M Andries |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588623276 PECOS PAC ID: 3678537552 Enrollment ID: I20101221000160 |
| Provider Name | Sharon P Deskins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275592537 PECOS PAC ID: 1850355736 Enrollment ID: I20101221000236 |
| Provider Name | Charlotte Lofgren |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154529436 PECOS PAC ID: 6507054269 Enrollment ID: I20101221001161 |
| Provider Name | Samuel E Logan |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1013914241 PECOS PAC ID: 3274712427 Enrollment ID: I20110120000695 |
| Provider Name | Daniel Stephens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831127463 PECOS PAC ID: 6305920034 Enrollment ID: I20110127000687 |
| Provider Name | Ather M Bukhari |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992798391 PECOS PAC ID: 4688868110 Enrollment ID: I20110222000747 |
| Provider Name | Keith Vanoosterhout |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1851329957 PECOS PAC ID: 4587748223 Enrollment ID: I20110225000847 |
| Provider Name | Lucien P Tamer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1760655195 PECOS PAC ID: 8820270192 Enrollment ID: I20110308000323 |
| Provider Name | Lillian S Jardine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720188956 PECOS PAC ID: 8123043650 Enrollment ID: I20110328000574 |
| Provider Name | Sapna R Patel |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1801830732 PECOS PAC ID: 5890715684 Enrollment ID: I20110426000798 |
| Provider Name | Ameed Abdulrazzak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902069016 PECOS PAC ID: 5698943132 Enrollment ID: I20110727000533 |
| Provider Name | William T Mccadie |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1669414736 PECOS PAC ID: 9638174006 Enrollment ID: I20110801000390 |
| Provider Name | Craig M Kline |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679774517 PECOS PAC ID: 3870762784 Enrollment ID: I20110810000609 |
| Provider Name | John W Howard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205090065 PECOS PAC ID: 5991975609 Enrollment ID: I20110906000577 |
| Provider Name | Jonathan R Steen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750543849 PECOS PAC ID: 3072784404 Enrollment ID: I20110915000509 |
| Provider Name | Dave S Boparai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124284633 PECOS PAC ID: 9830360940 Enrollment ID: I20110921000810 |
| Provider Name | Vessela Giger-mateeva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487896254 PECOS PAC ID: 4789855776 Enrollment ID: I20110923000201 |
| Provider Name | David K Rhine |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1134377435 PECOS PAC ID: 0840461786 Enrollment ID: I20110926000252 |
| Provider Name | Ayyoub B Haddad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336390012 PECOS PAC ID: 9830361716 Enrollment ID: I20111019000424 |
| Provider Name | Heather A Sowinski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700036274 PECOS PAC ID: 0648446302 Enrollment ID: I20111229000621 |
| Provider Name | Ana I Huaringa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063781664 PECOS PAC ID: 8426225368 Enrollment ID: I20120118000407 |
| Provider Name | Rhonda Griffiths |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386686996 PECOS PAC ID: 5698838084 Enrollment ID: I20120328000355 |
| Provider Name | Daniel D Bosis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912193277 PECOS PAC ID: 5395908180 Enrollment ID: I20120514000718 |
| Provider Name | Danial Rashid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407098882 PECOS PAC ID: 9537323803 Enrollment ID: I20120618000372 |
| Provider Name | Shan E Abbas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730362674 PECOS PAC ID: 5597920272 Enrollment ID: I20120702000303 |
| Provider Name | Thomas R Birris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003083627 PECOS PAC ID: 9537324884 Enrollment ID: I20120711000532 |
| Provider Name | Ivelisse E Leonor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104146042 PECOS PAC ID: 5799809950 Enrollment ID: I20120801000299 |
| Provider Name | Nicholas Loafman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598998288 PECOS PAC ID: 6709032972 Enrollment ID: I20120803000809 |
| Provider Name | Peter Pingkwong Lai |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1629085022 PECOS PAC ID: 8224016290 Enrollment ID: I20120807000104 |
| Provider Name | Meghan K Murphy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780846261 PECOS PAC ID: 9436306834 Enrollment ID: I20120820000695 |
| Provider Name | Manuel E Cantor Varela |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093975658 PECOS PAC ID: 7911177068 Enrollment ID: I20120917000739 |
| Provider Name | Jamie K Birris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396926820 PECOS PAC ID: 5496837742 Enrollment ID: I20120918000547 |
| Provider Name | Joanna M Olewicz |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790954097 PECOS PAC ID: 4981890217 Enrollment ID: I20120926000407 |
| Provider Name | Anne E Dudley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588893283 PECOS PAC ID: 5395994537 Enrollment ID: I20121004000147 |
| Provider Name | Tarek Saleh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790915544 PECOS PAC ID: 5597915959 Enrollment ID: I20121019000205 |
| Provider Name | Rebecca L Kundan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619230935 PECOS PAC ID: 3274785860 Enrollment ID: I20121205000379 |
| Provider Name | Ruel R Lirio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679561211 PECOS PAC ID: 9638346646 Enrollment ID: I20121212000537 |
| Provider Name | Richard B Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437180874 PECOS PAC ID: 7315978228 Enrollment ID: I20130110000487 |
| Provider Name | Benjamin Thomas Gielda |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1386801496 PECOS PAC ID: 0840460184 Enrollment ID: I20130121000051 |
| Provider Name | Elizabeth R Egle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558599597 PECOS PAC ID: 4486807633 Enrollment ID: I20130121000141 |
| Provider Name | Eric D Tripp |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740222603 PECOS PAC ID: 3779551999 Enrollment ID: I20130201000516 |
| Provider Name | Michele Hursh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295984359 PECOS PAC ID: 6204997745 Enrollment ID: I20130726000765 |
| Provider Name | Nancy Jo Fantetti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891054458 PECOS PAC ID: 0244485639 Enrollment ID: I20130727000175 |
| Provider Name | Joseph A Farber |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477756062 PECOS PAC ID: 3779726633 Enrollment ID: I20130826000662 |
| Provider Name | Jiangyong Min |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811152887 PECOS PAC ID: 4284877739 Enrollment ID: I20130830000491 |
| Provider Name | David O Malaka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548568066 PECOS PAC ID: 5698919629 Enrollment ID: I20130913000172 |
| Provider Name | Desire M Andersen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093033029 PECOS PAC ID: 0143464982 Enrollment ID: I20130918000428 |
| Provider Name | Paul J Spilotro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982823159 PECOS PAC ID: 9133363567 Enrollment ID: I20130924000933 |
| Provider Name | Peter A Paximadis |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1710147756 PECOS PAC ID: 6406080779 Enrollment ID: I20130930000370 |
| Provider Name | Anca Tanase |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497920292 PECOS PAC ID: 3476626235 Enrollment ID: I20130930000551 |
| Provider Name | Brian E Bates |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558317446 PECOS PAC ID: 9133020167 Enrollment ID: I20131003000595 |
| Provider Name | Jacob C Blazo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861716748 PECOS PAC ID: 6103051388 Enrollment ID: I20131023001960 |
| Provider Name | Vivek Baluja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538205539 PECOS PAC ID: 0143408989 Enrollment ID: I20131028001256 |
| Provider Name | Wendy L Hays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841630910 PECOS PAC ID: 6709011539 Enrollment ID: I20131101000025 |
| Provider Name | Jay V Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487974663 PECOS PAC ID: 1658506373 Enrollment ID: I20131104001500 |
| Provider Name | Todd W Haney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598198673 PECOS PAC ID: 7618102187 Enrollment ID: I20131109000234 |
| Provider Name | Alissa M Conklin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437318953 PECOS PAC ID: 3375708423 Enrollment ID: I20131115001708 |
| Provider Name | Benjamin T Wood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093904468 PECOS PAC ID: 6305014846 Enrollment ID: I20131121001259 |
| Provider Name | David Kraklau |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033546122 PECOS PAC ID: 5890921613 Enrollment ID: I20131126000375 |
| Provider Name | Jennifer D Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417380221 PECOS PAC ID: 3476780917 Enrollment ID: I20131209000768 |
| Provider Name | Miguel E Bermeo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811167216 PECOS PAC ID: 7810074325 Enrollment ID: I20140103000381 |
| Provider Name | Christopher Ratnasamy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043411721 PECOS PAC ID: 7315039302 Enrollment ID: I20140107001260 |
| Provider Name | Eric E Erickson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558342220 PECOS PAC ID: 9931157120 Enrollment ID: I20140211000643 |
| Provider Name | Christin N Adams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275968018 PECOS PAC ID: 7517196702 Enrollment ID: I20140211000778 |
| Provider Name | Allison Turner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316100803 PECOS PAC ID: 6204066848 Enrollment ID: I20140227001959 |
| Provider Name | Dawn E Gebhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275974628 PECOS PAC ID: 0446481279 Enrollment ID: I20140320001054 |
| Provider Name | Wendy C Steinkraus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659670289 PECOS PAC ID: 1658503073 Enrollment ID: I20140416001945 |
| Provider Name | Michael Morris |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093005530 PECOS PAC ID: 8729210067 Enrollment ID: I20140421000213 |
| Provider Name | Hibajene Chisonga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811327943 PECOS PAC ID: 6103049440 Enrollment ID: I20140514000869 |
| Provider Name | Michelle D De Jesus Brazitis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922315522 PECOS PAC ID: 3870732415 Enrollment ID: I20140515000840 |
| Provider Name | Aaron Lanning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063831469 PECOS PAC ID: 0244453777 Enrollment ID: I20140602000196 |
| Provider Name | Linda K Slabaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558772913 PECOS PAC ID: 6305061813 Enrollment ID: I20140625001299 |
| Provider Name | Sharon A Rooney Gandy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083788285 PECOS PAC ID: 7113071440 Enrollment ID: I20140626001031 |
| Provider Name | Omran B Kaskar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629208798 PECOS PAC ID: 9436374378 Enrollment ID: I20140708002246 |
| Provider Name | Kenneth W Kaufmann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083925119 PECOS PAC ID: 7416172267 Enrollment ID: I20140710001737 |
| Provider Name | Rachel Rene Fabris |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669601464 PECOS PAC ID: 5890989032 Enrollment ID: I20140717000205 |
| Provider Name | Seth Devries |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518128974 PECOS PAC ID: 9032335518 Enrollment ID: I20140717002262 |
| Provider Name | Jordan Sall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811242753 PECOS PAC ID: 2062641194 Enrollment ID: I20140721000592 |
| Provider Name | Eeka Wendella Marshall |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376856724 PECOS PAC ID: 1658598545 Enrollment ID: I20140818001096 |
| Provider Name | Tobin Jay Klint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407260201 PECOS PAC ID: 7416175294 Enrollment ID: I20140820002683 |
| Provider Name | Mohammad Wisam Sakbani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689952228 PECOS PAC ID: 0143471003 Enrollment ID: I20140917000607 |
| Provider Name | Anastasia Luniova |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942461447 PECOS PAC ID: 8325277213 Enrollment ID: I20141013002133 |
| Provider Name | Crystal D Payton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639594054 PECOS PAC ID: 6800017302 Enrollment ID: I20141027001939 |
| Provider Name | Julia Kostyuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558766188 PECOS PAC ID: 8426270539 Enrollment ID: I20141105000674 |
| Provider Name | Okwudili Nnaji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912144403 PECOS PAC ID: 8224171475 Enrollment ID: I20141229000595 |
| Provider Name | Amy Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245637354 PECOS PAC ID: 6608199328 Enrollment ID: I20150102000835 |
| Provider Name | Kenlyn Marie Laureys |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558762476 PECOS PAC ID: 9830413160 Enrollment ID: I20150115000751 |
| Provider Name | Syed Q Quadri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821317991 PECOS PAC ID: 9335466192 Enrollment ID: I20150317000355 |
| Provider Name | Pamela J Klint |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033509286 PECOS PAC ID: 4385962083 Enrollment ID: I20150408002783 |
| Provider Name | Nassir Hm Monim Mansour |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1790923951 PECOS PAC ID: 1355666736 Enrollment ID: I20150421001075 |
| Provider Name | Adam Z Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487913158 PECOS PAC ID: 6507186806 Enrollment ID: I20150528001548 |
| Provider Name | Nina Ramessar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1467763201 PECOS PAC ID: 3577874718 Enrollment ID: I20150615002278 |
| Provider Name | Rebecca Taulbee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144521063 PECOS PAC ID: 0345420675 Enrollment ID: I20150618002066 |
| Provider Name | Nicholas Anthony Crawford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861756595 PECOS PAC ID: 2961714068 Enrollment ID: I20150702000290 |
| Provider Name | Usman Saeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710212758 PECOS PAC ID: 1254643059 Enrollment ID: I20150708001333 |
| Provider Name | Sri Venkata Uppalapati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538489810 PECOS PAC ID: 4688987613 Enrollment ID: I20150721000616 |
| Provider Name | Ibrahim M Abdullah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225395692 PECOS PAC ID: 9537391495 Enrollment ID: I20150723007823 |
| Provider Name | Ashley Dupuis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821396599 PECOS PAC ID: 5991019986 Enrollment ID: I20150804006069 |
| Provider Name | Betsy Marie Becker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427433176 PECOS PAC ID: 4880909241 Enrollment ID: I20150813010473 |
| Provider Name | Ome K Nwanze |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750522173 PECOS PAC ID: 8022154848 Enrollment ID: I20150814014665 |
| Provider Name | Elizabeth A Mcglothlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124394945 PECOS PAC ID: 9931414000 Enrollment ID: I20150818005941 |
| Provider Name | Redwan Asbahi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730445503 PECOS PAC ID: 5395050199 Enrollment ID: I20150821013669 |
| Provider Name | Jill L Gorsuch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851523377 PECOS PAC ID: 9830314426 Enrollment ID: I20150922002695 |
| Provider Name | Michael Lewis Webb |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578884441 PECOS PAC ID: 1658519095 Enrollment ID: I20150928000085 |
| Provider Name | Kathryn Kern |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1487021481 PECOS PAC ID: 8022327832 Enrollment ID: I20151019000605 |
| Provider Name | Kaitlin M Schoder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720462872 PECOS PAC ID: 8820308034 Enrollment ID: I20151029002674 |
| Provider Name | Gina K South |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255507596 PECOS PAC ID: 8527238047 Enrollment ID: I20151030000116 |
| Provider Name | Muhib Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043452337 PECOS PAC ID: 7315180536 Enrollment ID: I20151105001634 |
| Provider Name | Lourich E Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851647226 PECOS PAC ID: 6204136526 Enrollment ID: I20151118001385 |
| Provider Name | Ian A Jackson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598084691 PECOS PAC ID: 0244554277 Enrollment ID: I20151214001575 |
| Provider Name | Cary E Fechter |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649235714 PECOS PAC ID: 2567354632 Enrollment ID: I20160107002862 |
| Provider Name | Abimbola Adenike Matti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386931178 PECOS PAC ID: 7911176680 Enrollment ID: I20160201000825 |
| Provider Name | Karen Powers |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1558570580 PECOS PAC ID: 2466576608 Enrollment ID: I20160204000142 |
| Provider Name | Brian Daniel Facione |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720349210 PECOS PAC ID: 0446554638 Enrollment ID: I20160209001066 |
| Provider Name | Jonathan Richard Krauss |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376803544 PECOS PAC ID: 7315241502 Enrollment ID: I20160209001232 |
| Provider Name | Daniel Allen Seidling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033594726 PECOS PAC ID: 5092012435 Enrollment ID: I20160329002569 |
| Provider Name | Syed S Qadri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619233749 PECOS PAC ID: 1355648692 Enrollment ID: I20160331000390 |
| Provider Name | Emily Anna Burk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689939936 PECOS PAC ID: 1355649435 Enrollment ID: I20160406002268 |
| Provider Name | Kelly L Raymond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861746869 PECOS PAC ID: 9032417902 Enrollment ID: I20160408000580 |
| Provider Name | Nargiz Ruzmetova |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700047396 PECOS PAC ID: 9436309713 Enrollment ID: I20160502000751 |
| Provider Name | Amy J Laurent |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073670659 PECOS PAC ID: 1951499557 Enrollment ID: I20160502001197 |
| Provider Name | Amanda L Morris |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1730479270 PECOS PAC ID: 2961721600 Enrollment ID: I20160531001844 |
| Provider Name | Furqan Siddiqi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1639481344 PECOS PAC ID: 3971759358 Enrollment ID: I20160608000283 |
| Provider Name | Katherine A Skurski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750727608 PECOS PAC ID: 0941519920 Enrollment ID: I20160622000918 |
| Provider Name | Evan Tank |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124316054 PECOS PAC ID: 9931417813 Enrollment ID: I20160623000568 |
| Provider Name | Emil E Ebner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740541176 PECOS PAC ID: 0143451708 Enrollment ID: I20160628000351 |
| Provider Name | Jena Krueger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679898357 PECOS PAC ID: 8527350289 Enrollment ID: I20160718000389 |
| Provider Name | Michael James Burton |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407160559 PECOS PAC ID: 3577856251 Enrollment ID: I20160719001853 |
| Provider Name | Seth G Hauschild |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952747883 PECOS PAC ID: 8123349479 Enrollment ID: I20160721000101 |
| Provider Name | Abbas El-khatib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386709970 PECOS PAC ID: 7012200975 Enrollment ID: I20160729001081 |
| Provider Name | Prakash T Shrestha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427045392 PECOS PAC ID: 4486630456 Enrollment ID: I20160801002729 |
| Provider Name | Aubrey M Brannick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821440728 PECOS PAC ID: 9032403548 Enrollment ID: I20160805001587 |
| Provider Name | Debora Kay Tenter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467804567 PECOS PAC ID: 5294029120 Enrollment ID: I20160815002916 |
| Provider Name | Hussam Sabbagh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326452509 PECOS PAC ID: 7214239292 Enrollment ID: I20160817000659 |
| Provider Name | Riddhi Jay Shah |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1568504397 PECOS PAC ID: 0244330173 Enrollment ID: I20160823002359 |
| Provider Name | Stephen F Komara |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255628822 PECOS PAC ID: 2264745595 Enrollment ID: I20160824001690 |
| Provider Name | Sally E Birger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720300635 PECOS PAC ID: 2961536958 Enrollment ID: I20160916000610 |
| Provider Name | Ammar H Ali |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1669797627 PECOS PAC ID: 7719124262 Enrollment ID: I20160916001792 |
| Provider Name | Craig A Rigler |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073521068 PECOS PAC ID: 7113214149 Enrollment ID: I20160920000127 |
| Provider Name | Krista K Schulte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730630740 PECOS PAC ID: 6901184654 Enrollment ID: I20161031001820 |
| Provider Name | Jessica Rose Schulte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588113666 PECOS PAC ID: 1557649928 Enrollment ID: I20161107000584 |
| Provider Name | Mohammad K Khedr |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1427051705 PECOS PAC ID: 5496731341 Enrollment ID: I20161116000643 |
| Provider Name | Angel W Hernandez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457444531 PECOS PAC ID: 0749187516 Enrollment ID: I20161208000403 |
| Provider Name | Jaaneali Mehdi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104071885 PECOS PAC ID: 2567619406 Enrollment ID: I20161208002175 |
| Provider Name | Ginard Irwyn Henry |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1932149135 PECOS PAC ID: 0345245536 Enrollment ID: I20161212000047 |
| Provider Name | Tatiyana Stankovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609022243 PECOS PAC ID: 4587729017 Enrollment ID: I20161215000288 |
| Provider Name | Laurie Ann Gee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033442421 PECOS PAC ID: 4789719048 Enrollment ID: I20170113000123 |
| Provider Name | Olivia Cochran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184176786 PECOS PAC ID: 3274815840 Enrollment ID: I20170117001876 |
| Provider Name | Jeanette K Postelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841737046 PECOS PAC ID: 5799069969 Enrollment ID: I20170307002235 |
| Provider Name | Laurel J Yoder |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1336514587 PECOS PAC ID: 3678859444 Enrollment ID: I20170410001112 |
| Provider Name | Janelle M Cornforth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558801068 PECOS PAC ID: 5890062012 Enrollment ID: I20170518001510 |
| Provider Name | Priya Rana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1952643017 PECOS PAC ID: 5193035228 Enrollment ID: I20170522001648 |
| Provider Name | Rafid Asfar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1639468747 PECOS PAC ID: 2961626486 Enrollment ID: I20170523001348 |
| Provider Name | Rafeek Woods |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1164712600 PECOS PAC ID: 3476821430 Enrollment ID: I20170615000440 |
| Provider Name | Xinyue Pan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518374131 PECOS PAC ID: 6002185428 Enrollment ID: I20170628001570 |
| Provider Name | Stanley Sedore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306163092 PECOS PAC ID: 5193011450 Enrollment ID: I20170706001597 |
| Provider Name | Akinbode S Egbelakin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104117522 PECOS PAC ID: 3577780626 Enrollment ID: I20170710000894 |
| Provider Name | Deanna L Fulbright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548671837 PECOS PAC ID: 2163732090 Enrollment ID: I20170710000931 |
| Provider Name | Sandro James Corti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538503131 PECOS PAC ID: 4789953696 Enrollment ID: I20170710001228 |
| Provider Name | Emily Annette Dryer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437579992 PECOS PAC ID: 4183933013 Enrollment ID: I20170713002873 |
| Provider Name | Julie Anne Brownell |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1316246192 PECOS PAC ID: 2769615756 Enrollment ID: I20170719002722 |
| Provider Name | Bakhtiar Yamini |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1851456693 PECOS PAC ID: 4284814815 Enrollment ID: I20170801001013 |
| Provider Name | Ahmed Arshad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154461531 PECOS PAC ID: 1759579634 Enrollment ID: I20170801001019 |
| Provider Name | Leeann Marie Enix |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306360227 PECOS PAC ID: 3870866296 Enrollment ID: I20170907000687 |
| Provider Name | Kimberlee A Tomerlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013321140 PECOS PAC ID: 1759690605 Enrollment ID: I20170926000169 |
| Provider Name | Lindsey Michelle Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326564352 PECOS PAC ID: 3476828898 Enrollment ID: I20171010002765 |
| Provider Name | Richard Newman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831199850 PECOS PAC ID: 2365415957 Enrollment ID: I20171025001805 |
| Provider Name | Jonathan Patrick Egle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346470176 PECOS PAC ID: 5799041976 Enrollment ID: I20171102003600 |
| Provider Name | Soheila Roossien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629589015 PECOS PAC ID: 3476819236 Enrollment ID: I20171110000605 |
| Provider Name | Karen E Friday |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1295994432 PECOS PAC ID: 0648287003 Enrollment ID: I20171128003334 |
| Provider Name | Muhammad Naeem Ahmad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184016073 PECOS PAC ID: 4284919655 Enrollment ID: I20171221000045 |
| Provider Name | Barbara Marge Segal |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1710069208 PECOS PAC ID: 8628137288 Enrollment ID: I20180104001623 |
| Provider Name | Michelle E Doran |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669600581 PECOS PAC ID: 8820357635 Enrollment ID: I20180123002753 |
| Provider Name | Stacy Hendershott |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1255875472 PECOS PAC ID: 5698059624 Enrollment ID: I20180126000963 |
| Provider Name | Patricia M Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508140229 PECOS PAC ID: 5890055396 Enrollment ID: I20180201000058 |
| Provider Name | Ann Martha Rahe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962916023 PECOS PAC ID: 6305106626 Enrollment ID: I20180207000232 |
| Provider Name | Meredith Marie Krugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639684178 PECOS PAC ID: 6901167220 Enrollment ID: I20180301002562 |
| Provider Name | Tien Nguyen |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1841626546 PECOS PAC ID: 2466776208 Enrollment ID: I20180320000910 |
| Provider Name | Donald Wolfram |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669499257 PECOS PAC ID: 7113020009 Enrollment ID: I20180320001080 |
| Provider Name | Erin Nichole Hayden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841707106 PECOS PAC ID: 3678835170 Enrollment ID: I20180321001497 |
| Provider Name | Imran Ahmed Moinuddin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861649907 PECOS PAC ID: 5890963110 Enrollment ID: I20180424000564 |
| Provider Name | Ronald Glenn Ungerer |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255327813 PECOS PAC ID: 2365592912 Enrollment ID: I20180502001676 |
| Provider Name | John Maxwell Kofi Abbensetts |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215956115 PECOS PAC ID: 9032177795 Enrollment ID: I20180514001195 |
| Provider Name | Dawn Alita Hernandez |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1265449854 PECOS PAC ID: 3577599786 Enrollment ID: I20180529000327 |
| Provider Name | Nabil Wees |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164862454 PECOS PAC ID: 9133362700 Enrollment ID: I20180613002088 |
| Provider Name | Mark Jacob |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1063688497 PECOS PAC ID: 4486827011 Enrollment ID: I20180626003693 |
| Provider Name | Alexander Tennyson Hinckley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982049524 PECOS PAC ID: 8527377399 Enrollment ID: I20180628000835 |
| Provider Name | Nicole M Roe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790165272 PECOS PAC ID: 0345559282 Enrollment ID: I20180713000380 |
| Provider Name | Samantha Michelle Labay |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972984011 PECOS PAC ID: 4082923800 Enrollment ID: I20180713000492 |
| Provider Name | Priya Brian Joseph |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790161156 PECOS PAC ID: 6608123112 Enrollment ID: I20180716000263 |
| Provider Name | Yu Liu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043415706 PECOS PAC ID: 5395846901 Enrollment ID: I20180718001182 |
| Provider Name | Roxanne Wolfram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225360977 PECOS PAC ID: 5991064768 Enrollment ID: I20180719000536 |
| Provider Name | Nadeem Israr Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427481498 PECOS PAC ID: 6204052285 Enrollment ID: I20180727000287 |
| Provider Name | Troy Sankford Reeves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740669332 PECOS PAC ID: 5799098091 Enrollment ID: I20180803001036 |
| Provider Name | Albert Naveed |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1578710232 PECOS PAC ID: 7719207679 Enrollment ID: I20180807001771 |
| Provider Name | Tanya Sobaski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205322534 PECOS PAC ID: 3870841885 Enrollment ID: I20180808001250 |
| Provider Name | Audrey L Wedde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457743486 PECOS PAC ID: 9830409978 Enrollment ID: I20180815002403 |
| Provider Name | Erica Michelle Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932698883 PECOS PAC ID: 2163771635 Enrollment ID: I20180815003962 |
| Provider Name | Catherine Diane Boomus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225250921 PECOS PAC ID: 9133200686 Enrollment ID: I20180816001512 |
| Provider Name | Daniel K Benson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851770465 PECOS PAC ID: 1850601873 Enrollment ID: I20180820001499 |
| Provider Name | Amena Iqbal |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1124469523 PECOS PAC ID: 3476776220 Enrollment ID: I20180820002466 |
| Provider Name | Brandon R Cole |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033522313 PECOS PAC ID: 7113143868 Enrollment ID: I20180824000193 |
| Provider Name | Caitlyn Michele Plonka |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033599907 PECOS PAC ID: 6002129202 Enrollment ID: I20180827001695 |
| Provider Name | Dennis L Disch |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003812926 PECOS PAC ID: 2860394376 Enrollment ID: I20180910000539 |
| Provider Name | Elizabeth Haworth Hoeppner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700265816 PECOS PAC ID: 8729339627 Enrollment ID: I20180914001607 |
| Provider Name | Carrie Elizabeth Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861988180 PECOS PAC ID: 4981955481 Enrollment ID: I20180921002925 |
| Provider Name | Michael Alan Schiman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639657729 PECOS PAC ID: 5294086658 Enrollment ID: I20180924002737 |
| Provider Name | Steven Kenton Coy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598152951 PECOS PAC ID: 9335454750 Enrollment ID: I20181001001589 |
| Provider Name | Omar Khorfan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720345036 PECOS PAC ID: 5698076461 Enrollment ID: I20181005000093 |
| Provider Name | Ken Ochiai |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629455050 PECOS PAC ID: 8123331626 Enrollment ID: I20181005002001 |
| Provider Name | Gregory George Bingaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265700090 PECOS PAC ID: 1951699404 Enrollment ID: I20181015002905 |
| Provider Name | Emily C Delmotte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639653058 PECOS PAC ID: 2365795176 Enrollment ID: I20181024002771 |
| Provider Name | Raul Hector Torres |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982041620 PECOS PAC ID: 2163731373 Enrollment ID: I20181106002479 |
| Provider Name | Deanna Margaret Rucano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174011316 PECOS PAC ID: 0042554321 Enrollment ID: I20181128001543 |
| Provider Name | Cayla Ariel Dungey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720576929 PECOS PAC ID: 9931443942 Enrollment ID: I20181203000859 |
| Provider Name | David Sung-wook Moon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164866414 PECOS PAC ID: 2769727064 Enrollment ID: I20181214000167 |
| Provider Name | Sierra Lynn Richer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1912474388 PECOS PAC ID: 9931444205 Enrollment ID: I20181214002939 |
| Provider Name | Seth Leland Miller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497952691 PECOS PAC ID: 5597000182 Enrollment ID: I20190102000063 |
| Provider Name | Erin M Okazaki |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760747877 PECOS PAC ID: 3173756301 Enrollment ID: I20190124002550 |
| Provider Name | Paul Daniel Judge |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1184988685 PECOS PAC ID: 1456633296 Enrollment ID: I20190128000529 |
| Provider Name | Choudhury S Hasan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1629187752 PECOS PAC ID: 9638336530 Enrollment ID: I20190131000319 |
| Provider Name | Olga Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780047274 PECOS PAC ID: 9032482245 Enrollment ID: I20190211001977 |
| Provider Name | April Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386157915 PECOS PAC ID: 4587903224 Enrollment ID: I20190225001987 |
| Provider Name | Jason R Sebesto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861786246 PECOS PAC ID: 0749416238 Enrollment ID: I20190513002019 |
| Provider Name | Abigail R Ducheine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639528375 PECOS PAC ID: 9830481035 Enrollment ID: I20190514000100 |
| Provider Name | Vahid Behravan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871722520 PECOS PAC ID: 6507189123 Enrollment ID: I20190515001544 |
| Provider Name | Alberto R Figueroa-garcia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912167594 PECOS PAC ID: 3072754175 Enrollment ID: I20190515001600 |
| Provider Name | Jessica Floyd |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386888113 PECOS PAC ID: 3779729868 Enrollment ID: I20190515001810 |
| Provider Name | Harsha Ghatge Nagaraja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568606259 PECOS PAC ID: 5496983009 Enrollment ID: I20190515001942 |
| Provider Name | Nima Mowzoon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992774327 PECOS PAC ID: 1254358401 Enrollment ID: I20190515002019 |
| Provider Name | Chut Sombutmai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649320987 PECOS PAC ID: 4284807413 Enrollment ID: I20190515002082 |
| Provider Name | Theresa B. Sevilis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407111461 PECOS PAC ID: 6608191911 Enrollment ID: I20190515002107 |
| Provider Name | Katherine Colleen Riordan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689832107 PECOS PAC ID: 8224174354 Enrollment ID: I20190515002108 |
| Provider Name | Yazan M Suradi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952600223 PECOS PAC ID: 5698055945 Enrollment ID: I20190515002115 |
| Provider Name | Geetanjali Vajapey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740523935 PECOS PAC ID: 5799087441 Enrollment ID: I20190515002172 |
| Provider Name | Sam Kumar Saha |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629394390 PECOS PAC ID: 3870733181 Enrollment ID: I20190515002187 |
| Provider Name | Yelena G Vidgop |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336300771 PECOS PAC ID: 0941444095 Enrollment ID: I20190515002193 |
| Provider Name | Mai Won |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871676676 PECOS PAC ID: 2860418175 Enrollment ID: I20190515002203 |
| Provider Name | Vivian Marie Suarez Gonzalez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801107388 PECOS PAC ID: 7618145830 Enrollment ID: I20190515002366 |
| Provider Name | Deb K Mojumder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396023818 PECOS PAC ID: 4183928849 Enrollment ID: I20190515002657 |
| Provider Name | Neetu Dhadwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962842492 PECOS PAC ID: 4183852270 Enrollment ID: I20190515002802 |
| Provider Name | Mohammed Zaman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215126032 PECOS PAC ID: 4284882895 Enrollment ID: I20190515003165 |
| Provider Name | David K. Hahn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053625459 PECOS PAC ID: 7911217724 Enrollment ID: I20190523000298 |
| Provider Name | Stanley Garken Lue |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003017427 PECOS PAC ID: 6204005648 Enrollment ID: I20190523000328 |
| Provider Name | Michelle Boudreau |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346534864 PECOS PAC ID: 7416182480 Enrollment ID: I20190523000442 |
| Provider Name | Adam L Heller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710183041 PECOS PAC ID: 5991879793 Enrollment ID: I20190523000507 |
| Provider Name | Douglas A Valenta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851553879 PECOS PAC ID: 4688728181 Enrollment ID: I20190523000765 |
| Provider Name | Joao Mc-oneil Plancher |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700142668 PECOS PAC ID: 9638317837 Enrollment ID: I20190607000803 |
| Provider Name | Mark N Friedman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932181849 PECOS PAC ID: 5092732388 Enrollment ID: I20190610001173 |
| Provider Name | Michael Snyder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932239142 PECOS PAC ID: 7719084896 Enrollment ID: I20190611000069 |
| Provider Name | Adham Samy Kamel Elsayed Elokda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225264526 PECOS PAC ID: 9739357609 Enrollment ID: I20190611000659 |
| Provider Name | Patricia Colon-garcia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427157270 PECOS PAC ID: 0446356216 Enrollment ID: I20190611001435 |
| Provider Name | Muhammad Masud |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700179231 PECOS PAC ID: 8628381662 Enrollment ID: I20190611001463 |
| Provider Name | Nicholas M Frazier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184085458 PECOS PAC ID: 7214220896 Enrollment ID: I20190624000980 |
| Provider Name | Emily A Mitchell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043537020 PECOS PAC ID: 0941519185 Enrollment ID: I20190626000574 |
| Provider Name | Amanda J Avila |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184841397 PECOS PAC ID: 9830345735 Enrollment ID: I20190701002447 |
| Provider Name | Nicholas Absalom |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770744112 PECOS PAC ID: 5395900633 Enrollment ID: I20190701002478 |
| Provider Name | Harlori Kaur Bains |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497097588 PECOS PAC ID: 3476888769 Enrollment ID: I20190709001662 |
| Provider Name | Walter Morgan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225290497 PECOS PAC ID: 8729221247 Enrollment ID: I20190710002407 |
| Provider Name | Daniel R Douce |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1851541353 PECOS PAC ID: 5496981219 Enrollment ID: I20190730000264 |
| Provider Name | Harry Obeng Boamah |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1609136720 PECOS PAC ID: 6305173469 Enrollment ID: I20190812003646 |
| Provider Name | Raja A Rabadi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265815476 PECOS PAC ID: 5395025464 Enrollment ID: I20190829002211 |
| Provider Name | Maria Ficker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548620149 PECOS PAC ID: 2860721107 Enrollment ID: I20190911001610 |
| Provider Name | Tracy Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376925891 PECOS PAC ID: 6305155607 Enrollment ID: I20190912001508 |
| Provider Name | Bridget Lynn Russell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467008342 PECOS PAC ID: 4486983574 Enrollment ID: I20190916002015 |
| Provider Name | Tringo Dessie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326695552 PECOS PAC ID: 9739419474 Enrollment ID: I20190924001238 |
| Provider Name | Nordeli Estronza |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750333167 PECOS PAC ID: 1355352766 Enrollment ID: I20191003002734 |
| Provider Name | Maria Aguilar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518924190 PECOS PAC ID: 9133130156 Enrollment ID: I20191003002803 |
| Provider Name | Raina Gupta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366698482 PECOS PAC ID: 4385816685 Enrollment ID: I20191003002899 |
| Provider Name | Hassan A Al-shammaa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497173850 PECOS PAC ID: 1951600030 Enrollment ID: I20191009003071 |
| Provider Name | Elizabeth Rl Douce |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679716583 PECOS PAC ID: 0941531594 Enrollment ID: I20191011001316 |
| Provider Name | Kathryn M Vera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861033599 PECOS PAC ID: 1557794948 Enrollment ID: I20191125001541 |
| Provider Name | Linda Barbara Pauliks |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013903947 PECOS PAC ID: 7618881160 Enrollment ID: I20191126000091 |
| Provider Name | Thomas Joseph Wechter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578944328 PECOS PAC ID: 8325351430 Enrollment ID: I20191213001572 |
| Provider Name | Gary Witucki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184699472 PECOS PAC ID: 8527055961 Enrollment ID: I20191219000727 |
| Provider Name | Adil Keskin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1790754521 PECOS PAC ID: 6002857414 Enrollment ID: I20200107001855 |
| Provider Name | Cynthia-mendon Wister Kelrick |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1407499908 PECOS PAC ID: 9931534492 Enrollment ID: I20200110002593 |
| Provider Name | Mohamed Noureldin Birima Noureldin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437689437 PECOS PAC ID: 6002241858 Enrollment ID: I20200124000492 |
| Provider Name | Cynthia Salgado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598309437 PECOS PAC ID: 1850726555 Enrollment ID: I20200125000390 |
| Provider Name | Shubhangi Chumble |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881684074 PECOS PAC ID: 6305844242 Enrollment ID: I20200316001910 |
| Provider Name | Clifford Meyers |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699090217 PECOS PAC ID: 4688988256 Enrollment ID: I20200316002464 |
| Provider Name | Rebecca Jimenez-sanders |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154587152 PECOS PAC ID: 0143536656 Enrollment ID: I20200318000400 |
| Provider Name | Cory D Lamar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740469030 PECOS PAC ID: 5991952046 Enrollment ID: I20200318000498 |
| Provider Name | Rebecca L Krzysiak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023668951 PECOS PAC ID: 7517395932 Enrollment ID: I20200318002381 |
| Provider Name | Betty K Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366746257 PECOS PAC ID: 8628254414 Enrollment ID: I20200416000204 |
| Provider Name | Sarah Marie Nava |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356971261 PECOS PAC ID: 7810327095 Enrollment ID: I20200501000960 |
| Provider Name | Christopher Bixler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770575656 PECOS PAC ID: 8224100334 Enrollment ID: I20200505001015 |
| Provider Name | Jessica Lynn Feistel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952757817 PECOS PAC ID: 5496048068 Enrollment ID: I20200507002488 |
| Provider Name | Thomas D Schomaker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659306249 PECOS PAC ID: 9032540828 Enrollment ID: I20200512000102 |
| Provider Name | Susan Lynn Hiestand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366071268 PECOS PAC ID: 8628499639 Enrollment ID: I20200529001845 |
| Provider Name | Trisha Dickey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194143495 PECOS PAC ID: 5092061432 Enrollment ID: I20200615002855 |
| Provider Name | Hussain Aboud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902046246 PECOS PAC ID: 5890965834 Enrollment ID: I20200616003320 |
| Provider Name | Sheraz Younus |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396928552 PECOS PAC ID: 1153550116 Enrollment ID: I20200623000273 |
| Provider Name | Mazen Almidani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912936725 PECOS PAC ID: 4587667282 Enrollment ID: I20200710001132 |
| Provider Name | Robin Johnson Cook |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487068383 PECOS PAC ID: 8527375427 Enrollment ID: I20200716000074 |
| Provider Name | Cory Minier Schmidt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003336595 PECOS PAC ID: 4486924990 Enrollment ID: I20200720003649 |
| Provider Name | Kristina Aleksoniene |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659545002 PECOS PAC ID: 6901978139 Enrollment ID: I20200722002067 |
| Provider Name | Ana T Torres |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679191548 PECOS PAC ID: 7012332307 Enrollment ID: I20200804000450 |
| Provider Name | Murtaza Amir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508971920 PECOS PAC ID: 4688602915 Enrollment ID: I20200811001966 |
| Provider Name | Tia Chakraborty |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548677263 PECOS PAC ID: 6204054505 Enrollment ID: I20200818000752 |
| Provider Name | Nicole Alexis Phillips |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1063771087 PECOS PAC ID: 5991943144 Enrollment ID: I20200824003075 |
| Provider Name | Benjamin Erhardt |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1295096600 PECOS PAC ID: 6709011810 Enrollment ID: I20200910003234 |
| Provider Name | Sanam Chopra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538519848 PECOS PAC ID: 4587948906 Enrollment ID: I20200921001468 |
| Provider Name | April Emmons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063949246 PECOS PAC ID: 8224306030 Enrollment ID: I20200929002240 |
| Provider Name | Nattasha Acevedo Ramirez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366786451 PECOS PAC ID: 7214217793 Enrollment ID: I20201016001879 |
| Provider Name | Brian Sorace |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639565997 PECOS PAC ID: 9032426697 Enrollment ID: I20201020002043 |
| Provider Name | Birenkumar Rajandrakumar Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679900062 PECOS PAC ID: 0547533788 Enrollment ID: I20201020002192 |
| Provider Name | Lorianne Elizabeth Avino |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306898762 PECOS PAC ID: 6305859919 Enrollment ID: I20201020002198 |
| Provider Name | Angela Carder-sokolowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417594466 PECOS PAC ID: 4385064955 Enrollment ID: I20201020002397 |
| Provider Name | Lindsey Arden Kerr |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1326138926 PECOS PAC ID: 4385546548 Enrollment ID: I20201022002724 |
| Provider Name | Tao Tong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942401815 PECOS PAC ID: 2961558168 Enrollment ID: I20201030001441 |
| Provider Name | Georgy Cherkassky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760827778 PECOS PAC ID: 7416197702 Enrollment ID: I20201030002097 |
| Provider Name | Liliane Nyamuziga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578106035 PECOS PAC ID: 5193136505 Enrollment ID: I20201116000923 |
| Provider Name | Ramon Anel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467547711 PECOS PAC ID: 2769377423 Enrollment ID: I20201117000619 |
| Provider Name | Thomas J. Cartolano |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1366688632 PECOS PAC ID: 9335452846 Enrollment ID: I20201117001256 |
| Provider Name | Katie Fitton |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1982017422 PECOS PAC ID: 8224358288 Enrollment ID: I20201209002100 |
| Provider Name | Harman Fervaha |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1255719696 PECOS PAC ID: 3870882566 Enrollment ID: I20201210001360 |
| Provider Name | Maria T Rapciak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952675365 PECOS PAC ID: 0042505356 Enrollment ID: I20201214001345 |
| Provider Name | Renata Chalfin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043637143 PECOS PAC ID: 4486988383 Enrollment ID: I20201214002753 |
| Provider Name | Lindsey Catherine Healy |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1386007029 PECOS PAC ID: 4385056381 Enrollment ID: I20201216001316 |
| Provider Name | Jaclynn A Jackubowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427485945 PECOS PAC ID: 6406082593 Enrollment ID: I20201216001497 |
| Provider Name | Mariecken V Fowler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548200116 PECOS PAC ID: 4688602758 Enrollment ID: I20201216001677 |
| Provider Name | Stephen Gunnink |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912427402 PECOS PAC ID: 1850661471 Enrollment ID: I20201217002915 |
| Provider Name | James Strycker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134533565 PECOS PAC ID: 1254557804 Enrollment ID: I20201218001898 |
| Provider Name | Nina Grace Bradley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750692422 PECOS PAC ID: 6709025505 Enrollment ID: I20210121000774 |
| Provider Name | Hsiong Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912165374 PECOS PAC ID: 1456548601 Enrollment ID: I20210122001303 |
| Provider Name | Brooke Christine Bredbeck |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003268129 PECOS PAC ID: 7517250103 Enrollment ID: I20210127002193 |
| Provider Name | Joshua Todd Mendelson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265641070 PECOS PAC ID: 8921139023 Enrollment ID: I20210225001544 |
| Provider Name | Fermina Alia Pirmohamed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508138314 PECOS PAC ID: 9133369754 Enrollment ID: I20210225001834 |
| Provider Name | Esther R Servillas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922418425 PECOS PAC ID: 6800144551 Enrollment ID: I20210309001982 |
| Provider Name | Andrew S Olsen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811359532 PECOS PAC ID: 0143649541 Enrollment ID: I20210309002055 |
| Provider Name | Morgan Patrylo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972946002 PECOS PAC ID: 4880948959 Enrollment ID: I20210310000619 |
| Provider Name | Lori A Gore-green |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578658654 PECOS PAC ID: 7618974585 Enrollment ID: I20210319000802 |
| Provider Name | Edward Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992110316 PECOS PAC ID: 0143640748 Enrollment ID: I20210326001618 |
| Provider Name | Darshana Pritesh Amin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407901382 PECOS PAC ID: 4082750468 Enrollment ID: I20210423000257 |
| Provider Name | Obeidurahman Rehmani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619275963 PECOS PAC ID: 2668605106 Enrollment ID: I20210423001198 |
| Provider Name | Tigist Mehari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235490426 PECOS PAC ID: 4688955370 Enrollment ID: I20210426002255 |
| Provider Name | Willie E Lawrence |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851345466 PECOS PAC ID: 2860304326 Enrollment ID: I20210429001343 |
| Provider Name | Edmond Flood Feeks |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1043203649 PECOS PAC ID: 3870907611 Enrollment ID: I20210504001178 |
| Provider Name | Mark Mitchell Mcdonald |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366837429 PECOS PAC ID: 6709156334 Enrollment ID: I20210507000612 |
| Provider Name | Michael Quion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326018342 PECOS PAC ID: 2365625068 Enrollment ID: I20210513001954 |
| Provider Name | Lingling Rong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396064994 PECOS PAC ID: 7214244698 Enrollment ID: I20210524000446 |
| Provider Name | Blake Edward Senay |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922480136 PECOS PAC ID: 0143534198 Enrollment ID: I20210603001289 |
| Provider Name | Sara Layher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679147458 PECOS PAC ID: 9739589920 Enrollment ID: I20210609001653 |
| Provider Name | Shahroz Adil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093209611 PECOS PAC ID: 6002164365 Enrollment ID: I20210630003572 |
| Provider Name | Charles A Asbury |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114378692 PECOS PAC ID: 2769774728 Enrollment ID: I20210713003374 |
| Provider Name | Jennifer Nihei |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740775790 PECOS PAC ID: 2567718885 Enrollment ID: I20210727003204 |
| Provider Name | Sharanya Golagabathula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326536202 PECOS PAC ID: 6406105113 Enrollment ID: I20210728002533 |
| Provider Name | Betsy Fuzi |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1659949998 PECOS PAC ID: 6002210879 Enrollment ID: I20210802003100 |
| Provider Name | Evan G Black |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346260247 PECOS PAC ID: 6103724554 Enrollment ID: I20210803003530 |
| Provider Name | Ricky Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063779213 PECOS PAC ID: 6901039734 Enrollment ID: I20210803003676 |
| Provider Name | Joshua Johnson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659363190 PECOS PAC ID: 5092704791 Enrollment ID: I20210804003586 |
| Provider Name | Philippe Gerard Douyon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306169487 PECOS PAC ID: 3072755396 Enrollment ID: I20210805000116 |
| Provider Name | Eseosa Edo Osagie |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1871944215 PECOS PAC ID: 6103154364 Enrollment ID: I20210805000223 |
| Provider Name | Jenna R Kanter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063737302 PECOS PAC ID: 1850514456 Enrollment ID: I20210806000449 |
| Provider Name | Catharine Roos |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982867883 PECOS PAC ID: 9638320864 Enrollment ID: I20210817001321 |
| Provider Name | Sarah Hop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003303546 PECOS PAC ID: 1951706746 Enrollment ID: I20210817001473 |
| Provider Name | Natasha Victoria Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245803568 PECOS PAC ID: 8426453226 Enrollment ID: I20210817001871 |
| Provider Name | Gheith Yousif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184087843 PECOS PAC ID: 4587958632 Enrollment ID: I20210910001522 |
| Provider Name | Emad Wahashi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609368786 PECOS PAC ID: 7416203559 Enrollment ID: I20210923001953 |
| Provider Name | Kelly M Brash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922505007 PECOS PAC ID: 6608123203 Enrollment ID: I20210928000102 |
| Provider Name | Heidi Schmeltzer |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1043664063 PECOS PAC ID: 3678867363 Enrollment ID: I20210929002042 |
| Provider Name | Nerihan Hadji |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407350069 PECOS PAC ID: 4880941152 Enrollment ID: I20210929002719 |
| Provider Name | Benzion Chaim Yitzchok Blech |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538515465 PECOS PAC ID: 9638461056 Enrollment ID: I20211007001282 |
| Provider Name | Katherine A Bill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346733979 PECOS PAC ID: 3274888995 Enrollment ID: I20211007002290 |
| Provider Name | Yu-hsuan Liao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063868677 PECOS PAC ID: 9133523350 Enrollment ID: I20211008000499 |
| Provider Name | Jessica Shin Choe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215194030 PECOS PAC ID: 3678857323 Enrollment ID: I20211008001547 |
| Provider Name | Morgan Elizabeth Figurelle |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801241260 PECOS PAC ID: 8729373642 Enrollment ID: I20211014000292 |
| Provider Name | Abhi H Kapuria |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730542812 PECOS PAC ID: 8820493935 Enrollment ID: I20211019000464 |
| Provider Name | Benjamin Sopczynski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336554708 PECOS PAC ID: 9234354374 Enrollment ID: I20211019000993 |
| Provider Name | Jacob W Simpson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669829859 PECOS PAC ID: 2860782216 Enrollment ID: I20211019001071 |
| Provider Name | Sui Li |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992026371 PECOS PAC ID: 0345554929 Enrollment ID: I20211019002421 |
| Provider Name | Natalie Zimmer-maslon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821586108 PECOS PAC ID: 9537403076 Enrollment ID: I20211101001482 |
| Provider Name | Guha K Venkatraman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356517593 PECOS PAC ID: 3476721887 Enrollment ID: I20211118001472 |
| Provider Name | Satinder Kaur Grewal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386085546 PECOS PAC ID: 7618229436 Enrollment ID: I20211118002381 |
| Provider Name | Robert Myers |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700248937 PECOS PAC ID: 7416356324 Enrollment ID: I20211119000211 |
| Provider Name | Kristi Patricia Gill |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750514261 PECOS PAC ID: 6406080811 Enrollment ID: I20211119000267 |
| Provider Name | Colby A. Richardson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558724799 PECOS PAC ID: 2567866973 Enrollment ID: I20211119000343 |
| Provider Name | Mary E Gilchrist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073275228 PECOS PAC ID: 2264821735 Enrollment ID: I20211123001056 |
| Provider Name | Shelley Thibeault |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861155855 PECOS PAC ID: 3678963717 Enrollment ID: I20211206000594 |
| Provider Name | Claudine Luna Curioso-hughes |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760916159 PECOS PAC ID: 5496027765 Enrollment ID: I20211206000715 |
| Provider Name | Linda Y. Jiang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427476456 PECOS PAC ID: 3678870276 Enrollment ID: I20220111002854 |
| Provider Name | Lee Morris |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922595180 PECOS PAC ID: 6204239809 Enrollment ID: I20220114001212 |
| Provider Name | Sarah Badran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114067469 PECOS PAC ID: 2062703820 Enrollment ID: I20220210000486 |
| Provider Name | Andrew Novick |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316568728 PECOS PAC ID: 7315335361 Enrollment ID: I20220210002726 |
| Provider Name | Ravi Yarlagadda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679531636 PECOS PAC ID: 7911975560 Enrollment ID: I20220211000291 |
| Provider Name | John Lynch |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043251648 PECOS PAC ID: 0840294773 Enrollment ID: I20220223001694 |
| Provider Name | Kristyn M Beaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861150955 PECOS PAC ID: 5092100677 Enrollment ID: I20220317000773 |
| Provider Name | Nathan Piovesan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265421143 PECOS PAC ID: 3274709357 Enrollment ID: I20220318000735 |
| Provider Name | James Andry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205192838 PECOS PAC ID: 6002119633 Enrollment ID: I20220322000810 |
| Provider Name | Steven Gangloff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952756058 PECOS PAC ID: 4587951637 Enrollment ID: I20220322000906 |
| Provider Name | Wendi Kulin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043411333 PECOS PAC ID: 5193857647 Enrollment ID: I20220322000919 |
| Provider Name | Maleah Joy Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427716554 PECOS PAC ID: 1153716386 Enrollment ID: I20220324001636 |
| Provider Name | Lakshmi Mukundan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619137015 PECOS PAC ID: 6800111303 Enrollment ID: I20220328002340 |
| Provider Name | Linda Song |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720672090 PECOS PAC ID: 9234525155 Enrollment ID: I20220401000989 |
| Provider Name | Evan Lytle |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1932582269 PECOS PAC ID: 1153611009 Enrollment ID: I20220516000811 |
| Provider Name | Anant Shenoy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194998005 PECOS PAC ID: 5991855140 Enrollment ID: I20220519002220 |
| Provider Name | Asad Ahrar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861919722 PECOS PAC ID: 5890068696 Enrollment ID: I20220526001385 |
| Provider Name | Sheila Frances Waslawski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558881045 PECOS PAC ID: 9436429966 Enrollment ID: I20220601001250 |
| Provider Name | Erin K Beckman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1538812359 PECOS PAC ID: 0547648602 Enrollment ID: I20220601001329 |
| Provider Name | John Philip Markovic |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770903189 PECOS PAC ID: 2163649880 Enrollment ID: I20220609000436 |
| Provider Name | Colby Brooks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740717685 PECOS PAC ID: 7517237852 Enrollment ID: I20220609000807 |
| Provider Name | Lindsay Marie Scheffers |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215684402 PECOS PAC ID: 3870971492 Enrollment ID: I20220609001129 |
| Provider Name | Samantha Cencer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114412418 PECOS PAC ID: 4688928922 Enrollment ID: I20220617000588 |
| Provider Name | Dorcas Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477215895 PECOS PAC ID: 2961882519 Enrollment ID: I20220629002088 |
| Provider Name | Ryna Then |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427346303 PECOS PAC ID: 4587891080 Enrollment ID: I20220630002401 |
| Provider Name | Mark Burson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1104808229 PECOS PAC ID: 7113949728 Enrollment ID: I20220711002591 |
| Provider Name | Jeffrey Grondin |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1942640180 PECOS PAC ID: 1254658206 Enrollment ID: I20220802002268 |
| Provider Name | Luke William Linscheid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598495988 PECOS PAC ID: 2961884150 Enrollment ID: I20220804002040 |
| Provider Name | Stephanie Grace Abinoja Raymundo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003294455 PECOS PAC ID: 1254603566 Enrollment ID: I20220805000239 |
| Provider Name | Sarat Kuchipudi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1295715845 PECOS PAC ID: 0941104442 Enrollment ID: I20220808000202 |
| Provider Name | Nathanael J Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255794525 PECOS PAC ID: 0648560250 Enrollment ID: I20220811000757 |
| Provider Name | David Leonard Ortiz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619312246 PECOS PAC ID: 0345545273 Enrollment ID: I20220818000800 |
| Provider Name | Jessica Lynn Ham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558093104 PECOS PAC ID: 1153704499 Enrollment ID: I20220818001615 |
| Provider Name | Haley Stutzky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063147486 PECOS PAC ID: 4981088986 Enrollment ID: I20220824003184 |
| Provider Name | Michael R Baumgartner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578124970 PECOS PAC ID: 5294060414 Enrollment ID: I20220913003141 |
| Provider Name | Nicholas Anthony Ressa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366974867 PECOS PAC ID: 8921370404 Enrollment ID: I20220916002151 |
| Provider Name | Edward N Misulis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902396559 PECOS PAC ID: 8123409125 Enrollment ID: I20220922000942 |
| Provider Name | Benjamin C Groves |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396242202 PECOS PAC ID: 7012399033 Enrollment ID: I20220924000107 |
| Provider Name | Arvind Vasudevan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770503526 PECOS PAC ID: 2860414091 Enrollment ID: I20220926001465 |
| Provider Name | Manthan Kimmane-rathnakar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669109682 PECOS PAC ID: 4385020254 Enrollment ID: I20220929001743 |
| Provider Name | Felix G Rivera-perez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003078692 PECOS PAC ID: 4981755733 Enrollment ID: I20220929002129 |
| Provider Name | Srijana Zarkou |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649482340 PECOS PAC ID: 3779617139 Enrollment ID: I20220929003464 |
| Provider Name | Muhammad F Ahsan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225491095 PECOS PAC ID: 7012248487 Enrollment ID: I20221019000227 |
| Provider Name | David Timothy Beihl |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346656667 PECOS PAC ID: 7517205313 Enrollment ID: I20221019000846 |
| Provider Name | Evan Asper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023464161 PECOS PAC ID: 3870888381 Enrollment ID: I20221021000420 |
| Provider Name | Jimmy Diep Nguyen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285815605 PECOS PAC ID: 5799837621 Enrollment ID: I20221024000518 |
| Provider Name | Miguel Melo-bicchi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487093654 PECOS PAC ID: 5799050431 Enrollment ID: I20221025000874 |
| Provider Name | Lindsey K Kinney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124681853 PECOS PAC ID: 1153658661 Enrollment ID: I20221026001478 |
| Provider Name | Allison Hoch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235589227 PECOS PAC ID: 3678857588 Enrollment ID: I20221114002798 |
| Provider Name | Igor Alexandrovich Malenky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740714054 PECOS PAC ID: 8820361330 Enrollment ID: I20221115002039 |
| Provider Name | Eli R Sager |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548611320 PECOS PAC ID: 8628360609 Enrollment ID: I20221115003077 |
| Provider Name | Adam Mitchell Koss |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760801112 PECOS PAC ID: 2769604123 Enrollment ID: I20221116001797 |
| Provider Name | Jessica Steinacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609469790 PECOS PAC ID: 5294141768 Enrollment ID: I20221117000898 |
| Provider Name | Steven A Foley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194700179 PECOS PAC ID: 8224932090 Enrollment ID: I20221122000239 |
| Provider Name | Max A Schaefer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922590652 PECOS PAC ID: 7113274341 Enrollment ID: I20221128001333 |
| Provider Name | Genna Grondin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073170023 PECOS PAC ID: 0446588610 Enrollment ID: I20221206003039 |
| Provider Name | Allison K Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043939325 PECOS PAC ID: 9537538897 Enrollment ID: I20221207002792 |
| Provider Name | Amelyn C Magtanong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497198048 PECOS PAC ID: 0648417790 Enrollment ID: I20221214000449 |
| Provider Name | Jordan Fisher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477013126 PECOS PAC ID: 3274920293 Enrollment ID: I20221215002793 |
| Provider Name | Kenneth David Stahl |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043460488 PECOS PAC ID: 2466514989 Enrollment ID: I20221228001346 |
| Provider Name | Michel Randolph Peter Wagner |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1447200647 PECOS PAC ID: 4486725561 Enrollment ID: I20230124000287 |
| Provider Name | Lindsey A Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114685807 PECOS PAC ID: 8628440849 Enrollment ID: I20230215002017 |
| Provider Name | Chelsea Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427769082 PECOS PAC ID: 2961876743 Enrollment ID: I20230317000510 |
| Provider Name | William Ward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689657785 PECOS PAC ID: 8022144047 Enrollment ID: I20230317001390 |
| Provider Name | Aubrey T Tompkins |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1447963889 PECOS PAC ID: 7214301027 Enrollment ID: I20230317001630 |
| Provider Name | David Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770215428 PECOS PAC ID: 1658757208 Enrollment ID: I20230319000011 |
| Provider Name | Joseph Centa |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902875180 PECOS PAC ID: 8527092295 Enrollment ID: I20230322000595 |
| Provider Name | Kamelia Burrell Fowler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528633898 PECOS PAC ID: 0547650301 Enrollment ID: I20230417000801 |
| Provider Name | Agnelio Silverio Cardentey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164957452 PECOS PAC ID: 3870960412 Enrollment ID: I20230501002723 |
| Provider Name | Robert A Fishman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982807921 PECOS PAC ID: 2062667454 Enrollment ID: I20230502001203 |
| Provider Name | Edward George Boyer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073953683 PECOS PAC ID: 3779885678 Enrollment ID: I20230502001241 |
| Provider Name | Mallory Noelle Luckey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770932170 PECOS PAC ID: 4183902356 Enrollment ID: I20230502001345 |
| Provider Name | Kristen Veal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821594789 PECOS PAC ID: 5698141604 Enrollment ID: I20230502001759 |
| Provider Name | Indira De Jesus Alvelo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700074796 PECOS PAC ID: 2264651207 Enrollment ID: I20230502002303 |
| Provider Name | Bhavan U Shah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922458611 PECOS PAC ID: 6103221940 Enrollment ID: I20230502002825 |
| Provider Name | Stafford A Conway |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366498206 PECOS PAC ID: 3870515752 Enrollment ID: I20230502002917 |
| Provider Name | Amna Ramzan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063953297 PECOS PAC ID: 0244612356 Enrollment ID: I20230503000488 |
| Provider Name | Kyle Binder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841635422 PECOS PAC ID: 8325479116 Enrollment ID: I20230503000650 |
| Provider Name | Charlene L Gunasekera |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891292538 PECOS PAC ID: 1850648015 Enrollment ID: I20230504000109 |
| Provider Name | Alexis Danielle Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942900857 PECOS PAC ID: 4486019965 Enrollment ID: I20230505001802 |
| Provider Name | Shao-hwa P Wei |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205062361 PECOS PAC ID: 7517278146 Enrollment ID: I20230512002353 |
| Provider Name | Grace Colson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003487224 PECOS PAC ID: 7113323379 Enrollment ID: I20230522003153 |
| Provider Name | William F Dotson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033343579 PECOS PAC ID: 7719103332 Enrollment ID: I20230523001747 |
| Provider Name | Stella Margaret Kidwell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184696122 PECOS PAC ID: 1456398056 Enrollment ID: I20230531002947 |
| Provider Name | Stefania Lorena Soria Zurita |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962922955 PECOS PAC ID: 3274957261 Enrollment ID: I20230601000231 |
| Provider Name | Narayana Rao Gandham |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1194179911 PECOS PAC ID: 9133489172 Enrollment ID: I20230605000225 |
| Provider Name | Parham J Zamani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184287427 PECOS PAC ID: 6800254327 Enrollment ID: I20230615001043 |
| Provider Name | Michelle Renae Nicewander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407545049 PECOS PAC ID: 6608234778 Enrollment ID: I20230621003349 |
| Provider Name | Charisa Arinyedokiari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083865786 PECOS PAC ID: 0941482301 Enrollment ID: I20230622000626 |
| Provider Name | Justin De'prey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356872063 PECOS PAC ID: 3274806674 Enrollment ID: I20230622000713 |
| Provider Name | Tonia Jerrick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417418112 PECOS PAC ID: 3274912282 Enrollment ID: I20230623000268 |
| Provider Name | Crystal Thomas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801021886 PECOS PAC ID: 9931321338 Enrollment ID: I20230623002720 |
| Provider Name | Laura C Trail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548955412 PECOS PAC ID: 2466811856 Enrollment ID: I20230703001173 |
| Provider Name | Inderpreet K Madahar |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1255827994 PECOS PAC ID: 4385053404 Enrollment ID: I20230708000064 |
| Provider Name | Matthew W Globerson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1780112144 PECOS PAC ID: 3779850367 Enrollment ID: I20230724002952 |
| Provider Name | Shawn Marein |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1265964878 PECOS PAC ID: 0840577011 Enrollment ID: I20230802003632 |
| Provider Name | Ellie Frazey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003472366 PECOS PAC ID: 2567820848 Enrollment ID: I20230810002661 |
| Provider Name | Joshua Jaeger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528697919 PECOS PAC ID: 3678935004 Enrollment ID: I20230816001917 |
| Provider Name | Numthip Chitravas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073761789 PECOS PAC ID: 4486898095 Enrollment ID: I20230818001315 |
| Provider Name | Cintasha Redmond |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639437452 PECOS PAC ID: 8628344728 Enrollment ID: I20230818003214 |
| Provider Name | Hillary Nicole Edgerly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386376002 PECOS PAC ID: 6608238886 Enrollment ID: I20230821001589 |
| Provider Name | Mark Z Sabra |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942616560 PECOS PAC ID: 7911200340 Enrollment ID: I20230821002570 |
| Provider Name | Bradley M Klein |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619314705 PECOS PAC ID: 6709154743 Enrollment ID: I20230901000724 |
| Provider Name | Silvia M Soto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356961841 PECOS PAC ID: 7517321789 Enrollment ID: I20230907000858 |
| Provider Name | Dharti Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609364777 PECOS PAC ID: 5698174878 Enrollment ID: I20230907002456 |
| Provider Name | Alexandra Rose Vroom |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1528742822 PECOS PAC ID: 3173987286 Enrollment ID: I20230907003223 |
| Provider Name | Marmik Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922617661 PECOS PAC ID: 4385008325 Enrollment ID: I20230911000774 |
| Provider Name | Jason P Stabley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992713234 PECOS PAC ID: 8022904036 Enrollment ID: I20230911003824 |
| Provider Name | Chris R Collins |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114362613 PECOS PAC ID: 7416196639 Enrollment ID: I20230914000797 |
| Provider Name | Shishir Ojha |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1225223803 PECOS PAC ID: 3779711213 Enrollment ID: I20231009000144 |
| Provider Name | Erik Olson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831867555 PECOS PAC ID: 1153776372 Enrollment ID: I20231009001336 |
| Provider Name | Rebecca Mcclay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629613070 PECOS PAC ID: 0446667158 Enrollment ID: I20231017003376 |
| Provider Name | Holly Carrizales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013791581 PECOS PAC ID: 5597110189 Enrollment ID: I20231017003507 |
| Provider Name | Gary B. Sinensky |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376585067 PECOS PAC ID: 8921284449 Enrollment ID: I20231102000516 |
| Provider Name | Ava M Giugliano |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851826309 PECOS PAC ID: 1557631793 Enrollment ID: I20231116001518 |
| Provider Name | Jacob R Corbin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720534068 PECOS PAC ID: 4082995899 Enrollment ID: I20231117000977 |
| Provider Name | Piotr Tekiela |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902268626 PECOS PAC ID: 2264725290 Enrollment ID: I20231205002822 |
| Provider Name | Ammar Kheder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770925976 PECOS PAC ID: 3779711791 Enrollment ID: I20231215001463 |
| Provider Name | Neil G Jhamb |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477787067 PECOS PAC ID: 4082852769 Enrollment ID: I20231220000204 |
| Provider Name | Andrew Cooper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992164198 PECOS PAC ID: 6800247784 Enrollment ID: I20240104001824 |
| Provider Name | Devin Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730966102 PECOS PAC ID: 4082065917 Enrollment ID: I20240104003794 |
| Provider Name | Andrew Joseph Vaughan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1932634607 PECOS PAC ID: 5991185332 Enrollment ID: I20240105002719 |
| Provider Name | Fabian Arnaldo |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1245382852 PECOS PAC ID: 0648315572 Enrollment ID: I20240205001011 |
| Provider Name | Cassie Thiesse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316699119 PECOS PAC ID: 2668816000 Enrollment ID: I20240214000400 |
| Provider Name | Elizabeth Simcox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962272385 PECOS PAC ID: 5799129052 Enrollment ID: I20240215000351 |
| Provider Name | Janet Peters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396448726 PECOS PAC ID: 7214301498 Enrollment ID: I20240215001692 |
| Provider Name | Farhat Mehmood |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1205884178 PECOS PAC ID: 0941293286 Enrollment ID: I20240221001122 |
Brian T Doyle Md Plc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 405 Momany Dr, Saint Joseph, MI 49085 Phone: 269-982-1947 Fax: 269-982-1950 | |
Madonna Fabian Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3078 Niles Rd, Saint Joseph, MI 49085 Phone: 323-547-2155 | |
Rappha Medical Center, P.l.l.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3911 Stonegate Park Dr, Saint Joseph, MI 49085 Phone: 269-408-1777 Fax: 269-408-1755 | |
Lakeland Physician Care Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1234 Napier Ave, Saint Joseph, MI 49085 Phone: 269-684-0259 Fax: 269-684-0189 | |
Arcadia Family Health Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3901 Stonegate Park Ste F, Saint Joseph, MI 49085 Phone: 810-624-1586 | |
Lakeland Neurosurgery Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3950 Hollywood Rd, Suite 210, Saint Joseph, MI 49085 Phone: 269-556-1990 Fax: 269-556-1996 | |
Southwestern Infectious Diease Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3950 Hollywood Rd, Suite 100, Saint Joseph, MI 49085 Phone: 269-429-0900 Fax: 269-408-0996 |