| Lakeshore Medical Clinic, Llc | |
|
2000 E Layton Ave Ste 100 Saint Francis WI 53235-6054 | |
| (414) 744-6589 | |
| Not Available |
| Full Name | Lakeshore Medical Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2000 E Layton Ave Ste 100, Saint Francis, Wisconsin |
| Authorized Official Name and Position | Nan Nelson (ASSISTANT TREASURER) |
| Authorized Official Contact | 4142991610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeshore Medical Clinic, Llc Po Box 735044 Chicago IL 60673-5044 Ph: (414) 647-6326 | Lakeshore Medical Clinic, Llc 2000 E Layton Ave Ste 100 Saint Francis WI 53235-6054 Ph: (414) 744-6589 |
| NPI Number | 1003861188 |
|---|---|
| Provider Enumeration Date | 05/24/2006 |
| Last Update Date | 09/11/2023 |
| Medicare PECOS PAC ID | 7719890730 |
|---|---|
| Medicare Enrollment ID | O20031106000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003861188 | NPI | - | NPPES |
| 32797200 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| Provider Name | Jaideep S Joshi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972572592 PECOS PAC ID: 8123922283 Enrollment ID: I20031121000094 |
| Provider Name | Steven H Falconer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962517094 PECOS PAC ID: 4183529514 Enrollment ID: I20031126000697 |
| Provider Name | Louie N Kostopoulos |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1356431001 PECOS PAC ID: 1557262383 Enrollment ID: I20040115000695 |
| Provider Name | Daniel A Peterson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902913304 PECOS PAC ID: 5193627255 Enrollment ID: I20040121000419 |
| Provider Name | Noelle C Kisting |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649378969 PECOS PAC ID: 9234031659 Enrollment ID: I20040124000283 |
| Provider Name | Martin R Crain |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1285655159 PECOS PAC ID: 1658273057 Enrollment ID: I20040126000351 |
| Provider Name | Daniel P Malone |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972540664 PECOS PAC ID: 9436051844 Enrollment ID: I20040126000378 |
| Provider Name | Mack Alan Karnes |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225072721 PECOS PAC ID: 6305758624 Enrollment ID: I20040126000476 |
| Provider Name | Edward W St Ville |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003838111 PECOS PAC ID: 7810809142 Enrollment ID: I20040126000498 |
| Provider Name | Daniel T Rapp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881643880 PECOS PAC ID: 8022920347 Enrollment ID: I20040126000516 |
| Provider Name | Roger F Axtell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215958178 PECOS PAC ID: 4385546605 Enrollment ID: I20040126000541 |
| Provider Name | John C Cline |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982623229 PECOS PAC ID: 8628970977 Enrollment ID: I20040126000701 |
| Provider Name | Lawrence Rufer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174560742 PECOS PAC ID: 6507768850 Enrollment ID: I20040126000714 |
| Provider Name | Peter Drescher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063436996 PECOS PAC ID: 3173425444 Enrollment ID: I20040126000812 |
| Provider Name | Richard J Jochem |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407893191 PECOS PAC ID: 9931001211 Enrollment ID: I20040126000865 |
| Provider Name | Ann M Rohrer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174630420 PECOS PAC ID: 2163316357 Enrollment ID: I20040210000087 |
| Provider Name | Satchidanand J Hiremath |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1316968290 PECOS PAC ID: 6002718509 Enrollment ID: I20040216001276 |
| Provider Name | David H Hinke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225146368 PECOS PAC ID: 7517854128 Enrollment ID: I20040301000940 |
| Provider Name | Rosanna Ranieri |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1407802002 PECOS PAC ID: 1850280512 Enrollment ID: I20040311001267 |
| Provider Name | Kari A Kluessendorf |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477589869 PECOS PAC ID: 1557250214 Enrollment ID: I20040311001288 |
| Provider Name | Steven M Gryniewicz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457386153 PECOS PAC ID: 9335034586 Enrollment ID: I20040312000062 |
| Provider Name | Paul J Grebe |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1295764702 PECOS PAC ID: 7416842661 Enrollment ID: I20040312000199 |
| Provider Name | Lynn M Gilles |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194757955 PECOS PAC ID: 7315832565 Enrollment ID: I20040312000232 |
| Provider Name | Venkata K Thota |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134183783 PECOS PAC ID: 2961395421 Enrollment ID: I20040317001176 |
| Provider Name | Paul S Bernstein |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013917962 PECOS PAC ID: 3678485968 Enrollment ID: I20040318000684 |
| Provider Name | Jonathan R Berry |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952480824 PECOS PAC ID: 5395637219 Enrollment ID: I20040326000094 |
| Provider Name | David R Madenberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780751495 PECOS PAC ID: 8729070131 Enrollment ID: I20040402000832 |
| Provider Name | Colleen M Bonkowski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508814286 PECOS PAC ID: 1658364930 Enrollment ID: I20040405000125 |
| Provider Name | Robert E Neimon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336174036 PECOS PAC ID: 3678468824 Enrollment ID: I20040406000913 |
| Provider Name | William B Macdonald |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407883093 PECOS PAC ID: 8527953769 Enrollment ID: I20040406000970 |
| Provider Name | Mark T Lawton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932128568 PECOS PAC ID: 7214822469 Enrollment ID: I20040406001277 |
| Provider Name | Rick L Strickroot |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629043120 PECOS PAC ID: 2062406507 Enrollment ID: I20040408001185 |
| Provider Name | Sacha Ramirez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316025844 PECOS PAC ID: 4789678749 Enrollment ID: I20040413000147 |
| Provider Name | Stephen T Vanblarcom |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1982678553 PECOS PAC ID: 0345235958 Enrollment ID: I20040414001736 |
| Provider Name | Jeanette A Kalupa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285690198 PECOS PAC ID: 2365437787 Enrollment ID: I20040415001327 |
| Provider Name | Timothy G Buchanan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912085416 PECOS PAC ID: 8729074513 Enrollment ID: I20040426000792 |
| Provider Name | Deanne J Keim |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1619056587 PECOS PAC ID: 8123015914 Enrollment ID: I20040426000848 |
| Provider Name | Maysa L Sameh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629156146 PECOS PAC ID: 5395732010 Enrollment ID: I20040426001760 |
| Provider Name | Frank Lavora |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1316025893 PECOS PAC ID: 3577550094 Enrollment ID: I20040427001424 |
| Provider Name | Darin A Maccoux |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891874764 PECOS PAC ID: 6800883323 Enrollment ID: I20040427001461 |
| Provider Name | Brian J Dudor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942388459 PECOS PAC ID: 3678560109 Enrollment ID: I20040427001491 |
| Provider Name | Dexter R Rebancos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801974399 PECOS PAC ID: 8628065158 Enrollment ID: I20040427001547 |
| Provider Name | Paul Madsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760440994 PECOS PAC ID: 8426045717 Enrollment ID: I20040428001117 |
| Provider Name | Mark Glazer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396823878 PECOS PAC ID: 3779495098 Enrollment ID: I20040428001193 |
| Provider Name | Lawrence Dubin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982789111 PECOS PAC ID: 5294647517 Enrollment ID: I20040428001259 |
| Provider Name | Kathryn M Kiyono |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083793954 PECOS PAC ID: 3476540428 Enrollment ID: I20040429001405 |
| Provider Name | Shereen Mohis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043264609 PECOS PAC ID: 4486641354 Enrollment ID: I20040430000771 |
| Provider Name | Mabria Loqman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891862678 PECOS PAC ID: 1254320096 Enrollment ID: I20040507000938 |
| Provider Name | Jeffrey S Villwock |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659335743 PECOS PAC ID: 1355330663 Enrollment ID: I20040511001224 |
| Provider Name | Scott T Hardin |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1518074129 PECOS PAC ID: 2365423258 Enrollment ID: I20040526001302 |
| Provider Name | John J Mcguinness |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649247347 PECOS PAC ID: 0547243461 Enrollment ID: I20040611000179 |
| Provider Name | Sushil S Sabnis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922034982 PECOS PAC ID: 3971496373 Enrollment ID: I20040621001750 |
| Provider Name | Ethel V Sabnis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558395905 PECOS PAC ID: 0143113548 Enrollment ID: I20040622001618 |
| Provider Name | Mauricio E Palencia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770558264 PECOS PAC ID: 5294711560 Enrollment ID: I20040628000218 |
| Provider Name | Andrew D Simon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285665729 PECOS PAC ID: 7416933742 Enrollment ID: I20040628000669 |
| Provider Name | Raul Mateo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295814028 PECOS PAC ID: 8921085788 Enrollment ID: I20040630000786 |
| Provider Name | Paul E Robey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952489445 PECOS PAC ID: 1052224003 Enrollment ID: I20040630000859 |
| Provider Name | Syed Ali A Gardezi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1689626574 PECOS PAC ID: 9133106727 Enrollment ID: I20040701000815 |
| Provider Name | David Munoz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104905009 PECOS PAC ID: 2668459256 Enrollment ID: I20040701000834 |
| Provider Name | Milka Mandich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598830333 PECOS PAC ID: 4486631090 Enrollment ID: I20040701000902 |
| Provider Name | Rita E Schulz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083789820 PECOS PAC ID: 5799762308 Enrollment ID: I20040701000943 |
| Provider Name | Walter A Fuhr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194803676 PECOS PAC ID: 5597742122 Enrollment ID: I20040701001034 |
| Provider Name | Stephen C Lamberton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558435123 PECOS PAC ID: 7315850369 Enrollment ID: I20040701001063 |
| Provider Name | Michael D Damico |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386722866 PECOS PAC ID: 7315924966 Enrollment ID: I20040701001197 |
| Provider Name | Sridevi Koritala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992883474 PECOS PAC ID: 9537146006 Enrollment ID: I20040701001452 |
| Provider Name | Eric M Dorn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033192562 PECOS PAC ID: 2668459173 Enrollment ID: I20040702000071 |
| Provider Name | Todd H Goodman |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1952489478 PECOS PAC ID: 9537146915 Enrollment ID: I20040702000687 |
| Provider Name | Malini A Mehta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285709816 PECOS PAC ID: 4880671262 Enrollment ID: I20040702000701 |
| Provider Name | Richard M Hayes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053499566 PECOS PAC ID: 8224015607 Enrollment ID: I20040702000721 |
| Provider Name | Thomas J Broihier |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578641155 PECOS PAC ID: 5799762027 Enrollment ID: I20040702001101 |
| Provider Name | Stephen L Nord |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437237948 PECOS PAC ID: 5496733263 Enrollment ID: I20040708001094 |
| Provider Name | Rebecca L Scerpella |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518045038 PECOS PAC ID: 9830177617 Enrollment ID: I20040708001211 |
| Provider Name | Sarang B Baman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770661290 PECOS PAC ID: 4587642384 Enrollment ID: I20040708001352 |
| Provider Name | Erika S Sellers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689752107 PECOS PAC ID: 0547248148 Enrollment ID: I20040709001344 |
| Provider Name | John R Brill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285643932 PECOS PAC ID: 1153309505 Enrollment ID: I20040712000709 |
| Provider Name | Geoffrey S Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528029949 PECOS PAC ID: 2365421716 Enrollment ID: I20040719000547 |
| Provider Name | David W Litzau |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811929672 PECOS PAC ID: 0042299356 Enrollment ID: I20040719001028 |
| Provider Name | Shaik O Sayeed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679651103 PECOS PAC ID: 7618957416 Enrollment ID: I20040722000629 |
| Provider Name | Kendal J Hoard |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1740349984 PECOS PAC ID: 4385615780 Enrollment ID: I20040802000095 |
| Provider Name | Joseph M Cronin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164431219 PECOS PAC ID: 3476525866 Enrollment ID: I20040806000784 |
| Provider Name | Katherine M Hoyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932214822 PECOS PAC ID: 8123090297 Enrollment ID: I20040810000016 |
| Provider Name | Chihab E Bilal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275542961 PECOS PAC ID: 9537132857 Enrollment ID: I20040816000754 |
| Provider Name | John P Mooney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548208259 PECOS PAC ID: 4688647928 Enrollment ID: I20040816000875 |
| Provider Name | Christopher J Zellmer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346275435 PECOS PAC ID: 6800860933 Enrollment ID: I20040824000469 |
| Provider Name | Michelle C Peters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013934447 PECOS PAC ID: 6305811910 Enrollment ID: I20040827000640 |
| Provider Name | Edmund J Fernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669587739 PECOS PAC ID: 2769458132 Enrollment ID: I20040907001298 |
| Provider Name | Sandra Lee Mikolas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164539656 PECOS PAC ID: 5991772931 Enrollment ID: I20040910000536 |
| Provider Name | Jeffrey A Derus |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679564660 PECOS PAC ID: 8729055900 Enrollment ID: I20040916000271 |
| Provider Name | Nicholas G Stephani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114987203 PECOS PAC ID: 1456329457 Enrollment ID: I20040917000709 |
| Provider Name | Ahmet Demircioglu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114005642 PECOS PAC ID: 6406824655 Enrollment ID: I20040924000319 |
| Provider Name | Manoj K Nayak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538275243 PECOS PAC ID: 4587633714 Enrollment ID: I20040924001042 |
| Provider Name | Leyla M Solis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659459188 PECOS PAC ID: 7719963032 Enrollment ID: I20040928000479 |
| Provider Name | Debora A Mcfarland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487744173 PECOS PAC ID: 5092775494 Enrollment ID: I20041011000503 |
| Provider Name | Supriya Sharma |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225145410 PECOS PAC ID: 9537121439 Enrollment ID: I20041102001198 |
| Provider Name | Ronald I Cohen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982697942 PECOS PAC ID: 2961465315 Enrollment ID: I20041108000422 |
| Provider Name | Gloria J Maliszewski Weller |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235274598 PECOS PAC ID: 3779547542 Enrollment ID: I20041112000411 |
| Provider Name | Jessica L Zemlak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740320035 PECOS PAC ID: 3577527506 Enrollment ID: I20041118000535 |
| Provider Name | Jeffrey N Glaspy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619925237 PECOS PAC ID: 7719885235 Enrollment ID: I20041201000425 |
| Provider Name | Norman J Schroeder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245224245 PECOS PAC ID: 7315903630 Enrollment ID: I20041208000084 |
| Provider Name | Amy M Wiza |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1750435947 PECOS PAC ID: 9032176912 Enrollment ID: I20041213000323 |
| Provider Name | Mark H Hermanoff |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1447309786 PECOS PAC ID: 3274581616 Enrollment ID: I20050112000242 |
| Provider Name | Nancy J Blankenship |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104840636 PECOS PAC ID: 4789632175 Enrollment ID: I20050112000575 |
| Provider Name | Kathleen R Maginot |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922074095 PECOS PAC ID: 9739138983 Enrollment ID: I20050114000516 |
| Provider Name | Saleem Bakhtiar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528077294 PECOS PAC ID: 3971552795 Enrollment ID: I20050119000798 |
| Provider Name | Rizwan Loya |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447218755 PECOS PAC ID: 5890785166 Enrollment ID: I20050126000206 |
| Provider Name | Suhail Q Allaqaband |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1669449203 PECOS PAC ID: 9133170194 Enrollment ID: I20050207000881 |
| Provider Name | Kaylen Snoda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669424420 PECOS PAC ID: 3375595424 Enrollment ID: I20050216000760 |
| Provider Name | James A Toniolo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801815154 PECOS PAC ID: 4486607249 Enrollment ID: I20050222000441 |
| Provider Name | John S Hokanson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700852829 PECOS PAC ID: 2860446382 Enrollment ID: I20050308000886 |
| Provider Name | Muhammed Nmn Nadeem |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1760580955 PECOS PAC ID: 1153239181 Enrollment ID: I20050310000444 |
| Provider Name | Christopher S Wilson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053494559 PECOS PAC ID: 5395790646 Enrollment ID: I20050321000150 |
| Provider Name | Scott W Gage |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326076258 PECOS PAC ID: 1052205945 Enrollment ID: I20050404000644 |
| Provider Name | Ramagopal J Tumuluri |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1063489615 PECOS PAC ID: 0345297974 Enrollment ID: I20050405001094 |
| Provider Name | Luke Joseph Lamers |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952353799 PECOS PAC ID: 6305894668 Enrollment ID: I20050420001011 |
| Provider Name | Victoria L Bowe Fisher |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1952464174 PECOS PAC ID: 9739128166 Enrollment ID: I20050427000057 |
| Provider Name | Shelley K Watters |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1407963457 PECOS PAC ID: 3375582141 Enrollment ID: I20050502000067 |
| Provider Name | Brian E Lundeen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194775445 PECOS PAC ID: 8123083300 Enrollment ID: I20050504000245 |
| Provider Name | Matthew Brewer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225052152 PECOS PAC ID: 1557315504 Enrollment ID: I20050603000140 |
| Provider Name | George D Cherayil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952314049 PECOS PAC ID: 6002859758 Enrollment ID: I20050603000868 |
| Provider Name | Sandhya Sureddi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124134655 PECOS PAC ID: 8729021472 Enrollment ID: I20050603000879 |
| Provider Name | Meenaxi Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932217155 PECOS PAC ID: 4587607866 Enrollment ID: I20050607001242 |
| Provider Name | Jack A Tertadian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689780462 PECOS PAC ID: 6002859386 Enrollment ID: I20050607001264 |
| Provider Name | Vikram Nangia |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1316914963 PECOS PAC ID: 3678516788 Enrollment ID: I20050608001029 |
| Provider Name | Michael J Marquart |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467436998 PECOS PAC ID: 7517900665 Enrollment ID: I20050609000141 |
| Provider Name | Ryan T Hilbelink |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215963608 PECOS PAC ID: 4587607635 Enrollment ID: I20050609000165 |
| Provider Name | David S Stolp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538247051 PECOS PAC ID: 5991749731 Enrollment ID: I20050614000066 |
| Provider Name | Jonathan E Jennings |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760419337 PECOS PAC ID: 3072557495 Enrollment ID: I20050616000618 |
| Provider Name | Brian P Mcsorley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053305706 PECOS PAC ID: 8022921725 Enrollment ID: I20050630000638 |
| Provider Name | David M Sherman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861570350 PECOS PAC ID: 6901842822 Enrollment ID: I20050630000880 |
| Provider Name | Ajaz M Qhavi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184702615 PECOS PAC ID: 9931145471 Enrollment ID: I20050706000528 |
| Provider Name | Jodi M Kornak |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619062072 PECOS PAC ID: 7416984224 Enrollment ID: I20050725000030 |
| Provider Name | Tara A Rakowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437105525 PECOS PAC ID: 3577591031 Enrollment ID: I20050727000467 |
| Provider Name | Ather H Syed |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346210564 PECOS PAC ID: 9032147293 Enrollment ID: I20050728001151 |
| Provider Name | Suzanne Kletch |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497704902 PECOS PAC ID: 2567490600 Enrollment ID: I20050801000020 |
| Provider Name | Julia A Bruckner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215965892 PECOS PAC ID: 3779512702 Enrollment ID: I20050809001128 |
| Provider Name | Iram Nadeem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770535437 PECOS PAC ID: 0840220893 Enrollment ID: I20050818000854 |
| Provider Name | Harry M Brammer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1386675650 PECOS PAC ID: 6507897857 Enrollment ID: I20050825000945 |
| Provider Name | Susan R Oneson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538199690 PECOS PAC ID: 7214968569 Enrollment ID: I20050825000958 |
| Provider Name | Sarah E Reimer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750311759 PECOS PAC ID: 9739110099 Enrollment ID: I20050825000989 |
| Provider Name | Maria Quevedo Visaya |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487615431 PECOS PAC ID: 0244261329 Enrollment ID: I20050829000543 |
| Provider Name | Robert D Southwick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417975087 PECOS PAC ID: 8123052735 Enrollment ID: I20050922001171 |
| Provider Name | Hammad R Haider-shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881709939 PECOS PAC ID: 9830123397 Enrollment ID: I20050923000271 |
| Provider Name | Arturo Eduardo Eyzaguirre |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114029196 PECOS PAC ID: 4587699376 Enrollment ID: I20050929001167 |
| Provider Name | Douglas J Wermuth |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1871585505 PECOS PAC ID: 7517984081 Enrollment ID: I20051025000385 |
| Provider Name | Glenn E Gessert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255399739 PECOS PAC ID: 6103715545 Enrollment ID: I20051025000928 |
| Provider Name | Theodore Scott Derse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336254515 PECOS PAC ID: 9638197502 Enrollment ID: I20051109000468 |
| Provider Name | Ernest S Stremski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760434344 PECOS PAC ID: 4486672292 Enrollment ID: I20051109000876 |
| Provider Name | Piotr J Kolanowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922066422 PECOS PAC ID: 2668491283 Enrollment ID: I20051114000299 |
| Provider Name | Jacqueline P Jahnke |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356336945 PECOS PAC ID: 0941220065 Enrollment ID: I20051202000628 |
| Provider Name | John A Feilbach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538191168 PECOS PAC ID: 8820019037 Enrollment ID: I20051215000677 |
| Provider Name | Emily T Carman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619928090 PECOS PAC ID: 0749203545 Enrollment ID: I20060106000774 |
| Provider Name | Elizabeth W Ciurlik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043241458 PECOS PAC ID: 2062436223 Enrollment ID: I20060116000285 |
| Provider Name | Huong V Dangvu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861423261 PECOS PAC ID: 5991729170 Enrollment ID: I20060116000441 |
| Provider Name | Eric R Sover |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366472136 PECOS PAC ID: 4880618859 Enrollment ID: I20060117000843 |
| Provider Name | Jeffrey Bahr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770511453 PECOS PAC ID: 0042234866 Enrollment ID: I20060119000742 |
| Provider Name | Hanumantha R Kothur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306876552 PECOS PAC ID: 3678597408 Enrollment ID: I20060119000820 |
| Provider Name | Mary S Schmidt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972533834 PECOS PAC ID: 0941224539 Enrollment ID: I20060123000394 |
| Provider Name | John E Schuck |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376573246 PECOS PAC ID: 1355365941 Enrollment ID: I20060123000435 |
| Provider Name | Jeffrey P Hall |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1568467512 PECOS PAC ID: 7012962632 Enrollment ID: I20060315000025 |
| Provider Name | Angela M Sweeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225006695 PECOS PAC ID: 0446268890 Enrollment ID: I20060328000218 |
| Provider Name | Priti J Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205843067 PECOS PAC ID: 4183663883 Enrollment ID: I20060328000548 |
| Provider Name | Madhu Shyam Sadagopan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1235180290 PECOS PAC ID: 0749299691 Enrollment ID: I20060420000404 |
| Provider Name | Mandy Fawcett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447273156 PECOS PAC ID: 3678583325 Enrollment ID: I20060426000390 |
| Provider Name | Joaquin Solis |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1649221516 PECOS PAC ID: 6002828837 Enrollment ID: I20060619000205 |
| Provider Name | Joseph A Nicholas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528094588 PECOS PAC ID: 1850303223 Enrollment ID: I20060629000226 |
| Provider Name | Dorota B Wozniewicz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942238696 PECOS PAC ID: 1153334909 Enrollment ID: I20060720000122 |
| Provider Name | Derek J Orton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790742724 PECOS PAC ID: 8527091842 Enrollment ID: I20060726000168 |
| Provider Name | Adam P Myhre |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548218829 PECOS PAC ID: 4486691276 Enrollment ID: I20060804000188 |
| Provider Name | Laura C Kirkegaard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588670616 PECOS PAC ID: 5597768200 Enrollment ID: I20060818000452 |
| Provider Name | Agron S Ismaili |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922093707 PECOS PAC ID: 9638106057 Enrollment ID: I20061003000136 |
| Provider Name | Reny Varghese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134131626 PECOS PAC ID: 0941274500 Enrollment ID: I20061017000193 |
| Provider Name | Rick G Thyes |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164536892 PECOS PAC ID: 5991702631 Enrollment ID: I20061023000264 |
| Provider Name | Margery Howard |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1457326985 PECOS PAC ID: 6406853878 Enrollment ID: I20061026000565 |
| Provider Name | Dana A Gray |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194741389 PECOS PAC ID: 1759315260 Enrollment ID: I20061214000313 |
| Provider Name | David J Pencikowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962579243 PECOS PAC ID: 1254330327 Enrollment ID: I20061219000282 |
| Provider Name | Cynthia A Bauer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932118668 PECOS PAC ID: 4880695303 Enrollment ID: I20070126000209 |
| Provider Name | Marc V Kennedy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710900667 PECOS PAC ID: 5799773487 Enrollment ID: I20070319000425 |
| Provider Name | Dennis J Andersen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831123249 PECOS PAC ID: 1153424775 Enrollment ID: I20070319000601 |
| Provider Name | Jennifer R Thomas |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578573382 PECOS PAC ID: 8527161181 Enrollment ID: I20070320000292 |
| Provider Name | Shari L Purman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861523318 PECOS PAC ID: 8426155276 Enrollment ID: I20070514000246 |
| Provider Name | William S Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467429860 PECOS PAC ID: 8224136171 Enrollment ID: I20070531000281 |
| Provider Name | David J Fisher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033169438 PECOS PAC ID: 3678561123 Enrollment ID: I20070714000197 |
| Provider Name | Joseph C Schmidt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730202987 PECOS PAC ID: 9234239435 Enrollment ID: I20070717000027 |
| Provider Name | Michael W Foster |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740483981 PECOS PAC ID: 7012018062 Enrollment ID: I20070720000742 |
| Provider Name | Scott M Reabe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982798450 PECOS PAC ID: 3072557867 Enrollment ID: I20070728000097 |
| Provider Name | Xue Wang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265408579 PECOS PAC ID: 6800883992 Enrollment ID: I20070910000738 |
| Provider Name | Annisa Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114129590 PECOS PAC ID: 2365537552 Enrollment ID: I20071003000245 |
| Provider Name | Christopher J Canitz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699742049 PECOS PAC ID: 0547296139 Enrollment ID: I20071116000018 |
| Provider Name | Henry J Duffrin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750358198 PECOS PAC ID: 4082640677 Enrollment ID: I20071117000020 |
| Provider Name | Jose M Leiva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962496760 PECOS PAC ID: 7113015645 Enrollment ID: I20071117000059 |
| Provider Name | Marybeth Wisniewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952598377 PECOS PAC ID: 7911087226 Enrollment ID: I20071227000391 |
| Provider Name | Nighat D Siddiqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538296462 PECOS PAC ID: 5193805455 Enrollment ID: I20071228000180 |
| Provider Name | Karen Youngquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073798344 PECOS PAC ID: 2769563295 Enrollment ID: I20080122000691 |
| Provider Name | Anthony C De Franco |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1215930391 PECOS PAC ID: 4981672748 Enrollment ID: I20080211000092 |
| Provider Name | Joshua D Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740333780 PECOS PAC ID: 6608959580 Enrollment ID: I20080215000320 |
| Provider Name | John C Ralphe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811962921 PECOS PAC ID: 6608853056 Enrollment ID: I20080227000658 |
| Provider Name | Dennys E Maldonado |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700055621 PECOS PAC ID: 0749366573 Enrollment ID: I20080319000501 |
| Provider Name | Mark M Gramblicka |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1093896698 PECOS PAC ID: 8022196492 Enrollment ID: I20080425000083 |
| Provider Name | Rupesh P Patel |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1407020258 PECOS PAC ID: 3072686351 Enrollment ID: I20080718000711 |
| Provider Name | Nilay Kumar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427123702 PECOS PAC ID: 4789757071 Enrollment ID: I20080719000112 |
| Provider Name | Geetha Ganesan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003849407 PECOS PAC ID: 1759454689 Enrollment ID: I20080724000785 |
| Provider Name | Jimmy L Kim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861587263 PECOS PAC ID: 6002980844 Enrollment ID: I20080728000824 |
| Provider Name | Nicholas N Armstrong |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457329534 PECOS PAC ID: 1355415332 Enrollment ID: I20080808000719 |
| Provider Name | Omar Ahmad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801002209 PECOS PAC ID: 5597866616 Enrollment ID: I20080812000432 |
| Provider Name | Allan R Pasch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073513974 PECOS PAC ID: 5193629616 Enrollment ID: I20080820000561 |
| Provider Name | Andrea D Boeckman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194882514 PECOS PAC ID: 2365518073 Enrollment ID: I20080903000664 |
| Provider Name | Cathy A Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801940861 PECOS PAC ID: 0840367348 Enrollment ID: I20080925000326 |
| Provider Name | Lamberto Y Malinis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851570857 PECOS PAC ID: 8426125733 Enrollment ID: I20080927000124 |
| Provider Name | Dale S Schaper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801880372 PECOS PAC ID: 0749193431 Enrollment ID: I20080930000754 |
| Provider Name | Kaushik S Shahir |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407046816 PECOS PAC ID: 2264500784 Enrollment ID: I20081009000681 |
| Provider Name | Jeffrey A Aldred |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528051539 PECOS PAC ID: 5698688372 Enrollment ID: I20081010000520 |
| Provider Name | Thomas R Brand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023001047 PECOS PAC ID: 1951214634 Enrollment ID: I20081010000547 |
| Provider Name | Angela E Mack |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1902991078 PECOS PAC ID: 1759331085 Enrollment ID: I20081014000621 |
| Provider Name | Minhaj U Husain |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1265639397 PECOS PAC ID: 8820159619 Enrollment ID: I20081211000816 |
| Provider Name | Gina S Dorneanu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700098829 PECOS PAC ID: 4880756576 Enrollment ID: I20081213000200 |
| Provider Name | Susan L Hafemann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013166768 PECOS PAC ID: 1658433040 Enrollment ID: I20081218000433 |
| Provider Name | Stacey Lampone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689824096 PECOS PAC ID: 9032272133 Enrollment ID: I20090115000681 |
| Provider Name | Vaseem Iqbal |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780655548 PECOS PAC ID: 1557251295 Enrollment ID: I20090126000469 |
| Provider Name | Florin Stuleanu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1316958705 PECOS PAC ID: 9638234644 Enrollment ID: I20090206000441 |
| Provider Name | Mark D Plumb |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1821061367 PECOS PAC ID: 3779648787 Enrollment ID: I20090206000479 |
| Provider Name | Kurt E Brueckert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114936820 PECOS PAC ID: 4385701374 Enrollment ID: I20090318000436 |
| Provider Name | Clarence Grim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760404768 PECOS PAC ID: 2668529884 Enrollment ID: I20090403000528 |
| Provider Name | Anjoo M Gharia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154436160 PECOS PAC ID: 8729136965 Enrollment ID: I20090428000390 |
| Provider Name | Paula M Kasuboski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801035613 PECOS PAC ID: 2264581701 Enrollment ID: I20090513000016 |
| Provider Name | John T Hambrook |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477760577 PECOS PAC ID: 8628169158 Enrollment ID: I20090604000625 |
| Provider Name | Soniya K Pawar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255575569 PECOS PAC ID: 6901956028 Enrollment ID: I20090611000518 |
| Provider Name | Sarah E Pierce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851572713 PECOS PAC ID: 7517017452 Enrollment ID: I20090615000383 |
| Provider Name | Seth E Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033137815 PECOS PAC ID: 8426104571 Enrollment ID: I20090915000669 |
| Provider Name | Stephanie Slock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033278478 PECOS PAC ID: 2769538743 Enrollment ID: I20090916000171 |
| Provider Name | Khawaja A Ammar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477528065 PECOS PAC ID: 1951342963 Enrollment ID: I20091002000443 |
| Provider Name | Rachel L Kordonskiy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972836468 PECOS PAC ID: 2062551393 Enrollment ID: I20091130000419 |
| Provider Name | Sarah K Hambrook |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285842781 PECOS PAC ID: 8325113152 Enrollment ID: I20100212000026 |
| Provider Name | Jenny L Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871825323 PECOS PAC ID: 1850435678 Enrollment ID: I20100217000605 |
| Provider Name | Michael Roy Lunde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134177082 PECOS PAC ID: 4082741558 Enrollment ID: I20100415000414 |
| Provider Name | Shardha Srinivasan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205804010 PECOS PAC ID: 1850428657 Enrollment ID: I20100428000150 |
| Provider Name | Lauren M Pawlowski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194059485 PECOS PAC ID: 6608904206 Enrollment ID: I20100430000653 |
| Provider Name | Alex Sassani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669504494 PECOS PAC ID: 1052412004 Enrollment ID: I20100521000101 |
| Provider Name | Nicholas Vonbergen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124229406 PECOS PAC ID: 6002986619 Enrollment ID: I20100603000634 |
| Provider Name | Mary Jo R Rolfes-lo |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1508839838 PECOS PAC ID: 1254462302 Enrollment ID: I20100706000548 |
| Provider Name | Gregory M Heideman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295820546 PECOS PAC ID: 6305970021 Enrollment ID: I20100817001190 |
| Provider Name | David C Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871566349 PECOS PAC ID: 9638293012 Enrollment ID: I20100908000444 |
| Provider Name | Bradley R Ferguson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194862474 PECOS PAC ID: 7618028580 Enrollment ID: I20100910001061 |
| Provider Name | Mark A Girzadas |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1992842272 PECOS PAC ID: 6103941687 Enrollment ID: I20100921000981 |
| Provider Name | Amy L Peterson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679649123 PECOS PAC ID: 9830381763 Enrollment ID: I20101008001297 |
| Provider Name | Kevin J Kass |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740397272 PECOS PAC ID: 7911199526 Enrollment ID: I20101013001261 |
| Provider Name | Vipul Sharma |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831274109 PECOS PAC ID: 5496809279 Enrollment ID: I20101014000386 |
| Provider Name | Ahmad S Khraisat |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1750375143 PECOS PAC ID: 4587613682 Enrollment ID: I20101029001309 |
| Provider Name | Gwendolyn A Tanel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821160763 PECOS PAC ID: 1759467715 Enrollment ID: I20101030000134 |
| Provider Name | Bryan J Laundre |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578543401 PECOS PAC ID: 4082646393 Enrollment ID: I20101104001663 |
| Provider Name | Leandro A Espinosa |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124144217 PECOS PAC ID: 5890849558 Enrollment ID: I20101108000647 |
| Provider Name | Christopher J Tocco |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881622454 PECOS PAC ID: 5698960854 Enrollment ID: I20101112000914 |
| Provider Name | Mark Alan Dull |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1356437958 PECOS PAC ID: 5991787947 Enrollment ID: I20101122000102 |
| Provider Name | Daniel P Wiske |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1285808337 PECOS PAC ID: 2466648639 Enrollment ID: I20101130000758 |
| Provider Name | Kathleen E Omara |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437362035 PECOS PAC ID: 5698826170 Enrollment ID: I20101201000144 |
| Provider Name | David P Dielentheis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447304423 PECOS PAC ID: 8628264702 Enrollment ID: I20101201000813 |
| Provider Name | Mary K Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346357761 PECOS PAC ID: 3870780893 Enrollment ID: I20101202001290 |
| Provider Name | Wendi A Quentin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083749147 PECOS PAC ID: 4789872573 Enrollment ID: I20101221000316 |
| Provider Name | Michael G Manske |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396775466 PECOS PAC ID: 0840284915 Enrollment ID: I20110121000061 |
| Provider Name | Jill K Wanggaard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396734034 PECOS PAC ID: 8022297985 Enrollment ID: I20110124001179 |
| Provider Name | Holly A Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952635864 PECOS PAC ID: 2769664366 Enrollment ID: I20110302000997 |
| Provider Name | Amber G Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386944122 PECOS PAC ID: 1557543154 Enrollment ID: I20110302001028 |
| Provider Name | Alexis Chesrow |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1427207281 PECOS PAC ID: 8022162858 Enrollment ID: I20110318000691 |
| Provider Name | Jennifer Crnkovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952619959 PECOS PAC ID: 4688857030 Enrollment ID: I20110323000479 |
| Provider Name | Joshua Dpt Schneider |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477859320 PECOS PAC ID: 7911181268 Enrollment ID: I20110411000512 |
| Provider Name | Tabitha M Sheen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477689883 PECOS PAC ID: 4486838398 Enrollment ID: I20110418000295 |
| Provider Name | Heather L Sielaff |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295907418 PECOS PAC ID: 0648456822 Enrollment ID: I20110524000561 |
| Provider Name | Katherine Ann Hallenbeck |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427237403 PECOS PAC ID: 3779616784 Enrollment ID: I20110621000503 |
| Provider Name | Tracey L Dovi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417120825 PECOS PAC ID: 8224117460 Enrollment ID: I20110720000109 |
| Provider Name | Laurel R Marek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013206663 PECOS PAC ID: 2062680515 Enrollment ID: I20110727000650 |
| Provider Name | Amy K Dankwardt |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1992810170 PECOS PAC ID: 7416126123 Enrollment ID: I20110815000820 |
| Provider Name | Scott J Schutten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699079343 PECOS PAC ID: 7517137839 Enrollment ID: I20110824000459 |
| Provider Name | Rebecca S Severe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124004445 PECOS PAC ID: 3678597473 Enrollment ID: I20110826000624 |
| Provider Name | Michael E Nunag |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588827729 PECOS PAC ID: 6406026418 Enrollment ID: I20110831000169 |
| Provider Name | Diana L Rawson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033497953 PECOS PAC ID: 3870764848 Enrollment ID: I20110922000778 |
| Provider Name | Tonga K Nfor |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1821277724 PECOS PAC ID: 0547432627 Enrollment ID: I20111014000085 |
| Provider Name | Emmaleigh Madeline Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487812889 PECOS PAC ID: 9537203302 Enrollment ID: I20111026000335 |
| Provider Name | Jayzon P Martonito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306099676 PECOS PAC ID: 9032383922 Enrollment ID: I20111110000219 |
| Provider Name | David M Wehby |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1689817959 PECOS PAC ID: 4082880406 Enrollment ID: I20120105000441 |
| Provider Name | Joseph H Mehring |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1104198605 PECOS PAC ID: 5294995700 Enrollment ID: I20120320000921 |
| Provider Name | Edward V Braun |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1194856070 PECOS PAC ID: 8022279132 Enrollment ID: I20120417000817 |
| Provider Name | Kyle J Nelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891012449 PECOS PAC ID: 1951562917 Enrollment ID: I20120418000571 |
| Provider Name | Peter J Bartzen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053329789 PECOS PAC ID: 5991699142 Enrollment ID: I20120503000194 |
| Provider Name | Jessica A Dekan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699044156 PECOS PAC ID: 5698938140 Enrollment ID: I20120518000548 |
| Provider Name | Lynne M Nevershoeft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417234428 PECOS PAC ID: 0941463004 Enrollment ID: I20120530000080 |
| Provider Name | Rebecca L Zimmermann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669788477 PECOS PAC ID: 0345404109 Enrollment ID: I20120607000595 |
| Provider Name | Brett R St John |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205192200 PECOS PAC ID: 3274797345 Enrollment ID: I20120621000391 |
| Provider Name | Erich N Mussak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639343148 PECOS PAC ID: 2264698471 Enrollment ID: I20120716000262 |
| Provider Name | Enisa Hodzic |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285869560 PECOS PAC ID: 8527224153 Enrollment ID: I20120725000541 |
| Provider Name | Elmer L Linboom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487882320 PECOS PAC ID: 8820254337 Enrollment ID: I20120727000790 |
| Provider Name | Jason E Foil |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073786422 PECOS PAC ID: 5092962449 Enrollment ID: I20120821000115 |
| Provider Name | Bradley C Lepkowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831446921 PECOS PAC ID: 3375790561 Enrollment ID: I20120822000690 |
| Provider Name | Muhammad Fuad Jan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1912956178 PECOS PAC ID: 6406875913 Enrollment ID: I20120823000683 |
| Provider Name | Elizabeth A Vissat |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1609003508 PECOS PAC ID: 4688821168 Enrollment ID: I20120906000378 |
| Provider Name | Sara M Kotschi |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811242894 PECOS PAC ID: 5294983623 Enrollment ID: I20120910000631 |
| Provider Name | Matthew Wichman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609023548 PECOS PAC ID: 8729258082 Enrollment ID: I20120928000540 |
| Provider Name | Kelly N Billingsley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063761724 PECOS PAC ID: 4789834573 Enrollment ID: I20121102000101 |
| Provider Name | Jodi Wilde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598013534 PECOS PAC ID: 1456504828 Enrollment ID: I20130115000190 |
| Provider Name | Kelly A Kristbaum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215271994 PECOS PAC ID: 0143465252 Enrollment ID: I20130320000492 |
| Provider Name | Mary E Petoskey |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1265706444 PECOS PAC ID: 7214172931 Enrollment ID: I20130401000268 |
| Provider Name | Carl L Chojnacki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043551971 PECOS PAC ID: 1456596881 Enrollment ID: I20130405000345 |
| Provider Name | Madeline A Mcnally |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457517195 PECOS PAC ID: 0648417105 Enrollment ID: I20130501000217 |
| Provider Name | Melissa R Nowicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679831655 PECOS PAC ID: 4486892049 Enrollment ID: I20130521000667 |
| Provider Name | Orlin Hadjiev |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528269719 PECOS PAC ID: 7719030493 Enrollment ID: I20130524000299 |
| Provider Name | Gregg Tetting |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023196524 PECOS PAC ID: 8123268042 Enrollment ID: I20130717000130 |
| Provider Name | Dinesh J Belani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659642452 PECOS PAC ID: 7719127604 Enrollment ID: I20130718000072 |
| Provider Name | Damian C Kosempa |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1912173311 PECOS PAC ID: 0042451924 Enrollment ID: I20130719000347 |
| Provider Name | Bonnie L Bobot |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164748570 PECOS PAC ID: 8325289804 Enrollment ID: I20130725000508 |
| Provider Name | Celeste M Buchaklian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720363005 PECOS PAC ID: 3971744210 Enrollment ID: I20130729000551 |
| Provider Name | Karen L Lorfeld |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437342003 PECOS PAC ID: 6103081153 Enrollment ID: I20130821000163 |
| Provider Name | Steve M Czymbor |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1285949420 PECOS PAC ID: 9032352109 Enrollment ID: I20130821000885 |
| Provider Name | Ursala B Marinan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700227865 PECOS PAC ID: 5294978243 Enrollment ID: I20130823000785 |
| Provider Name | Vikram Bamra |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952569667 PECOS PAC ID: 6507009263 Enrollment ID: I20130827000974 |
| Provider Name | Inna A Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649581315 PECOS PAC ID: 3971747148 Enrollment ID: I20130910000714 |
| Provider Name | Brenda Ann Blunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174878839 PECOS PAC ID: 8921242454 Enrollment ID: I20130923000591 |
| Provider Name | Rebecca L Landgraf |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073773453 PECOS PAC ID: 5294969473 Enrollment ID: I20131001000067 |
| Provider Name | Kristina J Krogstad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528492469 PECOS PAC ID: 2860627015 Enrollment ID: I20131024001599 |
| Provider Name | Charles Player |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376779215 PECOS PAC ID: 2466687116 Enrollment ID: I20131105000482 |
| Provider Name | Bridget C Halenda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518394246 PECOS PAC ID: 8325273998 Enrollment ID: I20131107000567 |
| Provider Name | David L Baugh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790948438 PECOS PAC ID: 3274769211 Enrollment ID: I20131121000066 |
| Provider Name | Ali Alrefai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386081800 PECOS PAC ID: 1254569106 Enrollment ID: I20140122001607 |
| Provider Name | Ashley L Kwasinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801225164 PECOS PAC ID: 9234368853 Enrollment ID: I20140131000310 |
| Provider Name | Katalin Szaniszlo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265557045 PECOS PAC ID: 5698906634 Enrollment ID: I20140317000103 |
| Provider Name | Matthew J Howenstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548419336 PECOS PAC ID: 5799957163 Enrollment ID: I20140320002155 |
| Provider Name | Arshad Jahangir |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1164402137 PECOS PAC ID: 0648348672 Enrollment ID: I20140327000386 |
| Provider Name | Jamie Hosmer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841452927 PECOS PAC ID: 8527209386 Enrollment ID: I20140507001005 |
| Provider Name | Joseph A Rebro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699192104 PECOS PAC ID: 4880817162 Enrollment ID: I20140514002087 |
| Provider Name | Brandon R Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538396437 PECOS PAC ID: 4284873274 Enrollment ID: I20140602000482 |
| Provider Name | Steven D Huffman |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1922266105 PECOS PAC ID: 1153544507 Enrollment ID: I20140603002168 |
| Provider Name | Erik P Skulborstad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831494996 PECOS PAC ID: 1052535424 Enrollment ID: I20140605001128 |
| Provider Name | Renuka Jain |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811037161 PECOS PAC ID: 0143246678 Enrollment ID: I20140613000524 |
| Provider Name | Tarun Sharma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1104037340 PECOS PAC ID: 0648362186 Enrollment ID: I20140616002098 |
| Provider Name | Maqsood Khan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811019680 PECOS PAC ID: 2769534528 Enrollment ID: I20140617000574 |
| Provider Name | Tarun Kaura |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255640058 PECOS PAC ID: 7012131725 Enrollment ID: I20140620000404 |
| Provider Name | Nicholas L Marinelli |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427287549 PECOS PAC ID: 1951524735 Enrollment ID: I20140620000574 |
| Provider Name | Luke A Falesch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689998148 PECOS PAC ID: 9537383039 Enrollment ID: I20140623001899 |
| Provider Name | Melanie B Fukui |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932108685 PECOS PAC ID: 1850305442 Enrollment ID: I20140728001196 |
| Provider Name | Nisha D Sheth |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1992949895 PECOS PAC ID: 6901023530 Enrollment ID: I20140805002743 |
| Provider Name | Marina Kovacevic Horschak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134548274 PECOS PAC ID: 2668699851 Enrollment ID: I20140812001453 |
| Provider Name | Turia M Hollingsworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245539915 PECOS PAC ID: 1456578236 Enrollment ID: I20140819001868 |
| Provider Name | Naweed Chowdhury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306133673 PECOS PAC ID: 5597982389 Enrollment ID: I20140819002034 |
| Provider Name | Heather L Bartlett |
|---|---|
| Provider Type | Practitioner - Adult Congenital Heart Disease (achd) |
| Provider Identifiers | NPI Number: 1487649323 PECOS PAC ID: 9133146012 Enrollment ID: I20140828001997 |
| Provider Name | Jillian H Hudson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730488404 PECOS PAC ID: 7315170727 Enrollment ID: I20140909001931 |
| Provider Name | Lindsey Panko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659780674 PECOS PAC ID: 3274753850 Enrollment ID: I20141002000507 |
| Provider Name | James D Prahl |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1437211539 PECOS PAC ID: 8426213331 Enrollment ID: I20141008002300 |
| Provider Name | Holly L Leahy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538578653 PECOS PAC ID: 7719108687 Enrollment ID: I20141016002698 |
| Provider Name | Kelle J Tomatz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972912764 PECOS PAC ID: 8426270497 Enrollment ID: I20141106000319 |
| Provider Name | Jothis C Jose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306130737 PECOS PAC ID: 6608098355 Enrollment ID: I20141112001708 |
| Provider Name | Alexa D Chesner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902208754 PECOS PAC ID: 8224350418 Enrollment ID: I20141125000051 |
| Provider Name | Ashley A Moriwaki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902214612 PECOS PAC ID: 3577885466 Enrollment ID: I20141203002170 |
| Provider Name | Veronica L Zimmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518373166 PECOS PAC ID: 5991027898 Enrollment ID: I20141203002735 |
| Provider Name | Megan K Crow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316347214 PECOS PAC ID: 2567784358 Enrollment ID: I20141205000769 |
| Provider Name | Nicola M Charlton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326050436 PECOS PAC ID: 7810211463 Enrollment ID: I20150130001135 |
| Provider Name | Dina W Romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144643537 PECOS PAC ID: 0941430953 Enrollment ID: I20150306001692 |
| Provider Name | Melissa R Themar Geck |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861641565 PECOS PAC ID: 0042496432 Enrollment ID: I20150320000286 |
| Provider Name | Elizabeth L Merry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366833188 PECOS PAC ID: 3375861271 Enrollment ID: I20150404000036 |
| Provider Name | Kristin M Sauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447643812 PECOS PAC ID: 0941528442 Enrollment ID: I20150413002563 |
| Provider Name | Benjamin C Gillen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316108343 PECOS PAC ID: 7911073739 Enrollment ID: I20150508001768 |
| Provider Name | Jordan Perry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033441019 PECOS PAC ID: 9638363583 Enrollment ID: I20150513001227 |
| Provider Name | Samuel I Frost |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861704223 PECOS PAC ID: 6002136983 Enrollment ID: I20150515001326 |
| Provider Name | Darcey J Bedward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538551254 PECOS PAC ID: 6204721707 Enrollment ID: I20150515001729 |
| Provider Name | Kathleen A Senebouttarath |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295053775 PECOS PAC ID: 2466421599 Enrollment ID: I20150609003064 |
| Provider Name | Victoria J Cryer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316928203 PECOS PAC ID: 8820019516 Enrollment ID: I20150611002607 |
| Provider Name | Karla M Zilinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043690399 PECOS PAC ID: 2860703121 Enrollment ID: I20150612002136 |
| Provider Name | Zuber S Ali |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548536204 PECOS PAC ID: 2860703311 Enrollment ID: I20150624002198 |
| Provider Name | Rebecca D Rudella |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588046890 PECOS PAC ID: 2769794858 Enrollment ID: I20150702000035 |
| Provider Name | Anil Y Tumu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508094756 PECOS PAC ID: 3779895537 Enrollment ID: I20150708000165 |
| Provider Name | Rubinder Malczewski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679860605 PECOS PAC ID: 1254654288 Enrollment ID: I20150730011684 |
| Provider Name | Kristen E Kotecki |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336574847 PECOS PAC ID: 6709190713 Enrollment ID: I20150805006679 |
| Provider Name | Trista Kleppin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689015554 PECOS PAC ID: 8820302714 Enrollment ID: I20150805009548 |
| Provider Name | Jodi L Zilinski |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1023213626 PECOS PAC ID: 3072770817 Enrollment ID: I20150807013838 |
| Provider Name | Dominic B Draper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891060992 PECOS PAC ID: 9931414620 Enrollment ID: I20150810001593 |
| Provider Name | Colleen F Cassidy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275899841 PECOS PAC ID: 3577878271 Enrollment ID: I20150810001971 |
| Provider Name | Sebouh A Gueyikian |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1316947062 PECOS PAC ID: 4486544863 Enrollment ID: I20150811006139 |
| Provider Name | Deanna J Rusch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710362850 PECOS PAC ID: 1951616200 Enrollment ID: I20150814013483 |
| Provider Name | Briana B Czymbor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144456732 PECOS PAC ID: 5991929689 Enrollment ID: I20150817000606 |
| Provider Name | Fatima Ali |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740546829 PECOS PAC ID: 2961717020 Enrollment ID: I20150818005832 |
| Provider Name | Tatiana Petrikova |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528313061 PECOS PAC ID: 0042525008 Enrollment ID: I20150819009220 |
| Provider Name | Razieh Hadian Jazi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477802148 PECOS PAC ID: 9830412444 Enrollment ID: I20150828001535 |
| Provider Name | Renelle L Staus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013393768 PECOS PAC ID: 8527035443 Enrollment ID: I20150902000864 |
| Provider Name | Megan M Rorabeck |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104202282 PECOS PAC ID: 5698082535 Enrollment ID: I20150910000103 |
| Provider Name | Nyama M Sillah |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1770713182 PECOS PAC ID: 1557584778 Enrollment ID: I20150916000386 |
| Provider Name | Drew Goede |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1952785719 PECOS PAC ID: 1658688163 Enrollment ID: I20150916001255 |
| Provider Name | Lakshmi Muthukumar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538315221 PECOS PAC ID: 1759442924 Enrollment ID: I20150916003420 |
| Provider Name | Julia A Heim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336525740 PECOS PAC ID: 5294042594 Enrollment ID: I20150918002048 |
| Provider Name | Abdel Aziz A Jaffan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871799304 PECOS PAC ID: 2264584747 Enrollment ID: I20151013000178 |
| Provider Name | Neelofar Nabi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194083493 PECOS PAC ID: 6204145139 Enrollment ID: I20151015002225 |
| Provider Name | John-jeremiah Kretchy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487902805 PECOS PAC ID: 3274842570 Enrollment ID: I20151028001445 |
| Provider Name | Sandra L Homan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194193813 PECOS PAC ID: 1254641335 Enrollment ID: I20151102000278 |
| Provider Name | Heather Rubio-cockroft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386038677 PECOS PAC ID: 6800197179 Enrollment ID: I20151211000725 |
| Provider Name | Natalie A Fox |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063887529 PECOS PAC ID: 3779886270 Enrollment ID: I20160115001373 |
| Provider Name | Cynthia M Bellanger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164887063 PECOS PAC ID: 5799089132 Enrollment ID: I20160205000748 |
| Provider Name | Kelly Tritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710357116 PECOS PAC ID: 0941504708 Enrollment ID: I20160215002413 |
| Provider Name | Nicholas Perifanos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730549387 PECOS PAC ID: 9739485491 Enrollment ID: I20160308000139 |
| Provider Name | Samantha M Walch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538521372 PECOS PAC ID: 2668779026 Enrollment ID: I20160330000550 |
| Provider Name | Mary Nyamizi Kudoja |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770945263 PECOS PAC ID: 3870892417 Enrollment ID: I20160503000506 |
| Provider Name | Sharon A Bachman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942527007 PECOS PAC ID: 7214176890 Enrollment ID: I20160510001296 |
| Provider Name | Laam V Ko |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467624197 PECOS PAC ID: 6800024803 Enrollment ID: I20160513001789 |
| Provider Name | Nathan E Thompson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780902395 PECOS PAC ID: 4880997121 Enrollment ID: I20160516001129 |
| Provider Name | Zachary R Laste |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417243866 PECOS PAC ID: 3678862596 Enrollment ID: I20160517000989 |
| Provider Name | Adrianne L King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578919791 PECOS PAC ID: 2466741848 Enrollment ID: I20160525002179 |
| Provider Name | Meghan R Wisneski |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1851604078 PECOS PAC ID: 0446540579 Enrollment ID: I20160602000861 |
| Provider Name | Danielle K Szudrowitz Warner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487008348 PECOS PAC ID: 4082904123 Enrollment ID: I20160602001195 |
| Provider Name | Kevin E Hudak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275826760 PECOS PAC ID: 3476872839 Enrollment ID: I20160614000454 |
| Provider Name | Lauren M Kayser |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861849432 PECOS PAC ID: 8022309558 Enrollment ID: I20160614000545 |
| Provider Name | Melissa I Swainston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689029217 PECOS PAC ID: 8426349580 Enrollment ID: I20160620002356 |
| Provider Name | Ronald J Schmitt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316268360 PECOS PAC ID: 4385959865 Enrollment ID: I20160621001699 |
| Provider Name | Ben M Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487004172 PECOS PAC ID: 2567753247 Enrollment ID: I20160628001240 |
| Provider Name | Timothy Joseph Baures |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1104111376 PECOS PAC ID: 8820315542 Enrollment ID: I20160705000022 |
| Provider Name | Danielle M Fox |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477904738 PECOS PAC ID: 2062704489 Enrollment ID: I20160706000194 |
| Provider Name | Amitjeet Kalirao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801116306 PECOS PAC ID: 3971895681 Enrollment ID: I20160715001013 |
| Provider Name | Thomas F Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730503657 PECOS PAC ID: 3375836083 Enrollment ID: I20160718002006 |
| Provider Name | Joseph Sullivan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295022903 PECOS PAC ID: 4284923327 Enrollment ID: I20160720002703 |
| Provider Name | Paul P Heideman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144546870 PECOS PAC ID: 6002085107 Enrollment ID: I20160726002065 |
| Provider Name | Nathan Wallenfang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386090512 PECOS PAC ID: 2062706757 Enrollment ID: I20160803000675 |
| Provider Name | Khalid G Al Abdul Raheem |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306112305 PECOS PAC ID: 3375862865 Enrollment ID: I20160803001477 |
| Provider Name | Tarek M Amin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710322789 PECOS PAC ID: 3779802947 Enrollment ID: I20160805001152 |
| Provider Name | Gena M Dermody |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609141761 PECOS PAC ID: 9537488010 Enrollment ID: I20160810002894 |
| Provider Name | Jacob T Demaster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215373147 PECOS PAC ID: 3779892914 Enrollment ID: I20160816001713 |
| Provider Name | Laurence A Donahue |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1376856195 PECOS PAC ID: 5890080709 Enrollment ID: I20160817000002 |
| Provider Name | Margaret Mary Greco |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760686414 PECOS PAC ID: 9739251703 Enrollment ID: I20160817003183 |
| Provider Name | Denise M Elizondo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407289200 PECOS PAC ID: 9638487317 Enrollment ID: I20160818001046 |
| Provider Name | Mandeep K Kalirao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750662813 PECOS PAC ID: 9739306937 Enrollment ID: I20160823001405 |
| Provider Name | Catherine Cooch Allen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265673164 PECOS PAC ID: 5991090110 Enrollment ID: I20160825002781 |
| Provider Name | Justine M Benin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942541362 PECOS PAC ID: 2466748223 Enrollment ID: I20160906001102 |
| Provider Name | Lauren T H Tyler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578016143 PECOS PAC ID: 4385930957 Enrollment ID: I20160907002702 |
| Provider Name | Angela M Kochanik-pirelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659825701 PECOS PAC ID: 6103112347 Enrollment ID: I20160914000877 |
| Provider Name | Lauren M Tran |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174889034 PECOS PAC ID: 6406090943 Enrollment ID: I20160915001844 |
| Provider Name | Katherine A Faust |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154876175 PECOS PAC ID: 6608163456 Enrollment ID: I20160922001737 |
| Provider Name | Priya Ramdass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023458171 PECOS PAC ID: 2769779370 Enrollment ID: I20160926001813 |
| Provider Name | Aharon B Goodwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487102471 PECOS PAC ID: 2264729771 Enrollment ID: I20160928000086 |
| Provider Name | Katie M Slocum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659826238 PECOS PAC ID: 3870881873 Enrollment ID: I20161006001486 |
| Provider Name | Ana M Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053869305 PECOS PAC ID: 8527356583 Enrollment ID: I20161007000703 |
| Provider Name | Nicole Ebel Mubanga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285976563 PECOS PAC ID: 8527285030 Enrollment ID: I20161007000817 |
| Provider Name | Veronica Elchert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801344213 PECOS PAC ID: 0244528735 Enrollment ID: I20161017001710 |
| Provider Name | Sarah Arvelo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326594474 PECOS PAC ID: 3577841469 Enrollment ID: I20161027001297 |
| Provider Name | Lindsey Kay Rozewicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003365909 PECOS PAC ID: 9436438058 Enrollment ID: I20161122000581 |
| Provider Name | Rachel A Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265975825 PECOS PAC ID: 2961783709 Enrollment ID: I20170110000950 |
| Provider Name | Sussy Lynn King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942325923 PECOS PAC ID: 2769465061 Enrollment ID: I20170127001335 |
| Provider Name | Jacqueline Y Sandoval |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497292379 PECOS PAC ID: 5395028880 Enrollment ID: I20170207002402 |
| Provider Name | Molly Yurk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528515954 PECOS PAC ID: 8224317482 Enrollment ID: I20170213001870 |
| Provider Name | Megan M Brezinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356888176 PECOS PAC ID: 1951685882 Enrollment ID: I20170221001826 |
| Provider Name | Jason R Gehring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881133593 PECOS PAC ID: 9032493465 Enrollment ID: I20170303000974 |
| Provider Name | Ashley L Vos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336686211 PECOS PAC ID: 3173807484 Enrollment ID: I20170306002210 |
| Provider Name | Amber Schmitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689112492 PECOS PAC ID: 0840574018 Enrollment ID: I20170307001944 |
| Provider Name | Suzanne C Major |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629518238 PECOS PAC ID: 7911281027 Enrollment ID: I20170308001482 |
| Provider Name | Melissa Frederick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881134054 PECOS PAC ID: 1759666753 Enrollment ID: I20170313002282 |
| Provider Name | Deborah Nealon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1538603196 PECOS PAC ID: 3577848092 Enrollment ID: I20170324001527 |
| Provider Name | Desiree A Mengo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447791363 PECOS PAC ID: 7113203217 Enrollment ID: I20170403002593 |
| Provider Name | Stacy M Syrcle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023339132 PECOS PAC ID: 2163642760 Enrollment ID: I20170420000817 |
| Provider Name | Lisa A Schwartz |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1548699945 PECOS PAC ID: 5991082638 Enrollment ID: I20170504002301 |
| Provider Name | Bridget K Larson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285993725 PECOS PAC ID: 3476836024 Enrollment ID: I20170505001209 |
| Provider Name | Lori L Leidel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932633724 PECOS PAC ID: 0547547051 Enrollment ID: I20170511000822 |
| Provider Name | Daniel Ortiz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487929584 PECOS PAC ID: 6204119449 Enrollment ID: I20170516001735 |
| Provider Name | Mark E Sharafinski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952612194 PECOS PAC ID: 4486932951 Enrollment ID: I20170525001641 |
| Provider Name | Peter V Gikas |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1396001327 PECOS PAC ID: 2769793447 Enrollment ID: I20170612000184 |
| Provider Name | Prashan Gunasekera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770848194 PECOS PAC ID: 4284876087 Enrollment ID: I20170612001722 |
| Provider Name | Roberto F Rojas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326347667 PECOS PAC ID: 4688942758 Enrollment ID: I20170613002335 |
| Provider Name | Stefan G Doerge |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295034445 PECOS PAC ID: 3072803261 Enrollment ID: I20170616001122 |
| Provider Name | Massihullah Hamidi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043509680 PECOS PAC ID: 9739484791 Enrollment ID: I20170627001571 |
| Provider Name | Rebecca J Ioder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922558931 PECOS PAC ID: 6507135977 Enrollment ID: I20170629000370 |
| Provider Name | Alexander M Riordan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972879534 PECOS PAC ID: 8527387166 Enrollment ID: I20170727000470 |
| Provider Name | Aaron Bos |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1629363130 PECOS PAC ID: 1557665197 Enrollment ID: I20170815003108 |
| Provider Name | Josie M Rukamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295257236 PECOS PAC ID: 3779855341 Enrollment ID: I20170816002193 |
| Provider Name | Jessica A Schilz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770865933 PECOS PAC ID: 5799959706 Enrollment ID: I20170817001355 |
| Provider Name | Kyle C Janicke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265956288 PECOS PAC ID: 1850663295 Enrollment ID: I20170821001638 |
| Provider Name | Kari E Brueck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770006835 PECOS PAC ID: 6608149968 Enrollment ID: I20170907003013 |
| Provider Name | Kimberly E Poenisch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710320023 PECOS PAC ID: 1951675396 Enrollment ID: I20170922001907 |
| Provider Name | Heather N Korus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770018848 PECOS PAC ID: 9335413624 Enrollment ID: I20170926001522 |
| Provider Name | Krisen Rampersad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558774430 PECOS PAC ID: 8224303623 Enrollment ID: I20171011002218 |
| Provider Name | Dawn M Garthee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639693138 PECOS PAC ID: 8325314222 Enrollment ID: I20171020000995 |
| Provider Name | Lauren Stieber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003334194 PECOS PAC ID: 5395011191 Enrollment ID: I20171023002537 |
| Provider Name | Charles Brandsmeier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891214763 PECOS PAC ID: 1557627718 Enrollment ID: I20171106000308 |
| Provider Name | Samir P Shah |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1063535995 PECOS PAC ID: 6002139045 Enrollment ID: I20171121002980 |
| Provider Name | Maikeng Her |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255843397 PECOS PAC ID: 5395002307 Enrollment ID: I20171129002912 |
| Provider Name | Katherine M Jung |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780197269 PECOS PAC ID: 8224395033 Enrollment ID: I20171205003542 |
| Provider Name | Duachy Vang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285157354 PECOS PAC ID: 3173897477 Enrollment ID: I20171214000665 |
| Provider Name | Bao Xiong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225548712 PECOS PAC ID: 4385902550 Enrollment ID: I20171215001454 |
| Provider Name | Kari Megan Dyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689189482 PECOS PAC ID: 7214296656 Enrollment ID: I20180110003428 |
| Provider Name | Scott D Mingilino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770090102 PECOS PAC ID: 6204195076 Enrollment ID: I20180124001816 |
| Provider Name | Andy Kieu |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1215355730 PECOS PAC ID: 1658650023 Enrollment ID: I20180307000825 |
| Provider Name | Krystle K Stolzel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356843775 PECOS PAC ID: 3476815846 Enrollment ID: I20180322002030 |
| Provider Name | Melissa L Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982106738 PECOS PAC ID: 3375806300 Enrollment ID: I20180404001609 |
| Provider Name | Grace L Van Valin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396248084 PECOS PAC ID: 6204199151 Enrollment ID: I20180406001209 |
| Provider Name | Kimberly J Gehrig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437655438 PECOS PAC ID: 4385908359 Enrollment ID: I20180430001281 |
| Provider Name | Kailyn E Heiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568967339 PECOS PAC ID: 8921362559 Enrollment ID: I20180508001736 |
| Provider Name | Jennifer A Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548295272 PECOS PAC ID: 4880756030 Enrollment ID: I20180531001555 |
| Provider Name | Scott A Cameron |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912297078 PECOS PAC ID: 9931454394 Enrollment ID: I20180626002571 |
| Provider Name | Kate M Essad |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497098123 PECOS PAC ID: 7719119718 Enrollment ID: I20180710001913 |
| Provider Name | Michael David Nezworski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225520927 PECOS PAC ID: 2062769565 Enrollment ID: I20180713002942 |
| Provider Name | Christopher Joseph Bermudez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578729190 PECOS PAC ID: 1759604119 Enrollment ID: I20180719001998 |
| Provider Name | Nabila Quadri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124413935 PECOS PAC ID: 6608171152 Enrollment ID: I20180719002266 |
| Provider Name | Eric S Hulse |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1396269395 PECOS PAC ID: 0840547519 Enrollment ID: I20180726001077 |
| Provider Name | Lara N Mrak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063832608 PECOS PAC ID: 2062716541 Enrollment ID: I20180727001506 |
| Provider Name | Shahzad C Chaudhry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457745630 PECOS PAC ID: 8820304199 Enrollment ID: I20180730000278 |
| Provider Name | Jonathan E Kiechle |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1083903512 PECOS PAC ID: 6709134281 Enrollment ID: I20180731000739 |
| Provider Name | Lauren J Hollandsworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760877559 PECOS PAC ID: 6901154483 Enrollment ID: I20180731001016 |
| Provider Name | Tesalia R Jordens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750762472 PECOS PAC ID: 3375840168 Enrollment ID: I20180808001091 |
| Provider Name | Ahmed M Ibn-mahfoudh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457320970 PECOS PAC ID: 8820019946 Enrollment ID: I20180810000540 |
| Provider Name | Daniel J Rogers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437545670 PECOS PAC ID: 1557610151 Enrollment ID: I20180815000494 |
| Provider Name | Sara Marie Stanenas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609296250 PECOS PAC ID: 7719236959 Enrollment ID: I20180821001110 |
| Provider Name | Omar Sinno |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477997955 PECOS PAC ID: 3678701828 Enrollment ID: I20180821001534 |
| Provider Name | Kristen Wilde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275927642 PECOS PAC ID: 0345599452 Enrollment ID: I20180823000903 |
| Provider Name | Neil P Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376821082 PECOS PAC ID: 3274806245 Enrollment ID: I20180925004135 |
| Provider Name | Kerry Katz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679703961 PECOS PAC ID: 2668627324 Enrollment ID: I20180927000446 |
| Provider Name | Abdur R Khan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1780675439 PECOS PAC ID: 4688625296 Enrollment ID: I20180927000541 |
| Provider Name | Elisabeth E Solwold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689155020 PECOS PAC ID: 0446501621 Enrollment ID: I20180927000988 |
| Provider Name | Yuriy Zamota |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104232909 PECOS PAC ID: 8820340714 Enrollment ID: I20181003002692 |
| Provider Name | Luis-alejandro Roldan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184101586 PECOS PAC ID: 3274885629 Enrollment ID: I20181011002846 |
| Provider Name | Samuel E Kaminski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013495068 PECOS PAC ID: 0648522847 Enrollment ID: I20181017001229 |
| Provider Name | Trent J Meltzer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962896316 PECOS PAC ID: 2668776469 Enrollment ID: I20181030002496 |
| Provider Name | Brittany Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174037667 PECOS PAC ID: 7719231653 Enrollment ID: I20181113002239 |
| Provider Name | Adam Cosson |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1912408246 PECOS PAC ID: 1052665544 Enrollment ID: I20181120001185 |
| Provider Name | Lourdes Robles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174099063 PECOS PAC ID: 2860736790 Enrollment ID: I20181204002808 |
| Provider Name | John R Slaby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134309354 PECOS PAC ID: 7810185147 Enrollment ID: I20181206001576 |
| Provider Name | Mirza A Baig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679868707 PECOS PAC ID: 9335376409 Enrollment ID: I20181211003149 |
| Provider Name | Bhavna Kapurji Thakor |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245572817 PECOS PAC ID: 4789977729 Enrollment ID: I20181218000106 |
| Provider Name | Andrea F Penister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427374156 PECOS PAC ID: 5395080998 Enrollment ID: I20190102000667 |
| Provider Name | Leyda M Su Ham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912169657 PECOS PAC ID: 1557533957 Enrollment ID: I20190107000408 |
| Provider Name | Mary Beth Pelon |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770031833 PECOS PAC ID: 7810233129 Enrollment ID: I20190108001149 |
| Provider Name | Heidi L Medina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578048203 PECOS PAC ID: 0446597173 Enrollment ID: I20190204000017 |
| Provider Name | Laura M Harrigan |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1336567437 PECOS PAC ID: 7214275957 Enrollment ID: I20190205001815 |
| Provider Name | Elizabeth M Ullig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467923409 PECOS PAC ID: 6204174154 Enrollment ID: I20190219001099 |
| Provider Name | Heather H Weber |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831319748 PECOS PAC ID: 0840382156 Enrollment ID: I20190319001018 |
| Provider Name | Stacie A Binter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467918375 PECOS PAC ID: 0648510891 Enrollment ID: I20190326000163 |
| Provider Name | Katie A Kowaleski |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1689165243 PECOS PAC ID: 8022365329 Enrollment ID: I20190402000298 |
| Provider Name | Samantha J Goedde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770048134 PECOS PAC ID: 7113268905 Enrollment ID: I20190404000035 |
| Provider Name | Angela J David |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538624010 PECOS PAC ID: 3779824297 Enrollment ID: I20190410002617 |
| Provider Name | Tynisha Mcwright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346700820 PECOS PAC ID: 5496096729 Enrollment ID: I20190413000099 |
| Provider Name | Kristen D Holzwart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609330414 PECOS PAC ID: 4880935097 Enrollment ID: I20190416000491 |
| Provider Name | Kelly L Riffel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467915983 PECOS PAC ID: 5698017671 Enrollment ID: I20190423000128 |
| Provider Name | Linsey M Bishop |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1639697717 PECOS PAC ID: 9931473576 Enrollment ID: I20190514002296 |
| Provider Name | Ruchi Sharma |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598184764 PECOS PAC ID: 9931322385 Enrollment ID: I20190515001038 |
| Provider Name | Alison Marie Damato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508421728 PECOS PAC ID: 1951644665 Enrollment ID: I20190521002340 |
| Provider Name | Michael P Mullin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891136743 PECOS PAC ID: 3274880810 Enrollment ID: I20190523000022 |
| Provider Name | Justin E Friske |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477896447 PECOS PAC ID: 1557616406 Enrollment ID: I20190523000563 |
| Provider Name | Harry Merrill Matschke |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1629032115 PECOS PAC ID: 0941233373 Enrollment ID: I20190523002705 |
| Provider Name | Joshua P Lechusz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841533692 PECOS PAC ID: 4587914924 Enrollment ID: I20190604000560 |
| Provider Name | Samantha Orlowski |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1427458470 PECOS PAC ID: 1951634872 Enrollment ID: I20190610000040 |
| Provider Name | Tarek Ajam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588059356 PECOS PAC ID: 4688977507 Enrollment ID: I20190610002720 |
| Provider Name | Sotirios A Vasilopoulos |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568432912 PECOS PAC ID: 7719931849 Enrollment ID: I20190611003332 |
| Provider Name | Heidi L Newton |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306363551 PECOS PAC ID: 2466785142 Enrollment ID: I20190612000869 |
| Provider Name | Michael Goshorn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750737367 PECOS PAC ID: 3375813900 Enrollment ID: I20190621001660 |
| Provider Name | Joseph J Doherty |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457746448 PECOS PAC ID: 5193088300 Enrollment ID: I20190624000887 |
| Provider Name | Mahmoud Ali |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1366837635 PECOS PAC ID: 5698077410 Enrollment ID: I20190626003140 |
| Provider Name | Syed A Rahman |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1376981068 PECOS PAC ID: 0446515639 Enrollment ID: I20190710002883 |
| Provider Name | Casey A Melcher |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1689014417 PECOS PAC ID: 7911262928 Enrollment ID: I20190711001524 |
| Provider Name | Nicholas W Hawley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992166821 PECOS PAC ID: 0941536361 Enrollment ID: I20190723002842 |
| Provider Name | Nader N Sallam |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083068316 PECOS PAC ID: 0446501720 Enrollment ID: I20190723003699 |
| Provider Name | Nolan P Machernis |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1669765681 PECOS PAC ID: 4587947833 Enrollment ID: I20190729002156 |
| Provider Name | Abdulrehman Siddiqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003278268 PECOS PAC ID: 1153683826 Enrollment ID: I20190805002835 |
| Provider Name | Justin Peterson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033558010 PECOS PAC ID: 0547580185 Enrollment ID: I20190814003398 |
| Provider Name | Laura R Langford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558915074 PECOS PAC ID: 8921336900 Enrollment ID: I20190829000845 |
| Provider Name | Andrew R Wroblewski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083273197 PECOS PAC ID: 0143559039 Enrollment ID: I20190830001870 |
| Provider Name | Amanpreet Dhaliwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548756281 PECOS PAC ID: 4789913401 Enrollment ID: I20190905002521 |
| Provider Name | Linda M Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265487805 PECOS PAC ID: 2668482563 Enrollment ID: I20190905002764 |
| Provider Name | Shelly L P Glascock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598310468 PECOS PAC ID: 7911236138 Enrollment ID: I20190912001365 |
| Provider Name | Erin Lynne Pape |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720635485 PECOS PAC ID: 6002145240 Enrollment ID: I20190912002053 |
| Provider Name | Annakaren Morelos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891145090 PECOS PAC ID: 3971864182 Enrollment ID: I20190926001485 |
| Provider Name | Margarita Luckhardt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679957781 PECOS PAC ID: 2668717653 Enrollment ID: I20191014001625 |
| Provider Name | Jill D Bushberger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497105837 PECOS PAC ID: 2062744808 Enrollment ID: I20191029001669 |
| Provider Name | Aaron R Eastman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538710827 PECOS PAC ID: 8123350790 Enrollment ID: I20191031000957 |
| Provider Name | Nikolas M Blascoe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508232729 PECOS PAC ID: 2466762836 Enrollment ID: I20191204001689 |
| Provider Name | Merissa E Lauzon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346617941 PECOS PAC ID: 4587097373 Enrollment ID: I20191209002978 |
| Provider Name | Robin Julianne Poedel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942637921 PECOS PAC ID: 3779706130 Enrollment ID: I20191218003245 |
| Provider Name | Anna Seckar-anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023654662 PECOS PAC ID: 6305270414 Enrollment ID: I20191226000729 |
| Provider Name | Kristin Marie Sell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1962537878 PECOS PAC ID: 5294160644 Enrollment ID: I20200114000857 |
| Provider Name | Jaime D Novales |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730395609 PECOS PAC ID: 0749469393 Enrollment ID: I20200114001282 |
| Provider Name | Mackenzie L Zuleger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205473584 PECOS PAC ID: 0042646101 Enrollment ID: I20200207002509 |
| Provider Name | Suzanne M Girard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578196770 PECOS PAC ID: 6608204110 Enrollment ID: I20200317000461 |
| Provider Name | Mirza Baig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376906917 PECOS PAC ID: 6800224957 Enrollment ID: I20200324000706 |
| Provider Name | Nan Wu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073903142 PECOS PAC ID: 5597052514 Enrollment ID: I20200325002235 |
| Provider Name | Jeremy S Wells |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124658422 PECOS PAC ID: 2466881636 Enrollment ID: I20200409001321 |
| Provider Name | Nicholas E Tadeo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992192256 PECOS PAC ID: 2769812841 Enrollment ID: I20200414002564 |
| Provider Name | Jennifer Vargo |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1861940330 PECOS PAC ID: 4880972926 Enrollment ID: I20200427000358 |
| Provider Name | Sabina C Mullin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1275890584 PECOS PAC ID: 0840620068 Enrollment ID: I20200430000801 |
| Provider Name | Shehla Baig |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356863047 PECOS PAC ID: 7719312883 Enrollment ID: I20200527000415 |
| Provider Name | Sara L Madsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104243252 PECOS PAC ID: 2961797279 Enrollment ID: I20200608000356 |
| Provider Name | Melissa C Helm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598222465 PECOS PAC ID: 4486997483 Enrollment ID: I20200608002223 |
| Provider Name | Joshua H Finkle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528408903 PECOS PAC ID: 9638472764 Enrollment ID: I20200610001858 |
| Provider Name | Jacqueline Ann Ots |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003456823 PECOS PAC ID: 7214359561 Enrollment ID: I20200616000191 |
| Provider Name | Marina Doliner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841452489 PECOS PAC ID: 3678895638 Enrollment ID: I20200709003277 |
| Provider Name | Andrew B Ingraham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841642642 PECOS PAC ID: 8628362126 Enrollment ID: I20200714002284 |
| Provider Name | Carl Bellinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558892539 PECOS PAC ID: 0941539837 Enrollment ID: I20200716000140 |
| Provider Name | Melody Chen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558789388 PECOS PAC ID: 2365866928 Enrollment ID: I20200716000736 |
| Provider Name | Mitchell R Elgin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528421369 PECOS PAC ID: 4082039623 Enrollment ID: I20200730000775 |
| Provider Name | Anand Patel |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1730445255 PECOS PAC ID: 5890074140 Enrollment ID: I20200803001596 |
| Provider Name | Jacob L Morgan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689024788 PECOS PAC ID: 1355633165 Enrollment ID: I20200807000166 |
| Provider Name | Harsh Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730528340 PECOS PAC ID: 4789994500 Enrollment ID: I20200811003173 |
| Provider Name | Linda Thu Nguyen |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1407104813 PECOS PAC ID: 0547531170 Enrollment ID: I20200813002966 |
| Provider Name | Elizabeth V Craig |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245523216 PECOS PAC ID: 9830492784 Enrollment ID: I20200817003312 |
| Provider Name | Harry S Nayar |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1588009658 PECOS PAC ID: 6204050636 Enrollment ID: I20200818000514 |
| Provider Name | Michelle M Hofmeister |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053726026 PECOS PAC ID: 2264732163 Enrollment ID: I20200824002153 |
| Provider Name | Shilpa Chaku |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780091959 PECOS PAC ID: 3173815701 Enrollment ID: I20200826001486 |
| Provider Name | Thang D Ngo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538352059 PECOS PAC ID: 4789751439 Enrollment ID: I20200827001919 |
| Provider Name | Laura L Sickley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437763802 PECOS PAC ID: 7315365095 Enrollment ID: I20200911001649 |
| Provider Name | Long Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962817700 PECOS PAC ID: 1658606777 Enrollment ID: I20200917002959 |
| Provider Name | Elizabeth Gastineau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376197574 PECOS PAC ID: 9638504129 Enrollment ID: I20200921000968 |
| Provider Name | Priti Rana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669904090 PECOS PAC ID: 7618212762 Enrollment ID: I20200926000181 |
| Provider Name | Kellie A Greenwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962036830 PECOS PAC ID: 0749609402 Enrollment ID: I20200929002828 |
| Provider Name | Carly B Worden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053926949 PECOS PAC ID: 5193144822 Enrollment ID: I20200930001448 |
| Provider Name | Courtney Amborn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629685110 PECOS PAC ID: 6002226180 Enrollment ID: I20201030000795 |
| Provider Name | Jamie L Kivisto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568074359 PECOS PAC ID: 6901216381 Enrollment ID: I20201113002799 |
| Provider Name | Michael G. Barkett |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831546134 PECOS PAC ID: 1254742133 Enrollment ID: I20201125000606 |
| Provider Name | Ahmed A Quraishi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770010167 PECOS PAC ID: 5991074866 Enrollment ID: I20201125001700 |
| Provider Name | Zachary Smith |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508493198 PECOS PAC ID: 4880005628 Enrollment ID: I20201130000669 |
| Provider Name | Karlie E Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518572940 PECOS PAC ID: 1658783568 Enrollment ID: I20201217003084 |
| Provider Name | Adam J Basler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376983627 PECOS PAC ID: 5395094775 Enrollment ID: I20201228000049 |
| Provider Name | Amber R Marasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952900474 PECOS PAC ID: 4981017290 Enrollment ID: I20210106000212 |
| Provider Name | Brooke D Simons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811530116 PECOS PAC ID: 9830520022 Enrollment ID: I20210210002197 |
| Provider Name | Craig P Swanson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437511557 PECOS PAC ID: 9234546292 Enrollment ID: I20210318002532 |
| Provider Name | Emily G Holzwart |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1902482243 PECOS PAC ID: 9537576293 Enrollment ID: I20210324001250 |
| Provider Name | Adejimi Adeniji |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750349676 PECOS PAC ID: 2163455221 Enrollment ID: I20210326001217 |
| Provider Name | Megan Mr Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174108815 PECOS PAC ID: 7012325095 Enrollment ID: I20210412000834 |
| Provider Name | Angela K King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417338351 PECOS PAC ID: 7911298716 Enrollment ID: I20210414001457 |
| Provider Name | Emma J Saunders |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1346829280 PECOS PAC ID: 2365850617 Enrollment ID: I20210426002246 |
| Provider Name | Shelly W Reimer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306200886 PECOS PAC ID: 2769881044 Enrollment ID: I20210519002056 |
| Provider Name | Esther M Motlhatlhedi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023347010 PECOS PAC ID: 7012195688 Enrollment ID: I20210608000364 |
| Provider Name | Mohamed Hendawi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134624034 PECOS PAC ID: 8224438601 Enrollment ID: I20210608000533 |
| Provider Name | Jacob Deutsch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942689450 PECOS PAC ID: 4284970906 Enrollment ID: I20210615001885 |
| Provider Name | Jackson Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700381977 PECOS PAC ID: 3072933050 Enrollment ID: I20210616001023 |
| Provider Name | Nicole Hammes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386620987 PECOS PAC ID: 2365491107 Enrollment ID: I20210628002228 |
| Provider Name | Haroon Zubair |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013295583 PECOS PAC ID: 2062734866 Enrollment ID: I20210629001494 |
| Provider Name | Jennifer Zanow |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1265002562 PECOS PAC ID: 9032511274 Enrollment ID: I20210712001504 |
| Provider Name | Jalel Abera Hunde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194220558 PECOS PAC ID: 5597167569 Enrollment ID: I20210713003344 |
| Provider Name | Leart Neziri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073018347 PECOS PAC ID: 9436580644 Enrollment ID: I20210714000096 |
| Provider Name | Kanisha Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699341834 PECOS PAC ID: 8224430152 Enrollment ID: I20210714001725 |
| Provider Name | Andrew Jacob Chapel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619406352 PECOS PAC ID: 1254692452 Enrollment ID: I20210720000194 |
| Provider Name | Patrick David Foss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851896898 PECOS PAC ID: 5496176042 Enrollment ID: I20210721001309 |
| Provider Name | Nathan P Meyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538612445 PECOS PAC ID: 1557655701 Enrollment ID: I20210723001082 |
| Provider Name | Laura Marie Steele |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1235730672 PECOS PAC ID: 6709280555 Enrollment ID: I20210802002297 |
| Provider Name | Cody A Mather |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629640115 PECOS PAC ID: 1557765708 Enrollment ID: I20210810001551 |
| Provider Name | Stacie M Hauenstein |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508424300 PECOS PAC ID: 8921331679 Enrollment ID: I20210810001904 |
| Provider Name | Stephaney Anne Bublitz |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013589035 PECOS PAC ID: 8123422268 Enrollment ID: I20210811001553 |
| Provider Name | Erin L Storeygard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447841952 PECOS PAC ID: 5799180527 Enrollment ID: I20210817003264 |
| Provider Name | Jamie L Schoknecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295300010 PECOS PAC ID: 4486059227 Enrollment ID: I20210817003517 |
| Provider Name | Andrew Mahnke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750055125 PECOS PAC ID: 1355746843 Enrollment ID: I20210820003015 |
| Provider Name | Kartik Kesavabhotla |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548689144 PECOS PAC ID: 6901189778 Enrollment ID: I20210824001331 |
| Provider Name | Michelle Guenther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285206201 PECOS PAC ID: 8729483094 Enrollment ID: I20210825000352 |
| Provider Name | Hayley Demario |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538834510 PECOS PAC ID: 0547665697 Enrollment ID: I20210827000215 |
| Provider Name | Lloyd R Munson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679775860 PECOS PAC ID: 0345646238 Enrollment ID: I20210831003629 |
| Provider Name | Shujahat Chaudhry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184112963 PECOS PAC ID: 2668721655 Enrollment ID: I20210901001006 |
| Provider Name | Anna Medical Karst |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841796737 PECOS PAC ID: 8224464052 Enrollment ID: I20210922001825 |
| Provider Name | Megan Roidt |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457924466 PECOS PAC ID: 4981001534 Enrollment ID: I20210923002165 |
| Provider Name | Gregory L Rasmussen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225419989 PECOS PAC ID: 8224436357 Enrollment ID: I20211005000041 |
| Provider Name | Amanda Jo Carlson-dondero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114597168 PECOS PAC ID: 3375941362 Enrollment ID: I20211005002570 |
| Provider Name | Ilya Kadushin |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932874971 PECOS PAC ID: 2668870403 Enrollment ID: I20211008002683 |
| Provider Name | Katie L Cole |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1639200181 PECOS PAC ID: 1951356559 Enrollment ID: I20211012001660 |
| Provider Name | Elizabeth Bart |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1952757809 PECOS PAC ID: 1951693464 Enrollment ID: I20211015002121 |
| Provider Name | Arielle M Tenor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922770858 PECOS PAC ID: 7012305261 Enrollment ID: I20211021000635 |
| Provider Name | James David Nencka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417526179 PECOS PAC ID: 3870982903 Enrollment ID: I20211111001119 |
| Provider Name | Nathaniel R Marshall |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447779319 PECOS PAC ID: 6002205986 Enrollment ID: I20211115002133 |
| Provider Name | Samantha J Williams |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164196291 PECOS PAC ID: 3678962347 Enrollment ID: I20211118000842 |
| Provider Name | Erika R Breeser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033886239 PECOS PAC ID: 2769873298 Enrollment ID: I20211216002836 |
| Provider Name | Sharon L Frigo Doyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689248098 PECOS PAC ID: 3476945080 Enrollment ID: I20220111001558 |
| Provider Name | Michael G Olenchek |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972897544 PECOS PAC ID: 1658763206 Enrollment ID: I20220112000406 |
| Provider Name | Jayson C Osborn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861999492 PECOS PAC ID: 3971918111 Enrollment ID: I20220121000961 |
| Provider Name | Erin M Nachreiner-mackesey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245895655 PECOS PAC ID: 3870985963 Enrollment ID: I20220124000536 |
| Provider Name | Matthew Klinka |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790274934 PECOS PAC ID: 8224387519 Enrollment ID: I20220124001643 |
| Provider Name | Mary Lewis Delcore |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477508489 PECOS PAC ID: 5890188502 Enrollment ID: I20220201002245 |
| Provider Name | Chloe T Leszczynski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720638323 PECOS PAC ID: 6406188499 Enrollment ID: I20220207002578 |
| Provider Name | Amy C Pearson |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1831457357 PECOS PAC ID: 5496989360 Enrollment ID: I20220221000538 |
| Provider Name | Sabrina R Hafeman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710653282 PECOS PAC ID: 4284028531 Enrollment ID: I20220302000878 |
| Provider Name | Kristin N Fohr |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1609521731 PECOS PAC ID: 4486048683 Enrollment ID: I20220304001087 |
| Provider Name | Anibal R Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124349675 PECOS PAC ID: 6709023880 Enrollment ID: I20220310001862 |
| Provider Name | Navneesh Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922319805 PECOS PAC ID: 6709010176 Enrollment ID: I20220311001489 |
| Provider Name | Adan F Hernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043709850 PECOS PAC ID: 8426485640 Enrollment ID: I20220314001636 |
| Provider Name | Kristin Randa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417452996 PECOS PAC ID: 9335564848 Enrollment ID: I20220321000432 |
| Provider Name | Mohammed Mehdi Premjee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548643778 PECOS PAC ID: 0547655052 Enrollment ID: I20220321000931 |
| Provider Name | Vicki L Roth |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811439615 PECOS PAC ID: 1254726466 Enrollment ID: I20220324000694 |
| Provider Name | Jaime L Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598411902 PECOS PAC ID: 3476949942 Enrollment ID: I20220408002118 |
| Provider Name | Haley A Dubose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467101436 PECOS PAC ID: 5092102095 Enrollment ID: I20220421000868 |
| Provider Name | Colleen L Mcelroy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932849668 PECOS PAC ID: 0749677631 Enrollment ID: I20220422001886 |
| Provider Name | Allyson R Kiriaki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659027316 PECOS PAC ID: 4789071135 Enrollment ID: I20220503002662 |
| Provider Name | Heidi L Mackey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366646358 PECOS PAC ID: 0042697310 Enrollment ID: I20220509000115 |
| Provider Name | Liliana D Lozano De Velasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518601947 PECOS PAC ID: 8527445519 Enrollment ID: I20220512001504 |
| Provider Name | Tryn A Gasiorowski |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396489746 PECOS PAC ID: 8426435421 Enrollment ID: I20220512001958 |
| Provider Name | Lauren E Heaberlin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033503958 PECOS PAC ID: 1658758685 Enrollment ID: I20220513000363 |
| Provider Name | Margaret R Salinas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093141210 PECOS PAC ID: 6002047719 Enrollment ID: I20220520000967 |
| Provider Name | Chelsea Lyn Livingston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275287948 PECOS PAC ID: 2365829777 Enrollment ID: I20220524000627 |
| Provider Name | Kenneth A Lahrman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750822953 PECOS PAC ID: 4688051048 Enrollment ID: I20220524002745 |
| Provider Name | Molly S Peterson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346774726 PECOS PAC ID: 0941571152 Enrollment ID: I20220610000996 |
| Provider Name | John A Scherer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598151193 PECOS PAC ID: 8224326509 Enrollment ID: I20220614000093 |
| Provider Name | Alison E Wild |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881940104 PECOS PAC ID: 0941689608 Enrollment ID: I20220627001433 |
| Provider Name | Emily Ann Feather |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639792666 PECOS PAC ID: 7517348238 Enrollment ID: I20220713000236 |
| Provider Name | Bennett S Serchen |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1770221459 PECOS PAC ID: 4981085628 Enrollment ID: I20220713000965 |
| Provider Name | Jiahao Hu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902260433 PECOS PAC ID: 2668853235 Enrollment ID: I20220714001231 |
| Provider Name | Saivenkat H Vagvala |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831546571 PECOS PAC ID: 2860783891 Enrollment ID: I20220719000465 |
| Provider Name | Zacharias P Zitterkopf |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023469186 PECOS PAC ID: 6002218989 Enrollment ID: I20220719002343 |
| Provider Name | Jacob M Meleski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184285744 PECOS PAC ID: 2466833272 Enrollment ID: I20220725002135 |
| Provider Name | Joseph D Roehrkasse |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760120570 PECOS PAC ID: 7810378668 Enrollment ID: I20220725003539 |
| Provider Name | Emily E Hurst |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376277509 PECOS PAC ID: 3476935073 Enrollment ID: I20220728002835 |
| Provider Name | Stephanie Schoenleber |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1609301555 PECOS PAC ID: 7517237555 Enrollment ID: I20220729000681 |
| Provider Name | Mercedes M Williams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558866079 PECOS PAC ID: 8123379583 Enrollment ID: I20220801001083 |
| Provider Name | Nishant K Vaidy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841510492 PECOS PAC ID: 2163648767 Enrollment ID: I20220803000871 |
| Provider Name | Melissa L Klaeser |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194459149 PECOS PAC ID: 2365824653 Enrollment ID: I20220803001338 |
| Provider Name | Jared Ludlow |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306339643 PECOS PAC ID: 2961757547 Enrollment ID: I20220803001656 |
| Provider Name | Jack Steiner |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1164926499 PECOS PAC ID: 8527471747 Enrollment ID: I20220809001503 |
| Provider Name | Umair Mubashar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083174528 PECOS PAC ID: 3173906658 Enrollment ID: I20220816002007 |
| Provider Name | Hui Zhang |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134581200 PECOS PAC ID: 1153615018 Enrollment ID: I20220818003320 |
| Provider Name | Nicholas M Beaudrie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801391875 PECOS PAC ID: 8325395684 Enrollment ID: I20220824000549 |
| Provider Name | Carol E Soteropulos |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1831552041 PECOS PAC ID: 9032401880 Enrollment ID: I20220826002828 |
| Provider Name | Adam Y Sadik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679004956 PECOS PAC ID: 4880965029 Enrollment ID: I20220905000380 |
| Provider Name | David J Lucero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851027502 PECOS PAC ID: 4385028653 Enrollment ID: I20220906001258 |
| Provider Name | Raissa G Spencer |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043973407 PECOS PAC ID: 1658755863 Enrollment ID: I20220907000344 |
| Provider Name | Molly O'hearn |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1649998832 PECOS PAC ID: 2769867530 Enrollment ID: I20220914002159 |
| Provider Name | Krista M Michel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902355795 PECOS PAC ID: 5496130288 Enrollment ID: I20220914003209 |
| Provider Name | Ashley M Beadling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477939338 PECOS PAC ID: 6103126909 Enrollment ID: I20220915000055 |
| Provider Name | Mischel Marie Marshall |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1326160730 PECOS PAC ID: 6901281583 Enrollment ID: I20220919000108 |
| Provider Name | Lacey Harrington |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1174987176 PECOS PAC ID: 1254668965 Enrollment ID: I20221028002256 |
| Provider Name | Adriana E Marciniak |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295406031 PECOS PAC ID: 1759758097 Enrollment ID: I20221031000537 |
| Provider Name | Timothy Yazzie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639218662 PECOS PAC ID: 1456448026 Enrollment ID: I20221031001051 |
| Provider Name | Jay P Patel |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1275893281 PECOS PAC ID: 9032369384 Enrollment ID: I20221031001104 |
| Provider Name | Jacquelyn A Kubiak |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083157473 PECOS PAC ID: 5092182188 Enrollment ID: I20221102001311 |
| Provider Name | Alexandra M Cistaro |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1619640109 PECOS PAC ID: 2062889009 Enrollment ID: I20221104001023 |
| Provider Name | Sumant Tumuluru |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215270285 PECOS PAC ID: 6204057250 Enrollment ID: I20221110001143 |
| Provider Name | Niral Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083845945 PECOS PAC ID: 4587815329 Enrollment ID: I20221116001044 |
| Provider Name | Kaitlyn M Reinke |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811486541 PECOS PAC ID: 9436528056 Enrollment ID: I20221202002454 |
| Provider Name | Jennifer P Florentino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245638014 PECOS PAC ID: 0749505212 Enrollment ID: I20221214000083 |
| Provider Name | Amy J Connolly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841909504 PECOS PAC ID: 7012386014 Enrollment ID: I20221214001713 |
| Provider Name | Katherine L Pampuch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831800200 PECOS PAC ID: 2567831217 Enrollment ID: I20221220000528 |
| Provider Name | Jennifer K Millisor |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992475321 PECOS PAC ID: 9032589528 Enrollment ID: I20221227001390 |
| Provider Name | Melissa Kasbohm |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356382659 PECOS PAC ID: 9931579463 Enrollment ID: I20221228000579 |
| Provider Name | Johanna L Pipia |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275191058 PECOS PAC ID: 5991175150 Enrollment ID: I20230104000513 |
| Provider Name | Ryan J Smilanich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811619075 PECOS PAC ID: 4486025871 Enrollment ID: I20230123000964 |
| Provider Name | Maja I Kern |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194283580 PECOS PAC ID: 8123499464 Enrollment ID: I20230124000860 |
| Provider Name | Kaitlyn M Larson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730819517 PECOS PAC ID: 9739550781 Enrollment ID: I20230130001790 |
| Provider Name | Jacqueline M Karman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336852342 PECOS PAC ID: 3274904180 Enrollment ID: I20230131002241 |
| Provider Name | Sandi J. Nath |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629233788 PECOS PAC ID: 3870965692 Enrollment ID: I20230203002089 |
| Provider Name | Jennifer L Pogodzinski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639626260 PECOS PAC ID: 9537531777 Enrollment ID: I20230215002926 |
| Provider Name | Michael Heiser |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689304958 PECOS PAC ID: 0143693457 Enrollment ID: I20230308000753 |
| Provider Name | Kathryn M Kalvestrand |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679288765 PECOS PAC ID: 5092189811 Enrollment ID: I20230317002247 |
| Provider Name | Ally Victoria Kellerman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558060285 PECOS PAC ID: 7719351535 Enrollment ID: I20230317002268 |
| Provider Name | Clare E Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679270060 PECOS PAC ID: 2163896986 Enrollment ID: I20230317002370 |
| Provider Name | David S Rayan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194287870 PECOS PAC ID: 0840626149 Enrollment ID: I20230505000530 |
| Provider Name | Martin P. Kasofsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598783722 PECOS PAC ID: 4183665284 Enrollment ID: I20230511001845 |
| Provider Name | Nicholas D Nassif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427675230 PECOS PAC ID: 6204292824 Enrollment ID: I20230523002935 |
| Provider Name | Keshav M Menon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669816658 PECOS PAC ID: 7416198700 Enrollment ID: I20230606002753 |
| Provider Name | Amy S Murray |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083758999 PECOS PAC ID: 3274990080 Enrollment ID: I20230609003011 |
| Provider Name | Emily J Churchill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881392165 PECOS PAC ID: 1951768639 Enrollment ID: I20230612002050 |
| Provider Name | Lisa A Kommer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649472838 PECOS PAC ID: 2769849314 Enrollment ID: I20230613001584 |
| Provider Name | Syed F Hussaini |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770014847 PECOS PAC ID: 3375888985 Enrollment ID: I20230614001379 |
| Provider Name | Michael K Knight |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134899248 PECOS PAC ID: 8022478676 Enrollment ID: I20230714001712 |
| Provider Name | Martha Holterman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508598152 PECOS PAC ID: 8820458292 Enrollment ID: I20230717002185 |
| Provider Name | Dylan G Washkuhn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174217467 PECOS PAC ID: 2961863808 Enrollment ID: I20230725003275 |
| Provider Name | Adil Ghafoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689109126 PECOS PAC ID: 0345519013 Enrollment ID: I20230727001529 |
| Provider Name | Rachel L Sipple |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679205181 PECOS PAC ID: 1254792872 Enrollment ID: I20230731000453 |
| Provider Name | Sara Gurda |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689359457 PECOS PAC ID: 2163883554 Enrollment ID: I20230801004496 |
| Provider Name | Amjed Zidan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538621321 PECOS PAC ID: 7416280201 Enrollment ID: I20230809002890 |
| Provider Name | Stacey L Rooker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093065062 PECOS PAC ID: 8325400138 Enrollment ID: I20230810002916 |
| Provider Name | Kristen E Garey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487331187 PECOS PAC ID: 0143683029 Enrollment ID: I20230824002799 |
| Provider Name | Jenna M Sarantakos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790309508 PECOS PAC ID: 1850715848 Enrollment ID: I20230911001194 |
| Provider Name | Amber N Kieck |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780128124 PECOS PAC ID: 4486018942 Enrollment ID: I20230915003252 |
| Provider Name | Vallikantha Nellaiappan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1548557812 PECOS PAC ID: 8022250042 Enrollment ID: I20230918002859 |
| Provider Name | Adam Y Pfaller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922667575 PECOS PAC ID: 8224366174 Enrollment ID: I20230920000742 |
| Provider Name | Agnes S Prospere |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083241301 PECOS PAC ID: 0749665008 Enrollment ID: I20230920001322 |
| Provider Name | Jacquelyn Marie Spring |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669091807 PECOS PAC ID: 6406201334 Enrollment ID: I20231012004007 |
| Provider Name | Anand S Brahmamdam |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063830784 PECOS PAC ID: 6800129511 Enrollment ID: I20231026001324 |
| Provider Name | Anna Tai Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033892237 PECOS PAC ID: 2769838481 Enrollment ID: I20231031003288 |
| Provider Name | Charl Khalil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851755375 PECOS PAC ID: 3870830169 Enrollment ID: I20231102000896 |
| Provider Name | Sarah A Devcich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851174114 PECOS PAC ID: 9537516117 Enrollment ID: I20231104000268 |
| Provider Name | Kelsey R Gerena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477326536 PECOS PAC ID: 7517315179 Enrollment ID: I20231121001734 |
| Provider Name | Johnathan Brett Reddick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245988781 PECOS PAC ID: 9537555735 Enrollment ID: I20231211001768 |
| Provider Name | Jacob R Mcchrystal |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184335366 PECOS PAC ID: 9032569900 Enrollment ID: I20231219002688 |
| Provider Name | Kyla R Phu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083076798 PECOS PAC ID: 1153603121 Enrollment ID: I20231219002981 |
| Provider Name | Melody Mumford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629242078 PECOS PAC ID: 2365609674 Enrollment ID: I20231220002087 |
| Provider Name | Ryanne Nicole Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497434401 PECOS PAC ID: 9032560545 Enrollment ID: I20240109003908 |
| Provider Name | Caroline Zehren |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376273961 PECOS PAC ID: 2466803788 Enrollment ID: I20240110004026 |
| Provider Name | Aswin Kumar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629469382 PECOS PAC ID: 5799184628 Enrollment ID: I20240123002559 |
| Provider Name | Kelsey A Thompson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033810510 PECOS PAC ID: 6901258136 Enrollment ID: I20240123003476 |
| Provider Name | Kristen Kelly Frederiksen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093409997 PECOS PAC ID: 7012360753 Enrollment ID: I20240129003530 |
| Provider Name | Holly B Moran |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1811779390 PECOS PAC ID: 9830532852 Enrollment ID: I20240207000677 |
| Provider Name | April Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073092979 PECOS PAC ID: 0345592440 Enrollment ID: I20240208003876 |
| Provider Name | Molly Schulteis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760243992 PECOS PAC ID: 0749623361 Enrollment ID: I20240209002850 |
| Provider Name | Raquel Rodriguez Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700240603 PECOS PAC ID: 3072869700 Enrollment ID: I20240220002428 |
| Provider Name | Richard Eugene Eccles |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053525014 PECOS PAC ID: 1052581501 Enrollment ID: I20240227001723 |
| Provider Name | Aaliyah Camille Dorsey-brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700400488 PECOS PAC ID: 1759727159 Enrollment ID: I20240307002889 |
| Provider Name | Hannah E Sugden |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346001575 PECOS PAC ID: 1850737099 Enrollment ID: I20240311003041 |