| Lutheran Medical Group LLC | |
|
7916 W Jefferson Blvd Fort Wayne IN 46804-4140 | |
| (260) 432-2297 | |
| Not Available |
| Full Name | Lutheran Medical Group LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 7916 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Kristina Music (DIRECTOR, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 8778929815 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Medical Group LLC Po Box 689022 Franklin TN 37068-9022 Ph: (888) 304-1116 | Lutheran Medical Group LLC 7916 W Jefferson Blvd Fort Wayne IN 46804-4140 Ph: (260) 432-2297 |
| NPI Number | 1164662805 |
|---|---|
| Provider Enumeration Date | 02/20/2009 |
| Last Update Date | 07/09/2025 |
| Certification Date | 07/09/2025 |
| Medicare PECOS PAC ID | 4981751617 |
|---|---|
| Medicare Enrollment ID | O20090414000705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164662805 | NPI | - | NPPES |
| 2938843 | Medicaid | OH | |
| 200934510 | Medicaid | IN |
| Provider Name | Scott a Waters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235233867 PECOS PAC ID: 6507778966 Enrollment ID: I20031104000224 |
| Provider Name | Terri A. Cordes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356300198 PECOS PAC ID: 2163329855 Enrollment ID: I20031219000135 |
| Provider Name | Jason K Sprunger |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1306850904 PECOS PAC ID: 9830087253 Enrollment ID: I20040308000982 |
| Provider Name | Maryann Meo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265412266 PECOS PAC ID: 1355233172 Enrollment ID: I20040326000810 |
| Provider Name | William P Deschner |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1811999626 PECOS PAC ID: 4284534942 Enrollment ID: I20040422000913 |
| Provider Name | Vincent a Scavo |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1679575435 PECOS PAC ID: 9133115389 Enrollment ID: I20040422001010 |
| Provider Name | Bhaktavatsala R Apuri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902960966 PECOS PAC ID: 7315938354 Enrollment ID: I20040522000295 |
| Provider Name | Anil K Rao |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1649216391 PECOS PAC ID: 8820074461 Enrollment ID: I20040625000108 |
| Provider Name | Sadie S Kintz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508825142 PECOS PAC ID: 6507846938 Enrollment ID: I20040724000316 |
| Provider Name | Karen R Ringwald |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1922075084 PECOS PAC ID: 7810963436 Enrollment ID: I20040906000034 |
| Provider Name | Preetham Jetty |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962469510 PECOS PAC ID: 8022084177 Enrollment ID: I20040909000457 |
| Provider Name | Salah Elsaharty |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982625224 PECOS PAC ID: 3072581800 Enrollment ID: I20040920001132 |
| Provider Name | Stacey a Hudson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972593531 PECOS PAC ID: 9638130107 Enrollment ID: I20041019001157 |
| Provider Name | Maria Theresa a Cabe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336187335 PECOS PAC ID: 3274582960 Enrollment ID: I20050120000252 |
| Provider Name | Sanjay J Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447227319 PECOS PAC ID: 8426000399 Enrollment ID: I20050218000597 |
| Provider Name | Steven D Ko |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1992771257 PECOS PAC ID: 9436101243 Enrollment ID: I20050219000019 |
| Provider Name | Andrew E Katz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548237951 PECOS PAC ID: 1153373964 Enrollment ID: I20050219000028 |
| Provider Name | Sushil K Jain |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649247057 PECOS PAC ID: 7416909221 Enrollment ID: I20050219000033 |
| Provider Name | Sudheer K Meesa |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245207984 PECOS PAC ID: 8729031224 Enrollment ID: I20050224000503 |
| Provider Name | Erin Lynn Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093721862 PECOS PAC ID: 3577516004 Enrollment ID: I20050224000740 |
| Provider Name | Sanjay S Jain |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205803632 PECOS PAC ID: 6204727548 Enrollment ID: I20050301000307 |
| Provider Name | Sheila C Falloon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831166073 PECOS PAC ID: 4486601325 Enrollment ID: I20050603001011 |
| Provider Name | Mark a Meier |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831169960 PECOS PAC ID: 7416990981 Enrollment ID: I20050606000754 |
| Provider Name | Eustace S Fernandes |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1821040791 PECOS PAC ID: 3577508613 Enrollment ID: I20050620001168 |
| Provider Name | Shelby Ann Kenner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538170832 PECOS PAC ID: 8123057932 Enrollment ID: I20050811000275 |
| Provider Name | Scott Thomas Armstrong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861402760 PECOS PAC ID: 7113956830 Enrollment ID: I20050811000966 |
| Provider Name | Glenn L Goldstein |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1346336575 PECOS PAC ID: 2668402157 Enrollment ID: I20050817000156 |
| Provider Name | Dana Rae Forrest |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902831167 PECOS PAC ID: 3870510456 Enrollment ID: I20051102000370 |
| Provider Name | Cheng Du |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245209246 PECOS PAC ID: 2668491168 Enrollment ID: I20051114001121 |
| Provider Name | Akindolapo O Akinwande |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891766309 PECOS PAC ID: 2860411246 Enrollment ID: I20051115000501 |
| Provider Name | Venkata Rama Prasad Nalamolu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801866934 PECOS PAC ID: 1951322759 Enrollment ID: I20051208000242 |
| Provider Name | Horia Draghiciu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912975525 PECOS PAC ID: 8527082528 Enrollment ID: I20060117001117 |
| Provider Name | Sunil Ramrakhiani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407805849 PECOS PAC ID: 4880603810 Enrollment ID: I20060419000253 |
| Provider Name | Daniel Abraha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063419166 PECOS PAC ID: 3779565858 Enrollment ID: I20061226000041 |
| Provider Name | Suzanne B Smith-elekes |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447242599 PECOS PAC ID: 0446259147 Enrollment ID: I20070124000399 |
| Provider Name | Amy E Nugent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245299288 PECOS PAC ID: 1456352780 Enrollment ID: I20070129000548 |
| Provider Name | Brian a Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013927904 PECOS PAC ID: 3678678448 Enrollment ID: I20070424000178 |
| Provider Name | Thomas L Lazoff |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1457354433 PECOS PAC ID: 4981605870 Enrollment ID: I20070504000379 |
| Provider Name | Amit N Sanghvi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366472755 PECOS PAC ID: 2668570904 Enrollment ID: I20070609000087 |
| Provider Name | Bruce M Graham |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1598734659 PECOS PAC ID: 6204740202 Enrollment ID: I20070619000462 |
| Provider Name | Peter Anthony Jakacki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669463089 PECOS PAC ID: 9830290212 Enrollment ID: I20070730000419 |
| Provider Name | Bryon J Stephens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639170491 PECOS PAC ID: 7315937067 Enrollment ID: I20071212000350 |
| Provider Name | David S Lippie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558362319 PECOS PAC ID: 0345230090 Enrollment ID: I20071213000806 |
| Provider Name | Emmanuel C Cabe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215928791 PECOS PAC ID: 3476649393 Enrollment ID: I20080206000165 |
| Provider Name | Duane Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750392676 PECOS PAC ID: 7517042880 Enrollment ID: I20080311000378 |
| Provider Name | Brenda S Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801064266 PECOS PAC ID: 2567547730 Enrollment ID: I20080312000167 |
| Provider Name | Vicente Rodriguez |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407832694 PECOS PAC ID: 5597734756 Enrollment ID: I20080401000672 |
| Provider Name | Angela Karl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700088333 PECOS PAC ID: 4688775448 Enrollment ID: I20081001000790 |
| Provider Name | Houda a Trabulsi-younis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598721128 PECOS PAC ID: 9830256213 Enrollment ID: I20090330000641 |
| Provider Name | Craig E Hanson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578600565 PECOS PAC ID: 6608886874 Enrollment ID: I20090331000572 |
| Provider Name | Yu Liu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043415706 PECOS PAC ID: 5395846901 Enrollment ID: I20090413000037 |
| Provider Name | Brandi Ross-douglas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1588779904 PECOS PAC ID: 0941205876 Enrollment ID: I20090415000079 |
| Provider Name | Stanley D Rich |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437129111 PECOS PAC ID: 1658428321 Enrollment ID: I20090415000335 |
| Provider Name | H Stephen Beyer |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1518915800 PECOS PAC ID: 8527048719 Enrollment ID: I20090421000367 |
| Provider Name | Krishnan Ramani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518937630 PECOS PAC ID: 7810896990 Enrollment ID: I20090421000735 |
| Provider Name | Subhash K Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821068511 PECOS PAC ID: 1254488620 Enrollment ID: I20090422000410 |
| Provider Name | Catherine S Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447210778 PECOS PAC ID: 8628125010 Enrollment ID: I20090422000588 |
| Provider Name | Peter C Hanley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346220993 PECOS PAC ID: 2062560360 Enrollment ID: I20090424000206 |
| Provider Name | Vijay K Chilakamarri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548230758 PECOS PAC ID: 4981752060 Enrollment ID: I20090429000191 |
| Provider Name | Brandy M Dantzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558505131 PECOS PAC ID: 8628126232 Enrollment ID: I20090508000069 |
| Provider Name | Dinesh Agnihotri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932186723 PECOS PAC ID: 9133171390 Enrollment ID: I20090623000355 |
| Provider Name | Lisa R Stanley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033155726 PECOS PAC ID: 9335293158 Enrollment ID: I20090813000350 |
| Provider Name | Justin Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134358005 PECOS PAC ID: 5799830923 Enrollment ID: I20090911000172 |
| Provider Name | Lubna W Ahmed |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1144345075 PECOS PAC ID: 7113089566 Enrollment ID: I20091030000338 |
| Provider Name | Anne Therese Hines |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790787539 PECOS PAC ID: 9537126735 Enrollment ID: I20100104000260 |
| Provider Name | Gretchen L Crampton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1275536211 PECOS PAC ID: 0143364729 Enrollment ID: I20100219000722 |
| Provider Name | John B Addo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922063189 PECOS PAC ID: 8123163391 Enrollment ID: I20100227000090 |
| Provider Name | Dorothea O Addo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063478360 PECOS PAC ID: 1759426927 Enrollment ID: I20100227000106 |
| Provider Name | David J Paris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134110430 PECOS PAC ID: 3870680515 Enrollment ID: I20100727000224 |
| Provider Name | Patrick M Holly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811933583 PECOS PAC ID: 5496743585 Enrollment ID: I20100807000088 |
| Provider Name | Lorie L Dwyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538479845 PECOS PAC ID: 3274727045 Enrollment ID: I20101105000381 |
| Provider Name | Barbara L Rondot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609071125 PECOS PAC ID: 0749477784 Enrollment ID: I20101203000130 |
| Provider Name | Vinit J Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1649415084 PECOS PAC ID: 3476740630 Enrollment ID: I20101214000590 |
| Provider Name | Tariq Akbar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386692143 PECOS PAC ID: 6305941139 Enrollment ID: I20101221000862 |
| Provider Name | Claudia Merkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174524573 PECOS PAC ID: 7618165127 Enrollment ID: I20101228000903 |
| Provider Name | Rakesh Khatri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437360732 PECOS PAC ID: 6406901586 Enrollment ID: I20110610000000 |
| Provider Name | Matthew L Bilodeau |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1457408320 PECOS PAC ID: 5193809358 Enrollment ID: I20110613000468 |
| Provider Name | Benjamin G Martin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1942414800 PECOS PAC ID: 1557539566 Enrollment ID: I20110719000097 |
| Provider Name | David J Choi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285864702 PECOS PAC ID: 8921147745 Enrollment ID: I20110811000341 |
| Provider Name | Anupma Lal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487600599 PECOS PAC ID: 8527237171 Enrollment ID: I20110816000502 |
| Provider Name | Melissa K Gephart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174893531 PECOS PAC ID: 4880860048 Enrollment ID: I20120110000623 |
| Provider Name | Motaz M Shaher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427058825 PECOS PAC ID: 1456333137 Enrollment ID: I20120213000744 |
| Provider Name | Ulfur T Gudjonsson |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1467656926 PECOS PAC ID: 3779678594 Enrollment ID: I20120302000466 |
| Provider Name | Srinivas R Pamidi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598725913 PECOS PAC ID: 5395649701 Enrollment ID: I20120430000005 |
| Provider Name | Francis P Esguerra |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790949477 PECOS PAC ID: 5193989549 Enrollment ID: I20120614000375 |
| Provider Name | Carrie B Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275891640 PECOS PAC ID: 2365607884 Enrollment ID: I20120709000536 |
| Provider Name | Austin R Schlie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871721332 PECOS PAC ID: 6800042102 Enrollment ID: I20120801000647 |
| Provider Name | Leah a Keena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518226471 PECOS PAC ID: 2365699279 Enrollment ID: I20120829000135 |
| Provider Name | Andrew Frederick Shaar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659364792 PECOS PAC ID: 1052338456 Enrollment ID: I20120907000354 |
| Provider Name | My Padmalingam |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275795379 PECOS PAC ID: 6709952781 Enrollment ID: I20121219000429 |
| Provider Name | Michelle Estep |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063631141 PECOS PAC ID: 8628145687 Enrollment ID: I20121219000449 |
| Provider Name | Linda M Toth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184965329 PECOS PAC ID: 1759528375 Enrollment ID: I20130518000054 |
| Provider Name | Keith J Derickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538480439 PECOS PAC ID: 4880845619 Enrollment ID: I20130724000656 |
| Provider Name | Shakeel Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922084862 PECOS PAC ID: 6103848957 Enrollment ID: I20130913000455 |
| Provider Name | Sarah J Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609162676 PECOS PAC ID: 7416107024 Enrollment ID: I20131112001984 |
| Provider Name | Christina M Griggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093075624 PECOS PAC ID: 2264689595 Enrollment ID: I20131211001316 |
| Provider Name | Michelle D Bolyard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316370018 PECOS PAC ID: 7012145147 Enrollment ID: I20140116000855 |
| Provider Name | David S Mohan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578876785 PECOS PAC ID: 6002002722 Enrollment ID: I20140409000096 |
| Provider Name | Julia a Ellingwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790199255 PECOS PAC ID: 5294950887 Enrollment ID: I20140716001056 |
| Provider Name | Nicholai Kiehl |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1124269055 PECOS PAC ID: 4789802810 Enrollment ID: I20140902001216 |
| Provider Name | Gregory C Dowling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487916698 PECOS PAC ID: 7911157532 Enrollment ID: I20140915001650 |
| Provider Name | Leia a Becktell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447668579 PECOS PAC ID: 8123248713 Enrollment ID: I20141002001065 |
| Provider Name | Jeffrey Levenda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619298411 PECOS PAC ID: 1254582083 Enrollment ID: I20141003000660 |
| Provider Name | Rami S Wali |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235183203 PECOS PAC ID: 1658376777 Enrollment ID: I20141113000644 |
| Provider Name | Tyler L Warnecke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245664184 PECOS PAC ID: 2668608969 Enrollment ID: I20150428001615 |
| Provider Name | Marena Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467842344 PECOS PAC ID: 0941512818 Enrollment ID: I20150707000605 |
| Provider Name | Chimi Nusbaum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265809321 PECOS PAC ID: 1153638762 Enrollment ID: I20150915001456 |
| Provider Name | Abdillahi Abdinoor |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336377043 PECOS PAC ID: 2163731183 Enrollment ID: I20151014000989 |
| Provider Name | Christine Springer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871969220 PECOS PAC ID: 2264741925 Enrollment ID: I20151020000421 |
| Provider Name | Deborah a Gill Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881075059 PECOS PAC ID: 1759690480 Enrollment ID: I20151021000334 |
| Provider Name | Matthew Connor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427429943 PECOS PAC ID: 8628388691 Enrollment ID: I20151103000772 |
| Provider Name | Ibad Ul-haq Farooqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427499318 PECOS PAC ID: 8224260062 Enrollment ID: I20160726000218 |
| Provider Name | Kanika Jaggi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073954962 PECOS PAC ID: 7618109448 Enrollment ID: I20160726000383 |
| Provider Name | Sara M Westfall |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831631837 PECOS PAC ID: 9931488939 Enrollment ID: I20161115001707 |
| Provider Name | Nicholas Ramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114370152 PECOS PAC ID: 9436438223 Enrollment ID: I20161118001066 |
| Provider Name | Hari Krishna Puttagunta |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1841451218 PECOS PAC ID: 5597999516 Enrollment ID: I20170317000459 |
| Provider Name | Alyssa L Detommaso |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801339791 PECOS PAC ID: 3779868476 Enrollment ID: I20170321000150 |
| Provider Name | Emanuel E Nearing |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346564390 PECOS PAC ID: 4486890308 Enrollment ID: I20170629002574 |
| Provider Name | Reid R Pflueger |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1013201995 PECOS PAC ID: 1052559549 Enrollment ID: I20170711002860 |
| Provider Name | Patrick James Noonan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972892958 PECOS PAC ID: 7719106459 Enrollment ID: I20170815001495 |
| Provider Name | Edward a Lebrija |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1932112000 PECOS PAC ID: 9335278910 Enrollment ID: I20170815003013 |
| Provider Name | Ashlee N Pinkston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083131056 PECOS PAC ID: 1658644786 Enrollment ID: I20170912000460 |
| Provider Name | Kirsten L Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740719210 PECOS PAC ID: 3072887165 Enrollment ID: I20170928001869 |
| Provider Name | Aaron James Lehman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871012732 PECOS PAC ID: 3072889161 Enrollment ID: I20171017002111 |
| Provider Name | Jennifer K Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184142903 PECOS PAC ID: 1052687035 Enrollment ID: I20171018002093 |
| Provider Name | Anna K Menze-wagner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831547124 PECOS PAC ID: 7810288693 Enrollment ID: I20171113000550 |
| Provider Name | Justin Weirich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992154686 PECOS PAC ID: 4880986470 Enrollment ID: I20171121003272 |
| Provider Name | Melissa A. Willard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801310610 PECOS PAC ID: 8628335726 Enrollment ID: I20171128001361 |
| Provider Name | Charles Morgan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174813497 PECOS PAC ID: 3971897463 Enrollment ID: I20180212001944 |
| Provider Name | Gregory Ridenour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447708979 PECOS PAC ID: 4688935331 Enrollment ID: I20180221001148 |
| Provider Name | Dedrick K. Bowe |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235481755 PECOS PAC ID: 7113229469 Enrollment ID: I20180621002849 |
| Provider Name | Muzammil Hanif Musani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093945651 PECOS PAC ID: 4981851268 Enrollment ID: I20180716001487 |
| Provider Name | Yan Ortiz-pomales |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346448537 PECOS PAC ID: 6002110988 Enrollment ID: I20180718000621 |
| Provider Name | Abdul Hamid Khan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134401896 PECOS PAC ID: 3870767734 Enrollment ID: I20180801002588 |
| Provider Name | Tamika Rozema |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912265836 PECOS PAC ID: 3678823325 Enrollment ID: I20180830001660 |
| Provider Name | Nikki Mo Wynn |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1184979882 PECOS PAC ID: 5395987788 Enrollment ID: I20180907001200 |
| Provider Name | Fouad Kutuby |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1114367067 PECOS PAC ID: 9931419207 Enrollment ID: I20180917000425 |
| Provider Name | Kersten L. Weigle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982180501 PECOS PAC ID: 8921350745 Enrollment ID: I20181005001568 |
| Provider Name | Fahim Khan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245527803 PECOS PAC ID: 4981874666 Enrollment ID: I20181213001821 |
| Provider Name | Dina Abi Fadel |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1528234135 PECOS PAC ID: 4880872209 Enrollment ID: I20181219000510 |
| Provider Name | Crystal M Trabel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912480039 PECOS PAC ID: 8820341340 Enrollment ID: I20190124000627 |
| Provider Name | Erasmo Ruggiero |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467617605 PECOS PAC ID: 6901055524 Enrollment ID: I20190125002387 |
| Provider Name | Armais V Akovbyan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1730472945 PECOS PAC ID: 6507014404 Enrollment ID: I20190311002502 |
| Provider Name | Maryann Albaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740491901 PECOS PAC ID: 8123240520 Enrollment ID: I20190323000054 |
| Provider Name | Joyce A. Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497217277 PECOS PAC ID: 5597007070 Enrollment ID: I20190502001854 |
| Provider Name | Mohammad Q. Najib |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578510103 PECOS PAC ID: 5991790024 Enrollment ID: I20190520001273 |
| Provider Name | Ford W Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467019349 PECOS PAC ID: 1153657861 Enrollment ID: I20190801001170 |
| Provider Name | Brian Michael Orr |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295145159 PECOS PAC ID: 5991920076 Enrollment ID: I20190801001785 |
| Provider Name | Kelsey A. Harner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306498241 PECOS PAC ID: 2466789433 Enrollment ID: I20190814000492 |
| Provider Name | Azriel Avezbadalov |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376833129 PECOS PAC ID: 2961780499 Enrollment ID: I20190823000572 |
| Provider Name | Kimberly Million |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871154401 PECOS PAC ID: 0244568681 Enrollment ID: I20190823000735 |
| Provider Name | Asim A. Mohammed |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1922285139 PECOS PAC ID: 9032260609 Enrollment ID: I20190920001279 |
| Provider Name | Larry V Carson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1588764385 PECOS PAC ID: 4183600893 Enrollment ID: I20191004001091 |
| Provider Name | J. Rod Gimbel |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1932199627 PECOS PAC ID: 2961484837 Enrollment ID: I20191015001605 |
| Provider Name | Wen-chou Tang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033405626 PECOS PAC ID: 9537385315 Enrollment ID: I20191120001444 |
| Provider Name | Christopher E Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841713229 PECOS PAC ID: 4385905603 Enrollment ID: I20191211003159 |
| Provider Name | Lyndi S Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659917771 PECOS PAC ID: 1850727645 Enrollment ID: I20200215000126 |
| Provider Name | Caitlin Rea Mckay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477106649 PECOS PAC ID: 6002243458 Enrollment ID: I20200224002193 |
| Provider Name | Karmen N. Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689216442 PECOS PAC ID: 4587092291 Enrollment ID: I20200311002348 |
| Provider Name | Lindsey P. Felger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902444144 PECOS PAC ID: 8527497239 Enrollment ID: I20200401000758 |
| Provider Name | Nathan D. Nicola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154956209 PECOS PAC ID: 5890124507 Enrollment ID: I20200401000808 |
| Provider Name | Natasha L. Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841824893 PECOS PAC ID: 7012347008 Enrollment ID: I20200414003754 |
| Provider Name | Lucas Gregory Berghoff |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1821521394 PECOS PAC ID: 9830468511 Enrollment ID: I20200508001764 |
| Provider Name | Jason Rodriguez |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1093078339 PECOS PAC ID: 5092020859 Enrollment ID: I20200520003457 |
| Provider Name | Allen Maertin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790206977 PECOS PAC ID: 3577832336 Enrollment ID: I20200604002077 |
| Provider Name | Andrew Wieging |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689104242 PECOS PAC ID: 8729357926 Enrollment ID: I20200622002470 |
| Provider Name | Mario Ammirati |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1730137043 PECOS PAC ID: 6103812417 Enrollment ID: I20200831001692 |
| Provider Name | Holly Bowman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487264818 PECOS PAC ID: 3870912652 Enrollment ID: I20200928002433 |
| Provider Name | Natasha Sinanon-oyeneye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992311849 PECOS PAC ID: 7214357789 Enrollment ID: I20201022000135 |
| Provider Name | Kelly Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699388496 PECOS PAC ID: 4183034192 Enrollment ID: I20201103001362 |
| Provider Name | Alexis Kate Felger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528665585 PECOS PAC ID: 7618387648 Enrollment ID: I20201103002289 |
| Provider Name | Kaylee Marie Casper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770172728 PECOS PAC ID: 1759795891 Enrollment ID: I20210201000570 |
| Provider Name | Angela S. Ebersole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851987853 PECOS PAC ID: 3375958424 Enrollment ID: I20210223001102 |
| Provider Name | Andrea J Evans-seibert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518556117 PECOS PAC ID: 8527473685 Enrollment ID: I20210223001537 |
| Provider Name | Kalie M. Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184200222 PECOS PAC ID: 7618385410 Enrollment ID: I20210415001937 |
| Provider Name | Brittney L Hetrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316513146 PECOS PAC ID: 9133529563 Enrollment ID: I20210607002061 |
| Provider Name | Megan Louise Trotter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922605336 PECOS PAC ID: 6800297060 Enrollment ID: I20210624002591 |
| Provider Name | Danielle Kemp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225521107 PECOS PAC ID: 4284980046 Enrollment ID: I20210712001210 |
| Provider Name | Sergey Kozyr |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1174937130 PECOS PAC ID: 8820332414 Enrollment ID: I20210714002320 |
| Provider Name | Adam J Zuber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144895574 PECOS PAC ID: 3274936919 Enrollment ID: I20210719003336 |
| Provider Name | Grant Michael Blauvelt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477122711 PECOS PAC ID: 8123421625 Enrollment ID: I20210721002301 |
| Provider Name | Douglas S Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174192421 PECOS PAC ID: 6002210739 Enrollment ID: I20210803001956 |
| Provider Name | Benjamin Monson |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1063588812 PECOS PAC ID: 2567600513 Enrollment ID: I20210824002452 |
| Provider Name | Karsten E. Cooper |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124698311 PECOS PAC ID: 4284039330 Enrollment ID: I20210827000196 |
| Provider Name | Kevin D. Waldo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356018543 PECOS PAC ID: 0840697181 Enrollment ID: I20210929000840 |
| Provider Name | Andrea Place |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467024455 PECOS PAC ID: 6204234271 Enrollment ID: I20211005001910 |
| Provider Name | Crystal C Neal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730787599 PECOS PAC ID: 8325446271 Enrollment ID: I20211007002240 |
| Provider Name | Jacey a Lepage |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790166494 PECOS PAC ID: 1254622541 Enrollment ID: I20211102000426 |
| Provider Name | Erin Dodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346661428 PECOS PAC ID: 9537559547 Enrollment ID: I20211207000820 |
| Provider Name | Andrew J. Schlatter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659035277 PECOS PAC ID: 4486045630 Enrollment ID: I20211222001285 |
| Provider Name | Kristen A. Bradtmueller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093482598 PECOS PAC ID: 0244622249 Enrollment ID: I20220125002473 |
| Provider Name | Julie N Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144989443 PECOS PAC ID: 9133513351 Enrollment ID: I20220303000870 |
| Provider Name | Casey R Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427714898 PECOS PAC ID: 6305230558 Enrollment ID: I20220303002088 |
| Provider Name | Hanh Truong |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881854024 PECOS PAC ID: 8224184882 Enrollment ID: I20220307001395 |
| Provider Name | Allison Soldner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538554399 PECOS PAC ID: 9931595261 Enrollment ID: I20220413000881 |
| Provider Name | Reegan L Flattery |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821754482 PECOS PAC ID: 5193111474 Enrollment ID: I20220414000095 |
| Provider Name | Alaa Akhras |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1992108005 PECOS PAC ID: 8527486877 Enrollment ID: I20220603001034 |
| Provider Name | Stephanie Ann Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750033957 PECOS PAC ID: 0941688808 Enrollment ID: I20220606000187 |
| Provider Name | Darcy Rose Wyss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275287559 PECOS PAC ID: 2264810837 Enrollment ID: I20220610000137 |
| Provider Name | Kamel Sadat |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013189281 PECOS PAC ID: 4880710706 Enrollment ID: I20220627003614 |
| Provider Name | Robert D. Roether |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1801278841 PECOS PAC ID: 2062725609 Enrollment ID: I20220706002298 |
| Provider Name | Candie Jo Nicole Schleter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558094193 PECOS PAC ID: 8921480567 Enrollment ID: I20220729000794 |
| Provider Name | Haris Uzair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922568179 PECOS PAC ID: 9739417197 Enrollment ID: I20220801000284 |
| Provider Name | Issa H. Kutkut |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1528449220 PECOS PAC ID: 6406168525 Enrollment ID: I20220803000177 |
| Provider Name | Chelsey A. Buitrago |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770255762 PECOS PAC ID: 8527440627 Enrollment ID: I20220805002994 |
| Provider Name | Saeed Chowdhry |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1780837922 PECOS PAC ID: 8325190416 Enrollment ID: I20220811001462 |
| Provider Name | Ajit N Chary |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1396184214 PECOS PAC ID: 0143453043 Enrollment ID: I20220824001894 |
| Provider Name | Mitra Sahebazamani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1780814392 PECOS PAC ID: 3476691353 Enrollment ID: I20220907001291 |
| Provider Name | Harrison Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720704745 PECOS PAC ID: 7214303817 Enrollment ID: I20221024001186 |
| Provider Name | Kayla L. Strine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053039750 PECOS PAC ID: 5496121949 Enrollment ID: I20221025001089 |
| Provider Name | Terry Bauch |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790774768 PECOS PAC ID: 8628170065 Enrollment ID: I20221102000788 |
| Provider Name | Chiduzie C. Madubata |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053639344 PECOS PAC ID: 8325288475 Enrollment ID: I20221104001300 |
| Provider Name | Brian S. Cooper |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1134286792 PECOS PAC ID: 1355585175 Enrollment ID: I20221104001684 |
| Provider Name | Sourabh Prabhakar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679875892 PECOS PAC ID: 3870873961 Enrollment ID: I20221104002134 |
| Provider Name | Christopher a Fegley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003814476 PECOS PAC ID: 0648224352 Enrollment ID: I20221108000266 |
| Provider Name | Kent Hall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184935983 PECOS PAC ID: 5395165757 Enrollment ID: I20221110002500 |
| Provider Name | William Peery |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821294588 PECOS PAC ID: 7719150481 Enrollment ID: I20221222001553 |
| Provider Name | Madhu G Jyothinagaram |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114983491 PECOS PAC ID: 8224027016 Enrollment ID: I20221222001601 |
| Provider Name | Albert Attah-kofi Sey |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396051785 PECOS PAC ID: 0143464271 Enrollment ID: I20221223001314 |
| Provider Name | Adrienne Michelle Peery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588124556 PECOS PAC ID: 7416298500 Enrollment ID: I20230228001124 |
| Provider Name | Lanie E. Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114634722 PECOS PAC ID: 5890168298 Enrollment ID: I20230306002684 |
| Provider Name | Ramzy Taylor Burns |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1871083261 PECOS PAC ID: 0648526780 Enrollment ID: I20230516002440 |
| Provider Name | Stephanie A. Robbins |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1497448971 PECOS PAC ID: 2567829278 Enrollment ID: I20230611000167 |
| Provider Name | Billy Preece |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417525759 PECOS PAC ID: 5991109522 Enrollment ID: I20230616000967 |
| Provider Name | William Strimel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366425134 PECOS PAC ID: 0345243028 Enrollment ID: I20230623002683 |
| Provider Name | Steven M Paris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982228755 PECOS PAC ID: 3274956743 Enrollment ID: I20230715000230 |
| Provider Name | Laura M Macy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598381295 PECOS PAC ID: 4082037502 Enrollment ID: I20230719003227 |
| Provider Name | Emily Metzinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598444846 PECOS PAC ID: 7416318357 Enrollment ID: I20230725003255 |
| Provider Name | Kingsley Saahene Okai |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114456696 PECOS PAC ID: 6406124460 Enrollment ID: I20230727001967 |
| Provider Name | Karen Stephan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952031387 PECOS PAC ID: 2769844042 Enrollment ID: I20230817004105 |
| Provider Name | Mohannad H. Alhasani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1801243548 PECOS PAC ID: 5698179273 Enrollment ID: I20230912001365 |
| Provider Name | Lauren Stipp |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093133704 PECOS PAC ID: 7810113610 Enrollment ID: I20230913000780 |
| Provider Name | Christopher Maroules |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285861708 PECOS PAC ID: 6507050036 Enrollment ID: I20230913003095 |
| Provider Name | Nicole M. Kellner |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245581677 PECOS PAC ID: 3577708007 Enrollment ID: I20230914003527 |
| Provider Name | Brenna Nicole Grove |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326753856 PECOS PAC ID: 5799149076 Enrollment ID: I20230920000267 |
| Provider Name | Prasanna Kumar Reddy Tadi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689962441 PECOS PAC ID: 3678791241 Enrollment ID: I20231020000228 |
| Provider Name | Kori B Engdahl |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518262807 PECOS PAC ID: 8123475118 Enrollment ID: I20231113003155 |
| Provider Name | Leah Vanderhorst |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1861103749 PECOS PAC ID: 0345697355 Enrollment ID: I20231114000551 |
| Provider Name | Kendra E. Stark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376325126 PECOS PAC ID: 2062869985 Enrollment ID: I20231114001040 |
| Provider Name | Claire Elizabeth Aubrey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033523808 PECOS PAC ID: 8729382932 Enrollment ID: I20231115002706 |
| Provider Name | Michael Allen Rudoff |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1134570690 PECOS PAC ID: 9234421298 Enrollment ID: I20231115003392 |
| Provider Name | Vaneska Bottino Da Costa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003292525 PECOS PAC ID: 5294083721 Enrollment ID: I20231206001598 |
| Provider Name | Heather J Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326728601 PECOS PAC ID: 9931558301 Enrollment ID: I20231211001420 |
| Provider Name | Karen E. Troxel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376768952 PECOS PAC ID: 6305295668 Enrollment ID: I20231212001506 |
| Provider Name | Colleen R. Incremona |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1740057843 PECOS PAC ID: 7618327305 Enrollment ID: I20231220003956 |
| Provider Name | Jessica L Leffers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043092372 PECOS PAC ID: 1355791955 Enrollment ID: I20231222000331 |
| Provider Name | Seth a Bellister |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891043956 PECOS PAC ID: 9537433727 Enrollment ID: I20231229001295 |
| Provider Name | Stephanie M Vanderhorst |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1598859506 PECOS PAC ID: 9234580150 Enrollment ID: I20240104003441 |
| Provider Name | Chinenye O Iwuchukwu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780909713 PECOS PAC ID: 6305181694 Enrollment ID: I20240108004378 |
| Provider Name | Steven Lacey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104229210 PECOS PAC ID: 2668776576 Enrollment ID: I20240117001608 |
| Provider Name | Allissa M. Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194593491 PECOS PAC ID: 5698127892 Enrollment ID: I20240123002433 |
| Provider Name | Elizabeth Anne Mysliwiec |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013640200 PECOS PAC ID: 0749624724 Enrollment ID: I20240217000351 |
| Provider Name | Kayleen M Grashoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487421251 PECOS PAC ID: 8820433774 Enrollment ID: I20240229004374 |
| Provider Name | John Lobo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1962512699 PECOS PAC ID: 3274579891 Enrollment ID: I20240308001878 |
| Provider Name | Matthew Mackowsky |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104276542 PECOS PAC ID: 2769850031 Enrollment ID: I20240315002406 |
| Provider Name | Cole M. Polnow |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538939434 PECOS PAC ID: 8022455625 Enrollment ID: I20240319000821 |
| Provider Name | Daniel P. Butler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144090507 PECOS PAC ID: 7719324334 Enrollment ID: I20240319001317 |
| Provider Name | Quantel V. Rolle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700204583 PECOS PAC ID: 4981038270 Enrollment ID: I20240319001503 |
| Provider Name | Sultana Saber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710752175 PECOS PAC ID: 2860839958 Enrollment ID: I20240325003351 |
| Provider Name | Austin R Shepard |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194595090 PECOS PAC ID: 6406294198 Enrollment ID: I20240401000668 |
| Provider Name | Kevin a Vaught |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1689623811 PECOS PAC ID: 6103875901 Enrollment ID: I20240415002469 |
| Provider Name | Muhammad Usman Mirza |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588197917 PECOS PAC ID: 8729428248 Enrollment ID: I20240501002655 |
| Provider Name | Osama Hallak |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154852614 PECOS PAC ID: 9234400268 Enrollment ID: I20240518000608 |
| Provider Name | Tianli Du |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205217148 PECOS PAC ID: 8820389190 Enrollment ID: I20240522000841 |
| Provider Name | Parth Udayan Thakker |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053874800 PECOS PAC ID: 9739416058 Enrollment ID: I20240522003969 |
| Provider Name | Stacy L Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649038308 PECOS PAC ID: 8628410388 Enrollment ID: I20240525000175 |
| Provider Name | Jacqueline J. Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265289839 PECOS PAC ID: 4183066558 Enrollment ID: I20240530002760 |
| Provider Name | Eric Hick |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1346236353 PECOS PAC ID: 9436283025 Enrollment ID: I20240611004303 |
| Provider Name | Mohamed Hamdi Ibrahim Kamel |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1699903740 PECOS PAC ID: 9931255098 Enrollment ID: I20240627000927 |
| Provider Name | Amy Linn Spurling |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861840084 PECOS PAC ID: 0749724516 Enrollment ID: I20240703002269 |
| Provider Name | Ibraheam Mohammed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346814761 PECOS PAC ID: 9335549534 Enrollment ID: I20240723003114 |
| Provider Name | Corey R. Campbell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629485677 PECOS PAC ID: 3072824093 Enrollment ID: I20240731003188 |
| Provider Name | Ranae B. Ray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891531661 PECOS PAC ID: 1951848050 Enrollment ID: I20240807002130 |
| Provider Name | Jennifer L. Huber |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871026229 PECOS PAC ID: 8921547142 Enrollment ID: I20240830002797 |
| Provider Name | Pranav K Panchatsharam |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1851957526 PECOS PAC ID: 6103151915 Enrollment ID: I20240904002732 |
| Provider Name | Melvin Maximillian Susanto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558939629 PECOS PAC ID: 0042611485 Enrollment ID: I20240910001760 |
| Provider Name | Angela M. Payton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144051368 PECOS PAC ID: 0547700981 Enrollment ID: I20240911003693 |
| Provider Name | Matthew Malamet |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1275655912 PECOS PAC ID: 6901061431 Enrollment ID: I20240916000744 |
| Provider Name | Ginard Irwin Henry |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1932149135 PECOS PAC ID: 0345245536 Enrollment ID: I20241024003337 |
| Provider Name | Huma Y Samar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366455099 PECOS PAC ID: 9931343654 Enrollment ID: I20241030001083 |
| Provider Name | Divya Kondapi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1013361708 PECOS PAC ID: 9133466758 Enrollment ID: I20241112001154 |
| Provider Name | Omar Nehme |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1427222561 PECOS PAC ID: 5890850721 Enrollment ID: I20241112002247 |
| Provider Name | Christopher James Keto |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1134446339 PECOS PAC ID: 4981844743 Enrollment ID: I20241112003068 |
| Provider Name | Cody Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104241595 PECOS PAC ID: 1254753411 Enrollment ID: I20241227001608 |
| Provider Name | Karl Sillay |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1184734030 PECOS PAC ID: 0941309447 Enrollment ID: I20250116000806 |
| Provider Name | Sheridan F. Francescon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750166781 PECOS PAC ID: 5496275042 Enrollment ID: I20250226000719 |
| Provider Name | Andrew Gavagan |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1225011596 PECOS PAC ID: 1951483114 Enrollment ID: I20250423000264 |
| Provider Name | Yitzchok I Greenberg |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1538587928 PECOS PAC ID: 5799182820 Enrollment ID: I20250423000508 |
| Provider Name | Hazar G Saadeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164293973 PECOS PAC ID: 7719403062 Enrollment ID: I20250429002853 |
| Provider Name | Farhan Ali |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023513397 PECOS PAC ID: 1951844570 Enrollment ID: I20250625001087 |
| Provider Name | Aamir I Malik |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1396757928 PECOS PAC ID: 7911916762 Enrollment ID: I20250716003925 |
| Provider Name | Alex M. Koenemann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952290918 PECOS PAC ID: 7214443191 Enrollment ID: I20250718000533 |
| Provider Name | Dhafer Salem |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467855973 PECOS PAC ID: 8921356429 Enrollment ID: I20250909002947 |
| Provider Name | Levi Myers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821729005 PECOS PAC ID: 8224417142 Enrollment ID: I20250916003257 |
| Provider Name | Brian York |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538890710 PECOS PAC ID: 6709265622 Enrollment ID: I20250917000349 |
| Provider Name | Nausheer a Khan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1134166135 PECOS PAC ID: 1153352794 Enrollment ID: I20250918003590 |
| Provider Name | Fnu Zafrullah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255852687 PECOS PAC ID: 9234595307 Enrollment ID: I20251114001380 |
| Provider Name | Lauren G Arias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124802475 PECOS PAC ID: 7810343043 Enrollment ID: I20251117000084 |
| Provider Name | Sabrina Alex Salomon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235263450 PECOS PAC ID: 1658301080 Enrollment ID: I20251118001979 |
| Provider Name | Ala' Abdel Jalil |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427267871 PECOS PAC ID: 5991868366 Enrollment ID: I20251208002655 |
| Provider Name | Monica Chungmi Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194698688 PECOS PAC ID: 7911491402 Enrollment ID: I20251211002239 |
| Provider Name | Amilyn Taplin |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295027472 PECOS PAC ID: 0648539130 Enrollment ID: I20251215000763 |
| Provider Name | Jordan N. Wilhelm |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770297053 PECOS PAC ID: 9032603238 Enrollment ID: I20251215003542 |
| Provider Name | Ryan Patrick Mckendry |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326910910 PECOS PAC ID: 1850886474 Enrollment ID: I20251222000482 |
| Provider Name | Todd Vento |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1487630802 PECOS PAC ID: 1557599248 Enrollment ID: I20251231001274 |
| Provider Name | Sovik De Sirkar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588124739 PECOS PAC ID: 0143664334 Enrollment ID: I20260112001073 |
| Provider Name | Thomas Steineke |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1477553782 PECOS PAC ID: 9638142375 Enrollment ID: I20260209001289 |
| Provider Name | Temidayo Ayotomiwa Abe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366947798 PECOS PAC ID: 9436546017 Enrollment ID: I20260209001396 |
| Provider Name | Tullio Emanuele |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083655047 PECOS PAC ID: 0941195291 Enrollment ID: I20260225000284 |
| Provider Name | Charles Anene |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124108303 PECOS PAC ID: 2769453083 Enrollment ID: I20260326002573 |
| Provider Name | Omid Hajiseyedjavadi |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1720032808 PECOS PAC ID: 6507878378 Enrollment ID: I20260429000702 |
| Provider Name | Loretta Brestan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861415812 PECOS PAC ID: 7315039534 Enrollment ID: I20260504007317 |
| Provider Name | Jefferson V.L. Dias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154054260 PECOS PAC ID: 4789106543 Enrollment ID: I20260520003493 |
| Provider Name | Ryan Earnest |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700063732 PECOS PAC ID: 1052689627 Enrollment ID: I20260529000737 |
| Provider Name | Madison M. Eghigian |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366315335 PECOS PAC ID: 6608346648 Enrollment ID: I20260530000263 |
| Provider Name | Susan Casey |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1821058413 PECOS PAC ID: 5395644934 Enrollment ID: I20260605002651 |
| Provider Name | Erin Mcdowell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801579610 PECOS PAC ID: 6901254747 Enrollment ID: I20260611002384 |
Aptcare in 1 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11718 Woodstream Ridge Ct, Fort Wayne, IN 46845 Phone: 260-602-9574 |
Northeast Medical Associates, PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1234 E. Dupont Rd., Suite 6, Fort Wayne, IN 46825 Phone: 260-480-2600 Fax: 260-496-8077 |
Anthony Medical Associates P C Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1330 N Coliseum Blvd, Fort Wayne, IN 46805 Phone: 260-447-8982 Fax: 260-447-4483 |
Brooklyn Medical Associates LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3534 Brooklyn Ave, Fort Wayne, IN 46809 Phone: 260-747-6171 Fax: 260-478-5125 |
Community Open Mri of Auburn LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2428 Lake Ave, Fort Wayne, IN 46805 Phone: 260-422-1491 Fax: 260-423-1421 |
Ashraf H. Hanna, M.D., P.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4306 Lake Avenue, Fort Wayne, IN 46815 Phone: 260-422-1906 Fax: 260-422-1925 |