| Martin Memorial Medical Center Inc | |
|
200 Se Hospital Ave Stuart FL 34994-2346 | |
| (772) 287-5200 | |
| Not Available |
| Full Name | Martin Memorial Medical Center Inc |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 200 Se Hospital Ave, Stuart, Florida |
| Authorized Official Name and Position | Tim Longville (CHIEF ACCOUNTING OFFICER AND CONTRO) |
| Authorized Official Contact | 2166367416 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Martin Memorial Medical Center Inc 6801 Brecksville Rd Ste 20, Dpc Rk2-7 Independence OH 44131-5062 Ph: (216) 442-5724 | Martin Memorial Medical Center Inc 200 Se Hospital Ave Stuart FL 34994-2346 Ph: (772) 287-5200 |
| NPI Number | 1194790055 |
|---|---|
| Provider Enumeration Date | 02/22/2006 |
| Last Update Date | 04/14/2025 |
| Medicare PECOS PAC ID | 2961300611 |
|---|---|
| Medicare Enrollment ID | O20031222000241 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194790055 | NPI | - | NPPES |
| 010118400 | Medicaid | FL | |
| 206 | Other | FL | BLUE CROSS BLUE SHIELD |
| Provider Name | Amy M Eversole |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760442560 PECOS PAC ID: 5698660694 Enrollment ID: I20040218000799 |
| Provider Name | Judy R Dasilva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568405579 PECOS PAC ID: 6103807524 Enrollment ID: I20040601000192 |
| Provider Name | Robert Garrett |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730108572 PECOS PAC ID: 7719961333 Enrollment ID: I20040614000283 |
| Provider Name | Sukanya Pachaidee |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1326022427 PECOS PAC ID: 8527032424 Enrollment ID: I20040825001157 |
| Provider Name | Pablo A. Bejarano |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073532818 PECOS PAC ID: 1951370287 Enrollment ID: I20041001000976 |
| Provider Name | Srinivas C Yerneni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871552570 PECOS PAC ID: 9739074923 Enrollment ID: I20041007000515 |
| Provider Name | Keith Swanson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508952862 PECOS PAC ID: 6406819598 Enrollment ID: I20041109001161 |
| Provider Name | Venu G Jasti |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710091426 PECOS PAC ID: 5193623890 Enrollment ID: I20041130000461 |
| Provider Name | Yvette Bushey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750366878 PECOS PAC ID: 0244270718 Enrollment ID: I20050504000994 |
| Provider Name | Christopher Daniel Keller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124049549 PECOS PAC ID: 7315980877 Enrollment ID: I20050606000690 |
| Provider Name | Surendra Khera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467436519 PECOS PAC ID: 8921034828 Enrollment ID: I20050712000937 |
| Provider Name | Benita J Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124043260 PECOS PAC ID: 3779510185 Enrollment ID: I20050718000623 |
| Provider Name | Larry H Mufson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174583975 PECOS PAC ID: 0749212942 Enrollment ID: I20050909000113 |
| Provider Name | Arden J Bradley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780645150 PECOS PAC ID: 6103858303 Enrollment ID: I20050909000126 |
| Provider Name | Norman E Bennett |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093776411 PECOS PAC ID: 2365474566 Enrollment ID: I20050909000152 |
| Provider Name | Joseph S Gage |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033170410 PECOS PAC ID: 2668404864 Enrollment ID: I20050909000184 |
| Provider Name | Lismore B Heron |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326047432 PECOS PAC ID: 6800828005 Enrollment ID: I20050914000126 |
| Provider Name | Howard S Helfman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639178734 PECOS PAC ID: 9335112663 Enrollment ID: I20050914000162 |
| Provider Name | Isabel Teresa Casariego Cruz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073510939 PECOS PAC ID: 5991738544 Enrollment ID: I20050914000414 |
| Provider Name | Peter S Zeblisky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356359525 PECOS PAC ID: 7214959220 Enrollment ID: I20051219000705 |
| Provider Name | Diane H Hauge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790730794 PECOS PAC ID: 5395767040 Enrollment ID: I20051222000408 |
| Provider Name | Kathly M Jean- Gilles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700866068 PECOS PAC ID: 4880625714 Enrollment ID: I20051227000201 |
| Provider Name | Gregory A Parr |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194765495 PECOS PAC ID: 4688563505 Enrollment ID: I20060508000016 |
| Provider Name | Jeffrey A True |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437148574 PECOS PAC ID: 9830100692 Enrollment ID: I20060509000376 |
| Provider Name | Ernesto Porras Polo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952332652 PECOS PAC ID: 9234132341 Enrollment ID: I20060810000223 |
| Provider Name | Stephen E Mcintyre |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1710943071 PECOS PAC ID: 5496759508 Enrollment ID: I20060901000289 |
| Provider Name | Brian Breslaw |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366419384 PECOS PAC ID: 4082657622 Enrollment ID: I20061201000356 |
| Provider Name | Paul Y Casanova-romero |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1316963168 PECOS PAC ID: 9931108420 Enrollment ID: I20061211000373 |
| Provider Name | Rodolfo Perez Gallardo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821166604 PECOS PAC ID: 3173525714 Enrollment ID: I20070209000438 |
| Provider Name | Richard Degaetano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427008770 PECOS PAC ID: 0446252845 Enrollment ID: I20070214000313 |
| Provider Name | Michelle Duane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336161678 PECOS PAC ID: 0446357503 Enrollment ID: I20070524000221 |
| Provider Name | Amanda J Chaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811186422 PECOS PAC ID: 6103927017 Enrollment ID: I20070723000308 |
| Provider Name | Matthew Peebles |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528066958 PECOS PAC ID: 7214029529 Enrollment ID: I20070816000320 |
| Provider Name | Resham Khilnani |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1013952423 PECOS PAC ID: 2264439512 Enrollment ID: I20070828000808 |
| Provider Name | Richard Blankenbaker |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1639273253 PECOS PAC ID: 0547269649 Enrollment ID: I20070927000802 |
| Provider Name | Bernardo Obeso |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1184780454 PECOS PAC ID: 6507951738 Enrollment ID: I20071003000580 |
| Provider Name | Kiran Reddy |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1073589842 PECOS PAC ID: 4183711500 Enrollment ID: I20071101000547 |
| Provider Name | Vivek Kaul |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497853212 PECOS PAC ID: 1850488925 Enrollment ID: I20071106000625 |
| Provider Name | Lalit S Chaube |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851406250 PECOS PAC ID: 5395750269 Enrollment ID: I20071204000479 |
| Provider Name | Jorge G Castillo |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1477688265 PECOS PAC ID: 1658461694 Enrollment ID: I20071214000314 |
| Provider Name | Abdul Nadeem |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912993072 PECOS PAC ID: 1759471550 Enrollment ID: I20071217000717 |
| Provider Name | Su Su Naing |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427241215 PECOS PAC ID: 4981794401 Enrollment ID: I20080107000240 |
| Provider Name | Marius T Ratanu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821272758 PECOS PAC ID: 8921187774 Enrollment ID: I20080505000446 |
| Provider Name | Erin E Connolly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497927891 PECOS PAC ID: 5799855946 Enrollment ID: I20080602000131 |
| Provider Name | Ben Glaspey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154340990 PECOS PAC ID: 6901976406 Enrollment ID: I20080609000927 |
| Provider Name | Badih Adada |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1225128705 PECOS PAC ID: 4880763820 Enrollment ID: I20080627000504 |
| Provider Name | Frederick R Silfen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871563452 PECOS PAC ID: 6305912825 Enrollment ID: I20080908000340 |
| Provider Name | Claude L Jones |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952570863 PECOS PAC ID: 2264509058 Enrollment ID: I20080919000438 |
| Provider Name | John J Viola |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174551949 PECOS PAC ID: 6406939636 Enrollment ID: I20081104000598 |
| Provider Name | Trina Ortiz-gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902060528 PECOS PAC ID: 1658314927 Enrollment ID: I20081215000543 |
| Provider Name | Mark S Beatty |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356349773 PECOS PAC ID: 1557354982 Enrollment ID: I20090331000624 |
| Provider Name | Anne Jeffries |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649385261 PECOS PAC ID: 9436206885 Enrollment ID: I20090422000189 |
| Provider Name | Joanne Hotchkiss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861643363 PECOS PAC ID: 6608925987 Enrollment ID: I20090515000127 |
| Provider Name | Jason Scott Weisstein |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003817693 PECOS PAC ID: 3375514367 Enrollment ID: I20090811000447 |
| Provider Name | Edward B Savage |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1528030731 PECOS PAC ID: 5799703849 Enrollment ID: I20090930000108 |
| Provider Name | Maria Julia Diacovo |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1285755132 PECOS PAC ID: 9032255351 Enrollment ID: I20090930000125 |
| Provider Name | Sonya M Pease |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588677884 PECOS PAC ID: 3870631138 Enrollment ID: I20091107000019 |
| Provider Name | Sharon Khan Lepak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700875127 PECOS PAC ID: 3577602689 Enrollment ID: I20091203000167 |
| Provider Name | Bruce Vincent Ouellette |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285619221 PECOS PAC ID: 4284776154 Enrollment ID: I20100115000527 |
| Provider Name | George Rittersbach |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437157864 PECOS PAC ID: 8921091356 Enrollment ID: I20100330000426 |
| Provider Name | Donald B Hoffman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578525069 PECOS PAC ID: 2769460013 Enrollment ID: I20100330001030 |
| Provider Name | Robert J Vanvliet |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134137342 PECOS PAC ID: 4587791074 Enrollment ID: I20100414000461 |
| Provider Name | Genon Wicina |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255346003 PECOS PAC ID: 2961530019 Enrollment ID: I20100511000166 |
| Provider Name | Mona Fakhry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295796290 PECOS PAC ID: 5799816328 Enrollment ID: I20100626000075 |
| Provider Name | Katherine J Zaccheo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811211386 PECOS PAC ID: 2365573904 Enrollment ID: I20100626000184 |
| Provider Name | Kelly C Zukowski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528380839 PECOS PAC ID: 0143352112 Enrollment ID: I20100712000093 |
| Provider Name | Michael R Jampol |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649299306 PECOS PAC ID: 2668504531 Enrollment ID: I20100713000728 |
| Provider Name | Anis Yousif Akrawi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1083611776 PECOS PAC ID: 7618000506 Enrollment ID: I20100728001241 |
| Provider Name | Jeffrey Lee Glickman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1134126832 PECOS PAC ID: 4183757941 Enrollment ID: I20100729000947 |
| Provider Name | Gerald A Ross |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942295563 PECOS PAC ID: 1456413939 Enrollment ID: I20100917000265 |
| Provider Name | Karen L Vassell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679728091 PECOS PAC ID: 9537284278 Enrollment ID: I20100917000406 |
| Provider Name | Grace H Yoo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518952571 PECOS PAC ID: 2365568516 Enrollment ID: I20100925000182 |
| Provider Name | Thomas H Williams |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1871680348 PECOS PAC ID: 0941112213 Enrollment ID: I20100927000332 |
| Provider Name | Prasad Chalasani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760477269 PECOS PAC ID: 7012951601 Enrollment ID: I20101014000327 |
| Provider Name | Yubelkis V Tinoco |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700032448 PECOS PAC ID: 0547454779 Enrollment ID: I20101102000722 |
| Provider Name | Mariana E Berho |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1629037981 PECOS PAC ID: 6002001179 Enrollment ID: I20101115000829 |
| Provider Name | Hubert O Garcia |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831165844 PECOS PAC ID: 8820132517 Enrollment ID: I20101115001120 |
| Provider Name | Peter M Dayton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528027315 PECOS PAC ID: 9133132194 Enrollment ID: I20101122001177 |
| Provider Name | Luis R Arroyo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366439812 PECOS PAC ID: 3870617947 Enrollment ID: I20101213000784 |
| Provider Name | Elizabeth Mills |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1619273398 PECOS PAC ID: 8224219753 Enrollment ID: I20110216000988 |
| Provider Name | Hendrik Dinkla |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407899560 PECOS PAC ID: 3173422664 Enrollment ID: I20110307000235 |
| Provider Name | Kristen R Ward |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1578895066 PECOS PAC ID: 2163604919 Enrollment ID: I20110315000785 |
| Provider Name | Jose R Irizarry |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952374225 PECOS PAC ID: 5193802684 Enrollment ID: I20110708000559 |
| Provider Name | Benjamin Ngo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1679780563 PECOS PAC ID: 9739230343 Enrollment ID: I20110728000303 |
| Provider Name | Rebecca L Lehnhoff |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619264512 PECOS PAC ID: 3476722547 Enrollment ID: I20110805000332 |
| Provider Name | William Jason Mcmanus |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1265517619 PECOS PAC ID: 0749450070 Enrollment ID: I20110824000535 |
| Provider Name | Sarah Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831485390 PECOS PAC ID: 2567632763 Enrollment ID: I20110825000525 |
| Provider Name | Alexander F Debonet |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275775736 PECOS PAC ID: 8628249240 Enrollment ID: I20110912000342 |
| Provider Name | Patricia Joan La Medica |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467733931 PECOS PAC ID: 1658544960 Enrollment ID: I20111102000392 |
| Provider Name | Kamalakar T Rao |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174516017 PECOS PAC ID: 8820263395 Enrollment ID: I20111212000433 |
| Provider Name | Matthew S Zoffer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336108059 PECOS PAC ID: 1052588308 Enrollment ID: I20120127000173 |
| Provider Name | Nicolas A Brozzi |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1831366483 PECOS PAC ID: 6305033416 Enrollment ID: I20120320000569 |
| Provider Name | Michael L Sprague |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982728879 PECOS PAC ID: 4880748854 Enrollment ID: I20120521000348 |
| Provider Name | Ryan M Dahlgren |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1215133871 PECOS PAC ID: 8325201502 Enrollment ID: I20120525000545 |
| Provider Name | Annabelle Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831417492 PECOS PAC ID: 4688838451 Enrollment ID: I20120606000486 |
| Provider Name | Michelle C Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831187384 PECOS PAC ID: 8729146352 Enrollment ID: I20120711000222 |
| Provider Name | Kim Mohler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912289588 PECOS PAC ID: 2264698059 Enrollment ID: I20120723000915 |
| Provider Name | Reynald Altema |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548238892 PECOS PAC ID: 3577586890 Enrollment ID: I20120807000813 |
| Provider Name | Rajpreet Dogra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629205075 PECOS PAC ID: 2264689223 Enrollment ID: I20120827000135 |
| Provider Name | Dipesh B Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093942682 PECOS PAC ID: 8022267202 Enrollment ID: I20121003000434 |
| Provider Name | Oszkar Szentirmai |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1285771543 PECOS PAC ID: 8426209362 Enrollment ID: I20121127000254 |
| Provider Name | Kenson Lacossiere |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255576286 PECOS PAC ID: 6507902053 Enrollment ID: I20130131000436 |
| Provider Name | Ritesh D Kaushal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710298138 PECOS PAC ID: 0547414088 Enrollment ID: I20130208000090 |
| Provider Name | Stephanie Keane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841535119 PECOS PAC ID: 7315182144 Enrollment ID: I20130328000054 |
| Provider Name | Arlene Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992893952 PECOS PAC ID: 2365683901 Enrollment ID: I20130724000976 |
| Provider Name | Carlos Vinas Palomino |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043565062 PECOS PAC ID: 3173764370 Enrollment ID: I20130731000500 |
| Provider Name | Gaurav R Shah |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1013029289 PECOS PAC ID: 5698783306 Enrollment ID: I20130802000637 |
| Provider Name | Amanda J Simionie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831536978 PECOS PAC ID: 7012159189 Enrollment ID: I20130820000693 |
| Provider Name | Cynthia Lambert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265606610 PECOS PAC ID: 0547330318 Enrollment ID: I20130926000344 |
| Provider Name | Lindsay Morales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720162753 PECOS PAC ID: 9436160199 Enrollment ID: I20131025001354 |
| Provider Name | Patrick Kenney |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1104129634 PECOS PAC ID: 2769659424 Enrollment ID: I20131028001355 |
| Provider Name | Adarsha Shrestha |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1548426398 PECOS PAC ID: 6204974710 Enrollment ID: I20131203000291 |
| Provider Name | Jay Waddadar |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1861545303 PECOS PAC ID: 2961466370 Enrollment ID: I20131231001726 |
| Provider Name | Candy Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952725566 PECOS PAC ID: 2961634985 Enrollment ID: I20140407000226 |
| Provider Name | Susan D Agrama |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992895577 PECOS PAC ID: 2961479399 Enrollment ID: I20140410000853 |
| Provider Name | Richard Rothman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164733143 PECOS PAC ID: 9739321472 Enrollment ID: I20140521001433 |
| Provider Name | Kathleen Strunk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487934261 PECOS PAC ID: 2567685480 Enrollment ID: I20140522000688 |
| Provider Name | Ivan Todorov Stoev |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1730119595 PECOS PAC ID: 7214176874 Enrollment ID: I20140630000978 |
| Provider Name | Shira A Mcmahan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124339247 PECOS PAC ID: 7719100023 Enrollment ID: I20140716001892 |
| Provider Name | Roberto Rene Gonzalez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1326205774 PECOS PAC ID: 8426282633 Enrollment ID: I20140730002072 |
| Provider Name | Frank N Garcia |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114187457 PECOS PAC ID: 6305062001 Enrollment ID: I20140731002196 |
| Provider Name | Sattar Gojraty |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891957445 PECOS PAC ID: 7911123682 Enrollment ID: I20140801001608 |
| Provider Name | Jean A Vickers |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1477630648 PECOS PAC ID: 9032303573 Enrollment ID: I20141021000449 |
| Provider Name | Kristin M Ogden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356741417 PECOS PAC ID: 8820219298 Enrollment ID: I20141028002231 |
| Provider Name | Hardik M Soni |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639428394 PECOS PAC ID: 9830311398 Enrollment ID: I20141118000429 |
| Provider Name | Felix Nicolas Rodriguez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235577164 PECOS PAC ID: 5092038513 Enrollment ID: I20150107002524 |
| Provider Name | Robert Charkowick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649362260 PECOS PAC ID: 4486886454 Enrollment ID: I20150115000416 |
| Provider Name | Brenda L Dozack |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427456086 PECOS PAC ID: 8325364888 Enrollment ID: I20150302000068 |
| Provider Name | Michael Burke |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1346229168 PECOS PAC ID: 7012812506 Enrollment ID: I20150407001041 |
| Provider Name | Tegan Bissell |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1437542230 PECOS PAC ID: 4082932371 Enrollment ID: I20150416002416 |
| Provider Name | Andrey Lima |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1538475835 PECOS PAC ID: 2264752674 Enrollment ID: I20150527001603 |
| Provider Name | Deborah C Bueno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528469806 PECOS PAC ID: 8325369630 Enrollment ID: I20150611000639 |
| Provider Name | Hassan Ayaz Bokhari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811158082 PECOS PAC ID: 2062653462 Enrollment ID: I20150721002094 |
| Provider Name | Craig A Wengler |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1366609117 PECOS PAC ID: 5799933735 Enrollment ID: I20150721002180 |
| Provider Name | Lissette Michelle Feliz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912342866 PECOS PAC ID: 7113231671 Enrollment ID: I20150729007182 |
| Provider Name | George A Garcia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508112772 PECOS PAC ID: 5496060600 Enrollment ID: I20150818003806 |
| Provider Name | Micheca St.hilaire |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104113786 PECOS PAC ID: 1052629862 Enrollment ID: I20150928002870 |
| Provider Name | Steven M Kappler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265490163 PECOS PAC ID: 5597791145 Enrollment ID: I20151008001476 |
| Provider Name | Michael M Girtelschmid |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891879169 PECOS PAC ID: 3274677299 Enrollment ID: I20151008002205 |
| Provider Name | Verona A Stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043619612 PECOS PAC ID: 3375852395 Enrollment ID: I20151014000890 |
| Provider Name | Dennys Reyes Candedo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245598036 PECOS PAC ID: 8022333848 Enrollment ID: I20151019001753 |
| Provider Name | Sameh Demian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992935852 PECOS PAC ID: 0446412514 Enrollment ID: I20151029000816 |
| Provider Name | Kadian Simmonds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508240888 PECOS PAC ID: 6901106046 Enrollment ID: I20151123000735 |
| Provider Name | Viviane Andersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679904486 PECOS PAC ID: 5799086922 Enrollment ID: I20151214000789 |
| Provider Name | Eva Takacs-dilorenzo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225039985 PECOS PAC ID: 6800873498 Enrollment ID: I20151216002428 |
| Provider Name | Kunal Chaudhry |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1114138815 PECOS PAC ID: 3173649902 Enrollment ID: I20151217000002 |
| Provider Name | George J Goldman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1841255783 PECOS PAC ID: 9638277601 Enrollment ID: I20151228002078 |
| Provider Name | Alisha V Williams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821381542 PECOS PAC ID: 6608093968 Enrollment ID: I20160115000929 |
| Provider Name | Kimberly Wyatt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1326024902 PECOS PAC ID: 7012146210 Enrollment ID: I20160315002677 |
| Provider Name | Prakash B Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730476003 PECOS PAC ID: 6103095013 Enrollment ID: I20160316000366 |
| Provider Name | Juan Giachino |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1609899939 PECOS PAC ID: 4183884927 Enrollment ID: I20160502001976 |
| Provider Name | Purandath Lall |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1992777338 PECOS PAC ID: 9436174216 Enrollment ID: I20160518000025 |
| Provider Name | Susanna M Huhtamaki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255714093 PECOS PAC ID: 1153611850 Enrollment ID: I20160608002457 |
| Provider Name | Kelli L Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033501036 PECOS PAC ID: 3870884414 Enrollment ID: I20160629000394 |
| Provider Name | Marc A Pinn |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639431679 PECOS PAC ID: 3476867102 Enrollment ID: I20160718000170 |
| Provider Name | Marco A Ruiz Andia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356334171 PECOS PAC ID: 1456358449 Enrollment ID: I20160728001253 |
| Provider Name | Roderick Milton Baker |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063772101 PECOS PAC ID: 1557527942 Enrollment ID: I20160729000113 |
| Provider Name | Christina Schilero |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1154761229 PECOS PAC ID: 5698068450 Enrollment ID: I20160801002393 |
| Provider Name | Amitesh Agarwal |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629383674 PECOS PAC ID: 1850685074 Enrollment ID: I20160811000955 |
| Provider Name | Kristen L Mulcahy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689080376 PECOS PAC ID: 3971897844 Enrollment ID: I20160816001410 |
| Provider Name | Holly N Rotan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962853945 PECOS PAC ID: 4284929985 Enrollment ID: I20160819000651 |
| Provider Name | Joanne Broccoli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811902588 PECOS PAC ID: 3476573593 Enrollment ID: I20160823003169 |
| Provider Name | Sabrina M Seus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033452578 PECOS PAC ID: 7113214388 Enrollment ID: I20161003001530 |
| Provider Name | Carrie Jo Oscarson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316309313 PECOS PAC ID: 5395033658 Enrollment ID: I20161019002075 |
| Provider Name | Fady Geha |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1629235247 PECOS PAC ID: 8022286624 Enrollment ID: I20161103001922 |
| Provider Name | Juan M Castro |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376864157 PECOS PAC ID: 7012297484 Enrollment ID: I20161201001666 |
| Provider Name | David Sugar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265835854 PECOS PAC ID: 2860772167 Enrollment ID: I20161202000651 |
| Provider Name | Joshua D Leibner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417247032 PECOS PAC ID: 1850672981 Enrollment ID: I20170104001949 |
| Provider Name | Aaron J Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235672163 PECOS PAC ID: 0648554709 Enrollment ID: I20170309000703 |
| Provider Name | Lisamarie Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285179531 PECOS PAC ID: 8729363544 Enrollment ID: I20170317001310 |
| Provider Name | Zeina A. Nahleh |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1790742476 PECOS PAC ID: 7719899814 Enrollment ID: I20170425000883 |
| Provider Name | Antonio Soegaard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871544247 PECOS PAC ID: 9537066303 Enrollment ID: I20170505000035 |
| Provider Name | Mellecia E Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508229360 PECOS PAC ID: 0244507150 Enrollment ID: I20170525000339 |
| Provider Name | Melanie E Dinsmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215378831 PECOS PAC ID: 7719111806 Enrollment ID: I20170602001617 |
| Provider Name | Maryam Nouhi Arbatani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255748182 PECOS PAC ID: 3779851530 Enrollment ID: I20170620000922 |
| Provider Name | Marilu Margarita Jurado |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1245592195 PECOS PAC ID: 2961718044 Enrollment ID: I20170627001938 |
| Provider Name | Kari K Clark |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1639535784 PECOS PAC ID: 9638467665 Enrollment ID: I20170630001299 |
| Provider Name | Elvia I Goez-gutierrez |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1669746731 PECOS PAC ID: 2264701887 Enrollment ID: I20170712003554 |
| Provider Name | Marc-alain Babi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831483841 PECOS PAC ID: 5991075277 Enrollment ID: I20170719001421 |
| Provider Name | Wilson Cueva |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1366608713 PECOS PAC ID: 4486839008 Enrollment ID: I20170814002664 |
| Provider Name | Corbin T Hodder |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1073723565 PECOS PAC ID: 6406941616 Enrollment ID: I20170825003429 |
| Provider Name | Federico Jose Serrot |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386906550 PECOS PAC ID: 1153693064 Enrollment ID: I20170826000222 |
| Provider Name | Priya V Negandhi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013336171 PECOS PAC ID: 8426331695 Enrollment ID: I20171013000667 |
| Provider Name | Christian Donald Wolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669922191 PECOS PAC ID: 1254607559 Enrollment ID: I20171031001656 |
| Provider Name | Eric Owings |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740543057 PECOS PAC ID: 3971745217 Enrollment ID: I20171114002886 |
| Provider Name | Kaitlin E Hackett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275086217 PECOS PAC ID: 9931466901 Enrollment ID: I20171129001514 |
| Provider Name | Doris Mindy Ortiz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366966863 PECOS PAC ID: 4981961471 Enrollment ID: I20171208002187 |
| Provider Name | Zackary E Boomsaad |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1235394891 PECOS PAC ID: 3577887371 Enrollment ID: I20171221000141 |
| Provider Name | Ravishankar Shivashankar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003198938 PECOS PAC ID: 9537475116 Enrollment ID: I20171229000510 |
| Provider Name | Kathleen Anne Gribbon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316453244 PECOS PAC ID: 2163782293 Enrollment ID: I20180208002691 |
| Provider Name | Joao Miguel Serigado Soares Da Costa |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356706550 PECOS PAC ID: 5092008318 Enrollment ID: I20180221000021 |
| Provider Name | Aspen Twilight Soegaard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669826871 PECOS PAC ID: 2062700230 Enrollment ID: I20180316001384 |
| Provider Name | Henry J Jean |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1043620446 PECOS PAC ID: 7618239062 Enrollment ID: I20180322001237 |
| Provider Name | Melanie J Vanamsterdam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104956200 PECOS PAC ID: 9234039017 Enrollment ID: I20180404002770 |
| Provider Name | Allen Ozeran |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346525128 PECOS PAC ID: 2365705514 Enrollment ID: I20180501001038 |
| Provider Name | Candice Politi |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1053749697 PECOS PAC ID: 1850655531 Enrollment ID: I20180504000432 |
| Provider Name | Nivia Ivette Ruiz |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1962873323 PECOS PAC ID: 1355698283 Enrollment ID: I20180723002875 |
| Provider Name | Evangelina Bryant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538673645 PECOS PAC ID: 8921357948 Enrollment ID: I20180823001677 |
| Provider Name | Robert Donald Loflin |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1982961934 PECOS PAC ID: 4688817158 Enrollment ID: I20180828003974 |
| Provider Name | Valerie Rasberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053707323 PECOS PAC ID: 0042515447 Enrollment ID: I20180901000010 |
| Provider Name | Ronald Lee Rasberry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861888133 PECOS PAC ID: 9739484213 Enrollment ID: I20180910000629 |
| Provider Name | Katie Cleary Alonso |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1528324613 PECOS PAC ID: 8921243858 Enrollment ID: I20180912000816 |
| Provider Name | Andrew James Whipple |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1205275203 PECOS PAC ID: 1759512197 Enrollment ID: I20180912003151 |
| Provider Name | Kosisochukwu Nkenna Anago |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639564263 PECOS PAC ID: 4880985720 Enrollment ID: I20180914002529 |
| Provider Name | Rose Paccione |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1992094791 PECOS PAC ID: 8325349772 Enrollment ID: I20180919002965 |
| Provider Name | Lorenzo Digiorgio |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679918635 PECOS PAC ID: 0547512477 Enrollment ID: I20181004000457 |
| Provider Name | Nicholas C James |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1346403052 PECOS PAC ID: 6709018187 Enrollment ID: I20181015003174 |
| Provider Name | Sarah M Robitaille |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265935399 PECOS PAC ID: 0648522789 Enrollment ID: I20181017003000 |
| Provider Name | Karen D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871087544 PECOS PAC ID: 0446502504 Enrollment ID: I20181018000049 |
| Provider Name | Christopher Mark Begley |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1306282199 PECOS PAC ID: 8820229321 Enrollment ID: I20181022001747 |
| Provider Name | Konstantin Alekseyenko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164801130 PECOS PAC ID: 5092075127 Enrollment ID: I20181030000038 |
| Provider Name | Aleksey Alekseyenko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316326515 PECOS PAC ID: 9739433764 Enrollment ID: I20181110000272 |
| Provider Name | Mario Mayes-romero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639565047 PECOS PAC ID: 4284988171 Enrollment ID: I20181112002613 |
| Provider Name | Anthony J Liberatore |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1053622183 PECOS PAC ID: 2264755727 Enrollment ID: I20181115000495 |
| Provider Name | Brenda L Bartkowiak |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1295177756 PECOS PAC ID: 3072867688 Enrollment ID: I20181119001419 |
| Provider Name | Daniel Kittman Saul |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1922355619 PECOS PAC ID: 2668777996 Enrollment ID: I20181206002918 |
| Provider Name | Jeffrey W Miller |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1447311618 PECOS PAC ID: 7416957584 Enrollment ID: I20181212001553 |
| Provider Name | Pavlo Lukyanchykov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831572510 PECOS PAC ID: 5496091522 Enrollment ID: I20190110003041 |
| Provider Name | Iker Newell Unzalu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1528402187 PECOS PAC ID: 4385919836 Enrollment ID: I20190114000285 |
| Provider Name | Gina Marie Levine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851874317 PECOS PAC ID: 2961749007 Enrollment ID: I20190128000515 |
| Provider Name | Ashley East |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144791575 PECOS PAC ID: 3072851534 Enrollment ID: I20190208001609 |
| Provider Name | Nicole Rosenthal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366950685 PECOS PAC ID: 5496000754 Enrollment ID: I20190208002992 |
| Provider Name | Juancarlo Martinez Gonzalez |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1609189869 PECOS PAC ID: 2264784024 Enrollment ID: I20190213001069 |
| Provider Name | Delia M Brazzell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710465315 PECOS PAC ID: 4183962111 Enrollment ID: I20190215002132 |
| Provider Name | Evan W Alley |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1497726947 PECOS PAC ID: 4789669045 Enrollment ID: I20190219002640 |
| Provider Name | Teodora C Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851797054 PECOS PAC ID: 2769722214 Enrollment ID: I20190319002391 |
| Provider Name | Jose Navia |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1346204542 PECOS PAC ID: 0446262711 Enrollment ID: I20190322001880 |
| Provider Name | Katy Lynn Haddon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497212807 PECOS PAC ID: 4385984491 Enrollment ID: I20190327000356 |
| Provider Name | Andrew Thomas Vollman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902243009 PECOS PAC ID: 2769715002 Enrollment ID: I20190531000968 |
| Provider Name | Hemang B Panchal |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1508155144 PECOS PAC ID: 2860725678 Enrollment ID: I20190611001081 |
| Provider Name | Bill Moskos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881699262 PECOS PAC ID: 8820040488 Enrollment ID: I20190624003166 |
| Provider Name | Kristine E Salemi |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1396302378 PECOS PAC ID: 7113251919 Enrollment ID: I20190627003217 |
| Provider Name | Jacques J Lamothe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679673057 PECOS PAC ID: 5991775561 Enrollment ID: I20190628002961 |
| Provider Name | Aruna Shardah Khan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407200918 PECOS PAC ID: 6305137951 Enrollment ID: I20190719002154 |
| Provider Name | Neal Punnakudyil George |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1871853507 PECOS PAC ID: 6709000524 Enrollment ID: I20190801002233 |
| Provider Name | Christopher T Duncan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306263751 PECOS PAC ID: 0042529232 Enrollment ID: I20190805000213 |
| Provider Name | Preston Grieco |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437569142 PECOS PAC ID: 6901143338 Enrollment ID: I20190827000757 |
| Provider Name | Hetain N Patel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710227954 PECOS PAC ID: 2365735602 Enrollment ID: I20190906002410 |
| Provider Name | Onidis Patricia Lopez |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740303189 PECOS PAC ID: 0840521746 Enrollment ID: I20191008000301 |
| Provider Name | Jose Castaneda |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1346665130 PECOS PAC ID: 4385864545 Enrollment ID: I20191104003193 |
| Provider Name | Erica A Holden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740757855 PECOS PAC ID: 6002241353 Enrollment ID: I20200115001974 |
| Provider Name | Mohammed Ansari |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811438682 PECOS PAC ID: 0840627477 Enrollment ID: I20200220002178 |
| Provider Name | Isaac Dor |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982718409 PECOS PAC ID: 6103965918 Enrollment ID: I20200305000182 |
| Provider Name | Kelvin S Wilson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1275845869 PECOS PAC ID: 5597991158 Enrollment ID: I20200316001614 |
| Provider Name | George P Balis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790748630 PECOS PAC ID: 0749270551 Enrollment ID: I20200318001361 |
| Provider Name | Peter Evans |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215965405 PECOS PAC ID: 7012920812 Enrollment ID: I20200323000317 |
| Provider Name | Joseph Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871138958 PECOS PAC ID: 6901236108 Enrollment ID: I20200430000022 |
| Provider Name | Laura Lee Giandomenico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497383194 PECOS PAC ID: 7618308750 Enrollment ID: I20200505003315 |
| Provider Name | Jennifer Dean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144710252 PECOS PAC ID: 0749513760 Enrollment ID: I20200518000018 |
| Provider Name | Georgios Hatzoudis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164642096 PECOS PAC ID: 3678655198 Enrollment ID: I20200528000730 |
| Provider Name | Kimone Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184106809 PECOS PAC ID: 2668710591 Enrollment ID: I20200602000390 |
| Provider Name | Haren Bodepudi |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1518351410 PECOS PAC ID: 5496055287 Enrollment ID: I20200623000555 |
| Provider Name | Asadulla Chaudhary |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669866950 PECOS PAC ID: 0143520148 Enrollment ID: I20200714003898 |
| Provider Name | Roberto Rey Dios |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1487835211 PECOS PAC ID: 5294978235 Enrollment ID: I20200716003616 |
| Provider Name | Miles Landry |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093120958 PECOS PAC ID: 0446500706 Enrollment ID: I20200727002184 |
| Provider Name | John Delahay |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326046384 PECOS PAC ID: 5092859512 Enrollment ID: I20200818003480 |
| Provider Name | Elizabeth Nicole Feldman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326425117 PECOS PAC ID: 3476971003 Enrollment ID: I20200915000862 |
| Provider Name | Angelica Norman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124636089 PECOS PAC ID: 2668890146 Enrollment ID: I20200915002567 |
| Provider Name | Michael Mackechnie |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1023463726 PECOS PAC ID: 7810253416 Enrollment ID: I20201007001699 |
| Provider Name | Ashley M Mcintosh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891286209 PECOS PAC ID: 6800216904 Enrollment ID: I20201012000332 |
| Provider Name | Adrianna Kelmendi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528475621 PECOS PAC ID: 1456641414 Enrollment ID: I20201021002455 |
| Provider Name | Carlos J Romero Marrero |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194936757 PECOS PAC ID: 3779638911 Enrollment ID: I20201029000602 |
| Provider Name | Lisa Eleanor Kent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679174593 PECOS PAC ID: 6800208802 Enrollment ID: I20201216001424 |
| Provider Name | Corinne Arrington Watson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184069742 PECOS PAC ID: 0143634642 Enrollment ID: I20210125000996 |
| Provider Name | Susan Rae Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932768348 PECOS PAC ID: 2365478161 Enrollment ID: I20210128000785 |
| Provider Name | Norma Pichardo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922479146 PECOS PAC ID: 3577847268 Enrollment ID: I20210303000087 |
| Provider Name | Jennifer A Rector |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811989049 PECOS PAC ID: 9638585698 Enrollment ID: I20210317001246 |
| Provider Name | Raegan Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386234979 PECOS PAC ID: 3476960089 Enrollment ID: I20210326002024 |
| Provider Name | Kurt Spindler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497855456 PECOS PAC ID: 3678557683 Enrollment ID: I20210330000935 |
| Provider Name | Zuzanna Fedak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952995342 PECOS PAC ID: 2567870736 Enrollment ID: I20210428001391 |
| Provider Name | George Drake |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427173145 PECOS PAC ID: 6002900891 Enrollment ID: I20210525002113 |
| Provider Name | Allen Reisman |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1366462749 PECOS PAC ID: 0941253157 Enrollment ID: I20210609000107 |
| Provider Name | Samer Riaz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730573718 PECOS PAC ID: 0840505350 Enrollment ID: I20210610002721 |
| Provider Name | Kacy Bladergroen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508007329 PECOS PAC ID: 0547660524 Enrollment ID: I20210614000060 |
| Provider Name | Nicole Marie Tryon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841896438 PECOS PAC ID: 1153721063 Enrollment ID: I20210615001839 |
| Provider Name | Mauricio Mandel Brigido |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1982259461 PECOS PAC ID: 2860721016 Enrollment ID: I20210623004055 |
| Provider Name | Nadejda Alekseeva |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538298005 PECOS PAC ID: 2668874892 Enrollment ID: I20210712001128 |
| Provider Name | Yale Tiley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245762277 PECOS PAC ID: 5698177541 Enrollment ID: I20210714002462 |
| Provider Name | Daniel Carlyle |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1235585225 PECOS PAC ID: 6800180597 Enrollment ID: I20210721002333 |
| Provider Name | Hassan Amer |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1366804502 PECOS PAC ID: 6204239759 Enrollment ID: I20210722000035 |
| Provider Name | Anatoly Nikolaev |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1689037202 PECOS PAC ID: 3173810728 Enrollment ID: I20210722000538 |
| Provider Name | Sarah A Vogler |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1427256395 PECOS PAC ID: 1658521851 Enrollment ID: I20210805000571 |
| Provider Name | Kruti J Yagnik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114380763 PECOS PAC ID: 9133415870 Enrollment ID: I20210805002386 |
| Provider Name | Emanuela Silva-alvarenga |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1740607803 PECOS PAC ID: 6608091970 Enrollment ID: I20210811000375 |
| Provider Name | David Powers |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932410370 PECOS PAC ID: 6204196538 Enrollment ID: I20210811002853 |
| Provider Name | Sarah R Wolf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487103776 PECOS PAC ID: 4981009008 Enrollment ID: I20210826002673 |
| Provider Name | Jorge Luis Jorge |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366949737 PECOS PAC ID: 9537564687 Enrollment ID: I20210827000257 |
| Provider Name | Alexander Usorov |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1003010174 PECOS PAC ID: 5597810598 Enrollment ID: I20210827001123 |
| Provider Name | Sabih Hamad Iqbal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205330024 PECOS PAC ID: 5395141097 Enrollment ID: I20210903001578 |
| Provider Name | Mary Jean Buckman |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1750055364 PECOS PAC ID: 6406252006 Enrollment ID: I20210907003587 |
| Provider Name | Sydnie Kristine Bournival |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932706835 PECOS PAC ID: 8729484043 Enrollment ID: I20210910001863 |
| Provider Name | Ramada Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619964046 PECOS PAC ID: 3678541984 Enrollment ID: I20211015001132 |
| Provider Name | Adam J Kotkiewicz |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356491179 PECOS PAC ID: 1052509783 Enrollment ID: I20211209000945 |
| Provider Name | Jennifer Doak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609165984 PECOS PAC ID: 8820489412 Enrollment ID: I20211215000421 |
| Provider Name | Angela Michelle Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043972318 PECOS PAC ID: 5597787739 Enrollment ID: I20211218000002 |
| Provider Name | Rebecca O'bryan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1295900652 PECOS PAC ID: 5395992531 Enrollment ID: I20220103000824 |
| Provider Name | Susan Paris |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1851761100 PECOS PAC ID: 6901195841 Enrollment ID: I20220106001135 |
| Provider Name | Carlos Jordan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972786630 PECOS PAC ID: 6608057997 Enrollment ID: I20220118000114 |
| Provider Name | Luis Velazco Davila |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1992016539 PECOS PAC ID: 2062652704 Enrollment ID: I20220118001676 |
| Provider Name | Kathleen A Hayden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700814670 PECOS PAC ID: 1759439854 Enrollment ID: I20220126002427 |
| Provider Name | Katerina Alexander |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245646215 PECOS PAC ID: 2668729054 Enrollment ID: I20220127000144 |
| Provider Name | Ashley J Horn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487314662 PECOS PAC ID: 1153714050 Enrollment ID: I20220216001349 |
| Provider Name | Tracy Ann Bochantin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336255009 PECOS PAC ID: 6002842499 Enrollment ID: I20220311001850 |
| Provider Name | Daniel A Nedresky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902425119 PECOS PAC ID: 8123442787 Enrollment ID: I20220504000206 |
| Provider Name | Esther Yoon |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1639571698 PECOS PAC ID: 2264769892 Enrollment ID: I20220505001861 |
| Provider Name | Emmanuelle Bagdasarian |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558856674 PECOS PAC ID: 0840677332 Enrollment ID: I20220523002391 |
| Provider Name | Odalys Mena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659862241 PECOS PAC ID: 5294113551 Enrollment ID: I20220528000042 |
| Provider Name | Anthony Gabriel Sayoc |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700445533 PECOS PAC ID: 3274867213 Enrollment ID: I20220617001181 |
| Provider Name | Jamilyn Vaughn Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639736580 PECOS PAC ID: 1557740545 Enrollment ID: I20220622001275 |
| Provider Name | Celeste Panely |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1902206634 PECOS PAC ID: 2466774716 Enrollment ID: I20220628002744 |
| Provider Name | Alynda Christine Doran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063155430 PECOS PAC ID: 3971983248 Enrollment ID: I20220704000270 |
| Provider Name | Daniel Alejandro Benito |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1285168609 PECOS PAC ID: 0840670824 Enrollment ID: I20220707004095 |
| Provider Name | Pablo Caignet |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154889426 PECOS PAC ID: 8325443062 Enrollment ID: I20220709000753 |
| Provider Name | Nicholas P Vernace |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497216204 PECOS PAC ID: 1355672056 Enrollment ID: I20220712002638 |
| Provider Name | Vitalia Neiman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154947513 PECOS PAC ID: 8729469408 Enrollment ID: I20220713002254 |
| Provider Name | Amre Nouh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306162474 PECOS PAC ID: 2466679428 Enrollment ID: I20220714000621 |
| Provider Name | Gabriella M Muller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194285619 PECOS PAC ID: 3274860150 Enrollment ID: I20220715001084 |
| Provider Name | Matthew Mozzo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659832749 PECOS PAC ID: 2860727500 Enrollment ID: I20220718002411 |
| Provider Name | Kevin William Carroll |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861950255 PECOS PAC ID: 7911232335 Enrollment ID: I20220726003516 |
| Provider Name | Charles Robert Blackwell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508203225 PECOS PAC ID: 7315329083 Enrollment ID: I20220728001235 |
| Provider Name | Felix Filias |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063073658 PECOS PAC ID: 6103208749 Enrollment ID: I20220729000832 |
| Provider Name | Kimberly Anne Caracci |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1649917899 PECOS PAC ID: 3375926264 Enrollment ID: I20220810000104 |
| Provider Name | Roland Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407316326 PECOS PAC ID: 7618205592 Enrollment ID: I20220811003425 |
| Provider Name | Parth Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215433198 PECOS PAC ID: 5597016204 Enrollment ID: I20220815001910 |
| Provider Name | Crystal Del Mar Ayala Castillo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750847588 PECOS PAC ID: 6305229923 Enrollment ID: I20220815002754 |
| Provider Name | Christina B Vernace |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902369853 PECOS PAC ID: 7113259656 Enrollment ID: I20220816002055 |
| Provider Name | Vitaliy Molchanov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871053249 PECOS PAC ID: 3577986918 Enrollment ID: I20220819000689 |
| Provider Name | Gerson Florez |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205097896 PECOS PAC ID: 2466679394 Enrollment ID: I20220819001063 |
| Provider Name | John H Seymour |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093247249 PECOS PAC ID: 1951648005 Enrollment ID: I20220822002970 |
| Provider Name | Roger Coron |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588872873 PECOS PAC ID: 5991951071 Enrollment ID: I20220823001326 |
| Provider Name | Luba Muaddi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1669836177 PECOS PAC ID: 6901190081 Enrollment ID: I20220824001038 |
| Provider Name | Mahmoud Mahmoud |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1457715161 PECOS PAC ID: 4284923624 Enrollment ID: I20220824001863 |
| Provider Name | Eshban Emmanuel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356801518 PECOS PAC ID: 4789068768 Enrollment ID: I20220825002553 |
| Provider Name | Ronald Cossman |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1932161619 PECOS PAC ID: 8921083064 Enrollment ID: I20220908000015 |
| Provider Name | Awss Zidan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225472525 PECOS PAC ID: 2567730807 Enrollment ID: I20220912000977 |
| Provider Name | Niccia Ditrapano |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265922751 PECOS PAC ID: 1658625744 Enrollment ID: I20220929000213 |
| Provider Name | Brooke Kulp |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023472792 PECOS PAC ID: 1759617012 Enrollment ID: I20221005002770 |
| Provider Name | Mark Lucero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609527217 PECOS PAC ID: 5092191304 Enrollment ID: I20221010001437 |
| Provider Name | Brittney Ostrander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609448315 PECOS PAC ID: 0749656502 Enrollment ID: I20221019001031 |
| Provider Name | Bikash Acharya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780850743 PECOS PAC ID: 2567586837 Enrollment ID: I20221024000641 |
| Provider Name | Ankit Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619528148 PECOS PAC ID: 9436584448 Enrollment ID: I20221025000881 |
| Provider Name | Rajarshi Chakravarty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619170669 PECOS PAC ID: 1850562869 Enrollment ID: I20221027000596 |
| Provider Name | Marie Ngom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477505873 PECOS PAC ID: 0446272546 Enrollment ID: I20221109003210 |
| Provider Name | Amir Behdad |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1497978902 PECOS PAC ID: 8527192541 Enrollment ID: I20221121003310 |
| Provider Name | Xin Yao |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1174670145 PECOS PAC ID: 4082808993 Enrollment ID: I20221125000347 |
| Provider Name | Maria Defatima Pozuelo |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285681999 PECOS PAC ID: 6901846658 Enrollment ID: I20221217000311 |
| Provider Name | Darlene Gabeau |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1184605016 PECOS PAC ID: 1052459468 Enrollment ID: I20221220000938 |
| Provider Name | Michael W Howard |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1205549706 PECOS PAC ID: 0547631863 Enrollment ID: I20230125001173 |
| Provider Name | Richard B Zelman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518904267 PECOS PAC ID: 9537225081 Enrollment ID: I20230201000144 |
| Provider Name | Annette J Deutscher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356836019 PECOS PAC ID: 4082021100 Enrollment ID: I20230202000270 |
| Provider Name | Lisa Yamamoto |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134440035 PECOS PAC ID: 3577855352 Enrollment ID: I20230213000778 |
| Provider Name | Nekisha Hyman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508453200 PECOS PAC ID: 8426420464 Enrollment ID: I20230221000597 |
| Provider Name | Mohamed H Elgabaly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861656282 PECOS PAC ID: 9931366564 Enrollment ID: I20230222003264 |
| Provider Name | Neika N Small |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255097655 PECOS PAC ID: 4587039326 Enrollment ID: I20230410002608 |
| Provider Name | Jharendra Rijal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922313592 PECOS PAC ID: 1951544022 Enrollment ID: I20230508002789 |
| Provider Name | Yinn Shaung Ooi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013303304 PECOS PAC ID: 2567741283 Enrollment ID: I20230602002350 |
| Provider Name | Edison Castro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801376983 PECOS PAC ID: 2365849700 Enrollment ID: I20230614000274 |
| Provider Name | Darcie Ariel Linder |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558998856 PECOS PAC ID: 6002274479 Enrollment ID: I20230615003536 |
| Provider Name | Natacha Rigual Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902272099 PECOS PAC ID: 1456697358 Enrollment ID: I20230626003333 |
| Provider Name | Osama Alalao |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1619464781 PECOS PAC ID: 2264814805 Enrollment ID: I20230719002058 |
| Provider Name | Ahmed Koriesh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598179285 PECOS PAC ID: 6406101138 Enrollment ID: I20230727004010 |
| Provider Name | Zara Saba Azhar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871116152 PECOS PAC ID: 4082075734 Enrollment ID: I20230728000583 |
| Provider Name | Monica George-palop |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1801380530 PECOS PAC ID: 9335500545 Enrollment ID: I20230804000201 |
| Provider Name | Kyrie Herring |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740710292 PECOS PAC ID: 2466722699 Enrollment ID: I20230806000105 |
| Provider Name | Andrea Folds |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912535923 PECOS PAC ID: 4789005000 Enrollment ID: I20230807002346 |
| Provider Name | Thomas Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528371192 PECOS PAC ID: 9133448921 Enrollment ID: I20230809000926 |
| Provider Name | Angelica Italiano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255968277 PECOS PAC ID: 1153783378 Enrollment ID: I20230818002088 |
| Provider Name | James C Schuck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982231908 PECOS PAC ID: 2567847098 Enrollment ID: I20230821002501 |
| Provider Name | Whitney Evan Mayberry |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205331196 PECOS PAC ID: 8921461724 Enrollment ID: I20230828000146 |
| Provider Name | Jose Manuel Sarmiento |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1558814053 PECOS PAC ID: 5597021089 Enrollment ID: I20230828001231 |
| Provider Name | Parsa Seyed Mirmehdi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790312510 PECOS PAC ID: 4587085972 Enrollment ID: I20230829001315 |
| Provider Name | Gabriel Dunwoody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215619952 PECOS PAC ID: 6800250556 Enrollment ID: I20230913002145 |
| Provider Name | Parth Rajen Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093344020 PECOS PAC ID: 8921462516 Enrollment ID: I20230914004211 |
| Provider Name | Robert Haake |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659869147 PECOS PAC ID: 5597129106 Enrollment ID: I20230915000740 |
| Provider Name | Chelsea Morgan Nelson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174028518 PECOS PAC ID: 1254673924 Enrollment ID: I20230921002572 |
| Provider Name | Benjamin Aaron Eisenman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508492786 PECOS PAC ID: 2365861283 Enrollment ID: I20230921004148 |
| Provider Name | Kevin Wissinger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558884783 PECOS PAC ID: 3274969548 Enrollment ID: I20230925001801 |
| Provider Name | Stephany Sarmiento |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275161309 PECOS PAC ID: 8628422433 Enrollment ID: I20230928000028 |
| Provider Name | Jennifer Eagle |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710384235 PECOS PAC ID: 9436451747 Enrollment ID: I20231002000396 |
| Provider Name | Mark A Nielsen |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790873164 PECOS PAC ID: 7517988900 Enrollment ID: I20231012000612 |
| Provider Name | Christopher Pugh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1972535698 PECOS PAC ID: 7911977269 Enrollment ID: I20231014000314 |
| Provider Name | Lauren Ann Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982484531 PECOS PAC ID: 0749638807 Enrollment ID: I20231129003268 |
| Provider Name | Maria Gabrielle Dimler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407528284 PECOS PAC ID: 2264820885 Enrollment ID: I20231218002984 |
| Provider Name | Ryan Coram |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194285429 PECOS PAC ID: 9032567078 Enrollment ID: I20231219004199 |
| Provider Name | Stephen R Vijan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1700804168 PECOS PAC ID: 3476524786 Enrollment ID: I20240117000536 |
| Provider Name | Abigail Julia Klein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932888203 PECOS PAC ID: 4183077381 Enrollment ID: I20240124001024 |
| Provider Name | Anthony Lucchese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598537169 PECOS PAC ID: 3678926847 Enrollment ID: I20240124003528 |
| Provider Name | Kristin Alexandria Ellis |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1629472170 PECOS PAC ID: 6507268091 Enrollment ID: I20240318001461 |
| Provider Name | Sajith Foustin Joseph |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013295161 PECOS PAC ID: 6103076294 Enrollment ID: I20240322002756 |
| Provider Name | Melody Dawn Schrock |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1558133876 PECOS PAC ID: 1951843127 Enrollment ID: I20240604002071 |
| Provider Name | Christy Marie Vadakkan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881199040 PECOS PAC ID: 3971942277 Enrollment ID: I20240705001100 |
| Provider Name | Keith J Kincaid |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053817734 PECOS PAC ID: 4587913629 Enrollment ID: I20240716002922 |
| Provider Name | Gabrielle Lafave |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851979728 PECOS PAC ID: 6204244858 Enrollment ID: I20240726003447 |
| Provider Name | Ahmed Khalafalla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043897119 PECOS PAC ID: 4981008703 Enrollment ID: I20240805001037 |
| Provider Name | Rebecca Ashriel Levy-bedoya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558949164 PECOS PAC ID: 9537606439 Enrollment ID: I20240808001878 |
| Provider Name | Angelica Manzolillo Correa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952074189 PECOS PAC ID: 4082080965 Enrollment ID: I20240814000637 |
| Provider Name | Wojciech Roczniak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184205130 PECOS PAC ID: 3678011616 Enrollment ID: I20240821002344 |
| Provider Name | George Khoudari |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578978995 PECOS PAC ID: 4284908682 Enrollment ID: I20240821004906 |
| Provider Name | Mel Timtiman Lizaso |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1215497789 PECOS PAC ID: 0840610390 Enrollment ID: I20240823003602 |
| Provider Name | Christine Juliette Erie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386271542 PECOS PAC ID: 1658702923 Enrollment ID: I20240829004043 |
| Provider Name | Elsa Cassandra Rodriguez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548823487 PECOS PAC ID: 9133450570 Enrollment ID: I20240909001623 |
| Provider Name | Rosetta Marinelli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609443985 PECOS PAC ID: 0244630440 Enrollment ID: I20240909003239 |
| Provider Name | Christine Sun-mi Choi |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1588925408 PECOS PAC ID: 4981995701 Enrollment ID: I20240910000981 |
| Provider Name | Facundo Davaro |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1235670464 PECOS PAC ID: 4880963156 Enrollment ID: I20240910004425 |
| Provider Name | Simeon Walton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851977524 PECOS PAC ID: 5193133171 Enrollment ID: I20240910004552 |
| Provider Name | Alyssa Danielle Allem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881263713 PECOS PAC ID: 1456753011 Enrollment ID: I20240910004755 |
| Provider Name | Sara Margarita Ruiz Aguinaga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306423645 PECOS PAC ID: 8022558469 Enrollment ID: I20240911003931 |
| Provider Name | Amanda Valdes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972189504 PECOS PAC ID: 1052720505 Enrollment ID: I20240926004261 |
| Provider Name | Jorge Rafael Santiago Jordi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851914766 PECOS PAC ID: 6204231541 Enrollment ID: I20240930001336 |
| Provider Name | Rohit Ramasamy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417538711 PECOS PAC ID: 7618376690 Enrollment ID: I20241004000006 |
| Provider Name | Taylor Michele Slown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356189369 PECOS PAC ID: 6103357926 Enrollment ID: I20241004000020 |
| Provider Name | Lorena Carbajal Carballo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871169342 PECOS PAC ID: 5698206241 Enrollment ID: I20241007001886 |
| Provider Name | Mark Alan Molos |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427036797 PECOS PAC ID: 7012821127 Enrollment ID: I20241010003031 |
| Provider Name | Shelby Nicole Heinbaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497584130 PECOS PAC ID: 9638601503 Enrollment ID: I20241016002953 |
| Provider Name | Patrice Cohen |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1023494739 PECOS PAC ID: 1052604535 Enrollment ID: I20241024004436 |
| Provider Name | Diana Rachel Jolles |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1427167600 PECOS PAC ID: 0648223149 Enrollment ID: I20241106001122 |
| Provider Name | Armand Allkanjari |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1427439165 PECOS PAC ID: 7315488897 Enrollment ID: I20241126000481 |
| Provider Name | Susanna Maria Zurecka |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174185706 PECOS PAC ID: 9537495726 Enrollment ID: I20250116003517 |
| Provider Name | Jaime C Lewellyn |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1487064283 PECOS PAC ID: 5395030027 Enrollment ID: I20250121002415 |
| Provider Name | Dixie Bettel Reinoso |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124657200 PECOS PAC ID: 7719318070 Enrollment ID: I20250123003344 |
| Provider Name | Gabriel Decarvalho |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285194720 PECOS PAC ID: 4082948450 Enrollment ID: I20250129001660 |
| Provider Name | Gustavo Bedoya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467039008 PECOS PAC ID: 3870993272 Enrollment ID: I20250129002705 |
| Provider Name | Kelly Ann Brisbin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275359747 PECOS PAC ID: 0840710026 Enrollment ID: I20250218002282 |
| Provider Name | Martha Cristina Sanchez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144481201 PECOS PAC ID: 3375738180 Enrollment ID: I20250219003751 |
| Provider Name | Christian Lopez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083478713 PECOS PAC ID: 1557881265 Enrollment ID: I20250225003146 |
| Provider Name | Paige A Welsh |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1083378889 PECOS PAC ID: 6507387628 Enrollment ID: I20250305003223 |
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