| Mayo Clinic Health System-southwest Wisconsin Region, Inc. | |
|
800 West Avenue South Lacrosse WI 54601 | |
| (608) 392-3861 | |
| (608) 392-9518 |
| Full Name | Mayo Clinic Health System-southwest Wisconsin Region, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 800 West Avenue South, Lacrosse, Wisconsin |
| Authorized Official Name and Position | Mark Bortnem (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7158385270 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mayo Clinic Health System-southwest Wisconsin Region, Inc. Po Box 860056 Minneapolis MN 55486-0056 Ph: (608) 392-6528 | Mayo Clinic Health System-southwest Wisconsin Region, Inc. 800 West Avenue South Lacrosse WI 54601 Ph: (608) 392-3861 |
| NPI Number | 1629056049 |
|---|---|
| Provider Enumeration Date | 01/05/2006 |
| Last Update Date | 01/09/2024 |
| Medicare PECOS PAC ID | 0345152443 |
|---|---|
| Medicare Enrollment ID | O20031110000684 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629056049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Timothy R Cox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891712394 PECOS PAC ID: 2961306964 Enrollment ID: I20031121000304 |
| Provider Name | Peter J Franta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619967155 PECOS PAC ID: 7416857727 Enrollment ID: I20040112000443 |
| Provider Name | Jennifer J Nordstrom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851381354 PECOS PAC ID: 1850292400 Enrollment ID: I20040116000195 |
| Provider Name | Jeffry A Degenhardt |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205826716 PECOS PAC ID: 3274434899 Enrollment ID: I20040116000575 |
| Provider Name | Douglas J Wesely |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1124018635 PECOS PAC ID: 6204720832 Enrollment ID: I20040212000729 |
| Provider Name | Bashar A Omari |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1265592372 PECOS PAC ID: 7416844022 Enrollment ID: I20040228000529 |
| Provider Name | Andrew E Floren |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1013989888 PECOS PAC ID: 1557259306 Enrollment ID: I20040304001126 |
| Provider Name | Willard K Schanhofer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730179862 PECOS PAC ID: 0042100307 Enrollment ID: I20040318001582 |
| Provider Name | Tracy A Warsing |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639156128 PECOS PAC ID: 2567353220 Enrollment ID: I20040323000047 |
| Provider Name | Charles Cagin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720061096 PECOS PAC ID: 6800793290 Enrollment ID: I20040325000969 |
| Provider Name | Daniel Kincaid |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124080403 PECOS PAC ID: 0749273126 Enrollment ID: I20040405000053 |
| Provider Name | Michelle Lee Glenna Rein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477541423 PECOS PAC ID: 7012902893 Enrollment ID: I20040420000380 |
| Provider Name | Gregory Brickner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720059330 PECOS PAC ID: 0941296834 Enrollment ID: I20040424000371 |
| Provider Name | Mark Christian Bildsoe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912978529 PECOS PAC ID: 2567458458 Enrollment ID: I20040424000384 |
| Provider Name | Laura M Damrow |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1457333049 PECOS PAC ID: 5597752964 Enrollment ID: I20040428000132 |
| Provider Name | Laura J Prosperi |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1386625150 PECOS PAC ID: 0648267021 Enrollment ID: I20040428000169 |
| Provider Name | Edward J Wojciechowski |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1558421743 PECOS PAC ID: 3476541087 Enrollment ID: I20040503001519 |
| Provider Name | Dean A Wetzel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053301598 PECOS PAC ID: 2466442397 Enrollment ID: I20040513000983 |
| Provider Name | Lydia F Floren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629057708 PECOS PAC ID: 0941290274 Enrollment ID: I20040517001402 |
| Provider Name | Mary K Christian |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477535086 PECOS PAC ID: 4688664824 Enrollment ID: I20040518000581 |
| Provider Name | Kevin M Fitzgerald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730179243 PECOS PAC ID: 5698753291 Enrollment ID: I20040709001378 |
| Provider Name | Hilary Bingol |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1730299983 PECOS PAC ID: 6507839792 Enrollment ID: I20040816001381 |
| Provider Name | Daniel C Deetz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1699758730 PECOS PAC ID: 6901870138 Enrollment ID: I20040824000454 |
| Provider Name | Kathryn J Reedich |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083831853 PECOS PAC ID: 1951376268 Enrollment ID: I20040831000415 |
| Provider Name | Rebecca K Kearns |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1255313482 PECOS PAC ID: 7214902410 Enrollment ID: I20040831001196 |
| Provider Name | Barbara J Blank |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437134889 PECOS PAC ID: 4789653312 Enrollment ID: I20040929001080 |
| Provider Name | Sue E Wilson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528042322 PECOS PAC ID: 2860461498 Enrollment ID: I20040929001096 |
| Provider Name | Barbara Helgeson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336126135 PECOS PAC ID: 8123097714 Enrollment ID: I20040930000184 |
| Provider Name | Sandra J Eckstein Culver |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1205803277 PECOS PAC ID: 9638148224 Enrollment ID: I20040930000200 |
| Provider Name | Christine R Alioto |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942284641 PECOS PAC ID: 1951370568 Enrollment ID: I20040930000336 |
| Provider Name | Stacey Ansay Sjoquist |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790769404 PECOS PAC ID: 3375512981 Enrollment ID: I20040930000373 |
| Provider Name | Scott Jeffrey Cole |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124099551 PECOS PAC ID: 6608845177 Enrollment ID: I20040930000947 |
| Provider Name | Kolette E Paulson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1295719003 PECOS PAC ID: 8820057300 Enrollment ID: I20041008001205 |
| Provider Name | Marilyn A Goltz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700860590 PECOS PAC ID: 3274593694 Enrollment ID: I20041012000051 |
| Provider Name | Mary L Lokken |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750365466 PECOS PAC ID: 3971563396 Enrollment ID: I20041012000074 |
| Provider Name | Jeff C Legler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1225012925 PECOS PAC ID: 9133189558 Enrollment ID: I20041012000094 |
| Provider Name | Lisa A Morgan |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336124759 PECOS PAC ID: 2365402583 Enrollment ID: I20041013000022 |
| Provider Name | Caroline A Fisher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992787584 PECOS PAC ID: 5597725754 Enrollment ID: I20041013000362 |
| Provider Name | Kimberly A Whitford |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467436287 PECOS PAC ID: 3476514894 Enrollment ID: I20041020000063 |
| Provider Name | Joy E Steinback |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619951423 PECOS PAC ID: 4981665221 Enrollment ID: I20041020001138 |
| Provider Name | Mary S Alvarado |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962404194 PECOS PAC ID: 8325000672 Enrollment ID: I20041029000580 |
| Provider Name | Cheryl A Bihn |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1871576017 PECOS PAC ID: 8426010604 Enrollment ID: I20041029000929 |
| Provider Name | Kelli K Welper |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1386628089 PECOS PAC ID: 0345204061 Enrollment ID: I20041112000824 |
| Provider Name | Bradley J Lassa |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174505606 PECOS PAC ID: 9032176920 Enrollment ID: I20041213000416 |
| Provider Name | Michael C Stephens |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932153830 PECOS PAC ID: 5193782365 Enrollment ID: I20041220000524 |
| Provider Name | Christina Stanga |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1073502555 PECOS PAC ID: 7911955745 Enrollment ID: I20050110000021 |
| Provider Name | Jann N Sarkaria |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1225018419 PECOS PAC ID: 5799733234 Enrollment ID: I20050111000557 |
| Provider Name | Mauricio Infante |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003875568 PECOS PAC ID: 1456305978 Enrollment ID: I20050308000934 |
| Provider Name | Shoaib A Naseem |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558322164 PECOS PAC ID: 5496709453 Enrollment ID: I20050311000659 |
| Provider Name | Carmen M Dargel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194715698 PECOS PAC ID: 9830145739 Enrollment ID: I20050323001223 |
| Provider Name | Thomas K Marquardt |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1841245131 PECOS PAC ID: 7810975968 Enrollment ID: I20050324000358 |
| Provider Name | Marisa A Baorto |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588647291 PECOS PAC ID: 5092616383 Enrollment ID: I20050601000751 |
| Provider Name | David Rushlow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790775294 PECOS PAC ID: 8022051408 Enrollment ID: I20050607000286 |
| Provider Name | Kathryn E Mccabe |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154305860 PECOS PAC ID: 4284678160 Enrollment ID: I20050613000071 |
| Provider Name | Mark C Jungck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396735809 PECOS PAC ID: 9739110933 Enrollment ID: I20050827000090 |
| Provider Name | Peter J Schams |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760473714 PECOS PAC ID: 0345272225 Enrollment ID: I20050831000784 |
| Provider Name | Mark E. Deyo-svendsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124077839 PECOS PAC ID: 3870538242 Enrollment ID: I20050930000258 |
| Provider Name | Janet W Butler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679510507 PECOS PAC ID: 8628003159 Enrollment ID: I20051003000828 |
| Provider Name | Kim M Minnaert |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548251945 PECOS PAC ID: 4789619263 Enrollment ID: I20051004000349 |
| Provider Name | Lyndon S. Larkin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447232921 PECOS PAC ID: 9739114224 Enrollment ID: I20051004000399 |
| Provider Name | Thomas E Boulden |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1427052182 PECOS PAC ID: 0840217113 Enrollment ID: I20051026000371 |
| Provider Name | Jill Depke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275631558 PECOS PAC ID: 6608895594 Enrollment ID: I20051121000659 |
| Provider Name | Daniel C Maccharles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205839198 PECOS PAC ID: 2163442625 Enrollment ID: I20051129000462 |
| Provider Name | Lance W. Weagant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881671790 PECOS PAC ID: 7012937550 Enrollment ID: I20051129001081 |
| Provider Name | Edward J Malone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194786673 PECOS PAC ID: 0941229496 Enrollment ID: I20051208000332 |
| Provider Name | Craig S Bennett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073571444 PECOS PAC ID: 5092729145 Enrollment ID: I20060127000781 |
| Provider Name | Richard Hanna |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598727877 PECOS PAC ID: 7416962709 Enrollment ID: I20060207000955 |
| Provider Name | Renee F Thies |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598744666 PECOS PAC ID: 4183663123 Enrollment ID: I20060213000169 |
| Provider Name | Win C Hlaing |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912975392 PECOS PAC ID: 2860383981 Enrollment ID: I20060322000162 |
| Provider Name | Jennifer Koch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912088899 PECOS PAC ID: 9931117389 Enrollment ID: I20060328000185 |
| Provider Name | David K De Dianous |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1386695815 PECOS PAC ID: 6406864396 Enrollment ID: I20060404000525 |
| Provider Name | Carl H Rose |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780662114 PECOS PAC ID: 8628014156 Enrollment ID: I20060405000288 |
| Provider Name | Angela Marie Roethel |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1548455579 PECOS PAC ID: 8123037280 Enrollment ID: I20060418000460 |
| Provider Name | Jenny L Prinsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245207786 PECOS PAC ID: 8325058258 Enrollment ID: I20060421000426 |
| Provider Name | Thomas T Carmody |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1831151133 PECOS PAC ID: 4385657311 Enrollment ID: I20060717000166 |
| Provider Name | Steven W Schreiter |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1790747087 PECOS PAC ID: 2860405818 Enrollment ID: I20060717000334 |
| Provider Name | Thomas Cunningham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275550881 PECOS PAC ID: 5799677407 Enrollment ID: I20060810000224 |
| Provider Name | Umesh M Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285645168 PECOS PAC ID: 8921002247 Enrollment ID: I20060829000225 |
| Provider Name | Robert J Wiechmann |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1659333953 PECOS PAC ID: 5890799001 Enrollment ID: I20060830000541 |
| Provider Name | Suhail Shuja |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1982654851 PECOS PAC ID: 9234133117 Enrollment ID: I20060907000289 |
| Provider Name | James C Nesler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255342119 PECOS PAC ID: 9133123912 Enrollment ID: I20060911000063 |
| Provider Name | Connie C Schuh |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1295843332 PECOS PAC ID: 6901801604 Enrollment ID: I20061003000222 |
| Provider Name | Margaret M Grenisen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447231766 PECOS PAC ID: 3274530878 Enrollment ID: I20061024000297 |
| Provider Name | Mandeep Singh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740261841 PECOS PAC ID: 2264431113 Enrollment ID: I20061204000440 |
| Provider Name | Alfred E Oyler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1811072879 PECOS PAC ID: 0042219461 Enrollment ID: I20061213000230 |
| Provider Name | Rick W Stoughton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457311599 PECOS PAC ID: 5799785457 Enrollment ID: I20070102000288 |
| Provider Name | Vinay S Naik |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1255396503 PECOS PAC ID: 5395747992 Enrollment ID: I20070212000192 |
| Provider Name | Allison K Cabalka |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720065220 PECOS PAC ID: 6800999079 Enrollment ID: I20070328000101 |
| Provider Name | John J Poterucha |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1083689475 PECOS PAC ID: 4486681483 Enrollment ID: I20070410000023 |
| Provider Name | Anthony A Stans |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417929001 PECOS PAC ID: 7618929472 Enrollment ID: I20070416000520 |
| Provider Name | James P Mannion |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346238391 PECOS PAC ID: 8628173655 Enrollment ID: I20070419000081 |
| Provider Name | Genci Babameto |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841264702 PECOS PAC ID: 0749388130 Enrollment ID: I20070608000095 |
| Provider Name | Janel N Glantz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154307395 PECOS PAC ID: 7012816713 Enrollment ID: I20070822000354 |
| Provider Name | Christopher W Lindsay |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104899822 PECOS PAC ID: 4284535113 Enrollment ID: I20070907000044 |
| Provider Name | Deaglan F Ocochlain |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1982677274 PECOS PAC ID: 4385532803 Enrollment ID: I20070927000480 |
| Provider Name | Gokhan Anil |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902928153 PECOS PAC ID: 6305931395 Enrollment ID: I20071005000353 |
| Provider Name | Jon P Heiderscheit |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467536524 PECOS PAC ID: 6305930496 Enrollment ID: I20071026000669 |
| Provider Name | Dennis T Costakos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588654081 PECOS PAC ID: 3072693241 Enrollment ID: I20071231000454 |
| Provider Name | Petra Nedoba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912117896 PECOS PAC ID: 4789764655 Enrollment ID: I20080104000112 |
| Provider Name | Jodi R Breska |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952382053 PECOS PAC ID: 4385725688 Enrollment ID: I20080111000761 |
| Provider Name | Theresa M Hagen |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1356463053 PECOS PAC ID: 7416030648 Enrollment ID: I20080212000268 |
| Provider Name | James A Ottevaere |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356343107 PECOS PAC ID: 7315846094 Enrollment ID: I20080229000299 |
| Provider Name | Evie L Christensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578623831 PECOS PAC ID: 2668574476 Enrollment ID: I20080314000573 |
| Provider Name | James J Schuh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487713533 PECOS PAC ID: 7214998475 Enrollment ID: I20080321000209 |
| Provider Name | Evan R Nelson |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1154323467 PECOS PAC ID: 4183674799 Enrollment ID: I20080326000929 |
| Provider Name | Kathy L Errthum |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1326243445 PECOS PAC ID: 6901998368 Enrollment ID: I20080501000180 |
| Provider Name | Raymond D Pollock |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023177722 PECOS PAC ID: 3870571276 Enrollment ID: I20080520000702 |
| Provider Name | Nadia N Laack |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1710966999 PECOS PAC ID: 4284623893 Enrollment ID: I20081001000478 |
| Provider Name | Amye J. Tevaarwerk |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1306879028 PECOS PAC ID: 7113095365 Enrollment ID: I20081001000539 |
| Provider Name | Emma J Banwart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306036009 PECOS PAC ID: 5698843381 Enrollment ID: I20081008000289 |
| Provider Name | Grace A Skiles |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316146814 PECOS PAC ID: 7416016860 Enrollment ID: I20081030000451 |
| Provider Name | Amanda J Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730335365 PECOS PAC ID: 6406915396 Enrollment ID: I20081106000764 |
| Provider Name | Yolanda I Garces |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1871571653 PECOS PAC ID: 0840359634 Enrollment ID: I20081107000703 |
| Provider Name | Paul Raymond Horvath |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912029141 PECOS PAC ID: 8527169481 Enrollment ID: I20081112000731 |
| Provider Name | Jane M Korducki |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1356339535 PECOS PAC ID: 1557421013 Enrollment ID: I20081114000045 |
| Provider Name | John F Bresnahan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770569683 PECOS PAC ID: 8224199120 Enrollment ID: I20081210000824 |
| Provider Name | Kristine K Brueggen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538107982 PECOS PAC ID: 9931261328 Enrollment ID: I20081218000493 |
| Provider Name | Caroline G Clune |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336286236 PECOS PAC ID: 8527090661 Enrollment ID: I20090211000563 |
| Provider Name | Richard W Rogge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386660488 PECOS PAC ID: 9032010483 Enrollment ID: I20090303000125 |
| Provider Name | Sanda A Cepoi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306837919 PECOS PAC ID: 5597821322 Enrollment ID: I20090303000666 |
| Provider Name | Jeremy L Fogelson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1871565606 PECOS PAC ID: 2163444076 Enrollment ID: I20090318000162 |
| Provider Name | Stephanie M Skogen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659511525 PECOS PAC ID: 1153478714 Enrollment ID: I20090416000602 |
| Provider Name | Stacy L Blackburn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952551525 PECOS PAC ID: 2961550793 Enrollment ID: I20090504000587 |
| Provider Name | Michael J Fitzgerald |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1467412999 PECOS PAC ID: 8022167527 Enrollment ID: I20090512000407 |
| Provider Name | Steven K Perkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235146440 PECOS PAC ID: 5991705063 Enrollment ID: I20090514000493 |
| Provider Name | John M Merfeld |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578550281 PECOS PAC ID: 2264493485 Enrollment ID: I20090519000331 |
| Provider Name | Kathryn M Moen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215915970 PECOS PAC ID: 1052460862 Enrollment ID: I20090604000482 |
| Provider Name | David J Rea |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245218692 PECOS PAC ID: 8921150665 Enrollment ID: I20090710000259 |
| Provider Name | Felix Chukwudelunzu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568435071 PECOS PAC ID: 0547301913 Enrollment ID: I20100107000136 |
| Provider Name | Scott A Tober |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235462995 PECOS PAC ID: 2466594288 Enrollment ID: I20100116000122 |
| Provider Name | Robert C Rosenthal |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609109362 PECOS PAC ID: 1456493279 Enrollment ID: I20100116000134 |
| Provider Name | Todd C Phillips |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538161773 PECOS PAC ID: 2961545611 Enrollment ID: I20100203000902 |
| Provider Name | Jennifer R. Kaus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720314230 PECOS PAC ID: 9032253638 Enrollment ID: I20100220000098 |
| Provider Name | Mark R Beahm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689908360 PECOS PAC ID: 0446394076 Enrollment ID: I20100222000038 |
| Provider Name | Monique Freund |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053390526 PECOS PAC ID: 2860461779 Enrollment ID: I20100224000844 |
| Provider Name | Jessica J Peterson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235466319 PECOS PAC ID: 4486799020 Enrollment ID: I20100306000163 |
| Provider Name | Gretchen P Kelly |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1538159041 PECOS PAC ID: 1759416027 Enrollment ID: I20100312000253 |
| Provider Name | Mark R Brumm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780674283 PECOS PAC ID: 0143355834 Enrollment ID: I20100319000609 |
| Provider Name | David Dehart |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912997438 PECOS PAC ID: 5991832941 Enrollment ID: I20100422000480 |
| Provider Name | Joseph S Krien |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871575464 PECOS PAC ID: 0941370100 Enrollment ID: I20100422000504 |
| Provider Name | Erin M Pokorny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407838097 PECOS PAC ID: 9234266230 Enrollment ID: I20100423000014 |
| Provider Name | John W Cochran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982685202 PECOS PAC ID: 5991834301 Enrollment ID: I20100525000632 |
| Provider Name | Martha C Binn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306836812 PECOS PAC ID: 2961531256 Enrollment ID: I20100525000661 |
| Provider Name | Michael A Schultz |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1245220748 PECOS PAC ID: 2062541261 Enrollment ID: I20100526000945 |
| Provider Name | Nancy E Wetzel |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1922099050 PECOS PAC ID: 4385773498 Enrollment ID: I20100528000268 |
| Provider Name | Richard L Ellis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447255500 PECOS PAC ID: 6305749706 Enrollment ID: I20100607000650 |
| Provider Name | Charles P Nolte |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972593481 PECOS PAC ID: 5395875538 Enrollment ID: I20100614000784 |
| Provider Name | Sarah T Trane |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902846744 PECOS PAC ID: 7517097637 Enrollment ID: I20100615000808 |
| Provider Name | Jennifer L Brumm |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942290457 PECOS PAC ID: 1153451174 Enrollment ID: I20100617000194 |
| Provider Name | Douglas R Nelson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356331862 PECOS PAC ID: 7214067206 Enrollment ID: I20100618000144 |
| Provider Name | Jonathan J Uy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467434985 PECOS PAC ID: 0143223834 Enrollment ID: I20100618000662 |
| Provider Name | Jeffrey S Cavaness |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386634889 PECOS PAC ID: 1355471285 Enrollment ID: I20100618000707 |
| Provider Name | Rodney A Erickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528058021 PECOS PAC ID: 1850421785 Enrollment ID: I20100618000764 |
| Provider Name | Paul Edward Molling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487642674 PECOS PAC ID: 0840360004 Enrollment ID: I20100618000780 |
| Provider Name | Annette Faller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295730257 PECOS PAC ID: 5799816609 Enrollment ID: I20100621000739 |
| Provider Name | Michael C Stark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649260779 PECOS PAC ID: 0143351734 Enrollment ID: I20100625000448 |
| Provider Name | Patrick D Conway |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1841295102 PECOS PAC ID: 4284765736 Enrollment ID: I20100626000435 |
| Provider Name | Timothy J Buckley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578547493 PECOS PAC ID: 9931230422 Enrollment ID: I20100628000277 |
| Provider Name | Steven A Bowman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851374284 PECOS PAC ID: 2567593056 Enrollment ID: I20100628000294 |
| Provider Name | Nancy L Erickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457341992 PECOS PAC ID: 3971555335 Enrollment ID: I20100628000319 |
| Provider Name | Robert T Key |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801886312 PECOS PAC ID: 5597896860 Enrollment ID: I20100630000493 |
| Provider Name | Angus Scott Marshall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962483065 PECOS PAC ID: 6002877040 Enrollment ID: I20100702000202 |
| Provider Name | Anthony M Jarrett |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1033109541 PECOS PAC ID: 1456483452 Enrollment ID: I20100709000048 |
| Provider Name | Lori A Devine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770564874 PECOS PAC ID: 1052444668 Enrollment ID: I20100803000994 |
| Provider Name | Cindy J Glennie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639151889 PECOS PAC ID: 5799819512 Enrollment ID: I20100816001023 |
| Provider Name | Alice M Bachop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164400503 PECOS PAC ID: 5991839631 Enrollment ID: I20100817000111 |
| Provider Name | Thomas Roy |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740382688 PECOS PAC ID: 5395879043 Enrollment ID: I20100817000341 |
| Provider Name | Mark K Stevens |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1568443661 PECOS PAC ID: 4981603404 Enrollment ID: I20100817001496 |
| Provider Name | Cynthia A Dooley Pehler |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1962483578 PECOS PAC ID: 9739213364 Enrollment ID: I20100910000986 |
| Provider Name | Joerg Herrmann |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295713253 PECOS PAC ID: 0042232282 Enrollment ID: I20100916001273 |
| Provider Name | Aaron T Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316156227 PECOS PAC ID: 7315019718 Enrollment ID: I20100918000112 |
| Provider Name | Abigail K Deyo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447461025 PECOS PAC ID: 0345366480 Enrollment ID: I20100927000975 |
| Provider Name | Rayna M Grothe |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346210572 PECOS PAC ID: 4183518780 Enrollment ID: I20101005000630 |
| Provider Name | Michael S Meyers |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962485854 PECOS PAC ID: 2163483884 Enrollment ID: I20101015000610 |
| Provider Name | Daniel R Lenselink |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518957018 PECOS PAC ID: 5698969822 Enrollment ID: I20101102000648 |
| Provider Name | Dana Rademacher |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033100086 PECOS PAC ID: 9234323312 Enrollment ID: I20101102001457 |
| Provider Name | Robert J Freedland |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1376534958 PECOS PAC ID: 3779777859 Enrollment ID: I20101102001477 |
| Provider Name | Brian K Larsen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790776383 PECOS PAC ID: 2860686953 Enrollment ID: I20101102001490 |
| Provider Name | Anna Kathryn Olson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1790992295 PECOS PAC ID: 7214122050 Enrollment ID: I20101105001271 |
| Provider Name | Cheri L Olson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134119621 PECOS PAC ID: 2769507961 Enrollment ID: I20101109000257 |
| Provider Name | Thomas S Stoa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659361152 PECOS PAC ID: 1254339260 Enrollment ID: I20101110000756 |
| Provider Name | Janet R Papenfuss |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1538144985 PECOS PAC ID: 6204021165 Enrollment ID: I20101117000818 |
| Provider Name | Michael J Rogge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023008539 PECOS PAC ID: 1658566542 Enrollment ID: I20101117001245 |
| Provider Name | Joseph R Behn |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1336474105 PECOS PAC ID: 4284820671 Enrollment ID: I20101124000636 |
| Provider Name | Patrick W O'leary |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881672632 PECOS PAC ID: 1254425010 Enrollment ID: I20101130000854 |
| Provider Name | Anna M Kemp |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1356575336 PECOS PAC ID: 2264587377 Enrollment ID: I20101201000138 |
| Provider Name | James L Leenstra |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1174593982 PECOS PAC ID: 4284649120 Enrollment ID: I20101214000881 |
| Provider Name | Susan G Maclellan-tobert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952304834 PECOS PAC ID: 0941498984 Enrollment ID: I20101217000352 |
| Provider Name | Janice A Schreier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104063486 PECOS PAC ID: 6901953462 Enrollment ID: I20110103000992 |
| Provider Name | Anthony W Deuster |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1215967492 PECOS PAC ID: 8729267596 Enrollment ID: I20110125001212 |
| Provider Name | Zane P Forbes |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922238153 PECOS PAC ID: 3375722085 Enrollment ID: I20110127000460 |
| Provider Name | Rhonda Heun |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306840988 PECOS PAC ID: 4082893706 Enrollment ID: I20110127000615 |
| Provider Name | Jennifer Y Mcelroy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972540086 PECOS PAC ID: 0446259378 Enrollment ID: I20110203001004 |
| Provider Name | Bryan C Cannon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942380373 PECOS PAC ID: 2163592619 Enrollment ID: I20110207000558 |
| Provider Name | Kimberly A Schwabenbauer |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1740265198 PECOS PAC ID: 2668652603 Enrollment ID: I20110209000314 |
| Provider Name | Michelle A Neben Wittich |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1215914783 PECOS PAC ID: 8820069339 Enrollment ID: I20110216000131 |
| Provider Name | Derrick L Woodward |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487989125 PECOS PAC ID: 2769663897 Enrollment ID: I20110223000402 |
| Provider Name | Johan C Bakken |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093841843 PECOS PAC ID: 0840366894 Enrollment ID: I20110310000550 |
| Provider Name | Beau Q Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316029358 PECOS PAC ID: 7719161371 Enrollment ID: I20110406000846 |
| Provider Name | Catherine A Ziegler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013214717 PECOS PAC ID: 2860676970 Enrollment ID: I20110414000622 |
| Provider Name | Kymberly D Watt |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114939113 PECOS PAC ID: 2365445723 Enrollment ID: I20110622000732 |
| Provider Name | Vishnu V Patlolla |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1720187933 PECOS PAC ID: 3173616547 Enrollment ID: I20110706000326 |
| Provider Name | Stephanie R Niec |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619141785 PECOS PAC ID: 2860661261 Enrollment ID: I20110801000428 |
| Provider Name | Westley T Manske |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1477750362 PECOS PAC ID: 8325112899 Enrollment ID: I20110818000673 |
| Provider Name | Vien Le |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245406313 PECOS PAC ID: 2163693763 Enrollment ID: I20110912000082 |
| Provider Name | Eric Grube |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255530283 PECOS PAC ID: 8426239849 Enrollment ID: I20110920000368 |
| Provider Name | Jennifer Althoff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073545729 PECOS PAC ID: 6507934585 Enrollment ID: I20110921000508 |
| Provider Name | Christopher N Deyo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295770014 PECOS PAC ID: 6103097217 Enrollment ID: I20110921000819 |
| Provider Name | Casandra L Grube |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033319694 PECOS PAC ID: 8527251214 Enrollment ID: I20110928000339 |
| Provider Name | Marvelene Casner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033151220 PECOS PAC ID: 2365455755 Enrollment ID: I20111007000196 |
| Provider Name | Jessica Sosso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205042199 PECOS PAC ID: 1052482312 Enrollment ID: I20111010000228 |
| Provider Name | Michelle L Dahl |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184906166 PECOS PAC ID: 3476725243 Enrollment ID: I20111020000740 |
| Provider Name | Matthew P Roth |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841573482 PECOS PAC ID: 8820261506 Enrollment ID: I20111025000073 |
| Provider Name | Mindy Zenke |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1124308416 PECOS PAC ID: 6305019068 Enrollment ID: I20111026000116 |
| Provider Name | Cole B Dolan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245511682 PECOS PAC ID: 1456524123 Enrollment ID: I20111026000293 |
| Provider Name | Colleen P Teynor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386922144 PECOS PAC ID: 3577736149 Enrollment ID: I20111026000410 |
| Provider Name | Jonathan N Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285648899 PECOS PAC ID: 0446253470 Enrollment ID: I20111103000894 |
| Provider Name | Heather M Mpemwangi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710269667 PECOS PAC ID: 1557534526 Enrollment ID: I20111108000336 |
| Provider Name | Jena K Casper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154605376 PECOS PAC ID: 0749453736 Enrollment ID: I20111108000606 |
| Provider Name | Natalie J Gadient |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841572849 PECOS PAC ID: 8224201157 Enrollment ID: I20111109000333 |
| Provider Name | Joliene K Kues |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659426120 PECOS PAC ID: 1052313509 Enrollment ID: I20111219000802 |
| Provider Name | Nadim Salfiti |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194879262 PECOS PAC ID: 8628251568 Enrollment ID: I20120127000492 |
| Provider Name | Carol J Sobkowiak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669759429 PECOS PAC ID: 6103092630 Enrollment ID: I20120214000392 |
| Provider Name | Romi M Londre |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487936746 PECOS PAC ID: 3173781986 Enrollment ID: I20120224000818 |
| Provider Name | Meghan E Teska |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1821378332 PECOS PAC ID: 1254590060 Enrollment ID: I20120314000805 |
| Provider Name | Mitchell J Nesvik |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417253451 PECOS PAC ID: 7517140825 Enrollment ID: I20120327000765 |
| Provider Name | Bethany L Carlson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1457623423 PECOS PAC ID: 0941463889 Enrollment ID: I20120514000016 |
| Provider Name | Matthew A Sherrill |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1972722247 PECOS PAC ID: 2567649593 Enrollment ID: I20120627000192 |
| Provider Name | Michel K Barsoum |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215920483 PECOS PAC ID: 0547225716 Enrollment ID: I20120705000154 |
| Provider Name | Heather S Rabe |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629039540 PECOS PAC ID: 8628233020 Enrollment ID: I20120710000744 |
| Provider Name | Shahyar M Gharacholou |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477752715 PECOS PAC ID: 2567436157 Enrollment ID: I20120815000616 |
| Provider Name | Amy A Lloyd |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821305301 PECOS PAC ID: 3577710862 Enrollment ID: I20120821000711 |
| Provider Name | Dawn M Ortiz |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699035352 PECOS PAC ID: 2466600804 Enrollment ID: I20120910000783 |
| Provider Name | Patrick C Park |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1912169574 PECOS PAC ID: 7719135987 Enrollment ID: I20120912000646 |
| Provider Name | Anna P Duggan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780939512 PECOS PAC ID: 7618125477 Enrollment ID: I20120919000839 |
| Provider Name | David P Hubbard |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992934517 PECOS PAC ID: 7315195922 Enrollment ID: I20120924000165 |
| Provider Name | Alayna M Ruhbusch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366790511 PECOS PAC ID: 2860642006 Enrollment ID: I20121023000823 |
| Provider Name | Hans E Von Weiss |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1689667313 PECOS PAC ID: 3678510229 Enrollment ID: I20121029000754 |
| Provider Name | James H Bower |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730166513 PECOS PAC ID: 9830231588 Enrollment ID: I20121108000241 |
| Provider Name | Jason Harden Berg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992080246 PECOS PAC ID: 0941458392 Enrollment ID: I20121112000605 |
| Provider Name | Jennifer H Meyers |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1649471079 PECOS PAC ID: 2961585708 Enrollment ID: I20121112000722 |
| Provider Name | Kathleen Marie Grangaard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023398971 PECOS PAC ID: 4688845787 Enrollment ID: I20121126000383 |
| Provider Name | Brian A Crum |
|---|---|
| Provider Type | Practitioner - Neuropsychiatry |
| Provider Identifiers | NPI Number: 1558332163 PECOS PAC ID: 5395888259 Enrollment ID: I20121206000033 |
| Provider Name | Roxanne Grosskopf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417205451 PECOS PAC ID: 6901059617 Enrollment ID: I20130109000081 |
| Provider Name | Misty M Watters |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1720286784 PECOS PAC ID: 5395998751 Enrollment ID: I20130219000454 |
| Provider Name | Sarah E Gossett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508105495 PECOS PAC ID: 5193960011 Enrollment ID: I20130326000192 |
| Provider Name | Julie E Dewitt |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043346091 PECOS PAC ID: 3971749821 Enrollment ID: I20130418000523 |
| Provider Name | Raj Palraj |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1225203201 PECOS PAC ID: 7517090079 Enrollment ID: I20130419000170 |
| Provider Name | Ala S Dababneh |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1205032562 PECOS PAC ID: 2961696075 Enrollment ID: I20130419000199 |
| Provider Name | Katherine Crowley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1669717112 PECOS PAC ID: 4183860794 Enrollment ID: I20130425000659 |
| Provider Name | Susan E Otterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578588547 PECOS PAC ID: 0143329664 Enrollment ID: I20130523000064 |
| Provider Name | Zachary C Wilson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1265669980 PECOS PAC ID: 1254456064 Enrollment ID: I20130607000226 |
| Provider Name | Lee H Eckstein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619176187 PECOS PAC ID: 6002056801 Enrollment ID: I20130627000700 |
| Provider Name | Leighann M Gooden |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1174764682 PECOS PAC ID: 1254506991 Enrollment ID: I20130702000336 |
| Provider Name | Sebastian Strobel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346444759 PECOS PAC ID: 7517108426 Enrollment ID: I20130718000354 |
| Provider Name | Tara L Wilde |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1902152705 PECOS PAC ID: 3971744558 Enrollment ID: I20130724000299 |
| Provider Name | Jeremy F Mcbride |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1093905861 PECOS PAC ID: 7618044298 Enrollment ID: I20130725000875 |
| Provider Name | Raymund R Razonable |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1750351805 PECOS PAC ID: 5799814141 Enrollment ID: I20130802000206 |
| Provider Name | Abinash Virk |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1588644777 PECOS PAC ID: 0941343487 Enrollment ID: I20130802000670 |
| Provider Name | Carrie L Kern |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013233709 PECOS PAC ID: 5991976375 Enrollment ID: I20130806000491 |
| Provider Name | Brian L Withers |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1548464902 PECOS PAC ID: 9931349123 Enrollment ID: I20130808000251 |
| Provider Name | Denise J Grabowski |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992755185 PECOS PAC ID: 2567404007 Enrollment ID: I20130926000072 |
| Provider Name | Anna M Ryan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1437133964 PECOS PAC ID: 7719954502 Enrollment ID: I20130927000278 |
| Provider Name | Katherine N Eckstein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275797813 PECOS PAC ID: 3476727637 Enrollment ID: I20131004000249 |
| Provider Name | Renee S Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174958045 PECOS PAC ID: 6608001813 Enrollment ID: I20131024000505 |
| Provider Name | Cydney T Parker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1831161025 PECOS PAC ID: 2264400894 Enrollment ID: I20131024001460 |
| Provider Name | Lori L Greiner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972935997 PECOS PAC ID: 6103051354 Enrollment ID: I20131024001724 |
| Provider Name | Jonathan Ticku |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1922259589 PECOS PAC ID: 0446407712 Enrollment ID: I20131025000355 |
| Provider Name | Michelle M Frischmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376978775 PECOS PAC ID: 2769618909 Enrollment ID: I20131119000205 |
| Provider Name | Carl H Cramer |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1659392652 PECOS PAC ID: 5597768010 Enrollment ID: I20131211000240 |
| Provider Name | Katarzyna Luce |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902104102 PECOS PAC ID: 4981832698 Enrollment ID: I20131231001683 |
| Provider Name | Siobhan T Pittock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043282296 PECOS PAC ID: 6709884778 Enrollment ID: I20140115001140 |
| Provider Name | Torben H Larsen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801162011 PECOS PAC ID: 1355578261 Enrollment ID: I20140326000769 |
| Provider Name | Theresa J Wytaske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043634496 PECOS PAC ID: 9739310962 Enrollment ID: I20140401000298 |
| Provider Name | Sean S Park |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1447464078 PECOS PAC ID: 5890964787 Enrollment ID: I20140401001750 |
| Provider Name | Robert C Albright |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1417934738 PECOS PAC ID: 0749217768 Enrollment ID: I20140509001046 |
| Provider Name | Matthew R Evensen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093081200 PECOS PAC ID: 1850528662 Enrollment ID: I20140520001429 |
| Provider Name | Kaitlin S Earley |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1225295736 PECOS PAC ID: 1153544697 Enrollment ID: I20140602000612 |
| Provider Name | Kathleen A Hughes-kuda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1518022748 PECOS PAC ID: 7113162041 Enrollment ID: I20140604001511 |
| Provider Name | Kylee Anglemyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497166995 PECOS PAC ID: 9537383823 Enrollment ID: I20140605002038 |
| Provider Name | Christen Chamberland |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194984716 PECOS PAC ID: 7416171624 Enrollment ID: I20140610000049 |
| Provider Name | Tiffany Casper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407297575 PECOS PAC ID: 9931324027 Enrollment ID: I20140703000683 |
| Provider Name | Mackram F Eleid |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164451241 PECOS PAC ID: 5395822647 Enrollment ID: I20140721001529 |
| Provider Name | Jeffrey L Wiswell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245551001 PECOS PAC ID: 2466625595 Enrollment ID: I20140721002284 |
| Provider Name | Sasha J Schrunk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780901512 PECOS PAC ID: 8325286420 Enrollment ID: I20140728001478 |
| Provider Name | Grace Lin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285608547 PECOS PAC ID: 8426008061 Enrollment ID: I20140805000458 |
| Provider Name | Allan Jaffe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538146626 PECOS PAC ID: 8426192147 Enrollment ID: I20140820000374 |
| Provider Name | R Scott Wright |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558333922 PECOS PAC ID: 8325141948 Enrollment ID: I20140821001800 |
| Provider Name | Theodore W Vanderhorst |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336468362 PECOS PAC ID: 2567603178 Enrollment ID: I20140911000334 |
| Provider Name | Frank Cetta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306822549 PECOS PAC ID: 9931008570 Enrollment ID: I20140912000711 |
| Provider Name | Benjamin W Eidem |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306869433 PECOS PAC ID: 5496641052 Enrollment ID: I20140912000923 |
| Provider Name | Farris K Timimi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063483436 PECOS PAC ID: 5698717643 Enrollment ID: I20140912001133 |
| Provider Name | Nathaniel W Taggart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073593877 PECOS PAC ID: 9133158058 Enrollment ID: I20140912001347 |
| Provider Name | Lisa C Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194888222 PECOS PAC ID: 5698934164 Enrollment ID: I20140915000918 |
| Provider Name | Bridget L Moellers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952676710 PECOS PAC ID: 6204056971 Enrollment ID: I20140930002659 |
| Provider Name | Arik C Brye |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154646891 PECOS PAC ID: 8325270853 Enrollment ID: I20141002002396 |
| Provider Name | Chelsea M Ale |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831452069 PECOS PAC ID: 4587885389 Enrollment ID: I20141027002025 |
| Provider Name | David M Valencia |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841482866 PECOS PAC ID: 1153571351 Enrollment ID: I20141028000223 |
| Provider Name | Crystal R Bonnichsen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730151259 PECOS PAC ID: 5294750063 Enrollment ID: I20141105000895 |
| Provider Name | Titus C Evans |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437137213 PECOS PAC ID: 7214071935 Enrollment ID: I20141108000171 |
| Provider Name | Jenna K Sebranek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467895136 PECOS PAC ID: 3173745015 Enrollment ID: I20141110002109 |
| Provider Name | Matthew N Walker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285037523 PECOS PAC ID: 1456573302 Enrollment ID: I20141110002479 |
| Provider Name | Laura Stussy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730588914 PECOS PAC ID: 0648492280 Enrollment ID: I20141114000527 |
| Provider Name | Maseray Bangura |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1194038778 PECOS PAC ID: 2961624200 Enrollment ID: I20141120002354 |
| Provider Name | Rebecca A Scarseth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497075576 PECOS PAC ID: 3476795675 Enrollment ID: I20141203001349 |
| Provider Name | Erin F Morcomb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013350859 PECOS PAC ID: 4082936885 Enrollment ID: I20141205001325 |
| Provider Name | Gabriel T Berendes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013250653 PECOS PAC ID: 9739401563 Enrollment ID: I20141206000437 |
| Provider Name | Katherine M Jacobsen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730452046 PECOS PAC ID: 5698937456 Enrollment ID: I20141210000961 |
| Provider Name | Matthew E Mogensen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467877977 PECOS PAC ID: 1850524828 Enrollment ID: I20141211001860 |
| Provider Name | Katie A Lindahl |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679846869 PECOS PAC ID: 3375707839 Enrollment ID: I20141211001894 |
| Provider Name | Rosalie Jb Ivers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801861695 PECOS PAC ID: 7113056722 Enrollment ID: I20141212001015 |
| Provider Name | Penny L Roskos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326019738 PECOS PAC ID: 3870696834 Enrollment ID: I20150122001578 |
| Provider Name | Darlene R Bannon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033183702 PECOS PAC ID: 4082699111 Enrollment ID: I20150126000715 |
| Provider Name | Rebecca A Huth |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619373941 PECOS PAC ID: 2062738230 Enrollment ID: I20150305001226 |
| Provider Name | Evan Small |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316202476 PECOS PAC ID: 4183860802 Enrollment ID: I20150429002012 |
| Provider Name | Amy L Cress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790119824 PECOS PAC ID: 4688808934 Enrollment ID: I20150514001171 |
| Provider Name | Lisa L Malmo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013305481 PECOS PAC ID: 4688994510 Enrollment ID: I20150518000343 |
| Provider Name | Benjamin W Riley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053385419 PECOS PAC ID: 6709781008 Enrollment ID: I20150520002609 |
| Provider Name | Andrea Branson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093054561 PECOS PAC ID: 1456597699 Enrollment ID: I20150530000249 |
| Provider Name | Eric R Niendorf |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780685404 PECOS PAC ID: 2567414121 Enrollment ID: I20150601002261 |
| Provider Name | Philip L Wackel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982800645 PECOS PAC ID: 0345465183 Enrollment ID: I20150603000716 |
| Provider Name | Paul E Youssef |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871725705 PECOS PAC ID: 8628260668 Enrollment ID: I20150612000405 |
| Provider Name | Andrew D Calvin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295932176 PECOS PAC ID: 2860567245 Enrollment ID: I20150622002370 |
| Provider Name | Patrick R Gore |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356634364 PECOS PAC ID: 2365683158 Enrollment ID: I20150630001349 |
| Provider Name | Erik B Sviggum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114157369 PECOS PAC ID: 7810012622 Enrollment ID: I20150630001555 |
| Provider Name | Fnu Manjunatha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316293517 PECOS PAC ID: 9234360991 Enrollment ID: I20150707001385 |
| Provider Name | Megan B Meyers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568696573 PECOS PAC ID: 7618117920 Enrollment ID: I20150708001241 |
| Provider Name | Kelli A Tornstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538541511 PECOS PAC ID: 8022321058 Enrollment ID: I20150721000645 |
| Provider Name | Siva K Mulpuru |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770740417 PECOS PAC ID: 4284880352 Enrollment ID: I20150728004009 |
| Provider Name | Hon-chi Lee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477526101 PECOS PAC ID: 8628088317 Enrollment ID: I20150728005581 |
| Provider Name | Jacob L Erickson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1861787814 PECOS PAC ID: 0345498937 Enrollment ID: I20150805009653 |
| Provider Name | Dena L Brion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285989285 PECOS PAC ID: 8325295900 Enrollment ID: I20150817000115 |
| Provider Name | Anne L Shandera-ochsner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972989804 PECOS PAC ID: 5395050330 Enrollment ID: I20150819008603 |
| Provider Name | Marta L Lasater |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336404243 PECOS PAC ID: 2466605902 Enrollment ID: I20150904002197 |
| Provider Name | Alexander Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851768709 PECOS PAC ID: 6507173010 Enrollment ID: I20150916001479 |
| Provider Name | Kasey Lundstrom |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245607118 PECOS PAC ID: 0941517296 Enrollment ID: I20150918000264 |
| Provider Name | Jillian R Pechacek |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033588074 PECOS PAC ID: 4880903467 Enrollment ID: I20151023002059 |
| Provider Name | Andrew Severn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871977439 PECOS PAC ID: 0446569727 Enrollment ID: I20151028000683 |
| Provider Name | Trista Maria Williams |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1801295092 PECOS PAC ID: 6507189503 Enrollment ID: I20151103000809 |
| Provider Name | Jennifer Marie Crahan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972938173 PECOS PAC ID: 3971811787 Enrollment ID: I20151118000114 |
| Provider Name | Mohammad Sarraf |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1851447528 PECOS PAC ID: 5496817983 Enrollment ID: I20151208002369 |
| Provider Name | Denise R Newgard |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760852719 PECOS PAC ID: 3678874716 Enrollment ID: I20151215002230 |
| Provider Name | Sarah Kathleen Monson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215392246 PECOS PAC ID: 9830492818 Enrollment ID: I20160126000286 |
| Provider Name | Donald Dean Potter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205808490 PECOS PAC ID: 0345393708 Enrollment ID: I20160223002392 |
| Provider Name | Henry C Pitot |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700865102 PECOS PAC ID: 5698865947 Enrollment ID: I20160407001369 |
| Provider Name | Matthew E Bernard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831163732 PECOS PAC ID: 4284775172 Enrollment ID: I20160412001547 |
| Provider Name | Melanie Lyden |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780791707 PECOS PAC ID: 4789689449 Enrollment ID: I20160412002060 |
| Provider Name | Anna Klusendorf |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871963462 PECOS PAC ID: 0244539880 Enrollment ID: I20160503000478 |
| Provider Name | Won S Song |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144201930 PECOS PAC ID: 4183796204 Enrollment ID: I20160608001415 |
| Provider Name | Charles A Leder |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326279118 PECOS PAC ID: 5799940946 Enrollment ID: I20160610000163 |
| Provider Name | Rebecca S Danhof |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1598021768 PECOS PAC ID: 5799926770 Enrollment ID: I20160615000031 |
| Provider Name | Erin A Hirsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063862498 PECOS PAC ID: 1850682659 Enrollment ID: I20160627000861 |
| Provider Name | Erik Steckler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871812065 PECOS PAC ID: 9234443805 Enrollment ID: I20160706000599 |
| Provider Name | Jesse T Young |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558688077 PECOS PAC ID: 1850561101 Enrollment ID: I20160721000842 |
| Provider Name | Kimberly Kay Herman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992156053 PECOS PAC ID: 8426341330 Enrollment ID: I20160728002227 |
| Provider Name | Martin E Sievert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225392665 PECOS PAC ID: 5799913604 Enrollment ID: I20160809002071 |
| Provider Name | Jeffrey Jensen |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1700850294 PECOS PAC ID: 6709859424 Enrollment ID: I20160819001744 |
| Provider Name | Dante Schiavo |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1962632810 PECOS PAC ID: 6103018718 Enrollment ID: I20160820000144 |
| Provider Name | Sean Caples |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1417929449 PECOS PAC ID: 2668517319 Enrollment ID: I20160822000812 |
| Provider Name | Daniel Brown |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1801872734 PECOS PAC ID: 6305988874 Enrollment ID: I20160824001472 |
| Provider Name | Richard Patch |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1831257138 PECOS PAC ID: 0143220392 Enrollment ID: I20160824001592 |
| Provider Name | Philippe Bauer |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1871566166 PECOS PAC ID: 6901700707 Enrollment ID: I20160824001952 |
| Provider Name | Samrat V Bhat |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1053503607 PECOS PAC ID: 1254595903 Enrollment ID: I20160824002878 |
| Provider Name | David Wetzel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1457672198 PECOS PAC ID: 6204000730 Enrollment ID: I20160825002294 |
| Provider Name | Joshua F Gerrity |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609262211 PECOS PAC ID: 8022339217 Enrollment ID: I20160902001198 |
| Provider Name | Quintin Cappelle |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1023307170 PECOS PAC ID: 9335459593 Enrollment ID: I20160907000572 |
| Provider Name | Jonathan Webb |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1043531874 PECOS PAC ID: 0244403699 Enrollment ID: I20160908002875 |
| Provider Name | Heidi Inabnit |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417404799 PECOS PAC ID: 7810283967 Enrollment ID: I20160915001946 |
| Provider Name | Jacob Clements |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699222760 PECOS PAC ID: 6608162755 Enrollment ID: I20160915002085 |
| Provider Name | Bimal Bhindi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1336591833 PECOS PAC ID: 7911291083 Enrollment ID: I20160923002316 |
| Provider Name | Laura Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801343066 PECOS PAC ID: 0749577021 Enrollment ID: I20160930000234 |
| Provider Name | Jennifer Lynn Fang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538122171 PECOS PAC ID: 7810919123 Enrollment ID: I20161004001233 |
| Provider Name | Angela Imhoff |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1912351131 PECOS PAC ID: 4789975368 Enrollment ID: I20161010001014 |
| Provider Name | John Mullon |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841277134 PECOS PAC ID: 0446239420 Enrollment ID: I20161013002336 |
| Provider Name | Thomas H Nichols |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346351228 PECOS PAC ID: 9436330263 Enrollment ID: I20161014001148 |
| Provider Name | Minerva Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962473058 PECOS PAC ID: 6406899111 Enrollment ID: I20161103001429 |
| Provider Name | William Carey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194748616 PECOS PAC ID: 3779561857 Enrollment ID: I20170110000327 |
| Provider Name | Christopher Collura |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548467426 PECOS PAC ID: 6406916386 Enrollment ID: I20170110000700 |
| Provider Name | Carol Goulet |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003351016 PECOS PAC ID: 2062793821 Enrollment ID: I20170110001922 |
| Provider Name | Christopher Colby |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427037977 PECOS PAC ID: 2264573492 Enrollment ID: I20170206001878 |
| Provider Name | Muhammad Yasir Qureshi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1407065014 PECOS PAC ID: 3577719749 Enrollment ID: I20170309001777 |
| Provider Name | Jamie L Pronschinske |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1942741624 PECOS PAC ID: 2769767516 Enrollment ID: I20170320000147 |
| Provider Name | Daisy Batista |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598892929 PECOS PAC ID: 0345391959 Enrollment ID: I20170420002609 |
| Provider Name | Gregory Cascino |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144200437 PECOS PAC ID: 9931198207 Enrollment ID: I20170421000578 |
| Provider Name | Sandra Kopp |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124090147 PECOS PAC ID: 5991849531 Enrollment ID: I20170424001373 |
| Provider Name | Gabriel Luis Pagani-estevez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508204637 PECOS PAC ID: 9830339944 Enrollment ID: I20170504001868 |
| Provider Name | Gurpreet Singh |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073820650 PECOS PAC ID: 5890087266 Enrollment ID: I20170516001350 |
| Provider Name | Thomas L Sanders |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730443961 PECOS PAC ID: 0244476083 Enrollment ID: I20170530000609 |
| Provider Name | Timothy Mckenna |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1881032746 PECOS PAC ID: 1355585340 Enrollment ID: I20170620002111 |
| Provider Name | David D Easker |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376837815 PECOS PAC ID: 7214178094 Enrollment ID: I20170629000869 |
| Provider Name | Andrew C Schmitt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235123902 PECOS PAC ID: 5395781439 Enrollment ID: I20170703000593 |
| Provider Name | Adam Skemp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164842290 PECOS PAC ID: 8224307319 Enrollment ID: I20170705002482 |
| Provider Name | Samuel Clements |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487028221 PECOS PAC ID: 5991007494 Enrollment ID: I20170706002714 |
| Provider Name | Daniel Small |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245217512 PECOS PAC ID: 9931120292 Enrollment ID: I20170706002895 |
| Provider Name | Horng H Chen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073599320 PECOS PAC ID: 0941342331 Enrollment ID: I20170706003089 |
| Provider Name | Abdul Khan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1548421738 PECOS PAC ID: 7719157791 Enrollment ID: I20170706003208 |
| Provider Name | Amy Pike |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073966099 PECOS PAC ID: 0547541278 Enrollment ID: I20170710001649 |
| Provider Name | Sally Pollock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073863684 PECOS PAC ID: 5890947238 Enrollment ID: I20170713002728 |
| Provider Name | John Ohoro |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1659513364 PECOS PAC ID: 0840447785 Enrollment ID: I20170713003142 |
| Provider Name | Carl Gladitsch |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447665542 PECOS PAC ID: 5092934166 Enrollment ID: I20170717001555 |
| Provider Name | Daniel Desimone |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1619298205 PECOS PAC ID: 5294906384 Enrollment ID: I20170718002956 |
| Provider Name | David A Foley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699751610 PECOS PAC ID: 3577502988 Enrollment ID: I20170720002251 |
| Provider Name | Katherine Noe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912980996 PECOS PAC ID: 3678487634 Enrollment ID: I20170720002453 |
| Provider Name | Terrence Lagerlund |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336126267 PECOS PAC ID: 0941336424 Enrollment ID: I20170720002878 |
| Provider Name | Martha Grogan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932188935 PECOS PAC ID: 8729167630 Enrollment ID: I20170720003030 |
| Provider Name | Michael Homer Scott |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457306995 PECOS PAC ID: 9032121777 Enrollment ID: I20170809002874 |
| Provider Name | Brandon Yuan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205064284 PECOS PAC ID: 6002008141 Enrollment ID: I20170824001761 |
| Provider Name | Kathleen Augustine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982677613 PECOS PAC ID: 1456301134 Enrollment ID: I20170908002002 |
| Provider Name | Sarah Lundblad Medrano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700301074 PECOS PAC ID: 3971877648 Enrollment ID: I20170919001309 |
| Provider Name | Jonathan Alleckson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346547445 PECOS PAC ID: 8123203106 Enrollment ID: I20170921000914 |
| Provider Name | Eric Moore |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1689653842 PECOS PAC ID: 6901931633 Enrollment ID: I20170929003298 |
| Provider Name | Kristina Schlecht |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083639363 PECOS PAC ID: 2264404193 Enrollment ID: I20171005003082 |
| Provider Name | Matthew Carlson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1831396712 PECOS PAC ID: 9234204611 Enrollment ID: I20171006001270 |
| Provider Name | Joshua Laack |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275052037 PECOS PAC ID: 8123393758 Enrollment ID: I20171009001245 |
| Provider Name | Diana Trifa |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588816300 PECOS PAC ID: 6204974546 Enrollment ID: I20171009001530 |
| Provider Name | Paras H Shah |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548528185 PECOS PAC ID: 2163709643 Enrollment ID: I20171010001652 |
| Provider Name | Matthew J Dubiel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114280898 PECOS PAC ID: 7911135256 Enrollment ID: I20171012000040 |
| Provider Name | Liana J Reiland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689198343 PECOS PAC ID: 7416222690 Enrollment ID: I20171014000394 |
| Provider Name | Cory Stewart |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1053607408 PECOS PAC ID: 6103128780 Enrollment ID: I20171018000001 |
| Provider Name | Daniel Borgeson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1033183520 PECOS PAC ID: 7719940477 Enrollment ID: I20171019000323 |
| Provider Name | Scott H Okuno |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1750367561 PECOS PAC ID: 2466535927 Enrollment ID: I20171019000602 |
| Provider Name | Benjamin Daniel Elder |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1609190156 PECOS PAC ID: 5698924868 Enrollment ID: I20171117000215 |
| Provider Name | Dale Ekbom |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1497871966 PECOS PAC ID: 9830285576 Enrollment ID: I20171120002332 |
| Provider Name | Abraham Tiffany |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023424561 PECOS PAC ID: 7719103134 Enrollment ID: I20171127002849 |
| Provider Name | Heidi Marie Stenerson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750898680 PECOS PAC ID: 1153680921 Enrollment ID: I20180124002116 |
| Provider Name | Laura J Orvidas |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1073592986 PECOS PAC ID: 4789625229 Enrollment ID: I20180124002976 |
| Provider Name | Cheryl Tran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538286216 PECOS PAC ID: 0446416523 Enrollment ID: I20180219000857 |
| Provider Name | Michael J Wolf |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649255209 PECOS PAC ID: 4880598861 Enrollment ID: I20180219001497 |
| Provider Name | Rachel Louise Sting |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1881926624 PECOS PAC ID: 2961763131 Enrollment ID: I20180305000046 |
| Provider Name | Jessica Marie Patten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437501228 PECOS PAC ID: 9335432160 Enrollment ID: I20180403002237 |
| Provider Name | Shelagh A Cofer |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1417031519 PECOS PAC ID: 2163590571 Enrollment ID: I20180514002354 |
| Provider Name | Taft Franklin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104266907 PECOS PAC ID: 2365753506 Enrollment ID: I20180716000017 |
| Provider Name | Matthew J. Thoendel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1205190139 PECOS PAC ID: 5890931844 Enrollment ID: I20180725000002 |
| Provider Name | Scott Pate |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1194161562 PECOS PAC ID: 1153627609 Enrollment ID: I20180803000577 |
| Provider Name | Bahram Badri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013399419 PECOS PAC ID: 0446544704 Enrollment ID: I20180814002979 |
| Provider Name | Jenifer Bantle-felt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316426091 PECOS PAC ID: 4789934993 Enrollment ID: I20180910002485 |
| Provider Name | Claire A Piepkorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851877278 PECOS PAC ID: 4688924756 Enrollment ID: I20180911002647 |
| Provider Name | Erin Amanda Fender |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982993812 PECOS PAC ID: 2860638152 Enrollment ID: I20181009001225 |
| Provider Name | Shyam Parshottam Kasundra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942615562 PECOS PAC ID: 1951697143 Enrollment ID: I20181010003006 |
| Provider Name | Courtney Mcalister |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1780168765 PECOS PAC ID: 3577816511 Enrollment ID: I20181022001808 |
| Provider Name | Alexander Ehlert |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609356468 PECOS PAC ID: 2365795986 Enrollment ID: I20181030000539 |
| Provider Name | Mari Charisse B Trinidad |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336386093 PECOS PAC ID: 3476717729 Enrollment ID: I20181107000685 |
| Provider Name | Ashley Lee Sammann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376010256 PECOS PAC ID: 6305180621 Enrollment ID: I20181127002730 |
| Provider Name | Michael Lindeke |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164954160 PECOS PAC ID: 8729336888 Enrollment ID: I20181130001385 |
| Provider Name | Mariah Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073035598 PECOS PAC ID: 6608141809 Enrollment ID: I20181205000932 |
| Provider Name | Jenna Bauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619448412 PECOS PAC ID: 7618212499 Enrollment ID: I20181226000463 |
| Provider Name | Kissinger O Anusionwu |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730510629 PECOS PAC ID: 0042443467 Enrollment ID: I20190103000125 |
| Provider Name | Brett A May |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942789904 PECOS PAC ID: 0042564791 Enrollment ID: I20190103003084 |
| Provider Name | Marc Clayton Patterson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932193786 PECOS PAC ID: 4284657065 Enrollment ID: I20190131001321 |
| Provider Name | Kyle W Runningen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497228571 PECOS PAC ID: 2567700271 Enrollment ID: I20190205000918 |
| Provider Name | Paul S Mueller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427021955 PECOS PAC ID: 5890838874 Enrollment ID: I20190212000433 |
| Provider Name | Joyce Marie Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790226835 PECOS PAC ID: 2961787767 Enrollment ID: I20190308002236 |
| Provider Name | Kathryn Louise Poppe |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154835098 PECOS PAC ID: 7618237793 Enrollment ID: I20190312003295 |
| Provider Name | Hugo Guerrero |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1942686605 PECOS PAC ID: 4082922596 Enrollment ID: I20190502000505 |
| Provider Name | Benjamin Dilger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235593815 PECOS PAC ID: 3678865656 Enrollment ID: I20190516002131 |
| Provider Name | Heather Schaefbauer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1609227552 PECOS PAC ID: 2860735362 Enrollment ID: I20190524002136 |
| Provider Name | Nishant Saran |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1558739797 PECOS PAC ID: 1456653625 Enrollment ID: I20190606002917 |
| Provider Name | Mark D Sawyer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487632485 PECOS PAC ID: 7214066828 Enrollment ID: I20190611000269 |
| Provider Name | Mark D Mceleney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144668757 PECOS PAC ID: 2961643481 Enrollment ID: I20190620000313 |
| Provider Name | Daniel Anderson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770996340 PECOS PAC ID: 0547485260 Enrollment ID: I20190628000132 |
| Provider Name | Aaron Bradley Klassen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750745428 PECOS PAC ID: 9638461163 Enrollment ID: I20190709001323 |
| Provider Name | Benjamin D Knutson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114248192 PECOS PAC ID: 3375790827 Enrollment ID: I20190711000331 |
| Provider Name | Stephen Kimball Stacey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407120702 PECOS PAC ID: 0446513816 Enrollment ID: I20190723003410 |
| Provider Name | Jaime Roberto Jimenez Lopez |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1104235571 PECOS PAC ID: 0547531261 Enrollment ID: I20190731002868 |
| Provider Name | Michael D. Olson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1477567576 PECOS PAC ID: 3476518739 Enrollment ID: I20190731004199 |
| Provider Name | Brodie Richar Marthaler |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093153751 PECOS PAC ID: 6608010608 Enrollment ID: I20190801002040 |
| Provider Name | Beth Ellen Wagner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740660117 PECOS PAC ID: 3971815820 Enrollment ID: I20190803000003 |
| Provider Name | Andrew Last |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225353576 PECOS PAC ID: 5395987234 Enrollment ID: I20190805003326 |
| Provider Name | Praveen Errabelli |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1710393145 PECOS PAC ID: 0648575134 Enrollment ID: I20190808000949 |
| Provider Name | Timothy Francis Burns |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1770826521 PECOS PAC ID: 2567720790 Enrollment ID: I20190813002453 |
| Provider Name | Sandy Kay Clayton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578827465 PECOS PAC ID: 4082852751 Enrollment ID: I20190814003193 |
| Provider Name | Nitika Arora |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1629419031 PECOS PAC ID: 3779895560 Enrollment ID: I20190819000572 |
| Provider Name | Alecia Gende |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366823171 PECOS PAC ID: 4981916947 Enrollment ID: I20190827002021 |
| Provider Name | Jasmine Kamboj |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1144557638 PECOS PAC ID: 8820380272 Enrollment ID: I20190829003528 |
| Provider Name | Kristina L Mcgivern |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306406723 PECOS PAC ID: 6406184399 Enrollment ID: I20190830001390 |
| Provider Name | June M Chae |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245529718 PECOS PAC ID: 8426368895 Enrollment ID: I20190911002070 |
| Provider Name | April Marie Mcclish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679926752 PECOS PAC ID: 1254625635 Enrollment ID: I20190912002990 |
| Provider Name | Luke Nathaniel Andera |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1790105997 PECOS PAC ID: 4385948843 Enrollment ID: I20190923001718 |
| Provider Name | Scott Aaron Kuzma |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275599664 PECOS PAC ID: 4082933460 Enrollment ID: I20190923002854 |
| Provider Name | Kariline Elizabeth Bringe |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346583200 PECOS PAC ID: 4587989256 Enrollment ID: I20191009000274 |
| Provider Name | Melissa Kay Myers |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1518373711 PECOS PAC ID: 2769601582 Enrollment ID: I20191028000179 |
| Provider Name | Erik K St Louis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922090851 PECOS PAC ID: 2264509439 Enrollment ID: I20191125001905 |
| Provider Name | Abbey A Rose |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1265074736 PECOS PAC ID: 7214360262 Enrollment ID: I20191204002266 |
| Provider Name | Brendan M Carr |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902285331 PECOS PAC ID: 1759698400 Enrollment ID: I20200107003285 |
| Provider Name | Trevor Rich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922531433 PECOS PAC ID: 4981976321 Enrollment ID: I20200109001615 |
| Provider Name | Heather Ann Heaton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255658399 PECOS PAC ID: 9436307675 Enrollment ID: I20200110000384 |
| Provider Name | Larry Deppe |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982802815 PECOS PAC ID: 5496822322 Enrollment ID: I20200123000838 |
| Provider Name | Brian Sinclair |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790859429 PECOS PAC ID: 4688579139 Enrollment ID: I20200204002083 |
| Provider Name | Fouad Chebib |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1235450602 PECOS PAC ID: 6507008745 Enrollment ID: I20200205000026 |
| Provider Name | Casey Clements |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497987226 PECOS PAC ID: 7315061694 Enrollment ID: I20200306001716 |
| Provider Name | Erik Scharrer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245525484 PECOS PAC ID: 5395983175 Enrollment ID: I20200330001434 |
| Provider Name | Kyle Wright |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265066542 PECOS PAC ID: 1153750773 Enrollment ID: I20200402002963 |
| Provider Name | Joe D Starke |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053315879 PECOS PAC ID: 8224057484 Enrollment ID: I20200403000214 |
| Provider Name | Rebecca Kathleen Albrecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124334305 PECOS PAC ID: 6406287614 Enrollment ID: I20200502000062 |
| Provider Name | Jason Homme |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497727374 PECOS PAC ID: 6709871700 Enrollment ID: I20200505003135 |
| Provider Name | Ana Dahl |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639683691 PECOS PAC ID: 5496016545 Enrollment ID: I20200513000093 |
| Provider Name | Teresa Ann Mallett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366949026 PECOS PAC ID: 5193074417 Enrollment ID: I20200528001103 |
| Provider Name | Savana M Becker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1457977886 PECOS PAC ID: 6305268285 Enrollment ID: I20200623001194 |
| Provider Name | Alison Grajkowski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952676835 PECOS PAC ID: 7911228416 Enrollment ID: I20200708001925 |
| Provider Name | Alexander Grunenwald |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992243984 PECOS PAC ID: 0042580045 Enrollment ID: I20200709000645 |
| Provider Name | Dana Steien |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053542357 PECOS PAC ID: 3072806520 Enrollment ID: I20200803001557 |
| Provider Name | Kyle Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114389186 PECOS PAC ID: 1951670140 Enrollment ID: I20200804000799 |
| Provider Name | Vaibhav Vaidya |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1568726008 PECOS PAC ID: 6800032467 Enrollment ID: I20200814000517 |
| Provider Name | Aaron Gronseth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962883280 PECOS PAC ID: 5799033767 Enrollment ID: I20200819000365 |
| Provider Name | Karyn Cecele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124552542 PECOS PAC ID: 1658641410 Enrollment ID: I20200904001598 |
| Provider Name | Mark H Ereth |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568448629 PECOS PAC ID: 9638118524 Enrollment ID: I20200914000436 |
| Provider Name | John Kohorst |
|---|---|
| Provider Type | Practitioner - Micrographic Dermatologic Surgery (mds) |
| Provider Identifiers | NPI Number: 1588044366 PECOS PAC ID: 6103137740 Enrollment ID: I20200922001723 |
| Provider Name | Sabrina Correa Da Costa |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710363890 PECOS PAC ID: 8123358173 Enrollment ID: I20200922002070 |
| Provider Name | Jay Erie |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1336127646 PECOS PAC ID: 8123158375 Enrollment ID: I20201007000898 |
| Provider Name | William Mauck |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1881667657 PECOS PAC ID: 7517039340 Enrollment ID: I20201008000572 |
| Provider Name | Arvind Garg |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1154551968 PECOS PAC ID: 2062640014 Enrollment ID: I20201014001897 |
| Provider Name | Mary H Rahrick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1346200094 PECOS PAC ID: 5496656365 Enrollment ID: I20201023001122 |
| Provider Name | Amir Orandi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467716027 PECOS PAC ID: 0840546149 Enrollment ID: I20201110003063 |
| Provider Name | Jimmy Taylor |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1528039898 PECOS PAC ID: 2961302856 Enrollment ID: I20201112000668 |
| Provider Name | Albert C Wu |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1982050852 PECOS PAC ID: 3870889280 Enrollment ID: I20201221001842 |
| Provider Name | Brooke Murphy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255847760 PECOS PAC ID: 8820358047 Enrollment ID: I20210120001073 |
| Provider Name | Jennifer Lorraine Skaden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275155798 PECOS PAC ID: 3072938307 Enrollment ID: I20210202000617 |
| Provider Name | Andrew Leinss |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295219996 PECOS PAC ID: 3971847120 Enrollment ID: I20210204001491 |
| Provider Name | Michael Garvey |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1477617892 PECOS PAC ID: 3173770880 Enrollment ID: I20210216001818 |
| Provider Name | Jennifer Garvey |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1346445632 PECOS PAC ID: 7012150071 Enrollment ID: I20210219001411 |
| Provider Name | Donald Derauf |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265521041 PECOS PAC ID: 3072794528 Enrollment ID: I20210220000159 |
| Provider Name | Angela Steiber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104419720 PECOS PAC ID: 9234546599 Enrollment ID: I20210402000397 |
| Provider Name | Amanda Gingrasso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932788429 PECOS PAC ID: 4082022397 Enrollment ID: I20210426000517 |
| Provider Name | William C Mundell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083689434 PECOS PAC ID: 2365572450 Enrollment ID: I20210426001106 |
| Provider Name | John Wheeler |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1790994390 PECOS PAC ID: 9830376581 Enrollment ID: I20210507000456 |
| Provider Name | Troy Seelhammer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1447480694 PECOS PAC ID: 1355579376 Enrollment ID: I20210510001248 |
| Provider Name | Jacob Strand |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1457510638 PECOS PAC ID: 9133387681 Enrollment ID: I20210511000312 |
| Provider Name | Jenny Montejo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053358655 PECOS PAC ID: 1557314747 Enrollment ID: I20210517001645 |
| Provider Name | Martha Hartz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679550206 PECOS PAC ID: 2062449838 Enrollment ID: I20210517001800 |
| Provider Name | Arashk Motiei |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225000748 PECOS PAC ID: 8123098373 Enrollment ID: I20210607000183 |
| Provider Name | Adekunle Odubeko |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588200968 PECOS PAC ID: 9032545538 Enrollment ID: I20210608002828 |
| Provider Name | Patricio Cuevas Gargollo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982661781 PECOS PAC ID: 6305854357 Enrollment ID: I20210609000121 |
| Provider Name | Devender Singh |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1255714549 PECOS PAC ID: 3870837958 Enrollment ID: I20210615002277 |
| Provider Name | Michelle Gonzalez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578849642 PECOS PAC ID: 9032421946 Enrollment ID: I20210625000540 |
| Provider Name | Sophia Pillai |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194910257 PECOS PAC ID: 7012157290 Enrollment ID: I20210629001776 |
| Provider Name | Alexander Thomas Theisen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457929499 PECOS PAC ID: 6608278924 Enrollment ID: I20210709000331 |
| Provider Name | Richard Boesch |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306927520 PECOS PAC ID: 7618912734 Enrollment ID: I20210715000533 |
| Provider Name | Theodore Hanson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417211483 PECOS PAC ID: 1254577240 Enrollment ID: I20210720002617 |
| Provider Name | Mark Norton |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1942689203 PECOS PAC ID: 3072825280 Enrollment ID: I20210726003492 |
| Provider Name | Andrew Joseph Larson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134797947 PECOS PAC ID: 1759784986 Enrollment ID: I20210727000290 |
| Provider Name | Kendall Snyder |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1861808651 PECOS PAC ID: 8022234426 Enrollment ID: I20210727001194 |
| Provider Name | Sarah Kruse |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275020380 PECOS PAC ID: 6507113412 Enrollment ID: I20210727002295 |
| Provider Name | Stephen Nogel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548643315 PECOS PAC ID: 4587959309 Enrollment ID: I20210728000701 |
| Provider Name | Matthew Basiaga |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689800260 PECOS PAC ID: 5395900898 Enrollment ID: I20210728001984 |
| Provider Name | Bradley Nitzsche |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790190890 PECOS PAC ID: 9032430004 Enrollment ID: I20210802000483 |
| Provider Name | Joshua Wiedermann |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1720345044 PECOS PAC ID: 0345531323 Enrollment ID: I20210802002211 |
| Provider Name | Harika Balagoni |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952783557 PECOS PAC ID: 1951705615 Enrollment ID: I20210803002980 |
| Provider Name | Alexander D Molter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1033650445 PECOS PAC ID: 2163796848 Enrollment ID: I20210804001344 |
| Provider Name | Sheri L Reed |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902870801 PECOS PAC ID: 5294860276 Enrollment ID: I20210805001911 |
| Provider Name | Joshua Brandan Jensen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588198972 PECOS PAC ID: 0648674796 Enrollment ID: I20210811001755 |
| Provider Name | Leah Putzier |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750997524 PECOS PAC ID: 0547680217 Enrollment ID: I20210812000225 |
| Provider Name | Christina M Wika |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851891055 PECOS PAC ID: 1850646548 Enrollment ID: I20210812000623 |
| Provider Name | Danica Michelle Lombardi |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1821762667 PECOS PAC ID: 9335544204 Enrollment ID: I20210817000049 |
| Provider Name | Alisha Morgan |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1053546937 PECOS PAC ID: 2466698048 Enrollment ID: I20210821000393 |
| Provider Name | Don Codipilly |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861870289 PECOS PAC ID: 9830400076 Enrollment ID: I20210823000066 |
| Provider Name | Lauren Baker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427402270 PECOS PAC ID: 7810281144 Enrollment ID: I20210825000659 |
| Provider Name | Jonathan N Warner |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437360757 PECOS PAC ID: 3476611294 Enrollment ID: I20210825003754 |
| Provider Name | Mauro Schenone |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750588596 PECOS PAC ID: 5092854000 Enrollment ID: I20210825004139 |
| Provider Name | Yonas Getachew |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669499000 PECOS PAC ID: 2567535461 Enrollment ID: I20210827000075 |
| Provider Name | Andrew David Morris |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194068320 PECOS PAC ID: 3476958406 Enrollment ID: I20210830000027 |
| Provider Name | Bryce Daniel Jenson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932776218 PECOS PAC ID: 8729485446 Enrollment ID: I20210923000719 |
| Provider Name | Min Jun Hur |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1871025437 PECOS PAC ID: 1557610177 Enrollment ID: I20210923001747 |
| Provider Name | Tal Yalon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972057891 PECOS PAC ID: 0749605962 Enrollment ID: I20210930001093 |
| Provider Name | Kelly Maureen Jakes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619647187 PECOS PAC ID: 7719385251 Enrollment ID: I20211013001840 |
| Provider Name | Jacob David Miller |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1619647062 PECOS PAC ID: 2264830736 Enrollment ID: I20211013003338 |
| Provider Name | Kevin Boyd |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1215162417 PECOS PAC ID: 1759529837 Enrollment ID: I20211025000791 |
| Provider Name | Vinayak Nagaraja |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1174185607 PECOS PAC ID: 0446588149 Enrollment ID: I20211115002723 |
| Provider Name | Fareeda Taher Nazer Hussain |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1396181483 PECOS PAC ID: 1951604818 Enrollment ID: I20211119001266 |
| Provider Name | Korena Kemerling-theobald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063069284 PECOS PAC ID: 5193056208 Enrollment ID: I20211124000318 |
| Provider Name | Alexander Covington |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730422429 PECOS PAC ID: 8820335896 Enrollment ID: I20211221001367 |
| Provider Name | John Schwartz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952764813 PECOS PAC ID: 9931499225 Enrollment ID: I20220120002620 |
| Provider Name | Maria Gonzalez Suarez |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1770878688 PECOS PAC ID: 1355560020 Enrollment ID: I20220121000697 |
| Provider Name | Rebecca K Ameduri |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861696569 PECOS PAC ID: 4688728116 Enrollment ID: I20220201001457 |
| Provider Name | William J Remington |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1730183104 PECOS PAC ID: 5698673929 Enrollment ID: I20220201001508 |
| Provider Name | Kalnettie D Cayman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144862806 PECOS PAC ID: 7911335369 Enrollment ID: I20220304002118 |
| Provider Name | Levi James Polus |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063165835 PECOS PAC ID: 1557756491 Enrollment ID: I20220311001359 |
| Provider Name | Stephanie J Thompson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760944698 PECOS PAC ID: 4082947338 Enrollment ID: I20220411000614 |
| Provider Name | Kathryn E Gebczyk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336894815 PECOS PAC ID: 0749677904 Enrollment ID: I20220419000474 |
| Provider Name | Charat Thongprayoon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659765188 PECOS PAC ID: 0345540159 Enrollment ID: I20220509001739 |
| Provider Name | Xiaoke Liu |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1528046034 PECOS PAC ID: 5890868533 Enrollment ID: I20220512002327 |
| Provider Name | Brian D Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386622421 PECOS PAC ID: 2062592546 Enrollment ID: I20220519002328 |
| Provider Name | Richard Siegfried |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1366522682 PECOS PAC ID: 7719951086 Enrollment ID: I20220526002701 |
| Provider Name | Aldis P Siltumens |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235660465 PECOS PAC ID: 9436400959 Enrollment ID: I20220526002733 |
| Provider Name | Indrani Sen |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1760915862 PECOS PAC ID: 0749552347 Enrollment ID: I20220527000858 |
| Provider Name | James J Schaefer |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1780941187 PECOS PAC ID: 2264810449 Enrollment ID: I20220531000586 |
| Provider Name | Sherief Shawki |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861714222 PECOS PAC ID: 0244538585 Enrollment ID: I20220607000995 |
| Provider Name | Jennifer A Winegarden |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1902845613 PECOS PAC ID: 3375590052 Enrollment ID: I20220607003030 |
| Provider Name | Rebecca Johnson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275794562 PECOS PAC ID: 2062471659 Enrollment ID: I20220618000222 |
| Provider Name | Nicole Christine Sztuk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932631504 PECOS PAC ID: 7618240144 Enrollment ID: I20220624000599 |
| Provider Name | Virginia Dines |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1346628765 PECOS PAC ID: 9931420320 Enrollment ID: I20220705001868 |
| Provider Name | Vidhu Anand |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164840591 PECOS PAC ID: 4981903572 Enrollment ID: I20220707003606 |
| Provider Name | Jing Miao |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1063860559 PECOS PAC ID: 6608115696 Enrollment ID: I20220721001708 |
| Provider Name | Robert Wendt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740715432 PECOS PAC ID: 3173897188 Enrollment ID: I20220721002813 |
| Provider Name | Christopher D Byers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891227252 PECOS PAC ID: 2961756051 Enrollment ID: I20220721003115 |
| Provider Name | Erica Zell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225599269 PECOS PAC ID: 6406181742 Enrollment ID: I20220802001330 |
| Provider Name | Anna C Jones |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1699152843 PECOS PAC ID: 0143533794 Enrollment ID: I20220804002616 |
| Provider Name | Rafael De Jesus Perez Rodriguez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750732863 PECOS PAC ID: 2365824448 Enrollment ID: I20220805002104 |
| Provider Name | Candice House |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518199231 PECOS PAC ID: 2567508039 Enrollment ID: I20220805002294 |
| Provider Name | Christopher Marcellino |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1356720510 PECOS PAC ID: 5698086429 Enrollment ID: I20220808000211 |
| Provider Name | Daniel Kaisler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063973865 PECOS PAC ID: 8123353141 Enrollment ID: I20220829001655 |
| Provider Name | Nicholas Oblizajek |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356705016 PECOS PAC ID: 1153613062 Enrollment ID: I20220906003002 |
| Provider Name | Molly Grace Paulino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164140349 PECOS PAC ID: 2961886197 Enrollment ID: I20220907001037 |
| Provider Name | Robyn M Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275269953 PECOS PAC ID: 1254716251 Enrollment ID: I20220912001726 |
| Provider Name | Katie Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578927190 PECOS PAC ID: 8820380140 Enrollment ID: I20220913001642 |
| Provider Name | Megan Jo Friesen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134847445 PECOS PAC ID: 9436534856 Enrollment ID: I20220920003167 |
| Provider Name | Alison Noble Beinborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194451880 PECOS PAC ID: 1951786292 Enrollment ID: I20220922001092 |
| Provider Name | Ishan Kamlesh Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417394578 PECOS PAC ID: 5890072789 Enrollment ID: I20220927003034 |
| Provider Name | Jodie Theresa Diemer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528521150 PECOS PAC ID: 3577897677 Enrollment ID: I20220927003971 |
| Provider Name | Matar Goumbala |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902343684 PECOS PAC ID: 2567745557 Enrollment ID: I20221004002331 |
| Provider Name | David M Kushner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922009224 PECOS PAC ID: 7315931292 Enrollment ID: I20221006002315 |
| Provider Name | Reza Nabavizadeh |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982134391 PECOS PAC ID: 7315328002 Enrollment ID: I20221006002383 |
| Provider Name | Christopher J Sigakis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629364310 PECOS PAC ID: 2466751979 Enrollment ID: I20221007001248 |
| Provider Name | Dorissa Lahner Gursahaney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467815381 PECOS PAC ID: 3870870934 Enrollment ID: I20221007002300 |
| Provider Name | Matthew J Klumpp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790217305 PECOS PAC ID: 3779829387 Enrollment ID: I20221011000965 |
| Provider Name | Kathriena L Greenwell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215382411 PECOS PAC ID: 3072908011 Enrollment ID: I20221014000533 |
| Provider Name | Madelyn Fellinger Neumann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982339586 PECOS PAC ID: 9931575750 Enrollment ID: I20221019003011 |
| Provider Name | Tabita Amoatemaa Darkwah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164156535 PECOS PAC ID: 8628444395 Enrollment ID: I20221020001905 |
| Provider Name | Mark Smith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1730490426 PECOS PAC ID: 0547430738 Enrollment ID: I20221026001782 |
| Provider Name | Summer L Berg |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902191398 PECOS PAC ID: 2668641572 Enrollment ID: I20221027002031 |
| Provider Name | Kevin L Denton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518304930 PECOS PAC ID: 0840597829 Enrollment ID: I20221028000570 |
| Provider Name | Livia Maria Frota Lima |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215460415 PECOS PAC ID: 8224386057 Enrollment ID: I20221107002662 |
| Provider Name | Ashley C Logan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053874222 PECOS PAC ID: 7214320324 Enrollment ID: I20221110000948 |
| Provider Name | Delaney E Collins |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1447616214 PECOS PAC ID: 0547637134 Enrollment ID: I20221111000437 |
| Provider Name | Tristan N Covington |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124482765 PECOS PAC ID: 2466740774 Enrollment ID: I20221114002695 |
| Provider Name | Rebecca A Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801510052 PECOS PAC ID: 1658749825 Enrollment ID: I20221118000998 |
| Provider Name | Joel Thomas Hollow |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1659096915 PECOS PAC ID: 4183092117 Enrollment ID: I20221123002001 |
| Provider Name | Bryan Gordon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518544303 PECOS PAC ID: 7618378688 Enrollment ID: I20221202000889 |
| Provider Name | Erin K Davis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396088787 PECOS PAC ID: 1557663093 Enrollment ID: I20221212000567 |
| Provider Name | Joseph L Yard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538556006 PECOS PAC ID: 3971871658 Enrollment ID: I20230106002678 |
| Provider Name | Samantha Vander Bloomen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1275969420 PECOS PAC ID: 8123437043 Enrollment ID: I20230119000250 |
| Provider Name | Alix Hopp |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154770774 PECOS PAC ID: 8729356829 Enrollment ID: I20230123000509 |
| Provider Name | Barrett Howell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487073243 PECOS PAC ID: 6709105091 Enrollment ID: I20230125000946 |
| Provider Name | Kelsie Marie Prins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689253429 PECOS PAC ID: 5395146211 Enrollment ID: I20230203002448 |
| Provider Name | Yi Tang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720229149 PECOS PAC ID: 0648322826 Enrollment ID: I20230206002654 |
| Provider Name | Dean F Leslie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619926664 PECOS PAC ID: 6305857749 Enrollment ID: I20230209001707 |
| Provider Name | Tami E Mullenbach |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841530193 PECOS PAC ID: 8729228622 Enrollment ID: I20230210001044 |
| Provider Name | Monica Lea Foster |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1902952393 PECOS PAC ID: 5698911568 Enrollment ID: I20230303002001 |
| Provider Name | Tia M Stringer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114167608 PECOS PAC ID: 5294883674 Enrollment ID: I20230306001710 |
| Provider Name | Michael A French |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487691598 PECOS PAC ID: 0244269801 Enrollment ID: I20230306002580 |
| Provider Name | Haley Lyn Bell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629784517 PECOS PAC ID: 8022481381 Enrollment ID: I20230307001939 |
| Provider Name | Ross Avant |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1801275128 PECOS PAC ID: 7719292275 Enrollment ID: I20230314002798 |
| Provider Name | Audra Joy Storm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730767419 PECOS PAC ID: 0749681716 Enrollment ID: I20230315000673 |
| Provider Name | John Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891451365 PECOS PAC ID: 1254705460 Enrollment ID: I20230420001021 |
| Provider Name | Chiranjeev Saha |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699921684 PECOS PAC ID: 8325234289 Enrollment ID: I20230427001962 |
| Provider Name | Gabriella Avitia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497421366 PECOS PAC ID: 2769880624 Enrollment ID: I20230501001408 |
| Provider Name | Danielle Sue Forrester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184328858 PECOS PAC ID: 0840655437 Enrollment ID: I20230504000716 |
| Provider Name | Jenna Marie Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942917265 PECOS PAC ID: 8628441474 Enrollment ID: I20230509002079 |
| Provider Name | Hussam Jenad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174597322 PECOS PAC ID: 7214841972 Enrollment ID: I20230510001301 |
| Provider Name | Stephanie Y Torres |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336645126 PECOS PAC ID: 6406104363 Enrollment ID: I20230510002787 |
| Provider Name | Tezo Karedan |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1679887376 PECOS PAC ID: 9032424247 Enrollment ID: I20230515001170 |
| Provider Name | Emily Judith Kirchner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679261515 PECOS PAC ID: 8123484284 Enrollment ID: I20230515002619 |
| Provider Name | John W Frey |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1538600754 PECOS PAC ID: 4688946247 Enrollment ID: I20230530001917 |
| Provider Name | Ned John Panara |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922082130 PECOS PAC ID: 1850345208 Enrollment ID: I20230606002050 |
| Provider Name | Daniel L.w. Heslop |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1972009306 PECOS PAC ID: 6406103209 Enrollment ID: I20230614003274 |
| Provider Name | Prashant Natteru |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790205078 PECOS PAC ID: 0749554608 Enrollment ID: I20230615001625 |
| Provider Name | Mais Abdou |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1326572066 PECOS PAC ID: 7618247818 Enrollment ID: I20230628000192 |
| Provider Name | Daryl L Jacobs |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1770686958 PECOS PAC ID: 5890684617 Enrollment ID: I20230706003287 |
| Provider Name | Gabu Bhardwaj |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811912553 PECOS PAC ID: 3577552009 Enrollment ID: I20230710001843 |
| Provider Name | Udit Singhal |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1649663493 PECOS PAC ID: 9537459771 Enrollment ID: I20230719002942 |
| Provider Name | Mohammad Qasim Raza |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1336501204 PECOS PAC ID: 6709160567 Enrollment ID: I20230720002074 |
| Provider Name | Johanna N Meyer |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1033851126 PECOS PAC ID: 2062873540 Enrollment ID: I20230731003468 |
| Provider Name | Melissa Renee Adelsen |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114603362 PECOS PAC ID: 9638530603 Enrollment ID: I20230807003777 |
| Provider Name | Now Bahar Alam |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1508363532 PECOS PAC ID: 7113389115 Enrollment ID: I20230808001548 |
| Provider Name | Jennifer Gutierrez-wu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275021263 PECOS PAC ID: 0941555254 Enrollment ID: I20230815002819 |
| Provider Name | Devika Kir |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1023466414 PECOS PAC ID: 2163716911 Enrollment ID: I20230817000203 |
| Provider Name | Shawn Sell |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1124517966 PECOS PAC ID: 9133470420 Enrollment ID: I20230822000991 |
| Provider Name | Mohammed A Osman |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1124403456 PECOS PAC ID: 5092004713 Enrollment ID: I20230822001325 |
| Provider Name | Steven R Alberts |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1780660209 PECOS PAC ID: 1254473648 Enrollment ID: I20230828001577 |
| Provider Name | Heather M Martin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760610638 PECOS PAC ID: 6608020201 Enrollment ID: I20230829000971 |
| Provider Name | Ifeloluwa A Olutola |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467065748 PECOS PAC ID: 1456778752 Enrollment ID: I20230829002569 |
| Provider Name | Clay A Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043531023 PECOS PAC ID: 4183873219 Enrollment ID: I20230831001456 |
| Provider Name | Sheereene G Hussain |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356661953 PECOS PAC ID: 9234368903 Enrollment ID: I20230831001715 |
| Provider Name | Elizabeth Ann Husted |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376172213 PECOS PAC ID: 4183046949 Enrollment ID: I20230905002529 |
| Provider Name | Mercedes Lynn Antolak |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730885047 PECOS PAC ID: 8022472018 Enrollment ID: I20230908002621 |
| Provider Name | Aaron Ronald Dale Owen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629573787 PECOS PAC ID: 9638426729 Enrollment ID: I20230912000424 |
| Provider Name | Elizabeth B Terhune |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386137990 PECOS PAC ID: 8224384524 Enrollment ID: I20230912000718 |
| Provider Name | Lane Clayton Thaut |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174984058 PECOS PAC ID: 2567792005 Enrollment ID: I20230912002376 |
| Provider Name | Sabina A Rebis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134515299 PECOS PAC ID: 7113275637 Enrollment ID: I20230912003465 |
| Provider Name | Brandon Robert Bukowski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770012882 PECOS PAC ID: 4688946304 Enrollment ID: I20230913001575 |
| Provider Name | Charles Derrick Farwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811009079 PECOS PAC ID: 3476917139 Enrollment ID: I20230913002889 |
| Provider Name | Dragos Balf |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1619178258 PECOS PAC ID: 7113014838 Enrollment ID: I20230913003355 |
| Provider Name | Crystal S Dyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841485018 PECOS PAC ID: 7012054448 Enrollment ID: I20230913004019 |
| Provider Name | Parivash Badar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356970149 PECOS PAC ID: 8426489956 Enrollment ID: I20230914002306 |
| Provider Name | Martin R Dittmer |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1083110928 PECOS PAC ID: 6406199736 Enrollment ID: I20230915000805 |
| Provider Name | Mark Wu |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619474616 PECOS PAC ID: 9335501105 Enrollment ID: I20230925001854 |
| Provider Name | Katherine Phillips Mcmullan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881952711 PECOS PAC ID: 9436383577 Enrollment ID: I20230927000189 |
| Provider Name | Mark James Dillman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851081921 PECOS PAC ID: 6709230527 Enrollment ID: I20230928000602 |
| Provider Name | Daryl Callahan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669574075 PECOS PAC ID: 4688979685 Enrollment ID: I20231010000135 |
| Provider Name | Briana Lee Mahowald |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528683224 PECOS PAC ID: 6305291428 Enrollment ID: I20231010002249 |
| Provider Name | Christopher Michael Hart |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518390467 PECOS PAC ID: 7315284544 Enrollment ID: I20231011000396 |
| Provider Name | Daniel John Schissel |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1992780761 PECOS PAC ID: 5193170819 Enrollment ID: I20231016001002 |
| Provider Name | Jad Abimansour |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417488248 PECOS PAC ID: 2567730799 Enrollment ID: I20231018000677 |
| Provider Name | Jeffrey Bender |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255656088 PECOS PAC ID: 3476875675 Enrollment ID: I20231018003052 |
| Provider Name | Bettina Thompson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497726582 PECOS PAC ID: 0749265049 Enrollment ID: I20231026003434 |
| Provider Name | Muteeb Ghaffar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598007049 PECOS PAC ID: 4981912920 Enrollment ID: I20231101000863 |
| Provider Name | Tristan Buchanan Weir |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952835928 PECOS PAC ID: 6901171834 Enrollment ID: I20231103003341 |
| Provider Name | Andrew George Dockendorff |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689304859 PECOS PAC ID: 5294182598 Enrollment ID: I20231108000867 |
| Provider Name | Kelly Sue Goszkowicz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346906823 PECOS PAC ID: 7113372657 Enrollment ID: I20231113001743 |
| Provider Name | Ami Riggert |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700092079 PECOS PAC ID: 6103919261 Enrollment ID: I20231207000621 |
| Provider Name | Smathorn Thakolwiboon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619497161 PECOS PAC ID: 1759653520 Enrollment ID: I20231212002045 |
| Provider Name | Poonam Sachdev |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659529527 PECOS PAC ID: 3476742081 Enrollment ID: I20231219001555 |
| Provider Name | Kayla L Scheuer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134416191 PECOS PAC ID: 0244574499 Enrollment ID: I20240103000452 |
| Provider Name | Jennifer D Strangstalien |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1891833042 PECOS PAC ID: 7012368053 Enrollment ID: I20240104000162 |
| Provider Name | Jackie K. Richter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447511183 PECOS PAC ID: 9638520679 Enrollment ID: I20240104000208 |
| Provider Name | Laquita Ashely Becker-zarecki |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1922775279 PECOS PAC ID: 9436500477 Enrollment ID: I20240104000262 |
| Provider Name | Julie A Conway |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1285675751 PECOS PAC ID: 9830540772 Enrollment ID: I20240104004128 |
| Provider Name | Paul Gagnet |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467944306 PECOS PAC ID: 2961758180 Enrollment ID: I20240109002064 |
| Provider Name | Karen L Hall |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1992054928 PECOS PAC ID: 0749631141 Enrollment ID: I20240110002739 |
| Provider Name | Ngu Thien T Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487913125 PECOS PAC ID: 5092948828 Enrollment ID: I20240116001114 |
| Provider Name | John C Styliaras |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1871720201 PECOS PAC ID: 7416189238 Enrollment ID: I20240117000954 |
| Provider Name | Jennifer Viner |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1871073254 PECOS PAC ID: 1557775210 Enrollment ID: I20240117000967 |
| Provider Name | Courtney Lynn Holland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952183212 PECOS PAC ID: 5193177954 Enrollment ID: I20240117001538 |
| Provider Name | John Schirger |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174597876 PECOS PAC ID: 8921143678 Enrollment ID: I20240122001344 |
| Provider Name | Faith I Brown |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1619213907 PECOS PAC ID: 7214389428 Enrollment ID: I20240123002871 |
| Provider Name | Jenna Marie Mullins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326798992 PECOS PAC ID: 5597145714 Enrollment ID: I20240124000367 |
| Provider Name | Lea Tiare Minton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669724324 PECOS PAC ID: 8921252818 Enrollment ID: I20240130002836 |
| Provider Name | Heather K Roellig |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1962861716 PECOS PAC ID: 7719321389 Enrollment ID: I20240222001406 |
| Provider Name | Edward A Luker |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1386935807 PECOS PAC ID: 5799129391 Enrollment ID: I20240222002292 |
| Provider Name | Karn E Ofte-schroeder |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1790239663 PECOS PAC ID: 3779927249 Enrollment ID: I20240223000654 |
| Provider Name | Emily J Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700183795 PECOS PAC ID: 8729242250 Enrollment ID: I20240223003084 |
| Provider Name | Lynette R Kansier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275028953 PECOS PAC ID: 8022453182 Enrollment ID: I20240228002059 |
| Provider Name | Nicole Marie Houge |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376026831 PECOS PAC ID: 8820433923 Enrollment ID: I20240228003286 |
| Provider Name | Kalvin D Kinstler |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336450469 PECOS PAC ID: 9739524711 Enrollment ID: I20240229001520 |