| Mercy Clinic Adult Hospitalists- Jefferson, Llc | |
|
1400 Us Highway 61 Festus MO 63028-4100 | |
| (314) 364-4200 | |
| Not Available |
| Full Name | Mercy Clinic Adult Hospitalists- Jefferson, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1400 Us Highway 61, Festus, Missouri |
| Authorized Official Name and Position | Kerry Dunger (EXECUTIVE DIRECTOR - FINANCE) |
| Authorized Official Contact | 3143643707 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Clinic Adult Hospitalists- Jefferson, Llc 1400 Us Highway 61 Festus MO 63028-4100 Ph: (314) 364-4200 | Mercy Clinic Adult Hospitalists- Jefferson, Llc 1400 Us Highway 61 Festus MO 63028-4100 Ph: (314) 364-4200 |
| NPI Number | 1083052492 |
|---|---|
| Provider Enumeration Date | 06/07/2013 |
| Last Update Date | 04/28/2025 |
| Medicare PECOS PAC ID | 8628205598 |
|---|---|
| Medicare Enrollment ID | O20131220001798 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083052492 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Buthaina Richeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598711855 PECOS PAC ID: 8921907106 Enrollment ID: I20040107000349 |
| Provider Name | Rodd L Hillard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073509907 PECOS PAC ID: 3476456278 Enrollment ID: I20040129000508 |
| Provider Name | Marcus S Teng |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083724389 PECOS PAC ID: 5193718336 Enrollment ID: I20040405001220 |
| Provider Name | Kelly Ludwig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992720361 PECOS PAC ID: 2365439437 Enrollment ID: I20040429000783 |
| Provider Name | Laishang P Zhang |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235143942 PECOS PAC ID: 7719974682 Enrollment ID: I20040430000804 |
| Provider Name | William O Imbeah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932240249 PECOS PAC ID: 1153311964 Enrollment ID: I20040514000003 |
| Provider Name | Brian P Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487723540 PECOS PAC ID: 9537149984 Enrollment ID: I20040726000005 |
| Provider Name | Cary L Hall |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184679326 PECOS PAC ID: 3678521341 Enrollment ID: I20050110000470 |
| Provider Name | Benjamin Y Albano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982603650 PECOS PAC ID: 2264482405 Enrollment ID: I20050126000419 |
| Provider Name | Abdul Muhammud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780690008 PECOS PAC ID: 5890745509 Enrollment ID: I20050129000167 |
| Provider Name | Monika Prost |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265409122 PECOS PAC ID: 5294786349 Enrollment ID: I20050207000012 |
| Provider Name | Mohammad Asif Qaisrani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245250968 PECOS PAC ID: 6103877923 Enrollment ID: I20050209000122 |
| Provider Name | Kamran Baig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285711747 PECOS PAC ID: 5991618225 Enrollment ID: I20050624000268 |
| Provider Name | Stephen J Wen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447329537 PECOS PAC ID: 9638105331 Enrollment ID: I20050714000072 |
| Provider Name | Eric V.a. Matlock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093788762 PECOS PAC ID: 9234169194 Enrollment ID: I20050819000602 |
| Provider Name | Malik I Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770557985 PECOS PAC ID: 5294752648 Enrollment ID: I20051026000073 |
| Provider Name | Gayathri Dundoo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114981008 PECOS PAC ID: 2365457389 Enrollment ID: I20060215000050 |
| Provider Name | Howis Yvette Aros |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033126156 PECOS PAC ID: 8628071214 Enrollment ID: I20060822000108 |
| Provider Name | Govindarajulu Nagaldinne |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316968779 PECOS PAC ID: 5092777383 Enrollment ID: I20060922000135 |
| Provider Name | Sean Gravely |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134295009 PECOS PAC ID: 3072615772 Enrollment ID: I20070227000544 |
| Provider Name | Rachel Keech |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558589572 PECOS PAC ID: 8224137187 Enrollment ID: I20070619000334 |
| Provider Name | Basem Abdeen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366545675 PECOS PAC ID: 0840382909 Enrollment ID: I20070821000022 |
| Provider Name | Binu S Mathew |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740323617 PECOS PAC ID: 8921194655 Enrollment ID: I20071011000103 |
| Provider Name | Matthew Stewart Wilson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649392796 PECOS PAC ID: 9830277573 Enrollment ID: I20080422000525 |
| Provider Name | Jordan A Freie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366592925 PECOS PAC ID: 3779504394 Enrollment ID: I20080512000266 |
| Provider Name | Karen L Austin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649398926 PECOS PAC ID: 3274606033 Enrollment ID: I20080728000067 |
| Provider Name | Jason D Dausman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235187899 PECOS PAC ID: 1759349533 Enrollment ID: I20080916000205 |
| Provider Name | Munier El-beck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376720953 PECOS PAC ID: 2769550268 Enrollment ID: I20081010000504 |
| Provider Name | Anitha Rayani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952506875 PECOS PAC ID: 9032279864 Enrollment ID: I20081124000206 |
| Provider Name | Peter Warner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093756017 PECOS PAC ID: 9133217599 Enrollment ID: I20090105000091 |
| Provider Name | Iana P Jeliazkova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689887432 PECOS PAC ID: 6901960400 Enrollment ID: I20090128000312 |
| Provider Name | Gautam Rohatgi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710065024 PECOS PAC ID: 3971667957 Enrollment ID: I20090206000034 |
| Provider Name | John J Kakkanathu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346458411 PECOS PAC ID: 3375698491 Enrollment ID: I20090825000716 |
| Provider Name | Dianna L Kornhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982834990 PECOS PAC ID: 2062567563 Enrollment ID: I20090908000057 |
| Provider Name | Devika Rani Nagaraj |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881644714 PECOS PAC ID: 2163562661 Enrollment ID: I20091214000633 |
| Provider Name | Omar Saleh Abu-romeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184805681 PECOS PAC ID: 5597892026 Enrollment ID: I20100414000970 |
| Provider Name | Attila L Varga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528011061 PECOS PAC ID: 2769510429 Enrollment ID: I20100517000810 |
| Provider Name | Eduardo Luis Garcia-ferrer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619917101 PECOS PAC ID: 8820128077 Enrollment ID: I20100614000814 |
| Provider Name | Mouner N Salem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124091145 PECOS PAC ID: 4587796701 Enrollment ID: I20100722000874 |
| Provider Name | Peninnah M Mutungi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720251945 PECOS PAC ID: 4183793433 Enrollment ID: I20100802000034 |
| Provider Name | Saad Alkaade |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033433594 PECOS PAC ID: 9436283652 Enrollment ID: I20100810000548 |
| Provider Name | Bhavana Choudhary |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1508022401 PECOS PAC ID: 0648304659 Enrollment ID: I20100812000691 |
| Provider Name | Katherine Lynne Garland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568634533 PECOS PAC ID: 0941334684 Enrollment ID: I20100817000159 |
| Provider Name | Michael R Banton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619984523 PECOS PAC ID: 4981796588 Enrollment ID: I20100824000118 |
| Provider Name | Umer H Siddiqui |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245251321 PECOS PAC ID: 4486659596 Enrollment ID: I20100901000276 |
| Provider Name | Cynthia Renee Hays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881908986 PECOS PAC ID: 9234254830 Enrollment ID: I20100920001018 |
| Provider Name | Timothy J Brinker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114181948 PECOS PAC ID: 0749467439 Enrollment ID: I20110606000678 |
| Provider Name | Nitika Kaswan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609032028 PECOS PAC ID: 3375714215 Enrollment ID: I20110926000153 |
| Provider Name | Venkata Kenguva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497911374 PECOS PAC ID: 1456523612 Enrollment ID: I20111012000030 |
| Provider Name | Ali Husain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154525707 PECOS PAC ID: 3971674540 Enrollment ID: I20120119000751 |
| Provider Name | Armine Nadiryan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346477486 PECOS PAC ID: 0840446282 Enrollment ID: I20120817000177 |
| Provider Name | Suraj Kumar Alakkassery Kumaran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568698306 PECOS PAC ID: 0244489821 Enrollment ID: I20120926000398 |
| Provider Name | Mikael G Garri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306076120 PECOS PAC ID: 7618127978 Enrollment ID: I20121022000586 |
| Provider Name | Ammar Barakat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588994289 PECOS PAC ID: 3678766243 Enrollment ID: I20130226000647 |
| Provider Name | Susan E Moser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154679314 PECOS PAC ID: 2062657976 Enrollment ID: I20130326000127 |
| Provider Name | Nisha S Shetty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285861294 PECOS PAC ID: 2769627546 Enrollment ID: I20130327000257 |
| Provider Name | Bikash Acharya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780850743 PECOS PAC ID: 2567586837 Enrollment ID: I20130611000599 |
| Provider Name | Gina M Bufe |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1326381765 PECOS PAC ID: 7517108384 Enrollment ID: I20130722000346 |
| Provider Name | Emily M Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265743025 PECOS PAC ID: 0547402596 Enrollment ID: I20130805000357 |
| Provider Name | Naveen Bondalapati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104147214 PECOS PAC ID: 3779724406 Enrollment ID: I20130816000361 |
| Provider Name | Pooja Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578728218 PECOS PAC ID: 3870736242 Enrollment ID: I20130904000466 |
| Provider Name | Sabrina N Padgett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568777365 PECOS PAC ID: 3072757509 Enrollment ID: I20130923000536 |
| Provider Name | Jason R Collier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750692232 PECOS PAC ID: 9830324227 Enrollment ID: I20131018001600 |
| Provider Name | Timothy J Bucci |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689985012 PECOS PAC ID: 9335374024 Enrollment ID: I20131105001998 |
| Provider Name | Rajyalakshmi Gadi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1245454495 PECOS PAC ID: 5991932972 Enrollment ID: I20131219000388 |
| Provider Name | Aayushman Misra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083926067 PECOS PAC ID: 9537396304 Enrollment ID: I20131226001627 |
| Provider Name | Mian Rizwan |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1437380276 PECOS PAC ID: 0042460412 Enrollment ID: I20140228001479 |
| Provider Name | Shannon Sikorski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275955494 PECOS PAC ID: 5193956860 Enrollment ID: I20140321000589 |
| Provider Name | Erica Robinson Mitchell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629366521 PECOS PAC ID: 1557586724 Enrollment ID: I20140701001731 |
| Provider Name | Karthik V Iyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013203454 PECOS PAC ID: 3678798808 Enrollment ID: I20140702001036 |
| Provider Name | Enquan Gao |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295051548 PECOS PAC ID: 0446475198 Enrollment ID: I20140714000586 |
| Provider Name | Nezar Ali El-ruwie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649408659 PECOS PAC ID: 6507082997 Enrollment ID: I20140721001028 |
| Provider Name | Tamer A Dabous |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356506711 PECOS PAC ID: 0446476709 Enrollment ID: I20140722000905 |
| Provider Name | Braden F Deloach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619231248 PECOS PAC ID: 9032336078 Enrollment ID: I20140814001394 |
| Provider Name | Asim Ayaz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144509563 PECOS PAC ID: 7416279807 Enrollment ID: I20141215001710 |
| Provider Name | Kiran K Chennareddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992752869 PECOS PAC ID: 6002846326 Enrollment ID: I20150602001852 |
| Provider Name | Aaron Anthony Pickrell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295072866 PECOS PAC ID: 7911218938 Enrollment ID: I20150617002424 |
| Provider Name | Rohit R Pawar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013237122 PECOS PAC ID: 8022321587 Enrollment ID: I20150714000133 |
| Provider Name | Mehwish Bilal |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1447596176 PECOS PAC ID: 9830404318 Enrollment ID: I20150812008108 |
| Provider Name | Ryan Kroeger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801150784 PECOS PAC ID: 9638397326 Enrollment ID: I20150923002776 |
| Provider Name | Mohamad A Albsheri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447508874 PECOS PAC ID: 3779891379 Enrollment ID: I20151001000551 |
| Provider Name | Erik Aubuchon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558596668 PECOS PAC ID: 2961674064 Enrollment ID: I20160204002169 |
| Provider Name | Brian Michael Fishman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225391824 PECOS PAC ID: 6608171210 Enrollment ID: I20160219000268 |
| Provider Name | Qin Zhang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831485630 PECOS PAC ID: 8224276019 Enrollment ID: I20160520000405 |
| Provider Name | Onaopemipo Ajiboye |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801155593 PECOS PAC ID: 9436468188 Enrollment ID: I20160531001523 |
| Provider Name | Tracey S Bertram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720428592 PECOS PAC ID: 8426276163 Enrollment ID: I20160615001626 |
| Provider Name | Pravesh Prabhu Deotale |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710275110 PECOS PAC ID: 2163660283 Enrollment ID: I20160708000233 |
| Provider Name | Fang Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841630647 PECOS PAC ID: 0749582575 Enrollment ID: I20160721001171 |
| Provider Name | Eric J Shelley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477999167 PECOS PAC ID: 7315181245 Enrollment ID: I20160804000810 |
| Provider Name | Shirley N Okwuashi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417247693 PECOS PAC ID: 1153638549 Enrollment ID: I20161012000677 |
| Provider Name | Shannon E Witty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013354588 PECOS PAC ID: 3779886189 Enrollment ID: I20161024000412 |
| Provider Name | Noaman F Siddiqi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124294749 PECOS PAC ID: 7618157470 Enrollment ID: I20161108001131 |
| Provider Name | Sreenivasulu Bogachenchu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831417070 PECOS PAC ID: 1052508561 Enrollment ID: I20170207001095 |
| Provider Name | Falak Bhatt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588928535 PECOS PAC ID: 1951622760 Enrollment ID: I20170301000326 |
| Provider Name | Pierre Laughton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578523999 PECOS PAC ID: 2860579778 Enrollment ID: I20170306000491 |
| Provider Name | Andrew Hellenga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437563731 PECOS PAC ID: 9638471048 Enrollment ID: I20170609000400 |
| Provider Name | Nathan C Robertson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124439252 PECOS PAC ID: 2769784222 Enrollment ID: I20170615001038 |
| Provider Name | Charles V Tran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396159836 PECOS PAC ID: 0648497305 Enrollment ID: I20170627003131 |
| Provider Name | Laura J Weitzel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073927794 PECOS PAC ID: 6305115601 Enrollment ID: I20170629001999 |
| Provider Name | Lauren R Counts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255741351 PECOS PAC ID: 7719280726 Enrollment ID: I20170711001221 |
| Provider Name | Renu Teckchandani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1831477421 PECOS PAC ID: 6608092119 Enrollment ID: I20170724001413 |
| Provider Name | Frederick Balch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154735439 PECOS PAC ID: 6800013368 Enrollment ID: I20170726003403 |
| Provider Name | Shady Hawatmeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922498617 PECOS PAC ID: 8325310725 Enrollment ID: I20170821000203 |
| Provider Name | Temitayo Ayokunnu Odesanya |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114309176 PECOS PAC ID: 2365738689 Enrollment ID: I20170822001610 |
| Provider Name | Anthony J Kruse |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306256375 PECOS PAC ID: 6800198227 Enrollment ID: I20170822002319 |
| Provider Name | Steven Nguyen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013353663 PECOS PAC ID: 8921371139 Enrollment ID: I20170911002281 |
| Provider Name | Bilquees Beig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649719600 PECOS PAC ID: 4082987128 Enrollment ID: I20170912000600 |
| Provider Name | Amber Marie Patterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952848707 PECOS PAC ID: 0749554673 Enrollment ID: I20170915002306 |
| Provider Name | Varundeep K Rakhra |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1346507316 PECOS PAC ID: 6800104571 Enrollment ID: I20171005002056 |
| Provider Name | Anshu Sood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659598225 PECOS PAC ID: 6608934666 Enrollment ID: I20180326000329 |
| Provider Name | Wasseem El-aneed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326372053 PECOS PAC ID: 1850533787 Enrollment ID: I20180416001120 |
| Provider Name | Ramya Chinnasamy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063708238 PECOS PAC ID: 6709009053 Enrollment ID: I20180724003131 |
| Provider Name | Jahanzeb Khurshid |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417203050 PECOS PAC ID: 1850615337 Enrollment ID: I20180725003489 |
| Provider Name | Mara Kathleen Hinkle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922543958 PECOS PAC ID: 5294017463 Enrollment ID: I20180725003522 |
| Provider Name | Catherine Ash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861874059 PECOS PAC ID: 4284942806 Enrollment ID: I20180807003033 |
| Provider Name | Changqing Zhao |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700183142 PECOS PAC ID: 5698992311 Enrollment ID: I20180815002287 |
| Provider Name | Zahra Fatimah Hassan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912388695 PECOS PAC ID: 5799036901 Enrollment ID: I20180927002160 |
| Provider Name | Anoushiravan Hakim |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407237274 PECOS PAC ID: 1557667458 Enrollment ID: I20181016000220 |
| Provider Name | Tamara K Young |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740317510 PECOS PAC ID: 3274586607 Enrollment ID: I20181113000444 |
| Provider Name | Muhammad Fs Malik |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336373364 PECOS PAC ID: 2668623869 Enrollment ID: I20181214000177 |
| Provider Name | Erica L Buchalter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770999575 PECOS PAC ID: 6901027911 Enrollment ID: I20190109001878 |
| Provider Name | Amanda F Whistler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497220594 PECOS PAC ID: 2466799622 Enrollment ID: I20190125000519 |
| Provider Name | Sana S Kang |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1922488584 PECOS PAC ID: 8325332067 Enrollment ID: I20190226001536 |
| Provider Name | He Zhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699156414 PECOS PAC ID: 9335441146 Enrollment ID: I20190314000660 |
| Provider Name | Ali Etemady-deylamy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760864888 PECOS PAC ID: 4486946076 Enrollment ID: I20190326001069 |
| Provider Name | Edmond Nelson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912285446 PECOS PAC ID: 1951541754 Enrollment ID: I20190613000446 |
| Provider Name | Rada Helen Gibson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508397910 PECOS PAC ID: 7517292311 Enrollment ID: I20190716003738 |
| Provider Name | Amy O Puderbaugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174878409 PECOS PAC ID: 9931420551 Enrollment ID: I20190722001455 |
| Provider Name | Matthew J Crisp |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710337274 PECOS PAC ID: 6608142773 Enrollment ID: I20190805001875 |
| Provider Name | Asm Iftiar Chowdhury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053759142 PECOS PAC ID: 1355582396 Enrollment ID: I20190805002113 |
| Provider Name | Swetha Edla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124403779 PECOS PAC ID: 9638463391 Enrollment ID: I20190807000330 |
| Provider Name | Christopher T Boyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205109675 PECOS PAC ID: 0244518785 Enrollment ID: I20190807001555 |
| Provider Name | Johnson Wong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861846909 PECOS PAC ID: 2466780770 Enrollment ID: I20190824000654 |
| Provider Name | Jessica Leigh Upchurch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457766974 PECOS PAC ID: 0648564914 Enrollment ID: I20190826000184 |
| Provider Name | Melody Kay Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336604370 PECOS PAC ID: 3375871510 Enrollment ID: I20190826001874 |
| Provider Name | Muhammad Sohaib Qamar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306291976 PECOS PAC ID: 3678811155 Enrollment ID: I20190827001985 |
| Provider Name | Shelah Beth Radke |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366695967 PECOS PAC ID: 8426386319 Enrollment ID: I20190830001285 |
| Provider Name | Aman Ullah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407207624 PECOS PAC ID: 6103103890 Enrollment ID: I20190926003341 |
| Provider Name | Kathryn Shemwell |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700263506 PECOS PAC ID: 0749582542 Enrollment ID: I20191007000249 |
| Provider Name | Tammy Lebrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508324351 PECOS PAC ID: 6002147402 Enrollment ID: I20191016002832 |
| Provider Name | Cristian Popu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790148500 PECOS PAC ID: 0345538609 Enrollment ID: I20191018001209 |
| Provider Name | Shalu Lama |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982243861 PECOS PAC ID: 6204263544 Enrollment ID: I20200225003016 |
| Provider Name | Bamidele Ganiyu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073155933 PECOS PAC ID: 1153759394 Enrollment ID: I20200320002762 |
| Provider Name | Brittany Nicole Mora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336780493 PECOS PAC ID: 1759719990 Enrollment ID: I20200321000087 |
| Provider Name | Christian G Caceres |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255787628 PECOS PAC ID: 6002194701 Enrollment ID: I20200506002538 |
| Provider Name | Alexandra L Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518501600 PECOS PAC ID: 3375965684 Enrollment ID: I20200615001666 |
| Provider Name | Swati Sood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801247184 PECOS PAC ID: 0446547087 Enrollment ID: I20200626000408 |
| Provider Name | Felix Nau Jr |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932632544 PECOS PAC ID: 5294005351 Enrollment ID: I20200721001367 |
| Provider Name | Talat Syed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588011605 PECOS PAC ID: 4587903414 Enrollment ID: I20200813001825 |
| Provider Name | Lindsey Marie Bushmann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417498601 PECOS PAC ID: 5193094985 Enrollment ID: I20200814000483 |
| Provider Name | Anne Longtine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134516701 PECOS PAC ID: 2961716584 Enrollment ID: I20200814001935 |
| Provider Name | Moye Philip Mathew |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063932986 PECOS PAC ID: 0042589806 Enrollment ID: I20200825001277 |
| Provider Name | Venkataramana Somisetty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215459375 PECOS PAC ID: 0547531345 Enrollment ID: I20200827000455 |
| Provider Name | Alexander Richard Vaynman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275065435 PECOS PAC ID: 0143647701 Enrollment ID: I20200827000474 |
| Provider Name | Christian Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467062646 PECOS PAC ID: 6800213331 Enrollment ID: I20200831000113 |
| Provider Name | Tiago Araujo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730600156 PECOS PAC ID: 2466726153 Enrollment ID: I20200901000423 |
| Provider Name | Corey Weicht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992315857 PECOS PAC ID: 5799103941 Enrollment ID: I20200921000728 |
| Provider Name | Vadim Vasilevski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831629823 PECOS PAC ID: 4082032255 Enrollment ID: I20200921001461 |
| Provider Name | Ramza Haque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619406410 PECOS PAC ID: 8022437151 Enrollment ID: I20200923001259 |
| Provider Name | Pearce W Mundhenke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679003388 PECOS PAC ID: 5496021057 Enrollment ID: I20201006001246 |
| Provider Name | James Hollis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710092721 PECOS PAC ID: 9032387196 Enrollment ID: I20201104002909 |
| Provider Name | Chisom Eze |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821527649 PECOS PAC ID: 6002187333 Enrollment ID: I20201130002054 |
| Provider Name | Desiree C Baumgartner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1811370273 PECOS PAC ID: 8729392709 Enrollment ID: I20201230000890 |
| Provider Name | Garwen Chen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1972959617 PECOS PAC ID: 1850627001 Enrollment ID: I20210113001805 |
| Provider Name | Kaile Jean Eggemeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588264493 PECOS PAC ID: 1658784533 Enrollment ID: I20210114000586 |
| Provider Name | Carolyn Hilliard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922488261 PECOS PAC ID: 1153634530 Enrollment ID: I20210201002777 |
| Provider Name | Hitu Khaira |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750710299 PECOS PAC ID: 2163703943 Enrollment ID: I20210218000208 |
| Provider Name | Zachary Treat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447743083 PECOS PAC ID: 0648525386 Enrollment ID: I20210308000707 |
| Provider Name | Jessica Booker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619574936 PECOS PAC ID: 5597173922 Enrollment ID: I20210422002783 |
| Provider Name | Krishna Syamala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164838017 PECOS PAC ID: 2567775398 Enrollment ID: I20210713001327 |
| Provider Name | Andrew Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427113729 PECOS PAC ID: 9931248366 Enrollment ID: I20210726003497 |
| Provider Name | Jonathan Henke |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922504752 PECOS PAC ID: 3971851247 Enrollment ID: I20210728001374 |
| Provider Name | William Frick |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396236402 PECOS PAC ID: 6800151481 Enrollment ID: I20210806001585 |
| Provider Name | Wagih Zayed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104302991 PECOS PAC ID: 3072917335 Enrollment ID: I20210809001470 |
| Provider Name | Tariq K Halasa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043754039 PECOS PAC ID: 8729482757 Enrollment ID: I20210812000854 |
| Provider Name | Neil Backer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962933911 PECOS PAC ID: 2769732015 Enrollment ID: I20210820000412 |
| Provider Name | Nicole F Hawatmeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497248801 PECOS PAC ID: 3971908336 Enrollment ID: I20210823002505 |
| Provider Name | Joanna Haag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760052310 PECOS PAC ID: 8022413350 Enrollment ID: I20210824002387 |
| Provider Name | Andre Robert Theuerkauf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932693181 PECOS PAC ID: 6709281744 Enrollment ID: I20210830000570 |
| Provider Name | Lingxiao Lu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083135909 PECOS PAC ID: 2365715638 Enrollment ID: I20210913003003 |
| Provider Name | Dorian Shimotani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407344393 PECOS PAC ID: 5496001042 Enrollment ID: I20210914001756 |
| Provider Name | Mohit Harsh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528553799 PECOS PAC ID: 4587061338 Enrollment ID: I20210922000988 |
| Provider Name | Archana Machavarapu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063866374 PECOS PAC ID: 4486984440 Enrollment ID: I20210927002285 |
| Provider Name | Olukayode A Bamgbelu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164677845 PECOS PAC ID: 1557496965 Enrollment ID: I20211020002180 |
| Provider Name | Vanaja Yedla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710483193 PECOS PAC ID: 4082002084 Enrollment ID: I20211025001346 |
| Provider Name | Rajasekhar Bhoda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144485798 PECOS PAC ID: 6305999012 Enrollment ID: I20211029000272 |
| Provider Name | Milos Ivanovic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063901270 PECOS PAC ID: 1254723786 Enrollment ID: I20220113001244 |
| Provider Name | Rajesh Kumar Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083841902 PECOS PAC ID: 2860634771 Enrollment ID: I20220218000615 |
| Provider Name | Satya Anilbhai Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669607842 PECOS PAC ID: 2163687179 Enrollment ID: I20220309001658 |
| Provider Name | Nikki Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831346204 PECOS PAC ID: 5294803508 Enrollment ID: I20220413000243 |
| Provider Name | Matthew Zide |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922752591 PECOS PAC ID: 6901292259 Enrollment ID: I20220413001537 |
| Provider Name | Amanda Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952797383 PECOS PAC ID: 9537478011 Enrollment ID: I20220413001554 |
| Provider Name | Mandy Silver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437655693 PECOS PAC ID: 0840694634 Enrollment ID: I20220627000794 |
| Provider Name | Chaitasi Naik |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306305677 PECOS PAC ID: 2264766070 Enrollment ID: I20220707001867 |
| Provider Name | Hayley A Motowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124688296 PECOS PAC ID: 3870829096 Enrollment ID: I20220711001548 |
| Provider Name | Akhi Mustari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356901110 PECOS PAC ID: 3274914783 Enrollment ID: I20220714003157 |
| Provider Name | Taimoor Haider |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659924017 PECOS PAC ID: 7214361492 Enrollment ID: I20220714003443 |
| Provider Name | Zachary Sloan Fletcher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184184525 PECOS PAC ID: 4183005127 Enrollment ID: I20220721001981 |
| Provider Name | John Pocholo Whitaker Tuason |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891347498 PECOS PAC ID: 2769863711 Enrollment ID: I20220721002591 |
| Provider Name | Kara Elise Nuspl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932760972 PECOS PAC ID: 3577899640 Enrollment ID: I20220726002431 |
| Provider Name | Basil I Shahin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851951982 PECOS PAC ID: 0446648802 Enrollment ID: I20220802000672 |
| Provider Name | Osarenren Idemudia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467013094 PECOS PAC ID: 0547592370 Enrollment ID: I20220803002477 |
| Provider Name | Ghislain B.k. Tchomobe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720548290 PECOS PAC ID: 7012390479 Enrollment ID: I20220817002166 |
| Provider Name | Anam Aqeel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073178315 PECOS PAC ID: 5799017356 Enrollment ID: I20220817003496 |
| Provider Name | Winnie M Hua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851850846 PECOS PAC ID: 8527393370 Enrollment ID: I20220822002944 |
| Provider Name | Birju V Amin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821658402 PECOS PAC ID: 0042694069 Enrollment ID: I20220825000360 |
| Provider Name | Tejas N Sangoi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417416256 PECOS PAC ID: 8820322076 Enrollment ID: I20220908000830 |
| Provider Name | Iqra Iqbal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104353614 PECOS PAC ID: 4183994015 Enrollment ID: I20220908001957 |
| Provider Name | Mark Bigg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750941571 PECOS PAC ID: 6901132190 Enrollment ID: I20220909000891 |
| Provider Name | Alexander Heese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871056333 PECOS PAC ID: 3577897321 Enrollment ID: I20220910000404 |
| Provider Name | Danni Habtu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508421777 PECOS PAC ID: 8820322704 Enrollment ID: I20220912000316 |
| Provider Name | Khristian M Sunga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417305434 PECOS PAC ID: 5799076543 Enrollment ID: I20220914001686 |
| Provider Name | Matthew Frederic Burke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457811481 PECOS PAC ID: 4082099791 Enrollment ID: I20220916000674 |
| Provider Name | Paulina G Rue |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871055046 PECOS PAC ID: 7315271418 Enrollment ID: I20220921003519 |
| Provider Name | Muhammad Atique Alam Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609338656 PECOS PAC ID: 9335477579 Enrollment ID: I20220922000563 |
| Provider Name | Charu Kolekar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811320856 PECOS PAC ID: 8729336565 Enrollment ID: I20221013002976 |
| Provider Name | Mytri Pokal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811250962 PECOS PAC ID: 0547483893 Enrollment ID: I20221013003227 |
| Provider Name | Vikram Sangani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821438995 PECOS PAC ID: 1052695673 Enrollment ID: I20221017002986 |
| Provider Name | Fariah Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568774347 PECOS PAC ID: 5991993032 Enrollment ID: I20230109001167 |
| Provider Name | Tamra Lynn Crouch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104301100 PECOS PAC ID: 4082088190 Enrollment ID: I20230313000644 |
| Provider Name | Adnan Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558865097 PECOS PAC ID: 8628324852 Enrollment ID: I20230330002322 |
| Provider Name | Aditi Lele |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356803548 PECOS PAC ID: 5092042390 Enrollment ID: I20230524000536 |
| Provider Name | Chizor Odibi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477702462 PECOS PAC ID: 9931389772 Enrollment ID: I20230525002831 |
| Provider Name | Bijoy Kar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407207699 PECOS PAC ID: 5193050599 Enrollment ID: I20230628003444 |
| Provider Name | Ram Sanjeev Alur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386808798 PECOS PAC ID: 5193185270 Enrollment ID: I20230720003309 |
| Provider Name | Chase Meyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154958908 PECOS PAC ID: 0941624001 Enrollment ID: I20230720004003 |
| Provider Name | Quang Trong Trung Le |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598285959 PECOS PAC ID: 1658640289 Enrollment ID: I20230803003097 |
| Provider Name | Akash Mandhan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194337428 PECOS PAC ID: 1850752049 Enrollment ID: I20230803004066 |
| Provider Name | Kelley Cassens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942993894 PECOS PAC ID: 6901267111 Enrollment ID: I20230804000543 |
| Provider Name | Edward Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386131423 PECOS PAC ID: 0042565160 Enrollment ID: I20230818000570 |
| Provider Name | Collin James Hill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821614439 PECOS PAC ID: 9133542939 Enrollment ID: I20230824001900 |
| Provider Name | Hilary Amaechi Elom |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437788213 PECOS PAC ID: 2062822562 Enrollment ID: I20230825002500 |
| Provider Name | Abigail Wheeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720608268 PECOS PAC ID: 4880071869 Enrollment ID: I20230829001188 |
| Provider Name | Ibipo Abdurraheem-salami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962024323 PECOS PAC ID: 9234504812 Enrollment ID: I20230830001824 |
| Provider Name | Elizabeth Houston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225653942 PECOS PAC ID: 4284051905 Enrollment ID: I20230919000457 |
| Provider Name | Samantha Jane Collins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114555927 PECOS PAC ID: 3072937580 Enrollment ID: I20230928002009 |
| Provider Name | Kenneth James Shortt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649767294 PECOS PAC ID: 0244564862 Enrollment ID: I20231006000330 |
| Provider Name | Mafaza Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275161796 PECOS PAC ID: 9931523321 Enrollment ID: I20231010001650 |
| Provider Name | Muhaddis Ejaz Ahmad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417576984 PECOS PAC ID: 9436504321 Enrollment ID: I20231012002308 |
| Provider Name | Nedaa Mohammad Husainat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558980037 PECOS PAC ID: 9830544675 Enrollment ID: I20231013000913 |
| Provider Name | Hamza Bajwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326668401 PECOS PAC ID: 6103273727 Enrollment ID: I20231103000570 |
| Provider Name | Caroline Song |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053940106 PECOS PAC ID: 5890139182 Enrollment ID: I20240214002466 |
| Provider Name | Emmanuelson N Chukwuyem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275396376 PECOS PAC ID: 9638517071 Enrollment ID: I20240404002839 |
| Provider Name | Corina Bakoylis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548019987 PECOS PAC ID: 4284171067 Enrollment ID: I20240730003034 |
| Provider Name | Nickolas Bacon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972172666 PECOS PAC ID: 7214331453 Enrollment ID: I20240813002661 |
| Provider Name | Adam A Douglas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558948703 PECOS PAC ID: 4082015177 Enrollment ID: I20240816001498 |
| Provider Name | Shavaun Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225624729 PECOS PAC ID: 7113320177 Enrollment ID: I20240816002828 |
| Provider Name | Lovepreet Singh Randhawa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003485947 PECOS PAC ID: 3678011947 Enrollment ID: I20240817000378 |
| Provider Name | Wei Zhang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386210995 PECOS PAC ID: 6406394501 Enrollment ID: I20240821000158 |
| Provider Name | George Sebastian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467940882 PECOS PAC ID: 8527301845 Enrollment ID: I20240826001649 |
| Provider Name | Tiffani D Berkel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629694930 PECOS PAC ID: 4385062306 Enrollment ID: I20240827001564 |
| Provider Name | Julianne Carroll Spiros |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194354282 PECOS PAC ID: 1052850450 Enrollment ID: I20240829001782 |
| Provider Name | Christina Merenda |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790308948 PECOS PAC ID: 5597187179 Enrollment ID: I20240903000407 |
| Provider Name | Rashid Mahmood Qureshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063036671 PECOS PAC ID: 2769921865 Enrollment ID: I20240903001175 |
| Provider Name | Andrea Ramos Richards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407422256 PECOS PAC ID: 2961803010 Enrollment ID: I20240906002548 |
| Provider Name | Dina Elsayed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669059895 PECOS PAC ID: 9537609375 Enrollment ID: I20240909000827 |
| Provider Name | Matthew Pettis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952988347 PECOS PAC ID: 2163962564 Enrollment ID: I20240912001302 |
| Provider Name | Wael Mohammed Abduljaber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174101489 PECOS PAC ID: 8921548249 Enrollment ID: I20240912002421 |
| Provider Name | Fnu Jitidhar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235702093 PECOS PAC ID: 6305387093 Enrollment ID: I20240920003559 |
| Provider Name | Ahmer Razzaque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366018137 PECOS PAC ID: 3779024351 Enrollment ID: I20240923003355 |
| Provider Name | Evan James Rose |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275101701 PECOS PAC ID: 9739582115 Enrollment ID: I20240925001582 |
| Provider Name | William J. Page |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710540794 PECOS PAC ID: 6002140555 Enrollment ID: I20240925004437 |
| Provider Name | Kirtana Viswanathan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578134912 PECOS PAC ID: 6507307865 Enrollment ID: I20240926001823 |
| Provider Name | Andrew Mcclintock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902485196 PECOS PAC ID: 8527590686 Enrollment ID: I20241014002749 |
| Provider Name | Muhammed Burak Durmus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972274231 PECOS PAC ID: 1557894946 Enrollment ID: I20241023003536 |
| Provider Name | Soha Afzal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023696507 PECOS PAC ID: 8729482872 Enrollment ID: I20241108001124 |
| Provider Name | Cullen Hoos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154973436 PECOS PAC ID: 8325374879 Enrollment ID: I20241126001460 |
| Provider Name | Scott David Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376117499 PECOS PAC ID: 5991106221 Enrollment ID: I20241220001381 |
| Provider Name | Abid Shaikh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831542489 PECOS PAC ID: 6103104625 Enrollment ID: I20241220002508 |
| Provider Name | Vaghdevi Bagam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609449388 PECOS PAC ID: 6709228190 Enrollment ID: I20250203001386 |
| Provider Name | Eric Boyum |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093034266 PECOS PAC ID: 7517107956 Enrollment ID: I20250408003834 |
| Provider Name | Sunil Sam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366934176 PECOS PAC ID: 5193146942 Enrollment ID: I20250506002882 |
Id Consultants, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1400 Us Highway 61 Ste 260, Festus, MO 63028 Phone: 636-933-2344 Fax: 636-937-9031 | |
Compass Health, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 112 S 2nd St, Festus, MO 63028 Phone: 636-931-2700 | |
Compass Health, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 222 N Mill St, Festus, MO 63028 Phone: 844-853-8937 | |
Gastroenterology And Liver Consultants Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 420 W Main St, Festus, MO 63028 Phone: 636-931-2320 Fax: 636-937-9693 | |
Southern Missouri Infectious Disease Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1447 Us Highway 61 Ste C, Festus, MO 63028 Phone: 636-375-4153 Fax: 636-333-4510 | |
South County Internal Medicine Physicians, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1479 Highway 61, Suite A, Festus, MO 63028 Phone: 636-579-6148 Fax: 888-756-6714 |