| Metro Health Hospital | |
|
5900 Byron Center Ave Sw Wyoming MI 49519-9606 | |
| (616) 252-7200 | |
| (616) 252-7830 |
| Full Name | Metro Health Hospital |
|---|---|
| Speciality | Internal Medicine |
| Location | 5900 Byron Center Ave Sw, Wyoming, Michigan |
| Authorized Official Name and Position | Timothy E Susterich (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6162525203 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Metro Health Hospital 985 Gezon Pkwy Sw Wyoming MI 49509-9563 Ph: (616) 252-4655 | Metro Health Hospital 5900 Byron Center Ave Sw Wyoming MI 49519-9606 Ph: (616) 252-7200 |
| NPI Number | 1811937519 |
|---|---|
| Provider Enumeration Date | 06/08/2006 |
| Last Update Date | 06/04/2014 |
| Medicare PECOS PAC ID | 5597651836 |
|---|---|
| Medicare Enrollment ID | O20040507000012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811937519 | NPI | - | NPPES |
| 700D160780 | Other | MI | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 410060 (Michigan) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 410060 (Michigan) | Secondary |
| Provider Name | Glenn E Merz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003819400 PECOS PAC ID: 6608774120 Enrollment ID: I20031222000599 |
| Provider Name | Kenneth J Easton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194713669 PECOS PAC ID: 7618871633 Enrollment ID: I20040102000750 |
| Provider Name | Danielle D Light |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154368660 PECOS PAC ID: 4587564257 Enrollment ID: I20040109000637 |
| Provider Name | Joseph J Gemmete |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578510517 PECOS PAC ID: 8224930607 Enrollment ID: I20040126000209 |
| Provider Name | Jon Arthur Jacobson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710068952 PECOS PAC ID: 1850286295 Enrollment ID: I20040216000995 |
| Provider Name | Daniel R Turner |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1649217134 PECOS PAC ID: 7214822238 Enrollment ID: I20040218000868 |
| Provider Name | Anita Irene Charochak |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1760484869 PECOS PAC ID: 7911892716 Enrollment ID: I20040219000910 |
| Provider Name | James L Horton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881639839 PECOS PAC ID: 4789570615 Enrollment ID: I20040226000358 |
| Provider Name | Daniela Nicola Minecan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548341787 PECOS PAC ID: 8729977178 Enrollment ID: I20040312001051 |
| Provider Name | Daniel P Hearld |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033183900 PECOS PAC ID: 0042101164 Enrollment ID: I20040320000091 |
| Provider Name | John T Dykstra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730177379 PECOS PAC ID: 7315839990 Enrollment ID: I20040329000052 |
| Provider Name | Anthony R Pucci |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922007582 PECOS PAC ID: 1153319348 Enrollment ID: I20040505001023 |
| Provider Name | Donna J Demann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801848189 PECOS PAC ID: 2769473578 Enrollment ID: I20040520000881 |
| Provider Name | Janice K Wabeke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962465690 PECOS PAC ID: 7810970217 Enrollment ID: I20040608000663 |
| Provider Name | David D Berg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457309767 PECOS PAC ID: 7214913557 Enrollment ID: I20040628000014 |
| Provider Name | Phillip G Wise |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1124124086 PECOS PAC ID: 8426036153 Enrollment ID: I20040709000826 |
| Provider Name | Joel Bates |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285738435 PECOS PAC ID: 7214915313 Enrollment ID: I20040713001138 |
| Provider Name | Erica Elsing Stevens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447213269 PECOS PAC ID: 2163317181 Enrollment ID: I20040722000905 |
| Provider Name | Eric C Feucht |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1356321996 PECOS PAC ID: 5597651711 Enrollment ID: I20040723000559 |
| Provider Name | Lance M Owens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548224728 PECOS PAC ID: 9739169285 Enrollment ID: I20040723000936 |
| Provider Name | Wayne A Christenson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407966773 PECOS PAC ID: 0547240012 Enrollment ID: I20040723001064 |
| Provider Name | Matthew J Boutell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043210818 PECOS PAC ID: 2961472295 Enrollment ID: I20040726001351 |
| Provider Name | Edwin T Kornoelje |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023071727 PECOS PAC ID: 8224008404 Enrollment ID: I20040727000258 |
| Provider Name | Kevin R Brader |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609807627 PECOS PAC ID: 8820068505 Enrollment ID: I20040729000733 |
| Provider Name | Alaa E Salhadar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609839349 PECOS PAC ID: 2668446154 Enrollment ID: I20040820000936 |
| Provider Name | Jaret A Beane |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1972537876 PECOS PAC ID: 6901870419 Enrollment ID: I20040820001019 |
| Provider Name | Erik C Hedlund |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1104864560 PECOS PAC ID: 7719951128 Enrollment ID: I20040823000421 |
| Provider Name | Eric Thomas Walchak |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962493395 PECOS PAC ID: 9436130234 Enrollment ID: I20040901000595 |
| Provider Name | Craig H Bethune |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134183619 PECOS PAC ID: 3870488646 Enrollment ID: I20040910000042 |
| Provider Name | Mohannad Ibrahim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639250871 PECOS PAC ID: 5991772873 Enrollment ID: I20040910000865 |
| Provider Name | Michael B Mazza |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639250764 PECOS PAC ID: 9436127388 Enrollment ID: I20040920000499 |
| Provider Name | Tracy Lynn Lixie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275643546 PECOS PAC ID: 8426018896 Enrollment ID: I20041012000412 |
| Provider Name | Kevin L Howard |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1811982044 PECOS PAC ID: 3779543137 Enrollment ID: I20041013001038 |
| Provider Name | Theodore J Boeve |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225000912 PECOS PAC ID: 4284696147 Enrollment ID: I20041103000245 |
| Provider Name | William R Lynch |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1568435980 PECOS PAC ID: 3375505233 Enrollment ID: I20041103000262 |
| Provider Name | Thomas A Stevenson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649377946 PECOS PAC ID: 4284699968 Enrollment ID: I20041122000837 |
| Provider Name | Mark De Haan |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1093707093 PECOS PAC ID: 6507757762 Enrollment ID: I20041124000147 |
| Provider Name | Julian Kuz |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1265424196 PECOS PAC ID: 6709777972 Enrollment ID: I20041124000170 |
| Provider Name | Noel Bell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942249628 PECOS PAC ID: 2264498823 Enrollment ID: I20041206000296 |
| Provider Name | Timothy E Daum |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1700832615 PECOS PAC ID: 2567420094 Enrollment ID: I20041229000927 |
| Provider Name | Douglas A Doyle |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1023074879 PECOS PAC ID: 3779532056 Enrollment ID: I20050113000271 |
| Provider Name | Brent B Ward |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1073611794 PECOS PAC ID: 5799734505 Enrollment ID: I20050119000705 |
| Provider Name | Diana L Dillman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235192188 PECOS PAC ID: 0143279752 Enrollment ID: I20050120000448 |
| Provider Name | Susan K Hicks |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043201551 PECOS PAC ID: 2769478528 Enrollment ID: I20050214000573 |
| Provider Name | Jeffrey Robert Williamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881641165 PECOS PAC ID: 5294789053 Enrollment ID: I20050304000538 |
| Provider Name | Peter G Goebel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306800651 PECOS PAC ID: 7911951603 Enrollment ID: I20050304000791 |
| Provider Name | Peter E Kaczkofsky |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710089453 PECOS PAC ID: 1658325113 Enrollment ID: I20050308000511 |
| Provider Name | Karlin E Sevensma |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144264003 PECOS PAC ID: 8820043243 Enrollment ID: I20050318000544 |
| Provider Name | Sheldon B Maltz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1881674489 PECOS PAC ID: 0648244251 Enrollment ID: I20050407001048 |
| Provider Name | Girish Gandikota |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114007903 PECOS PAC ID: 0941247100 Enrollment ID: I20050411000263 |
| Provider Name | John David Maskill |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669422077 PECOS PAC ID: 0840237731 Enrollment ID: I20050412001085 |
| Provider Name | Karl O Breitweiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154384931 PECOS PAC ID: 1254371453 Enrollment ID: I20050506000498 |
| Provider Name | Charles R Fenton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861456220 PECOS PAC ID: 6002856218 Enrollment ID: I20050506000546 |
| Provider Name | Scott A Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396709648 PECOS PAC ID: 7416997630 Enrollment ID: I20050506000584 |
| Provider Name | Michael C Mccully |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790749042 PECOS PAC ID: 4486694601 Enrollment ID: I20050506000601 |
| Provider Name | Steven T Bargwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326001223 PECOS PAC ID: 3870533011 Enrollment ID: I20050506000718 |
| Provider Name | Steven C Vannoord |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649234857 PECOS PAC ID: 4082654108 Enrollment ID: I20050509000626 |
| Provider Name | Laura S Bouch |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487617304 PECOS PAC ID: 6901846930 Enrollment ID: I20050509000830 |
| Provider Name | Linda M Bessert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811950736 PECOS PAC ID: 9537109574 Enrollment ID: I20050509000857 |
| Provider Name | John C Woodworth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518921725 PECOS PAC ID: 2466492400 Enrollment ID: I20050509000929 |
| Provider Name | Bradley James Clegg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780648139 PECOS PAC ID: 7618862640 Enrollment ID: I20050509000960 |
| Provider Name | Terrance W Barnes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891735981 PECOS PAC ID: 8123014982 Enrollment ID: I20050613000250 |
| Provider Name | Rudolph O Addy |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1003839168 PECOS PAC ID: 8022053669 Enrollment ID: I20050623000450 |
| Provider Name | Matthew W Sevensma |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255312302 PECOS PAC ID: 6800822826 Enrollment ID: I20050712000250 |
| Provider Name | Mark J Ivey |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1962450981 PECOS PAC ID: 4981631884 Enrollment ID: I20050725000080 |
| Provider Name | Gary N Sackett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780648170 PECOS PAC ID: 3476582735 Enrollment ID: I20050806000148 |
| Provider Name | James A Foote |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255372504 PECOS PAC ID: 8022047356 Enrollment ID: I20050808000487 |
| Provider Name | Eric P Anderson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578537478 PECOS PAC ID: 1658300900 Enrollment ID: I20050808000658 |
| Provider Name | Jonathan W Haft |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1922190313 PECOS PAC ID: 1153353180 Enrollment ID: I20050909000793 |
| Provider Name | Behrooz Shabahang |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1417980707 PECOS PAC ID: 7012992746 Enrollment ID: I20050914000695 |
| Provider Name | Barbara A Karenko |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447471636 PECOS PAC ID: 3870518079 Enrollment ID: I20051006000759 |
| Provider Name | Marc Allyn Afman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700844511 PECOS PAC ID: 5395762322 Enrollment ID: I20051028000956 |
| Provider Name | Vladimir Ferrer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1952358921 PECOS PAC ID: 5597789313 Enrollment ID: I20060119000737 |
| Provider Name | Robin L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689789968 PECOS PAC ID: 0648285809 Enrollment ID: I20060209000616 |
| Provider Name | Sarah L Vanhouten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407802556 PECOS PAC ID: 2769499821 Enrollment ID: I20060314000632 |
| Provider Name | Delmer John Dehart |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1922053339 PECOS PAC ID: 4183631278 Enrollment ID: I20060315000067 |
| Provider Name | Richard Lovy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407882855 PECOS PAC ID: 2668489691 Enrollment ID: I20060315000489 |
| Provider Name | Frank E Belsito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861455776 PECOS PAC ID: 5597650523 Enrollment ID: I20060517000061 |
| Provider Name | Ronald G Grifka |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386624666 PECOS PAC ID: 8921019373 Enrollment ID: I20060522000109 |
| Provider Name | David James Albrecht |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932140217 PECOS PAC ID: 8921011172 Enrollment ID: I20060711000251 |
| Provider Name | Kristi Sue Kern |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003859299 PECOS PAC ID: 4981617925 Enrollment ID: I20060717000295 |
| Provider Name | Aryn Clayton Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376586461 PECOS PAC ID: 3173536869 Enrollment ID: I20060725000233 |
| Provider Name | Mary F Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063431708 PECOS PAC ID: 4880697663 Enrollment ID: I20060816000543 |
| Provider Name | Scott David Burgess |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1023080991 PECOS PAC ID: 9133165079 Enrollment ID: I20060828000239 |
| Provider Name | Wendy L Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528078169 PECOS PAC ID: 3779587407 Enrollment ID: I20060911000515 |
| Provider Name | Jennifer A Cory |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023125473 PECOS PAC ID: 4486659869 Enrollment ID: I20060918000220 |
| Provider Name | Paul D Harris |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1033144266 PECOS PAC ID: 6406851898 Enrollment ID: I20060918000312 |
| Provider Name | Robert J Seiler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831159847 PECOS PAC ID: 5496750689 Enrollment ID: I20060921000396 |
| Provider Name | Sean P Edwards |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1952313892 PECOS PAC ID: 7214932011 Enrollment ID: I20060929000385 |
| Provider Name | Sung Moon Kim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588675961 PECOS PAC ID: 2668479262 Enrollment ID: I20061024000366 |
| Provider Name | Janan A Alkilidar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215031828 PECOS PAC ID: 1658318522 Enrollment ID: I20061024000407 |
| Provider Name | Bernard K Maupin |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1194783936 PECOS PAC ID: 5799782678 Enrollment ID: I20061107000478 |
| Provider Name | Edward J Kryshak |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1912948233 PECOS PAC ID: 2567460272 Enrollment ID: I20061113000257 |
| Provider Name | Jeffrey J Fletcher |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336252568 PECOS PAC ID: 1850352758 Enrollment ID: I20061116000580 |
| Provider Name | Douglas B Omara |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700803152 PECOS PAC ID: 5890604326 Enrollment ID: I20061117000174 |
| Provider Name | Mujahed Abbas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861500894 PECOS PAC ID: 0648279000 Enrollment ID: I20061212000396 |
| Provider Name | James K Hoekwater |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1518906163 PECOS PAC ID: 3971503723 Enrollment ID: I20070102000149 |
| Provider Name | Timothy B Cotts |
|---|---|
| Provider Type | Practitioner - Adult Congenital Heart Disease (achd) |
| Provider Identifiers | NPI Number: 1306852546 PECOS PAC ID: 8921009820 Enrollment ID: I20070119000200 |
| Provider Name | Cynthia L Mcnerlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336223619 PECOS PAC ID: 9830190727 Enrollment ID: I20070119000210 |
| Provider Name | Michael J Todd |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003985771 PECOS PAC ID: 7315040573 Enrollment ID: I20070309000069 |
| Provider Name | David J Bielema |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447248588 PECOS PAC ID: 3870560642 Enrollment ID: I20070426000448 |
| Provider Name | Caroline N Henein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427193036 PECOS PAC ID: 7618074212 Enrollment ID: I20070516000098 |
| Provider Name | Zachary S Delproposto |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114974672 PECOS PAC ID: 1557468592 Enrollment ID: I20070525000262 |
| Provider Name | Patricia E Guntern |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427162072 PECOS PAC ID: 7012015605 Enrollment ID: I20070605000440 |
| Provider Name | John A Key |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134103732 PECOS PAC ID: 5597863563 Enrollment ID: I20070614000624 |
| Provider Name | Daniel K Koschtial |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1467483727 PECOS PAC ID: 5193825917 Enrollment ID: I20070710000315 |
| Provider Name | Tandy L Champion |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164443578 PECOS PAC ID: 7315047875 Enrollment ID: I20070712000535 |
| Provider Name | Katherine K Hansul |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316169287 PECOS PAC ID: 4082715040 Enrollment ID: I20070720000854 |
| Provider Name | Adam Michael Passeno |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053502542 PECOS PAC ID: 8820199334 Enrollment ID: I20070727000788 |
| Provider Name | Paul A Brown |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1326160300 PECOS PAC ID: 4486755808 Enrollment ID: I20070728000163 |
| Provider Name | Kavita H Rajkotia |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023068103 PECOS PAC ID: 1759393457 Enrollment ID: I20070814000114 |
| Provider Name | James Anthony Spoto |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1457563959 PECOS PAC ID: 6305938168 Enrollment ID: I20070824000035 |
| Provider Name | Tamer Abdelhak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326100660 PECOS PAC ID: 8022019504 Enrollment ID: I20070824000070 |
| Provider Name | Alphonse Delucia |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1588612345 PECOS PAC ID: 6608879812 Enrollment ID: I20070926000885 |
| Provider Name | Paul J Kovack |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245221621 PECOS PAC ID: 4385556026 Enrollment ID: I20071012000266 |
| Provider Name | David B Bosscher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417950270 PECOS PAC ID: 1052407699 Enrollment ID: I20071012000374 |
| Provider Name | Joseph Peter Talcott |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134220270 PECOS PAC ID: 3173613874 Enrollment ID: I20071219000122 |
| Provider Name | Mark S Asperheim |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699763177 PECOS PAC ID: 6507833373 Enrollment ID: I20080229000332 |
| Provider Name | Nancy G Cutler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285693838 PECOS PAC ID: 8628152634 Enrollment ID: I20080229000362 |
| Provider Name | Emily J Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558548701 PECOS PAC ID: 8224114319 Enrollment ID: I20080331000101 |
| Provider Name | Rebecca L Werner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629034244 PECOS PAC ID: 2466521430 Enrollment ID: I20080516000115 |
| Provider Name | Mark W Armstrong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932104882 PECOS PAC ID: 1658336326 Enrollment ID: I20080529000791 |
| Provider Name | Paul R Gauthier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154431526 PECOS PAC ID: 7113813460 Enrollment ID: I20080529000830 |
| Provider Name | Monica M Goble |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922119049 PECOS PAC ID: 6406926906 Enrollment ID: I20080609000882 |
| Provider Name | James C Lang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467562041 PECOS PAC ID: 8325007982 Enrollment ID: I20080702000393 |
| Provider Name | Gregory R Neagos |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497716633 PECOS PAC ID: 6305919150 Enrollment ID: I20080726000113 |
| Provider Name | Michael R Wiltrakis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447465349 PECOS PAC ID: 1951475474 Enrollment ID: I20080801000096 |
| Provider Name | Robert Ward Selfe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003038605 PECOS PAC ID: 3072687078 Enrollment ID: I20080809000020 |
| Provider Name | Aditya Pandey |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1184825200 PECOS PAC ID: 7911007646 Enrollment ID: I20080816000029 |
| Provider Name | Paul G Wasielewski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164402772 PECOS PAC ID: 6608941182 Enrollment ID: I20080818000703 |
| Provider Name | John G Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700874294 PECOS PAC ID: 7517934383 Enrollment ID: I20080903000101 |
| Provider Name | Terrence J Endres |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962490441 PECOS PAC ID: 4284679457 Enrollment ID: I20081009000039 |
| Provider Name | Kevin D Hess |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942249107 PECOS PAC ID: 1658430665 Enrollment ID: I20081105000804 |
| Provider Name | Andrew C Michmerhuizen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326266404 PECOS PAC ID: 7517027592 Enrollment ID: I20081120000484 |
| Provider Name | Neeraj Chaudhary |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1265684450 PECOS PAC ID: 2466512488 Enrollment ID: I20081120000834 |
| Provider Name | Joanne R Coates |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710136163 PECOS PAC ID: 0244390029 Enrollment ID: I20081124000650 |
| Provider Name | Keith A Casper |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1932310224 PECOS PAC ID: 0648333765 Enrollment ID: I20090115000062 |
| Provider Name | Randal S Baker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104867480 PECOS PAC ID: 3173687704 Enrollment ID: I20090127000438 |
| Provider Name | Paul R Kemmeter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548217946 PECOS PAC ID: 8628132255 Enrollment ID: I20090128000371 |
| Provider Name | Brooke A Dylenski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437394061 PECOS PAC ID: 6800952359 Enrollment ID: I20090306000517 |
| Provider Name | Kevin M Furlong |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255396776 PECOS PAC ID: 6608785787 Enrollment ID: I20090313000021 |
| Provider Name | Allison L Edberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962622696 PECOS PAC ID: 3072670223 Enrollment ID: I20090316000415 |
| Provider Name | Matthew S Blair |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548225634 PECOS PAC ID: 0840357729 Enrollment ID: I20090319000597 |
| Provider Name | Eryn C Quinn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568427763 PECOS PAC ID: 6204853617 Enrollment ID: I20090323000286 |
| Provider Name | Adam T Wolfe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215992573 PECOS PAC ID: 4183781651 Enrollment ID: I20090327000203 |
| Provider Name | Lani S Cantu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699966119 PECOS PAC ID: 9638227820 Enrollment ID: I20090427000559 |
| Provider Name | Mohamad E El Mortada |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1215139175 PECOS PAC ID: 4183774201 Enrollment ID: I20090611000515 |
| Provider Name | Matthew A Tiede |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326264763 PECOS PAC ID: 2466503024 Enrollment ID: I20090623000137 |
| Provider Name | Dean A Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043448434 PECOS PAC ID: 4385797166 Enrollment ID: I20090727000255 |
| Provider Name | Anna A Papes |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679791784 PECOS PAC ID: 8426102401 Enrollment ID: I20090811000475 |
| Provider Name | Rishindra Mamidi Reddy |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1881712032 PECOS PAC ID: 2062566813 Enrollment ID: I20090813000576 |
| Provider Name | Jon M Curry |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982702270 PECOS PAC ID: 2163417239 Enrollment ID: I20091013000773 |
| Provider Name | John G Anema |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1053411215 PECOS PAC ID: 7113063637 Enrollment ID: I20091013000783 |
| Provider Name | Derek T Nagle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942413844 PECOS PAC ID: 9335286103 Enrollment ID: I20091027000752 |
| Provider Name | Terri L Rosel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326270760 PECOS PAC ID: 6002954542 Enrollment ID: I20091103000679 |
| Provider Name | Himanshu J Patel |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1629160015 PECOS PAC ID: 9638219447 Enrollment ID: I20091229000249 |
| Provider Name | Oren Sagher |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174620439 PECOS PAC ID: 8527109552 Enrollment ID: I20100112000692 |
| Provider Name | Andrew Ching-hung Chang |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1649286816 PECOS PAC ID: 8527109578 Enrollment ID: I20100113000044 |
| Provider Name | Peter C Theut |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1720076219 PECOS PAC ID: 2668417833 Enrollment ID: I20100114000436 |
| Provider Name | Colin Campbell Herd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417281510 PECOS PAC ID: 8022150929 Enrollment ID: I20100114000693 |
| Provider Name | Joanne M Grzeszak |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124083670 PECOS PAC ID: 4284776113 Enrollment ID: I20100115000055 |
| Provider Name | Thomas M Matelic |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1700873874 PECOS PAC ID: 5799752564 Enrollment ID: I20100115000456 |
| Provider Name | Donald R Bohay |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891783387 PECOS PAC ID: 9234106006 Enrollment ID: I20100115000485 |
| Provider Name | Brad A Irving |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649491135 PECOS PAC ID: 3971658253 Enrollment ID: I20100115000635 |
| Provider Name | Gabriel E Pedraza |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1992785588 PECOS PAC ID: 5799762902 Enrollment ID: I20100120000147 |
| Provider Name | Johnathan G Meier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932219599 PECOS PAC ID: 6204978505 Enrollment ID: I20100125000832 |
| Provider Name | Robert A Riley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659310399 PECOS PAC ID: 1850432576 Enrollment ID: I20100210000676 |
| Provider Name | Mark Edward Prince |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1184712606 PECOS PAC ID: 6800931452 Enrollment ID: I20100306000220 |
| Provider Name | David R Delongpre |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902861271 PECOS PAC ID: 3577580984 Enrollment ID: I20100316000929 |
| Provider Name | David J Boes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255310694 PECOS PAC ID: 3274668801 Enrollment ID: I20100320000152 |
| Provider Name | Robert F Gleffe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205891504 PECOS PAC ID: 2769409176 Enrollment ID: I20100327000097 |
| Provider Name | Erin C Beaton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477876050 PECOS PAC ID: 0648307389 Enrollment ID: I20100428000684 |
| Provider Name | James P Chiavaras |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972576783 PECOS PAC ID: 7618920448 Enrollment ID: I20100429000230 |
| Provider Name | Todd D Hartgerink |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528032539 PECOS PAC ID: 4981657715 Enrollment ID: I20100514000555 |
| Provider Name | John S Bradley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1033183066 PECOS PAC ID: 9436102266 Enrollment ID: I20100514000889 |
| Provider Name | Robert L Morris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255304069 PECOS PAC ID: 5890748628 Enrollment ID: I20100517000059 |
| Provider Name | Kurt J Meppelink |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093762015 PECOS PAC ID: 1456481738 Enrollment ID: I20100612000141 |
| Provider Name | Tera L Lotz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043459167 PECOS PAC ID: 8224169412 Enrollment ID: I20100702000250 |
| Provider Name | Gregory L Hazle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417995408 PECOS PAC ID: 4981766656 Enrollment ID: I20100806000025 |
| Provider Name | David O Kutsche |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235171158 PECOS PAC ID: 1355403023 Enrollment ID: I20100806000030 |
| Provider Name | Sherry Kuo |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1184839011 PECOS PAC ID: 6709919004 Enrollment ID: I20100806000866 |
| Provider Name | Jannah H Thompson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1104089986 PECOS PAC ID: 6305997867 Enrollment ID: I20100819000637 |
| Provider Name | Matthew V Zaccheo |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1033173257 PECOS PAC ID: 3779552948 Enrollment ID: I20100828000176 |
| Provider Name | Steven J Lown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083716724 PECOS PAC ID: 0840244398 Enrollment ID: I20100911000111 |
| Provider Name | Meghan E Coleman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538378518 PECOS PAC ID: 6608992987 Enrollment ID: I20100923000889 |
| Provider Name | Rakesh Latchamsetty |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1760648109 PECOS PAC ID: 8325067457 Enrollment ID: I20101101001090 |
| Provider Name | Judith A Florido |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750484390 PECOS PAC ID: 1759576077 Enrollment ID: I20101112000281 |
| Provider Name | Daniel L Mann |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1922284116 PECOS PAC ID: 2466648183 Enrollment ID: I20101119001203 |
| Provider Name | Jordan J Taylor |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215147343 PECOS PAC ID: 7618164377 Enrollment ID: I20101207000437 |
| Provider Name | Ashley Nicole Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760792444 PECOS PAC ID: 2668660432 Enrollment ID: I20101221000093 |
| Provider Name | Tiffany A Letts |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245253657 PECOS PAC ID: 0749382737 Enrollment ID: I20110114000840 |
| Provider Name | Rachel I Dykstra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467789651 PECOS PAC ID: 3375732605 Enrollment ID: I20110118000671 |
| Provider Name | Susan L Vandenbosch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265422653 PECOS PAC ID: 3678752433 Enrollment ID: I20110125001154 |
| Provider Name | Catherine L Webb |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437163680 PECOS PAC ID: 0547251522 Enrollment ID: I20110131000573 |
| Provider Name | Larry J Diaz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952301038 PECOS PAC ID: 1658351671 Enrollment ID: I20110203000547 |
| Provider Name | Steven J Vanlaan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982869137 PECOS PAC ID: 6608058532 Enrollment ID: I20110314000373 |
| Provider Name | Matthew A Erck |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003078023 PECOS PAC ID: 7719161330 Enrollment ID: I20110406000352 |
| Provider Name | Scott M Mahar |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1821390097 PECOS PAC ID: 5991989303 Enrollment ID: I20110408000711 |
| Provider Name | Uyen Thai Budzinski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245425388 PECOS PAC ID: 2961688437 Enrollment ID: I20110517000873 |
| Provider Name | Marc A Helzer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144249053 PECOS PAC ID: 2567648900 Enrollment ID: I20110519000032 |
| Provider Name | Matthew E Spector |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1487863684 PECOS PAC ID: 2062680796 Enrollment ID: I20110722000319 |
| Provider Name | Nathan P Reed |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1306066634 PECOS PAC ID: 1658496559 Enrollment ID: I20110725000554 |
| Provider Name | Augusto E Elias |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1700906997 PECOS PAC ID: 1850569468 Enrollment ID: I20110727000073 |
| Provider Name | Sara L Koster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740575877 PECOS PAC ID: 9830368745 Enrollment ID: I20110810000652 |
| Provider Name | David J Heeringa |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1245353853 PECOS PAC ID: 4284803107 Enrollment ID: I20110811000076 |
| Provider Name | Kurt R Schumacher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487871224 PECOS PAC ID: 0143491654 Enrollment ID: I20110913000811 |
| Provider Name | Alexander P Dehaan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932324522 PECOS PAC ID: 5092986455 Enrollment ID: I20110915000863 |
| Provider Name | Jeffrey D Postlewaite |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043219561 PECOS PAC ID: 4981668829 Enrollment ID: I20110926000034 |
| Provider Name | Sharon Aronovich |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1871777326 PECOS PAC ID: 2163576885 Enrollment ID: I20110927000572 |
| Provider Name | Kari S Blech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457671679 PECOS PAC ID: 7012180961 Enrollment ID: I20111203000172 |
| Provider Name | Qasim Omran |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861773491 PECOS PAC ID: 9638345226 Enrollment ID: I20120103000536 |
| Provider Name | Cheryl L Kruithof |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851600803 PECOS PAC ID: 6608034814 Enrollment ID: I20120220000582 |
| Provider Name | Cassidy S Bremmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902183247 PECOS PAC ID: 0648439026 Enrollment ID: I20120303000004 |
| Provider Name | Renee J Elderkin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982694667 PECOS PAC ID: 5698738367 Enrollment ID: I20120509000683 |
| Provider Name | Liliya Shevchenko Sutherland |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1942463252 PECOS PAC ID: 9032373295 Enrollment ID: I20120619000654 |
| Provider Name | William A Scalf |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1306802657 PECOS PAC ID: 0244495984 Enrollment ID: I20120703000399 |
| Provider Name | Viet H Do |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1023235884 PECOS PAC ID: 8820244817 Enrollment ID: I20120807000472 |
| Provider Name | Kimberly R Resseguie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083975478 PECOS PAC ID: 9931356540 Enrollment ID: I20120904000066 |
| Provider Name | Michael J Sumners |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1366753048 PECOS PAC ID: 3072761451 Enrollment ID: I20120910000021 |
| Provider Name | Vinayak Anand Manohar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1306855242 PECOS PAC ID: 5890799746 Enrollment ID: I20120910000435 |
| Provider Name | Vivian C Romero Romero |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245432368 PECOS PAC ID: 7719135011 Enrollment ID: I20120911000619 |
| Provider Name | Ixsy A Ramirez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104081124 PECOS PAC ID: 1759539471 Enrollment ID: I20120920000727 |
| Provider Name | Tracie N Rulewicz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174785398 PECOS PAC ID: 6507015617 Enrollment ID: I20121005000015 |
| Provider Name | Mark S Kosten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366799397 PECOS PAC ID: 7911932405 Enrollment ID: I20121005000482 |
| Provider Name | Shanna B Williams |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245416775 PECOS PAC ID: 1759530504 Enrollment ID: I20121011000200 |
| Provider Name | Heather L Volkema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124377320 PECOS PAC ID: 4284883976 Enrollment ID: I20121015000119 |
| Provider Name | Lucas Georgandellis |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1730132580 PECOS PAC ID: 5193786358 Enrollment ID: I20130211000173 |
| Provider Name | Jessica J Bruinius |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1609019330 PECOS PAC ID: 6507011640 Enrollment ID: I20130221000408 |
| Provider Name | Dana D Hop |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063708923 PECOS PAC ID: 9537300298 Enrollment ID: I20130724000021 |
| Provider Name | Kenneth M Kozlow |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437351780 PECOS PAC ID: 7416106190 Enrollment ID: I20130724000421 |
| Provider Name | Hilary A Schmid |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780901033 PECOS PAC ID: 7113160821 Enrollment ID: I20130828000570 |
| Provider Name | Christina Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831400407 PECOS PAC ID: 1759524473 Enrollment ID: I20130828000719 |
| Provider Name | Ryan D Hamby |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871793216 PECOS PAC ID: 3274776992 Enrollment ID: I20130828000763 |
| Provider Name | Elizabeth A Jeffery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245521848 PECOS PAC ID: 3476722968 Enrollment ID: I20130903000533 |
| Provider Name | Rony D Gorges |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881827095 PECOS PAC ID: 6709029911 Enrollment ID: I20130906000364 |
| Provider Name | Jan Michael Rajlich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386871846 PECOS PAC ID: 0446494611 Enrollment ID: I20130910000808 |
| Provider Name | Chaz Luke Stucken |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1194984997 PECOS PAC ID: 6507090529 Enrollment ID: I20131007001082 |
| Provider Name | Michelle M Muza-moons |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215137161 PECOS PAC ID: 0941435382 Enrollment ID: I20131021000762 |
| Provider Name | Timothy W Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154761336 PECOS PAC ID: 6608001524 Enrollment ID: I20131031001202 |
| Provider Name | Jessica S Grevenstuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588098685 PECOS PAC ID: 2567698996 Enrollment ID: I20131113001290 |
| Provider Name | Erin E Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427379916 PECOS PAC ID: 6204072622 Enrollment ID: I20131113001941 |
| Provider Name | Ashley E Foster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083046239 PECOS PAC ID: 6406082759 Enrollment ID: I20131115000918 |
| Provider Name | Lindsey E Chorney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386077873 PECOS PAC ID: 8325274418 Enrollment ID: I20131120000132 |
| Provider Name | Luke A Deroo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1891081758 PECOS PAC ID: 3173767118 Enrollment ID: I20131204000409 |
| Provider Name | Holly N Dishnow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376979898 PECOS PAC ID: 7315174091 Enrollment ID: I20131230001981 |
| Provider Name | Maranda Gary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033547658 PECOS PAC ID: 8224267695 Enrollment ID: I20140205000345 |
| Provider Name | Elissa J Davenport |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962824375 PECOS PAC ID: 4981834462 Enrollment ID: I20140228001413 |
| Provider Name | Christopher R Nall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1013171784 PECOS PAC ID: 2961633789 Enrollment ID: I20140411001202 |
| Provider Name | Ryan A Hop |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518253475 PECOS PAC ID: 5698919785 Enrollment ID: I20140424001807 |
| Provider Name | Steven C Behrendsen |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1306812656 PECOS PAC ID: 2365494234 Enrollment ID: I20140515001573 |
| Provider Name | Michael F Emiley |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1740571686 PECOS PAC ID: 0446401970 Enrollment ID: I20140604002746 |
| Provider Name | Olesya Krivospitskaya |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730318502 PECOS PAC ID: 4183848336 Enrollment ID: I20140610001539 |
| Provider Name | Kelsey Dayle Smits |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285046961 PECOS PAC ID: 4880818814 Enrollment ID: I20140613001387 |
| Provider Name | Christina Bakalis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477784056 PECOS PAC ID: 6305077967 Enrollment ID: I20140623000105 |
| Provider Name | Patricia L Fick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457639361 PECOS PAC ID: 7911136973 Enrollment ID: I20140630000632 |
| Provider Name | Rebecca H Klesmith |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164718029 PECOS PAC ID: 8022252758 Enrollment ID: I20140701000288 |
| Provider Name | Matthew E Tanis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851654487 PECOS PAC ID: 1658515226 Enrollment ID: I20140707000425 |
| Provider Name | Brian J Hinkley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619269222 PECOS PAC ID: 3971728957 Enrollment ID: I20140707002145 |
| Provider Name | Richard Walter Seeger |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1790713220 PECOS PAC ID: 7517040967 Enrollment ID: I20140709002560 |
| Provider Name | Benjamin L Viglianti |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609019033 PECOS PAC ID: 0749406338 Enrollment ID: I20140716001434 |
| Provider Name | Lisa M Glass |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154521177 PECOS PAC ID: 6608093091 Enrollment ID: I20140807002471 |
| Provider Name | Stephanie A Getz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417268012 PECOS PAC ID: 4082858634 Enrollment ID: I20140814001843 |
| Provider Name | Lisa M Theodorovich |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1821406455 PECOS PAC ID: 7517185317 Enrollment ID: I20140819002711 |
| Provider Name | Julie B Stinton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275949398 PECOS PAC ID: 5890913099 Enrollment ID: I20140902000068 |
| Provider Name | Frigga Jacob |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508153263 PECOS PAC ID: 6305072604 Enrollment ID: I20140905002074 |
| Provider Name | Michael T Schmuker |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982990842 PECOS PAC ID: 0244474872 Enrollment ID: I20140918002411 |
| Provider Name | Megan K Mouser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134529993 PECOS PAC ID: 2163641218 Enrollment ID: I20140922002807 |
| Provider Name | Scott A Baar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699180836 PECOS PAC ID: 5799905667 Enrollment ID: I20140929000988 |
| Provider Name | James P Reinhart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174842025 PECOS PAC ID: 2860621133 Enrollment ID: I20141023000026 |
| Provider Name | Nidhi Mishra |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1962663674 PECOS PAC ID: 4688805401 Enrollment ID: I20141111000940 |
| Provider Name | Natalie J Parr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962765594 PECOS PAC ID: 6406090075 Enrollment ID: I20141114001246 |
| Provider Name | Jonas P Berlin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932545886 PECOS PAC ID: 8224351481 Enrollment ID: I20141219002155 |
| Provider Name | Jessica D Averill |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1295138584 PECOS PAC ID: 7517281447 Enrollment ID: I20150123000286 |
| Provider Name | James R Fenton |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1912112806 PECOS PAC ID: 5799917951 Enrollment ID: I20150320000407 |
| Provider Name | Debora S Argetsinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376931717 PECOS PAC ID: 4587981964 Enrollment ID: I20150324000463 |
| Provider Name | Gabriel Aloysius Dunn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477818854 PECOS PAC ID: 0840426151 Enrollment ID: I20150522000279 |
| Provider Name | Kory J Johnson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1952539603 PECOS PAC ID: 8628212479 Enrollment ID: I20150602002763 |
| Provider Name | Stephen Greer |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1306868666 PECOS PAC ID: 7618866153 Enrollment ID: I20150619002164 |
| Provider Name | Jennifer C Kaufman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417269713 PECOS PAC ID: 5496998908 Enrollment ID: I20150622002524 |
| Provider Name | Mark T Tierney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659509701 PECOS PAC ID: 7911135876 Enrollment ID: I20150707003332 |
| Provider Name | Daniel S Mlnarik |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1205240256 PECOS PAC ID: 5496067282 Enrollment ID: I20150708000840 |
| Provider Name | Michael R Joynt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043482698 PECOS PAC ID: 8729391123 Enrollment ID: I20150714001649 |
| Provider Name | Jeremy Bushman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699088906 PECOS PAC ID: 8820227309 Enrollment ID: I20150716000745 |
| Provider Name | Jami A Kinnucan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003045634 PECOS PAC ID: 9133432230 Enrollment ID: I20150720000072 |
| Provider Name | Greta E Klein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336561026 PECOS PAC ID: 7911211529 Enrollment ID: I20150727001497 |
| Provider Name | Elizabeth A Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336523158 PECOS PAC ID: 1052625621 Enrollment ID: I20150728003620 |
| Provider Name | David Colombo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164487716 PECOS PAC ID: 0042111072 Enrollment ID: I20150729007057 |
| Provider Name | Danielle C Rush |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497139653 PECOS PAC ID: 6305150038 Enrollment ID: I20150807015224 |
| Provider Name | Ryan J Law |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508030925 PECOS PAC ID: 0648394403 Enrollment ID: I20150813010961 |
| Provider Name | Melissa L Mashni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720346695 PECOS PAC ID: 7517272867 Enrollment ID: I20150814013401 |
| Provider Name | Sara A Dumich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093071094 PECOS PAC ID: 9133435480 Enrollment ID: I20150901001016 |
| Provider Name | Adam T Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306078191 PECOS PAC ID: 3779890546 Enrollment ID: I20150911001413 |
| Provider Name | Jeremy R Herr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164731535 PECOS PAC ID: 2163602863 Enrollment ID: I20151016000074 |
| Provider Name | Jennifer L Bennetts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366814006 PECOS PAC ID: 1658681341 Enrollment ID: I20151109002212 |
| Provider Name | Mark J Tieszen |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1003838681 PECOS PAC ID: 3476677253 Enrollment ID: I20160121002336 |
| Provider Name | Matthew W Medley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033473053 PECOS PAC ID: 3072756071 Enrollment ID: I20160128002041 |
| Provider Name | Scott T Maurer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760437891 PECOS PAC ID: 2062663115 Enrollment ID: I20160208000889 |
| Provider Name | Danielle M Hainer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467818476 PECOS PAC ID: 4385940618 Enrollment ID: I20160311000964 |
| Provider Name | Anna M Wiersma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811388960 PECOS PAC ID: 5294033254 Enrollment ID: I20160407002235 |
| Provider Name | Peter Y Hahn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588642359 PECOS PAC ID: 8820076649 Enrollment ID: I20160413001512 |
| Provider Name | Caroline W Angus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750669636 PECOS PAC ID: 5597983833 Enrollment ID: I20160413002026 |
| Provider Name | Ryan M Bylsma |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1205275765 PECOS PAC ID: 9739318296 Enrollment ID: I20160415000969 |
| Provider Name | Michael Patrick Zintsmaster |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285946491 PECOS PAC ID: 1759695836 Enrollment ID: I20160425002250 |
| Provider Name | Brian D Dodson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1710905823 PECOS PAC ID: 8123035813 Enrollment ID: I20160505000939 |
| Provider Name | Bertha Parthenia Richardson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184674707 PECOS PAC ID: 0547243487 Enrollment ID: I20160518002469 |
| Provider Name | Carrie E Harvey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861770851 PECOS PAC ID: 6901039338 Enrollment ID: I20160622000054 |
| Provider Name | Evan Tank |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124316054 PECOS PAC ID: 9931417813 Enrollment ID: I20160623000568 |
| Provider Name | Joseph Zachariah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548585722 PECOS PAC ID: 3274759212 Enrollment ID: I20160623000802 |
| Provider Name | David Michael Ehrhardt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710255575 PECOS PAC ID: 7214229574 Enrollment ID: I20160706001632 |
| Provider Name | Christopher James Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205276383 PECOS PAC ID: 3274852975 Enrollment ID: I20160712000748 |
| Provider Name | Michael E Kogut |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649619925 PECOS PAC ID: 8527202159 Enrollment ID: I20160712002033 |
| Provider Name | Courtney S Streur |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417275736 PECOS PAC ID: 0345486346 Enrollment ID: I20160719000107 |
| Provider Name | Elizabeth A Pierce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154770550 PECOS PAC ID: 1052604675 Enrollment ID: I20160720000418 |
| Provider Name | Katherine M Weichhand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841641990 PECOS PAC ID: 2567755531 Enrollment ID: I20160728000669 |
| Provider Name | Natalie F Kent |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023457405 PECOS PAC ID: 4981848611 Enrollment ID: I20160810001016 |
| Provider Name | Annah Goote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740734656 PECOS PAC ID: 8325332216 Enrollment ID: I20160816001865 |
| Provider Name | Eric Joseph Krebill |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659667624 PECOS PAC ID: 8022246958 Enrollment ID: I20160817003409 |
| Provider Name | Armita Ghoddousi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1396050118 PECOS PAC ID: 4082918784 Enrollment ID: I20160818000974 |
| Provider Name | John Kim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255565842 PECOS PAC ID: 5991944423 Enrollment ID: I20160831001491 |
| Provider Name | Stacey L Tubergen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427507946 PECOS PAC ID: 3577850858 Enrollment ID: I20160930000227 |
| Provider Name | Marcos Itamar Cordoba-munoz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003084286 PECOS PAC ID: 8820217003 Enrollment ID: I20161019000698 |
| Provider Name | Lydia J Sutton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427500578 PECOS PAC ID: 9739467663 Enrollment ID: I20161028000185 |
| Provider Name | Kai Denski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104138841 PECOS PAC ID: 2466679923 Enrollment ID: I20161212000752 |
| Provider Name | Jean Sun |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265759716 PECOS PAC ID: 3577879535 Enrollment ID: I20161213000310 |
| Provider Name | Aniruddh P Behere |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265689897 PECOS PAC ID: 5092957308 Enrollment ID: I20170126001993 |
| Provider Name | Gregg T Malicke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1417211087 PECOS PAC ID: 5991089401 Enrollment ID: I20170313001231 |
| Provider Name | Leigh R Gasworth |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699157024 PECOS PAC ID: 2365759248 Enrollment ID: I20170606000854 |
| Provider Name | Kristina M. Manion |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1215165071 PECOS PAC ID: 5991947319 Enrollment ID: I20170616000151 |
| Provider Name | Alexander J Witte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932512779 PECOS PAC ID: 4688890817 Enrollment ID: I20170710002626 |
| Provider Name | Gunjan Gholkar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386922003 PECOS PAC ID: 8527358530 Enrollment ID: I20170712003277 |
| Provider Name | Andrew J Rosko |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1801157060 PECOS PAC ID: 0042525941 Enrollment ID: I20170713002474 |
| Provider Name | Noah Robert Smith |
|---|---|
| Provider Type | Practitioner - Micrographic Dermatologic Surgery (mds) |
| Provider Identifiers | NPI Number: 1972863389 PECOS PAC ID: 7012227135 Enrollment ID: I20170713002980 |
| Provider Name | Mounir Ghali |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205142932 PECOS PAC ID: 5597052134 Enrollment ID: I20170803002465 |
| Provider Name | Richard A Pearson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902148729 PECOS PAC ID: 9931332392 Enrollment ID: I20170804001087 |
| Provider Name | Tammy T Tran |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578856530 PECOS PAC ID: 9830460740 Enrollment ID: I20170810000575 |
| Provider Name | Allison R Schulman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1427378066 PECOS PAC ID: 7113165663 Enrollment ID: I20170814001725 |
| Provider Name | Catherine S Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922520691 PECOS PAC ID: 1557633211 Enrollment ID: I20170816001383 |
| Provider Name | Suprotim Samaddar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1689961369 PECOS PAC ID: 3678795358 Enrollment ID: I20170816002353 |
| Provider Name | Lucan Watt Chatterley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053793489 PECOS PAC ID: 8325352131 Enrollment ID: I20170829002309 |
| Provider Name | Eugene H Chung |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326087131 PECOS PAC ID: 9931112463 Enrollment ID: I20170912002275 |
| Provider Name | Victoria Rose Karcis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912436320 PECOS PAC ID: 6608140504 Enrollment ID: I20170915001208 |
| Provider Name | Aleksandr A Archiyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275945156 PECOS PAC ID: 7517182660 Enrollment ID: I20170919001514 |
| Provider Name | Kimberlee A Tomerlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013321140 PECOS PAC ID: 1759690605 Enrollment ID: I20170926000169 |
| Provider Name | Julie C Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235591280 PECOS PAC ID: 5193099471 Enrollment ID: I20170926000874 |
| Provider Name | Kenneth P Dood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568801843 PECOS PAC ID: 6103068655 Enrollment ID: I20170928001721 |
| Provider Name | Michael L Dozeman |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1487035333 PECOS PAC ID: 9830400407 Enrollment ID: I20170929001915 |
| Provider Name | Conor Mullin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013321983 PECOS PAC ID: 2961628573 Enrollment ID: I20171018002359 |
| Provider Name | Kristine N Tomlinson-miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023529427 PECOS PAC ID: 3779849849 Enrollment ID: I20171106000937 |
| Provider Name | Lindy J Deboer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720597685 PECOS PAC ID: 1052677002 Enrollment ID: I20171108001907 |
| Provider Name | Alex M Tomlinson-miles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710498142 PECOS PAC ID: 7517224975 Enrollment ID: I20171121000177 |
| Provider Name | Elizabeth L Albright |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487060125 PECOS PAC ID: 3274843891 Enrollment ID: I20171218001777 |
| Provider Name | Adam C Quiring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760900823 PECOS PAC ID: 7810255593 Enrollment ID: I20180102000261 |
| Provider Name | Alex D Bylsma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902316490 PECOS PAC ID: 8426316118 Enrollment ID: I20180102000497 |
| Provider Name | Katherine Joyce Sage |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073809935 PECOS PAC ID: 2264790823 Enrollment ID: I20180103002173 |
| Provider Name | Lisa Michele Thiel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699898940 PECOS PAC ID: 6901057280 Enrollment ID: I20180104000660 |
| Provider Name | David H Bryska |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831571389 PECOS PAC ID: 0244544245 Enrollment ID: I20180205001527 |
| Provider Name | Jagadish Balappa Khanagavi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1457669897 PECOS PAC ID: 4587960448 Enrollment ID: I20180404001792 |
| Provider Name | Melissa E Pillai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174025027 PECOS PAC ID: 8820351265 Enrollment ID: I20180417001171 |
| Provider Name | Guillermo R Sanchez |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1326012634 PECOS PAC ID: 3274542220 Enrollment ID: I20180424000184 |
| Provider Name | Jacob C Stremers |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508248923 PECOS PAC ID: 1254648108 Enrollment ID: I20180507001248 |
| Provider Name | Leezanne R Zeng |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962884387 PECOS PAC ID: 3779898168 Enrollment ID: I20180522002853 |
| Provider Name | Kelly L Woock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326536350 PECOS PAC ID: 1759646532 Enrollment ID: I20180526000032 |
| Provider Name | Kristina Lombardi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952891376 PECOS PAC ID: 0648535369 Enrollment ID: I20180530002838 |
| Provider Name | Kimberly R Meles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902031057 PECOS PAC ID: 0648535203 Enrollment ID: I20180531001637 |
| Provider Name | Nicholas J Robell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1538554704 PECOS PAC ID: 4183989676 Enrollment ID: I20180605000136 |
| Provider Name | Andrew J Bosch |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972985398 PECOS PAC ID: 5698082576 Enrollment ID: I20180621002838 |
| Provider Name | Jordan S Craig |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750515433 PECOS PAC ID: 3173767167 Enrollment ID: I20180623000120 |
| Provider Name | Kristin L Hollander |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508248931 PECOS PAC ID: 5193032068 Enrollment ID: I20180625001815 |
| Provider Name | Bryan Shanley Sack |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1487979951 PECOS PAC ID: 6901153352 Enrollment ID: I20180717002795 |
| Provider Name | Lindsey A Marchel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982105482 PECOS PAC ID: 0345597555 Enrollment ID: I20180719000676 |
| Provider Name | Erin D Burdi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629566542 PECOS PAC ID: 0345597563 Enrollment ID: I20180719001166 |
| Provider Name | Christina S Glenn |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1609188754 PECOS PAC ID: 1951671114 Enrollment ID: I20180723001779 |
| Provider Name | Mandy M Potter |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588959878 PECOS PAC ID: 8820346505 Enrollment ID: I20180813002647 |
| Provider Name | Katelyn M Gettel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194210914 PECOS PAC ID: 4981952678 Enrollment ID: I20180813002865 |
| Provider Name | Mallory A Myslenski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366937716 PECOS PAC ID: 5799033486 Enrollment ID: I20180813002909 |
| Provider Name | Emily M Mccloskey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184119901 PECOS PAC ID: 4385993930 Enrollment ID: I20180815002865 |
| Provider Name | Caitlin M Mlynarek |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376924340 PECOS PAC ID: 2567776750 Enrollment ID: I20180821000291 |
| Provider Name | Brandon James Hooks |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720346620 PECOS PAC ID: 7719207380 Enrollment ID: I20180822003080 |
| Provider Name | Sarah L Dikeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427543354 PECOS PAC ID: 4789934423 Enrollment ID: I20180830001557 |
| Provider Name | Garret W Caldwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447663844 PECOS PAC ID: 4082919279 Enrollment ID: I20180913002937 |
| Provider Name | Cynthia M Bailey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033698865 PECOS PAC ID: 9537410980 Enrollment ID: I20180924001781 |
| Provider Name | Ammar Zahid Hassan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1497072243 PECOS PAC ID: 7810122769 Enrollment ID: I20181005000659 |
| Provider Name | Margaret M Ohara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508341686 PECOS PAC ID: 6507118049 Enrollment ID: I20181010002000 |
| Provider Name | Lauren Meredith Warner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396123964 PECOS PAC ID: 3779887591 Enrollment ID: I20181011001271 |
| Provider Name | Cassandra P Fritch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013490762 PECOS PAC ID: 7113270190 Enrollment ID: I20181020000224 |
| Provider Name | Mark R Traill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972555308 PECOS PAC ID: 2961465273 Enrollment ID: I20181108000192 |
| Provider Name | Kristen Joy Kelting |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114494895 PECOS PAC ID: 3971848144 Enrollment ID: I20181215000296 |
| Provider Name | Sarah B Dickinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174091730 PECOS PAC ID: 3274878970 Enrollment ID: I20181228000962 |
| Provider Name | Jordan E Knot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124594890 PECOS PAC ID: 7719222421 Enrollment ID: I20181228001347 |
| Provider Name | Shannon V Donkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750874681 PECOS PAC ID: 3870831597 Enrollment ID: I20190205001273 |
| Provider Name | Zachary J Plotz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730341751 PECOS PAC ID: 5890939995 Enrollment ID: I20190212000921 |
| Provider Name | Richard N Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578035895 PECOS PAC ID: 7810235090 Enrollment ID: I20190213002018 |
| Provider Name | Kathrine E Post |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861972986 PECOS PAC ID: 5395084164 Enrollment ID: I20190222001940 |
| Provider Name | Michelle L Weston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659843621 PECOS PAC ID: 7214278936 Enrollment ID: I20190408000216 |
| Provider Name | Christina A Eller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053897595 PECOS PAC ID: 8022368794 Enrollment ID: I20190418001228 |
| Provider Name | Fazeel Mukhtar Siddiqui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154513687 PECOS PAC ID: 0345475331 Enrollment ID: I20190513001577 |
| Provider Name | Thomas B Bemenderfer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891105425 PECOS PAC ID: 9133462864 Enrollment ID: I20190521003475 |
| Provider Name | Amra Bristina |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699256784 PECOS PAC ID: 9133462534 Enrollment ID: I20190529001223 |
| Provider Name | Collin Chase Barber |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942628300 PECOS PAC ID: 9931467768 Enrollment ID: I20190531002183 |
| Provider Name | Dawn Rosser |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609830033 PECOS PAC ID: 4486988094 Enrollment ID: I20190701001607 |
| Provider Name | Rebecca R Kloote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588127799 PECOS PAC ID: 8123353596 Enrollment ID: I20190709000521 |
| Provider Name | Ashley Marie Veenstra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801451448 PECOS PAC ID: 2062747223 Enrollment ID: I20190710001027 |
| Provider Name | Abiy T Nigatu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952697252 PECOS PAC ID: 7416279641 Enrollment ID: I20190712002271 |
| Provider Name | Benjamin Matthew Strong |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174865174 PECOS PAC ID: 1557698297 Enrollment ID: I20190803000150 |
| Provider Name | Sarah R Lutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538633615 PECOS PAC ID: 1557699303 Enrollment ID: I20190819001154 |
| Provider Name | Matthew J Borr |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1417339847 PECOS PAC ID: 1557676434 Enrollment ID: I20190819001523 |
| Provider Name | Bryan D Brooks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740848316 PECOS PAC ID: 1850629106 Enrollment ID: I20190823001652 |
| Provider Name | Katie Lynn Mowers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609142959 PECOS PAC ID: 3274883608 Enrollment ID: I20190827000623 |
| Provider Name | Andrew J Lewandoski |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1578806113 PECOS PAC ID: 7113246430 Enrollment ID: I20190827003471 |
| Provider Name | Elizabeth M Dedoe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811558380 PECOS PAC ID: 3779813514 Enrollment ID: I20190923000293 |
| Provider Name | David C Weglicki |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932364627 PECOS PAC ID: 3870734080 Enrollment ID: I20190923000544 |
| Provider Name | Emily M. English |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417216896 PECOS PAC ID: 1759661929 Enrollment ID: I20190923001607 |
| Provider Name | Kseniya Bezpalko |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811347966 PECOS PAC ID: 8224322797 Enrollment ID: I20190925003220 |
| Provider Name | Elizabeth A Klynstra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326500455 PECOS PAC ID: 3274863741 Enrollment ID: I20190925003420 |
| Provider Name | Julia Marchal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235681503 PECOS PAC ID: 6901186857 Enrollment ID: I20190926001755 |
| Provider Name | Alexander David Grushky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174962328 PECOS PAC ID: 7113286816 Enrollment ID: I20191004000303 |
| Provider Name | Kaitlin E Campbell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831751650 PECOS PAC ID: 3678804457 Enrollment ID: I20191009000427 |
| Provider Name | Hope L Mickelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487114070 PECOS PAC ID: 7315278710 Enrollment ID: I20191016002645 |
| Provider Name | Kyle E Pfeifer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932494986 PECOS PAC ID: 5496054934 Enrollment ID: I20191016002924 |
| Provider Name | Rocio E Sanchez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649821786 PECOS PAC ID: 2567794654 Enrollment ID: I20191022002510 |
| Provider Name | Maxwell S Rouse |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1891146684 PECOS PAC ID: 2264724368 Enrollment ID: I20191025000539 |
| Provider Name | Julie A Perski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295393254 PECOS PAC ID: 5193057834 Enrollment ID: I20191029002566 |
| Provider Name | Lindsey M Devaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366098840 PECOS PAC ID: 9436481736 Enrollment ID: I20191105001708 |
| Provider Name | Haley Zimmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932580883 PECOS PAC ID: 9234440892 Enrollment ID: I20191120001853 |
| Provider Name | Rachel A Kloosterman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518508704 PECOS PAC ID: 1153753660 Enrollment ID: I20191120002912 |
| Provider Name | Rachel Burgess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326695867 PECOS PAC ID: 5698107084 Enrollment ID: I20191125000907 |
| Provider Name | Nicole Flory Sansom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295388098 PECOS PAC ID: 2062845456 Enrollment ID: I20191125001351 |
| Provider Name | Bryan J Canty |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841309515 PECOS PAC ID: 2567359334 Enrollment ID: I20191214000309 |
| Provider Name | Justin K Shurts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225291420 PECOS PAC ID: 6608047915 Enrollment ID: I20191227001063 |
| Provider Name | Rebecca L Veneklase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245882703 PECOS PAC ID: 1456785013 Enrollment ID: I20200107002720 |
| Provider Name | Elizabeth A Lojewski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336590074 PECOS PAC ID: 6002108107 Enrollment ID: I20200121001264 |
| Provider Name | Joshua J Vansluyters |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093235848 PECOS PAC ID: 5991075517 Enrollment ID: I20200327002420 |
| Provider Name | Jenna M Lehman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366085474 PECOS PAC ID: 9739518291 Enrollment ID: I20200403001032 |
| Provider Name | Kristopher R Danielson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376957134 PECOS PAC ID: 2860617198 Enrollment ID: I20200422001522 |
| Provider Name | Emily Marie Marlow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447293477 PECOS PAC ID: 9032118401 Enrollment ID: I20200505002414 |
| Provider Name | Antonia Jocelyn Henry |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1063574101 PECOS PAC ID: 6709024730 Enrollment ID: I20200615001837 |
| Provider Name | Delphia Catina Croff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447886692 PECOS PAC ID: 2365864550 Enrollment ID: I20200616002503 |
| Provider Name | Olivia Yost |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073034310 PECOS PAC ID: 6103173349 Enrollment ID: I20200701003117 |
| Provider Name | Monica K Urbanowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376063677 PECOS PAC ID: 8527337112 Enrollment ID: I20200713002902 |
| Provider Name | Shane T Mallon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750709119 PECOS PAC ID: 1759506850 Enrollment ID: I20200720001461 |
| Provider Name | Barbara Elizabeth Swartz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811082324 PECOS PAC ID: 6507928884 Enrollment ID: I20200728001487 |
| Provider Name | Hassan Suhail Anbari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699020776 PECOS PAC ID: 5991120586 Enrollment ID: I20200729002966 |
| Provider Name | Benjamin William Hale |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124464599 PECOS PAC ID: 7214232313 Enrollment ID: I20200731001534 |
| Provider Name | Jessica Gem Fried |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073909412 PECOS PAC ID: 2163847914 Enrollment ID: I20200811000178 |
| Provider Name | Thomas H Riley |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992899389 PECOS PAC ID: 0840247722 Enrollment ID: I20200824000236 |
| Provider Name | Alyssa M Vermeulen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700291515 PECOS PAC ID: 1355566167 Enrollment ID: I20200826000782 |
| Provider Name | Kayla Andres |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992155824 PECOS PAC ID: 1759675697 Enrollment ID: I20200828000306 |
| Provider Name | Katrina Y Cole-riley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932186426 PECOS PAC ID: 7214281500 Enrollment ID: I20200911002104 |
| Provider Name | Amit N Bhojwani |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1477986420 PECOS PAC ID: 6406102011 Enrollment ID: I20201012002213 |
| Provider Name | Mohammad Mahmoud Hasan Alhyari |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1346554912 PECOS PAC ID: 7113150111 Enrollment ID: I20201013002066 |
| Provider Name | Mark Manabu Goto |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1033189758 PECOS PAC ID: 6406036961 Enrollment ID: I20201022000180 |
| Provider Name | Gorav Ailawadi |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1710196894 PECOS PAC ID: 3375636756 Enrollment ID: I20201104003103 |
| Provider Name | Hannan Ali Saad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073908778 PECOS PAC ID: 6002115664 Enrollment ID: I20210225003206 |
| Provider Name | Rebecca M Royce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467030114 PECOS PAC ID: 8729495999 Enrollment ID: I20210406001206 |
| Provider Name | Courtney L Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598342123 PECOS PAC ID: 3476952623 Enrollment ID: I20210520002158 |
| Provider Name | Ron Van Beek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033794433 PECOS PAC ID: 6305245267 Enrollment ID: I20210525003114 |
| Provider Name | Matthew Clay Slotman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174141386 PECOS PAC ID: 7810397148 Enrollment ID: I20210608002932 |
| Provider Name | Michael A Fitzgerald |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992236277 PECOS PAC ID: 5294085056 Enrollment ID: I20210609001609 |
| Provider Name | Jessica-lynn Marie Fulton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114279841 PECOS PAC ID: 1658655816 Enrollment ID: I20210609002466 |
| Provider Name | Amanda E. Ruddy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154996684 PECOS PAC ID: 1456751601 Enrollment ID: I20210610000777 |
| Provider Name | Trevor Henry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235659277 PECOS PAC ID: 3870863137 Enrollment ID: I20210621000617 |
| Provider Name | Lindsay Jade Robell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861873903 PECOS PAC ID: 6507166311 Enrollment ID: I20210624002950 |
| Provider Name | William Z Punch |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518452259 PECOS PAC ID: 9335495191 Enrollment ID: I20210709000424 |
| Provider Name | Anthony Propson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124548227 PECOS PAC ID: 2264703784 Enrollment ID: I20210728002527 |
| Provider Name | Omaima Farid Ahmad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629565742 PECOS PAC ID: 9234533001 Enrollment ID: I20210802002788 |
| Provider Name | Ellen L Moore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992299515 PECOS PAC ID: 7810245180 Enrollment ID: I20210805000727 |
| Provider Name | Jhanna Moore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073976767 PECOS PAC ID: 9537405774 Enrollment ID: I20210809001898 |
| Provider Name | Benjamin V Hirshberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871955468 PECOS PAC ID: 1951694025 Enrollment ID: I20210811002319 |
| Provider Name | Sara Munoz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982274056 PECOS PAC ID: 4587069323 Enrollment ID: I20210817003468 |
| Provider Name | Stephen J Hickner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881191658 PECOS PAC ID: 2668728700 Enrollment ID: I20210819000846 |
| Provider Name | Abdel Rahman A Omer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356607626 PECOS PAC ID: 1850605866 Enrollment ID: I20210824000170 |
| Provider Name | Molly Elizabeth Roseland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164871620 PECOS PAC ID: 5799180071 Enrollment ID: I20210825000939 |
| Provider Name | Jack F Conner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043673239 PECOS PAC ID: 6608161757 Enrollment ID: I20210827000560 |
| Provider Name | Ashley C Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770938607 PECOS PAC ID: 6305242959 Enrollment ID: I20210907001135 |
| Provider Name | Gunjan B Malhotra |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083064133 PECOS PAC ID: 3274930763 Enrollment ID: I20210927001218 |
| Provider Name | Jacob W Simpson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669829859 PECOS PAC ID: 2860782216 Enrollment ID: I20211019001071 |
| Provider Name | Karissa Rentfrow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750960126 PECOS PAC ID: 0749670859 Enrollment ID: I20211203002211 |
| Provider Name | Elizabeth A Henschel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841955176 PECOS PAC ID: 8729472816 Enrollment ID: I20220307002170 |
| Provider Name | Danielle P Venema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043979628 PECOS PAC ID: 3072909985 Enrollment ID: I20220401000480 |
| Provider Name | Andrew D Deschaine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932771904 PECOS PAC ID: 6305232935 Enrollment ID: I20220408000137 |
| Provider Name | Kimberly A Chaney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790987469 PECOS PAC ID: 2961594239 Enrollment ID: I20220418000379 |
| Provider Name | Leona Tamara Kwekel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538751326 PECOS PAC ID: 8628465655 Enrollment ID: I20220421002149 |
| Provider Name | Alyssa C Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023785540 PECOS PAC ID: 5193112985 Enrollment ID: I20220426000868 |
| Provider Name | Georgia Gianakakos |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528229184 PECOS PAC ID: 0648317180 Enrollment ID: I20220517001701 |
| Provider Name | Kevin M Buria |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962852798 PECOS PAC ID: 3274892922 Enrollment ID: I20220531002199 |
| Provider Name | Alexander A Armada |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982167193 PECOS PAC ID: 5395070510 Enrollment ID: I20220607000481 |
| Provider Name | Michael D Koets |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184074015 PECOS PAC ID: 2163717059 Enrollment ID: I20220607000607 |
| Provider Name | Mallorie Lanette Hoover |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679969455 PECOS PAC ID: 4486974649 Enrollment ID: I20220608001763 |
| Provider Name | John M Jansen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437711520 PECOS PAC ID: 4183953938 Enrollment ID: I20220609000433 |
| Provider Name | Christine E Larkin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174051395 PECOS PAC ID: 9234408592 Enrollment ID: I20220610000768 |
| Provider Name | Maia E Sullivan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609361344 PECOS PAC ID: 4284980293 Enrollment ID: I20220618000373 |
| Provider Name | Avik Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962942383 PECOS PAC ID: 7416227434 Enrollment ID: I20220712001165 |
| Provider Name | Zachary C Hommer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982192431 PECOS PAC ID: 6002163383 Enrollment ID: I20220713003390 |
| Provider Name | Dona Murphey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144540584 PECOS PAC ID: 6204138670 Enrollment ID: I20220713003754 |
| Provider Name | Maraya M Baumanis |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1245768704 PECOS PAC ID: 8820361322 Enrollment ID: I20220713003783 |
| Provider Name | Maarten L Galantowicz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194257899 PECOS PAC ID: 6608146063 Enrollment ID: I20220715000349 |
| Provider Name | David J Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639602055 PECOS PAC ID: 8628459088 Enrollment ID: I20220715001107 |
| Provider Name | Michael J Hicks |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982125704 PECOS PAC ID: 1759656028 Enrollment ID: I20220715001119 |
| Provider Name | Allen C Wrubel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346772555 PECOS PAC ID: 7719257344 Enrollment ID: I20220725003376 |
| Provider Name | Chen Yin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124559091 PECOS PAC ID: 4486041613 Enrollment ID: I20220727000927 |
| Provider Name | Xueying Hu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174056188 PECOS PAC ID: 8729335419 Enrollment ID: I20220805000454 |
| Provider Name | Bess Marie Connors |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528412517 PECOS PAC ID: 0749578144 Enrollment ID: I20220812002893 |
| Provider Name | Ryan C Overby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881125516 PECOS PAC ID: 6709149875 Enrollment ID: I20220817003279 |
| Provider Name | Jack Hua |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437686201 PECOS PAC ID: 5597149161 Enrollment ID: I20220831000514 |
| Provider Name | Emily A Middlebrook |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790212611 PECOS PAC ID: 1052795473 Enrollment ID: I20220903000070 |
| Provider Name | Andrew J Kure |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053708263 PECOS PAC ID: 5799074597 Enrollment ID: I20220913003352 |
| Provider Name | Shana L Radomski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962931865 PECOS PAC ID: 0840676805 Enrollment ID: I20220929000815 |
| Provider Name | Dana Lynn Gurd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821732199 PECOS PAC ID: 0143606640 Enrollment ID: I20221006002919 |
| Provider Name | Kristie Pagel-compagner |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114306503 PECOS PAC ID: 4486020674 Enrollment ID: I20221012003225 |
| Provider Name | Jamie K Rabideau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083336358 PECOS PAC ID: 9830566454 Enrollment ID: I20221110000664 |
| Provider Name | Kelly A Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013642180 PECOS PAC ID: 4082083068 Enrollment ID: I20221214000772 |
| Provider Name | Stephen R O'neil |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336521756 PECOS PAC ID: 0840505681 Enrollment ID: I20230117000585 |
| Provider Name | Michael William Drazer |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1942564117 PECOS PAC ID: 3577866391 Enrollment ID: I20230118000911 |
| Provider Name | Laura Braaten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588253892 PECOS PAC ID: 9537524947 Enrollment ID: I20230508000367 |
| Provider Name | Elizabeth Margaret Colwell |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1811259047 PECOS PAC ID: 3173842705 Enrollment ID: I20230508000440 |
| Provider Name | Bethany J Busack |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1659802684 PECOS PAC ID: 6901178086 Enrollment ID: I20230517000432 |
| Provider Name | Mariel A Maitland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891482881 PECOS PAC ID: 5597122440 Enrollment ID: I20230607003098 |
| Provider Name | Volanni Brooke Markey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366137911 PECOS PAC ID: 7416314042 Enrollment ID: I20230613001025 |
| Provider Name | Zachary J. Hartley-blossom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225567902 PECOS PAC ID: 8325317894 Enrollment ID: I20230614002400 |
| Provider Name | Samantha L Milana |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669164034 PECOS PAC ID: 2062872732 Enrollment ID: I20230713002394 |
| Provider Name | Aubrey M Kuehnel |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1235633066 PECOS PAC ID: 3870840010 Enrollment ID: I20230713002460 |
| Provider Name | Eric Lee Cox |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1568968956 PECOS PAC ID: 4981968526 Enrollment ID: I20230713002570 |
| Provider Name | Tyler L Ledy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619596814 PECOS PAC ID: 2365867744 Enrollment ID: I20230714000800 |
| Provider Name | Bailey Ledy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861018442 PECOS PAC ID: 4880017771 Enrollment ID: I20230714002486 |
| Provider Name | Alexander Turin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1922426626 PECOS PAC ID: 2062712011 Enrollment ID: I20230715000122 |
| Provider Name | Joshua Logan Breeden |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053809483 PECOS PAC ID: 8426304486 Enrollment ID: I20230717003296 |
| Provider Name | Allie C Toth |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851881866 PECOS PAC ID: 3375890908 Enrollment ID: I20230718003395 |
| Provider Name | John Daniel Comer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790219160 PECOS PAC ID: 4082074307 Enrollment ID: I20230719000291 |
| Provider Name | Kyle Arthur Grassel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861996456 PECOS PAC ID: 6204182322 Enrollment ID: I20230719000369 |
| Provider Name | Michael Wolfe |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1124655824 PECOS PAC ID: 0143643254 Enrollment ID: I20230719000373 |
| Provider Name | Crysta B Iv Kyrazis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881191351 PECOS PAC ID: 8729337282 Enrollment ID: I20230719000567 |
| Provider Name | Benjamin R Himelhoch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487149852 PECOS PAC ID: 8921357260 Enrollment ID: I20230719001493 |
| Provider Name | Rishabh Gattu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376036707 PECOS PAC ID: 0345600342 Enrollment ID: I20230724000214 |
| Provider Name | Andrew D Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366071094 PECOS PAC ID: 5890155709 Enrollment ID: I20230724001169 |
| Provider Name | Stephen P. Winter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669961835 PECOS PAC ID: 0941551956 Enrollment ID: I20230725003197 |
| Provider Name | Scott Jeffery Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528557139 PECOS PAC ID: 1456712306 Enrollment ID: I20230725003603 |
| Provider Name | James D Chessrown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427677475 PECOS PAC ID: 6608298476 Enrollment ID: I20230726001864 |
| Provider Name | Andersen Jean Shemme |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861986481 PECOS PAC ID: 0143578120 Enrollment ID: I20230801000796 |
| Provider Name | Lindsay Israels |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316576804 PECOS PAC ID: 9931521663 Enrollment ID: I20230802002506 |
| Provider Name | Eric Robert Swy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619461233 PECOS PAC ID: 4183972482 Enrollment ID: I20230803000504 |
| Provider Name | Pamela Kay Henion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194100693 PECOS PAC ID: 6507156247 Enrollment ID: I20230808001827 |
| Provider Name | Eric D Schadler |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1225599897 PECOS PAC ID: 5890029375 Enrollment ID: I20230809000778 |
| Provider Name | Courtney A Plouff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750090932 PECOS PAC ID: 3971966037 Enrollment ID: I20230823001567 |
| Provider Name | Kathryn Arnold Leonard |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1346701919 PECOS PAC ID: 4183959489 Enrollment ID: I20230831004310 |
| Provider Name | Hanna M Poole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104432905 PECOS PAC ID: 0749690261 Enrollment ID: I20230913003582 |
| Provider Name | Kristy Lynn Natte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992483200 PECOS PAC ID: 2668827106 Enrollment ID: I20231018001847 |
| Provider Name | Migena Betz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144476367 PECOS PAC ID: 6002057668 Enrollment ID: I20240109004299 |
| Provider Name | Nathalie G Hautala |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336839174 PECOS PAC ID: 6406209725 Enrollment ID: I20240201004326 |
Jasper Health Worx Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5960 Burlingame Ave Sw Ste A, Wyoming, MI 49509 Phone: 877-291-6488 | |
Metro Health Community Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 781 36th St Se, Wyoming, MI 49548 Phone: 616-252-4100 Fax: 616-252-4953 | |
Catherines Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 950 36th St Sw, Wyoming, MI 49509 Phone: 616-336-8800 | |
Midwest Family Medicine Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1009 44th St Sw, Suite A1, Wyoming, MI 49509 Phone: 800-968-6866 | |
Pediatrics Primary Care Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4433 Byron Center Ave Sw, Pediatrics Primary Care, Wyoming, MI 49519 Phone: 616-530-2846 Fax: 616-530-2854 | |
Spectrum Health Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5500 Clyde Park Ave Sw, Wyoming, MI 49509 Phone: 616-486-6790 | |
Allen Surgical Care, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1009 44th St Sw Ste 101, Wyoming, MI 49509 Phone: 616-828-4622 |