| Mhs Primary Care, Inc | |
|
28 Crescent St Middletown CT 06457-3654 | |
| (860) 358-4820 | |
| (860) 358-8661 |
| Full Name | Mhs Primary Care, Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 28 Crescent St, Middletown, Connecticut |
| Authorized Official Name and Position | Susan Martin (VP FINANCE) |
| Authorized Official Contact | 8603583005 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mhs Primary Care, Inc 28 Crescent St Middletown CT 06457-3654 Ph: (860) 358-4820 | Mhs Primary Care, Inc 28 Crescent St Middletown CT 06457-3654 Ph: (860) 358-4820 |
| NPI Number | 1336279058 |
|---|---|
| Provider Enumeration Date | 03/06/2007 |
| Last Update Date | 05/03/2021 |
| Certification Date | 05/03/2021 |
| Medicare PECOS PAC ID | 4082507371 |
|---|---|
| Medicare Enrollment ID | O20040202000945 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336279058 | NPI | - | NPPES |
| 04201084 | Medicaid | CT | |
| 04173259 | Medicaid | CT | |
| 008073532 | Medicaid | CT | |
| 04181343 | Medicaid | CT |
| Provider Name | May S Habboosh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780621946 PECOS PAC ID: 9436056645 Enrollment ID: I20031216000692 |
| Provider Name | Pamela M Murphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043321474 PECOS PAC ID: 7517951304 Enrollment ID: I20040414000027 |
| Provider Name | Eric J Fisher |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730190034 PECOS PAC ID: 3577558162 Enrollment ID: I20040414001640 |
| Provider Name | Carla E Mcleod |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669424248 PECOS PAC ID: 9133192727 Enrollment ID: I20040812001187 |
| Provider Name | Jude J Ade |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508865585 PECOS PAC ID: 7719944354 Enrollment ID: I20041215000106 |
| Provider Name | Brendon T Thompson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649372509 PECOS PAC ID: 5193776847 Enrollment ID: I20050210000024 |
| Provider Name | Erika L Skinnon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578546925 PECOS PAC ID: 0143267435 Enrollment ID: I20050408000095 |
| Provider Name | John Carbone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366487563 PECOS PAC ID: 9335180223 Enrollment ID: I20050520000596 |
| Provider Name | Monika Hoang-skawinska |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1063427599 PECOS PAC ID: 9830119478 Enrollment ID: I20051129000219 |
| Provider Name | Andrea M Niziolek |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669415576 PECOS PAC ID: 5294741112 Enrollment ID: I20060302000200 |
| Provider Name | Elizabeth a Fabrizi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275636292 PECOS PAC ID: 9234148370 Enrollment ID: I20060418000316 |
| Provider Name | Christopher J Stacer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750340782 PECOS PAC ID: 5193735611 Enrollment ID: I20060428000108 |
| Provider Name | Amy K Brown |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1518900133 PECOS PAC ID: 5294748901 Enrollment ID: I20060725000358 |
| Provider Name | Maureen C Bracco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326072166 PECOS PAC ID: 6002813979 Enrollment ID: I20061107000346 |
| Provider Name | Deirdre Pagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740390103 PECOS PAC ID: 8325048911 Enrollment ID: I20070104000404 |
| Provider Name | Ying Zheng |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811062516 PECOS PAC ID: 1052413283 Enrollment ID: I20070219000616 |
| Provider Name | Elizabeth K Nelligan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174663884 PECOS PAC ID: 1456453364 Enrollment ID: I20070223000398 |
| Provider Name | Millicent M Malcolm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255418414 PECOS PAC ID: 2769586155 Enrollment ID: I20070323000363 |
| Provider Name | David Parmelee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124123518 PECOS PAC ID: 5294839262 Enrollment ID: I20070330000384 |
| Provider Name | Christine E Franzen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144322298 PECOS PAC ID: 0941304729 Enrollment ID: I20070404000138 |
| Provider Name | Malisa L Lahtinen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346371465 PECOS PAC ID: 5991890717 Enrollment ID: I20071009000026 |
| Provider Name | Elin L Christensen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356534457 PECOS PAC ID: 9335238484 Enrollment ID: I20071128000096 |
| Provider Name | Rosemarie G Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396930491 PECOS PAC ID: 4082795950 Enrollment ID: I20080116000732 |
| Provider Name | Shane T Ridge |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780884569 PECOS PAC ID: 8224116306 Enrollment ID: I20080416000010 |
| Provider Name | Edward G Myer |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1487845541 PECOS PAC ID: 4688746548 Enrollment ID: I20080709000512 |
| Provider Name | Richard O Frink |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1306941067 PECOS PAC ID: 3678645520 Enrollment ID: I20080709000551 |
| Provider Name | Howard P Boey |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1306868229 PECOS PAC ID: 5193898336 Enrollment ID: I20080721000540 |
| Provider Name | Laura G Bony |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750436119 PECOS PAC ID: 9931277753 Enrollment ID: I20081007000484 |
| Provider Name | Louise M Maloney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801825799 PECOS PAC ID: 1052479144 Enrollment ID: I20081017000527 |
| Provider Name | Bryan T Danna |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033360300 PECOS PAC ID: 4789743006 Enrollment ID: I20081031000319 |
| Provider Name | Shawna L Day |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700034717 PECOS PAC ID: 4789744319 Enrollment ID: I20081126000552 |
| Provider Name | Kelly a Rainey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699733477 PECOS PAC ID: 0042372609 Enrollment ID: I20081216000700 |
| Provider Name | Paul J Fortgang |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1649292566 PECOS PAC ID: 8224191630 Enrollment ID: I20090112000427 |
| Provider Name | Christopher German |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356587729 PECOS PAC ID: 6406913649 Enrollment ID: I20090316000342 |
| Provider Name | Jeffrey M O'connor |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730345117 PECOS PAC ID: 2961412044 Enrollment ID: I20090604000052 |
| Provider Name | Ken Yanagisawa |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1225055064 PECOS PAC ID: 2466504816 Enrollment ID: I20090715000561 |
| Provider Name | Ronald Hisao Hirokawa |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1346267200 PECOS PAC ID: 9739231119 Enrollment ID: I20090715000647 |
| Provider Name | Mark Dagostino |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1144230749 PECOS PAC ID: 9638221096 Enrollment ID: I20090715000682 |
| Provider Name | Lauren H Nichols |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1619200920 PECOS PAC ID: 4183760093 Enrollment ID: I20091007000314 |
| Provider Name | Kelsey E Caulfield |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245462589 PECOS PAC ID: 7214074640 Enrollment ID: I20091016000436 |
| Provider Name | Susanne L Scofield Hinton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548595275 PECOS PAC ID: 3476690207 Enrollment ID: I20091027000353 |
| Provider Name | Timothy a Tobin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184669566 PECOS PAC ID: 6406995307 Enrollment ID: I20091207000379 |
| Provider Name | Ioanna Anastasiadis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790858058 PECOS PAC ID: 7719027648 Enrollment ID: I20091228000243 |
| Provider Name | Melissa Marie Heins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255564464 PECOS PAC ID: 2668512567 Enrollment ID: I20100105000321 |
| Provider Name | Rena C Jacobs |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629301718 PECOS PAC ID: 2567503923 Enrollment ID: I20100107000117 |
| Provider Name | Wendy M Griswold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639406184 PECOS PAC ID: 5991847071 Enrollment ID: I20100128000029 |
| Provider Name | Stephen J Siegel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376570168 PECOS PAC ID: 4587707187 Enrollment ID: I20100204000443 |
| Provider Name | Robert W Kyrcz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346253457 PECOS PAC ID: 7517098403 Enrollment ID: I20100621000476 |
| Provider Name | Christopher S Curdo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497766422 PECOS PAC ID: 7416088307 Enrollment ID: I20100621000493 |
| Provider Name | Linda Jean Weiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245216787 PECOS PAC ID: 4981736824 Enrollment ID: I20100713000402 |
| Provider Name | Michael P Spada |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336348887 PECOS PAC ID: 0547393100 Enrollment ID: I20100803000362 |
| Provider Name | Kathryn M Mcdonnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649357807 PECOS PAC ID: 8527191725 Enrollment ID: I20100809000012 |
| Provider Name | Thomas E Gorsky |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356438451 PECOS PAC ID: 1557485299 Enrollment ID: I20100901000457 |
| Provider Name | Jennifer P Swenson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134223654 PECOS PAC ID: 6406944115 Enrollment ID: I20100911000131 |
| Provider Name | Jonathan S Aranow |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922176825 PECOS PAC ID: 8921123027 Enrollment ID: I20100913001017 |
| Provider Name | Andrea M Malon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306825609 PECOS PAC ID: 5597826487 Enrollment ID: I20101013000494 |
| Provider Name | Melissa S Salonia |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679886048 PECOS PAC ID: 1951595495 Enrollment ID: I20101028001430 |
| Provider Name | Peter S Romeyn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720068406 PECOS PAC ID: 2466513486 Enrollment ID: I20101215000633 |
| Provider Name | Johnny Chang |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1619975182 PECOS PAC ID: 6608974340 Enrollment ID: I20110110000788 |
| Provider Name | Fawzu F Mohammadu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235345430 PECOS PAC ID: 0749372142 Enrollment ID: I20110115000007 |
| Provider Name | Anne S Bingham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578516688 PECOS PAC ID: 9133309602 Enrollment ID: I20110216000053 |
| Provider Name | Margaret Healther Einstein |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1295791705 PECOS PAC ID: 3870667728 Enrollment ID: I20110606000414 |
| Provider Name | Timothy C Siegrist |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1720279946 PECOS PAC ID: 1759569437 Enrollment ID: I20110628000538 |
| Provider Name | James Parker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083932719 PECOS PAC ID: 2567594518 Enrollment ID: I20110919000134 |
| Provider Name | Keri a Klink |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336419886 PECOS PAC ID: 0941468292 Enrollment ID: I20120216000331 |
| Provider Name | Colleen R Chappell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487910527 PECOS PAC ID: 6103081260 Enrollment ID: I20120625000003 |
| Provider Name | Laura F Reddington |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932487238 PECOS PAC ID: 1254597206 Enrollment ID: I20120719000588 |
| Provider Name | Israel Cordero |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124281613 PECOS PAC ID: 3577719830 Enrollment ID: I20120802000297 |
| Provider Name | Nikolaos Vassiliou |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851554349 PECOS PAC ID: 1759537509 Enrollment ID: I20120809000519 |
| Provider Name | Jonathan a Cosin |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1417936139 PECOS PAC ID: 3173709920 Enrollment ID: I20121011000526 |
| Provider Name | Julie Ann Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316299704 PECOS PAC ID: 3971756974 Enrollment ID: I20121226000001 |
| Provider Name | Nathan W Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174868095 PECOS PAC ID: 0345494373 Enrollment ID: I20130129000201 |
| Provider Name | Jessica Paulson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366799587 PECOS PAC ID: 3375780786 Enrollment ID: I20130502000108 |
| Provider Name | Matthew F Nichols |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1093028052 PECOS PAC ID: 8426298324 Enrollment ID: I20130716000769 |
| Provider Name | Kenneth M Schwartz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164606372 PECOS PAC ID: 1456593359 Enrollment ID: I20130806000002 |
| Provider Name | Elise K Gates |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518176387 PECOS PAC ID: 9032361597 Enrollment ID: I20130813000648 |
| Provider Name | Nazmiye Esra Hatiboglu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225266547 PECOS PAC ID: 7911144761 Enrollment ID: I20130926000574 |
| Provider Name | Madeline Munn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174957476 PECOS PAC ID: 7719113463 Enrollment ID: I20131202001026 |
| Provider Name | Nicole M Kirley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447672233 PECOS PAC ID: 7719118546 Enrollment ID: I20140320001027 |
| Provider Name | Larissa Fopeano |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326396284 PECOS PAC ID: 1850522558 Enrollment ID: I20140321001567 |
| Provider Name | Jennifer Sutherland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063621829 PECOS PAC ID: 2365535788 Enrollment ID: I20140425001629 |
| Provider Name | Suzanne P Tingley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063834448 PECOS PAC ID: 2860615283 Enrollment ID: I20140603001012 |
| Provider Name | Kevin a Belanger |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932408002 PECOS PAC ID: 0446478028 Enrollment ID: I20140822001181 |
| Provider Name | Jessica a Terrone Roehr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710206339 PECOS PAC ID: 6002056405 Enrollment ID: I20140917000562 |
| Provider Name | Alexandra N Schain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578973905 PECOS PAC ID: 1850511973 Enrollment ID: I20141013000523 |
| Provider Name | Marguerite M Lamb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114326261 PECOS PAC ID: 3678794393 Enrollment ID: I20141022001518 |
| Provider Name | Priscilla Richards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396147005 PECOS PAC ID: 2860714789 Enrollment ID: I20141204000554 |
| Provider Name | Robert Giordano |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033525407 PECOS PAC ID: 1759606403 Enrollment ID: I20150220001852 |
| Provider Name | Kristy Michelle Zerfass |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558769935 PECOS PAC ID: 7810213832 Enrollment ID: I20150310000116 |
| Provider Name | Katherine S Erikson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366837056 PECOS PAC ID: 1759601610 Enrollment ID: I20150518001649 |
| Provider Name | Zoe G Mcglamery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013304526 PECOS PAC ID: 6507177946 Enrollment ID: I20150625001874 |
| Provider Name | Ephraim Wakszul |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528471687 PECOS PAC ID: 8426362989 Enrollment ID: I20150729007039 |
| Provider Name | Justin Caskey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346536398 PECOS PAC ID: 3375781099 Enrollment ID: I20150805008223 |
| Provider Name | Craig O Brancato |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912388257 PECOS PAC ID: 6002122579 Enrollment ID: I20150828000589 |
| Provider Name | Jaime a Camacho |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548643653 PECOS PAC ID: 4385952431 Enrollment ID: I20151009000391 |
| Provider Name | Lindsey C. Roncaioli |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962743872 PECOS PAC ID: 2961640701 Enrollment ID: I20151116001700 |
| Provider Name | Siobhan E Harder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588032866 PECOS PAC ID: 5092015297 Enrollment ID: I20151119001135 |
| Provider Name | Emily Miesse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871969998 PECOS PAC ID: 1456651603 Enrollment ID: I20151120000159 |
| Provider Name | Jennifer Freeman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083087142 PECOS PAC ID: 5991007635 Enrollment ID: I20160112001643 |
| Provider Name | Nicole L Davis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265864730 PECOS PAC ID: 8628203940 Enrollment ID: I20160427002002 |
| Provider Name | John D Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366707580 PECOS PAC ID: 9638319023 Enrollment ID: I20160803001271 |
| Provider Name | Kristen Donato |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174888390 PECOS PAC ID: 1153560206 Enrollment ID: I20160810002281 |
| Provider Name | Amanda R Weinberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174973812 PECOS PAC ID: 1052607413 Enrollment ID: I20160912000109 |
| Provider Name | Alyssa M Olsen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770933541 PECOS PAC ID: 6002102126 Enrollment ID: I20160915000852 |
| Provider Name | Nicholas R Klock |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629420435 PECOS PAC ID: 3476840190 Enrollment ID: I20160923001455 |
| Provider Name | Daniel Cervonka |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932125036 PECOS PAC ID: 7517245418 Enrollment ID: I20161027001870 |
| Provider Name | Kelly Elizabeth Smyth |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730634791 PECOS PAC ID: 8527347806 Enrollment ID: I20161108002473 |
| Provider Name | Chia-chi Wang |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1023254273 PECOS PAC ID: 9739230616 Enrollment ID: I20161209001179 |
| Provider Name | Kaylan C Mcdowell-smith |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255789129 PECOS PAC ID: 5496038150 Enrollment ID: I20170203001914 |
| Provider Name | Valerie C Mundy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407392673 PECOS PAC ID: 1557645330 Enrollment ID: I20170222001132 |
| Provider Name | Dana U Kivlin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1679869572 PECOS PAC ID: 0941599419 Enrollment ID: I20170310000583 |
| Provider Name | Justine Lauren Vanacore |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407101819 PECOS PAC ID: 8628368685 Enrollment ID: I20170324000366 |
| Provider Name | Kulwinder N Bajwa |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1952833394 PECOS PAC ID: 8224315346 Enrollment ID: I20170427001267 |
| Provider Name | Pamela Wertheim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205367117 PECOS PAC ID: 4183901507 Enrollment ID: I20170511001403 |
| Provider Name | Carol Standish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598219636 PECOS PAC ID: 8820368970 Enrollment ID: I20170721001672 |
| Provider Name | Amy R Scheel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437687282 PECOS PAC ID: 0749551125 Enrollment ID: I20170803000295 |
| Provider Name | Meredith Lindner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942616826 PECOS PAC ID: 4183995319 Enrollment ID: I20170807003197 |
| Provider Name | Marc Roy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720428576 PECOS PAC ID: 8426331208 Enrollment ID: I20170809000391 |
| Provider Name | Ivonne Juarez-chavez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114447190 PECOS PAC ID: 0941571939 Enrollment ID: I20170809003319 |
| Provider Name | Patrick Kehl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265872956 PECOS PAC ID: 7214170018 Enrollment ID: I20170816000286 |
| Provider Name | Shelley Burchsted |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235579251 PECOS PAC ID: 8628211224 Enrollment ID: I20170825002352 |
| Provider Name | Janis E Morin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194254417 PECOS PAC ID: 7315210838 Enrollment ID: I20170906000060 |
| Provider Name | Jessica Reichbind |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417367657 PECOS PAC ID: 8628341757 Enrollment ID: I20170912000198 |
| Provider Name | Marylou Silva |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932197811 PECOS PAC ID: 7618943465 Enrollment ID: I20171006002386 |
| Provider Name | Kittie Lee Spedding |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1801083498 PECOS PAC ID: 6305109067 Enrollment ID: I20180410001997 |
| Provider Name | Tiffany T Chen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1548603525 PECOS PAC ID: 7517212533 Enrollment ID: I20180615000861 |
| Provider Name | Brianna Louise Gawish |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245721992 PECOS PAC ID: 4688920267 Enrollment ID: I20180712000902 |
| Provider Name | Stephanie Katherine Schmitt |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013403682 PECOS PAC ID: 1355698101 Enrollment ID: I20180725000153 |
| Provider Name | Grigoriy Vitalyevich Klimovich |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932545399 PECOS PAC ID: 3870841364 Enrollment ID: I20180731001160 |
| Provider Name | Melissa a Fazzolari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477041564 PECOS PAC ID: 6901157155 Enrollment ID: I20180926003765 |
| Provider Name | Mary Elizabeth Van Siclen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730590860 PECOS PAC ID: 5092033597 Enrollment ID: I20181003002665 |
| Provider Name | Marguerite Palisoul |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1235425521 PECOS PAC ID: 8921390535 Enrollment ID: I20181012000615 |
| Provider Name | Stephanie Schmidt |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1366854499 PECOS PAC ID: 4981909884 Enrollment ID: I20181106001809 |
| Provider Name | Erin Michele Zaffis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1225507361 PECOS PAC ID: 3476899923 Enrollment ID: I20190104000755 |
| Provider Name | Stephen Daniel Socha |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013486034 PECOS PAC ID: 0244125573 Enrollment ID: I20190307002955 |
| Provider Name | Kelly M Donihe |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649741786 PECOS PAC ID: 3779823273 Enrollment ID: I20190320001229 |
| Provider Name | Daniela Calle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356905590 PECOS PAC ID: 3072846542 Enrollment ID: I20190617000095 |
| Provider Name | Kylie Marie Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609430362 PECOS PAC ID: 1850625781 Enrollment ID: I20190627000445 |
| Provider Name | Kristi a Zuniga Aguilar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811454804 PECOS PAC ID: 9032446570 Enrollment ID: I20190807000883 |
| Provider Name | Dana Marie Cantiello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518513647 PECOS PAC ID: 7416288329 Enrollment ID: I20191008000607 |
| Provider Name | Jason Mark Ziegler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326497876 PECOS PAC ID: 0648566588 Enrollment ID: I20191111000094 |
| Provider Name | Ariel C Morley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962062810 PECOS PAC ID: 5991137168 Enrollment ID: I20191111001010 |
| Provider Name | Michael R Tammaro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548801830 PECOS PAC ID: 5193157162 Enrollment ID: I20191112003362 |
| Provider Name | Neville J Graham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508415399 PECOS PAC ID: 0648603456 Enrollment ID: I20191210000900 |
| Provider Name | Juliette Nedah Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962889337 PECOS PAC ID: 4486942240 Enrollment ID: I20200130002827 |
| Provider Name | Elizabeth Barrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790332567 PECOS PAC ID: 1254767387 Enrollment ID: I20200207000839 |
| Provider Name | Peder Johnsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639791577 PECOS PAC ID: 2961823976 Enrollment ID: I20200529002020 |
| Provider Name | Jennifer Worth |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1538289269 PECOS PAC ID: 1456441385 Enrollment ID: I20200804002943 |
| Provider Name | Hannah Sharma |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306467170 PECOS PAC ID: 3375969025 Enrollment ID: I20200812002829 |
| Provider Name | Gabrielle Berthiaume |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396354973 PECOS PAC ID: 1658799382 Enrollment ID: I20200914000234 |
| Provider Name | Kathleen Frame |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033490461 PECOS PAC ID: 6305096439 Enrollment ID: I20201029000875 |
| Provider Name | Jenna Kaitlyn Parks |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407463235 PECOS PAC ID: 0941610828 Enrollment ID: I20201104001002 |
| Provider Name | Kristin Holahan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255855573 PECOS PAC ID: 4981979952 Enrollment ID: I20201123002201 |
| Provider Name | Kathy Ngo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1871157255 PECOS PAC ID: 9032520804 Enrollment ID: I20201130001874 |
| Provider Name | Kristi Poehlmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194325704 PECOS PAC ID: 9133530843 Enrollment ID: I20201202001245 |
| Provider Name | Marissa Louise Goodnight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982211199 PECOS PAC ID: 1557774635 Enrollment ID: I20210109000072 |
| Provider Name | Beitris Mckeon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457767238 PECOS PAC ID: 5799904090 Enrollment ID: I20210122000720 |
| Provider Name | Ellen M Schroeder |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770100042 PECOS PAC ID: 1850705229 Enrollment ID: I20210126001134 |
| Provider Name | Kertrisa R Mcwhite |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1023053485 PECOS PAC ID: 9739190471 Enrollment ID: I20210413000506 |
| Provider Name | Mary K Morrison |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386263010 PECOS PAC ID: 1557770328 Enrollment ID: I20210506002172 |
| Provider Name | Daniel Walker |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1760820682 PECOS PAC ID: 2466758826 Enrollment ID: I20210624000139 |
| Provider Name | Daniel Henriquez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326573072 PECOS PAC ID: 6103194337 Enrollment ID: I20210712002244 |
| Provider Name | Sarah Fortin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043745714 PECOS PAC ID: 0547537094 Enrollment ID: I20210719000020 |
| Provider Name | Daniel Underhill |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083251490 PECOS PAC ID: 3779987052 Enrollment ID: I20210809002483 |
| Provider Name | Mary Louise Burbank |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1922647601 PECOS PAC ID: 7113322520 Enrollment ID: I20210824001064 |
| Provider Name | Sommar Otfinoski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194392605 PECOS PAC ID: 3779989587 Enrollment ID: I20210902001171 |
| Provider Name | Nicole Sun Cirilli |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1154948990 PECOS PAC ID: 7214326487 Enrollment ID: I20211109001073 |
| Provider Name | Christina Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851051890 PECOS PAC ID: 0042601072 Enrollment ID: I20211229000973 |
| Provider Name | Danielle Nicole Schweidenback |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609534437 PECOS PAC ID: 8729470786 Enrollment ID: I20220125000723 |
| Provider Name | Alyssa Duperry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245994284 PECOS PAC ID: 0446644033 Enrollment ID: I20220224001331 |
| Provider Name | Taylor Griffeth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285394007 PECOS PAC ID: 5294120820 Enrollment ID: I20220318000037 |
| Provider Name | Debra August King |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508042664 PECOS PAC ID: 8325345119 Enrollment ID: I20220411002475 |
| Provider Name | Alexandra Anne Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063900983 PECOS PAC ID: 6406103746 Enrollment ID: I20220706003018 |
| Provider Name | Mark Lightowler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376000869 PECOS PAC ID: 9739422379 Enrollment ID: I20220711000271 |
| Provider Name | Justin T Van Backer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396139762 PECOS PAC ID: 2163768995 Enrollment ID: I20220728002186 |
| Provider Name | Rachel Ann Nuzzi |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356082051 PECOS PAC ID: 9638551914 Enrollment ID: I20220803000870 |
| Provider Name | Brooke Elizabeth Soderberg |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518617596 PECOS PAC ID: 8426431131 Enrollment ID: I20220812002160 |
| Provider Name | Yevgeniya Borovinskaya |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104314020 PECOS PAC ID: 0648527044 Enrollment ID: I20220817002756 |
| Provider Name | Jonathan Katz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467940395 PECOS PAC ID: 5294082517 Enrollment ID: I20220817002858 |
| Provider Name | Amanda Joyce |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609524727 PECOS PAC ID: 6901289040 Enrollment ID: I20220822003644 |
| Provider Name | Robert Cooper Brown |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417378019 PECOS PAC ID: 3577862085 Enrollment ID: I20220930002649 |
| Provider Name | Jessica M Bautista |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1659007052 PECOS PAC ID: 4587031950 Enrollment ID: I20221028000465 |
| Provider Name | Jenna Carolyn Phenicie |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083322929 PECOS PAC ID: 9335518307 Enrollment ID: I20221214000348 |
| Provider Name | Carly Bendzans |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1083002158 PECOS PAC ID: 3173806957 Enrollment ID: I20221221000539 |
| Provider Name | Katherine Parsley Glotzer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255783262 PECOS PAC ID: 7810281847 Enrollment ID: I20221228002459 |
| Provider Name | Wendy Baier Cartier |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1194322883 PECOS PAC ID: 4981074143 Enrollment ID: I20230104000547 |
| Provider Name | Mara Shaw Whitmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851004782 PECOS PAC ID: 0840664603 Enrollment ID: I20230316002651 |
| Provider Name | Taner Ulke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528478138 PECOS PAC ID: 7911293709 Enrollment ID: I20230427001957 |
| Provider Name | Tiffany Simone Olayinka Olier |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265894406 PECOS PAC ID: 9133463441 Enrollment ID: I20230718000849 |
| Provider Name | Sona Manoj Sadselia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285298992 PECOS PAC ID: 8325371552 Enrollment ID: I20230724002835 |
| Provider Name | Morgan Bryant Feshler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609552280 PECOS PAC ID: 7012370836 Enrollment ID: I20230828001022 |
| Provider Name | Kalpana Ginugu Reddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609430354 PECOS PAC ID: 3870826464 Enrollment ID: I20230901002568 |
| Provider Name | Izabela Anna Ferrer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548882830 PECOS PAC ID: 1951765445 Enrollment ID: I20230918000668 |
| Provider Name | Gabrielle Ann Lebeau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629762448 PECOS PAC ID: 3274987482 Enrollment ID: I20230921002401 |
| Provider Name | Paul Ericson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144713819 PECOS PAC ID: 4587910146 Enrollment ID: I20231013000679 |
| Provider Name | Alana Alesse Vega |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407636566 PECOS PAC ID: 9335596154 Enrollment ID: I20231115002109 |
| Provider Name | Gabrielle Schiavone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649750282 PECOS PAC ID: 7810238466 Enrollment ID: I20231213002255 |
| Provider Name | Jessie R Jones |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477012623 PECOS PAC ID: 4587992482 Enrollment ID: I20231222001332 |
| Provider Name | Caitlin Smith |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1750154357 PECOS PAC ID: 4486090925 Enrollment ID: I20240307000362 |
| Provider Name | Amanda Monfalcone |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790403855 PECOS PAC ID: 6901271808 Enrollment ID: I20240430002662 |
| Provider Name | Gina Lang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972165728 PECOS PAC ID: 6608104963 Enrollment ID: I20240625003893 |
| Provider Name | Samantha Vierling |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417579053 PECOS PAC ID: 5991121600 Enrollment ID: I20240705000423 |
| Provider Name | Steven Ferrara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396815577 PECOS PAC ID: 3779578695 Enrollment ID: I20240711000517 |
| Provider Name | Jillian Haynes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811524473 PECOS PAC ID: 3678010832 Enrollment ID: I20240806000616 |
| Provider Name | Jonathan Li |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1619436169 PECOS PAC ID: 4082941133 Enrollment ID: I20240806000869 |
| Provider Name | Tyler Joseph Ditunno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497521629 PECOS PAC ID: 1254870827 Enrollment ID: I20240827002489 |
| Provider Name | Nikki Santillo |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1275371486 PECOS PAC ID: 3779022017 Enrollment ID: I20240829003860 |
| Provider Name | Nicholas Alexander Read |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093335903 PECOS PAC ID: 0648691121 Enrollment ID: I20240910001377 |
| Provider Name | Rebekah Comer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730907148 PECOS PAC ID: 1355875030 Enrollment ID: I20241118002358 |
| Provider Name | David Augenblick |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073136305 PECOS PAC ID: 2668895699 Enrollment ID: I20250729001722 |
| Provider Name | Colleen Fritton Gardner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952861429 PECOS PAC ID: 1759624869 Enrollment ID: I20250802000118 |
| Provider Name | Alison Danielle Stedman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295314292 PECOS PAC ID: 7113326315 Enrollment ID: I20250905000189 |
| Provider Name | Ellen Walker Seyller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558940445 PECOS PAC ID: 0244639458 Enrollment ID: I20250909002782 |
| Provider Name | Mia Elana Fischbein |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457937286 PECOS PAC ID: 1658876461 Enrollment ID: I20250923004153 |
| Provider Name | Cara Jeanne Ciesla |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1649328881 PECOS PAC ID: 3173008588 Enrollment ID: I20260402001379 |
| Provider Name | Pamela Jean Dewitt |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1740133040 PECOS PAC ID: 5991270118 Enrollment ID: I20260406002372 |
| Provider Name | Sugata Bhattacharjee |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1114171840 PECOS PAC ID: 5496220345 Enrollment ID: I20260408000977 |
| Provider Name | Wilson Thanh Nguyen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972363901 PECOS PAC ID: 7012484645 Enrollment ID: I20260430002783 |
Preferred Care Walk-in Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 842 Washington St, Middletown, CT 06457 Phone: 860-346-4484 Fax: 860-347-1343 |
Revolutionary Recovery Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 799 Long Hill Rd Apt D, Middletown, CT 06457 Phone: 860-558-4226 |
Matthew Raider MD LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 645 Saybrook Rd, Middletown, CT 06457 Phone: 860-767-4024 |
Community Health Center Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 635 Main St, Middletown, CT 06457 Phone: 860-347-6971 Fax: 860-638-6601 |
Weslyan Sports Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 237 High St, Middletown, CT 06459 Phone: 860-685-3068 Fax: 972-367-3451 |
Saybrook Medical PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 760 Saybrook Rd, Middletown, CT 06457 Phone: 860-347-3304 Fax: 860-346-8245 |