| Nantucket Physicians Organization | |
|
57 Prospect St Room 101 Nantucket MA 02554-2799 | |
| (508) 776-7428 | |
| (508) 693-5942 |
| Full Name | Nantucket Physicians Organization |
|---|---|
| Speciality | Orthopaedic Surgery |
| Location | 57 Prospect St, Nantucket, Massachusetts |
| Authorized Official Name and Position | Jennifer Malloy Monto (MANAGER) |
| Authorized Official Contact | 5088251327 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nantucket Physicians Organization 57 Prospect St Room 122 Nantucket MA 02554-2799 Ph: (508) 825-1327 | Nantucket Physicians Organization 57 Prospect St Room 101 Nantucket MA 02554-2799 Ph: (508) 776-7428 |
| NPI Number | 1568798510 |
|---|---|
| Provider Enumeration Date | 10/27/2009 |
| Last Update Date | 08/16/2017 |
| Medicare PECOS PAC ID | 6608065438 |
|---|---|
| Medicare Enrollment ID | O20110111000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568798510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 242762 (Massachusetts) | Secondary |
| 207X00000X | Orthopaedic Surgery | 150697 (Massachusetts) | Primary |
| Provider Name | Gary J Brenner |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1447240627 PECOS PAC ID: 3375449598 Enrollment ID: I20031209000777 |
| Provider Name | Salma Batool Anwar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285624916 PECOS PAC ID: 1254230840 Enrollment ID: I20040102000428 |
| Provider Name | Nancy Lucchini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689697492 PECOS PAC ID: 8224931555 Enrollment ID: I20040202000585 |
| Provider Name | Richard H Ma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013995398 PECOS PAC ID: 0547153611 Enrollment ID: I20040203000820 |
| Provider Name | Caroline Kuhlman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215093133 PECOS PAC ID: 7517851223 Enrollment ID: I20040212000514 |
| Provider Name | Jeanne Griffin Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710042346 PECOS PAC ID: 6002800059 Enrollment ID: I20040413000114 |
| Provider Name | Matthew Tierney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134105646 PECOS PAC ID: 1052308558 Enrollment ID: I20040427001304 |
| Provider Name | Nandita Srividya Scott |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316051212 PECOS PAC ID: 0840289369 Enrollment ID: I20040510001305 |
| Provider Name | Cherylyn Black |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689697245 PECOS PAC ID: 4981694072 Enrollment ID: I20040512000870 |
| Provider Name | Gregg S Meyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811997927 PECOS PAC ID: 1456264829 Enrollment ID: I20040617000188 |
| Provider Name | Paul I Geraldez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457342958 PECOS PAC ID: 4981684958 Enrollment ID: I20040721000564 |
| Provider Name | Hana Dubsky |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1669568275 PECOS PAC ID: 7416927256 Enrollment ID: I20040728001417 |
| Provider Name | Shihab Ahmed |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1821088451 PECOS PAC ID: 7214900901 Enrollment ID: I20040819000929 |
| Provider Name | Joseph Michael Garasic |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154303808 PECOS PAC ID: 9436123502 Enrollment ID: I20040824000772 |
| Provider Name | John F Hanlon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417994153 PECOS PAC ID: 1153381033 Enrollment ID: I20041014000941 |
| Provider Name | Richard H. Koehler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831146414 PECOS PAC ID: 2668462706 Enrollment ID: I20041104000928 |
| Provider Name | Heather R Becker |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962403634 PECOS PAC ID: 2860440401 Enrollment ID: I20050110001043 |
| Provider Name | Shelly L Weedon |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982712394 PECOS PAC ID: 9739132069 Enrollment ID: I20050228000346 |
| Provider Name | Donald S Marks |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982680740 PECOS PAC ID: 4789630252 Enrollment ID: I20050328000853 |
| Provider Name | Diane R Pearl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427062959 PECOS PAC ID: 4183671761 Enrollment ID: I20050406000022 |
| Provider Name | Robert Partridge |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003836958 PECOS PAC ID: 5092753079 Enrollment ID: I20050420000674 |
| Provider Name | James a Greenberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962491456 PECOS PAC ID: 0648267112 Enrollment ID: I20050420000968 |
| Provider Name | John J Tierney |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417913047 PECOS PAC ID: 6507815214 Enrollment ID: I20050425000158 |
| Provider Name | Mari Kim Bunnell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205892361 PECOS PAC ID: 8820037294 Enrollment ID: I20050426001121 |
| Provider Name | David J. R. Steele |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1659352490 PECOS PAC ID: 5799725099 Enrollment ID: I20050505000917 |
| Provider Name | Michael a Mecley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609828920 PECOS PAC ID: 3375585680 Enrollment ID: I20050620001081 |
| Provider Name | Dana K Fugelso |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518925585 PECOS PAC ID: 9133165376 Enrollment ID: I20050628001266 |
| Provider Name | Duraisamy Balaguru |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154382703 PECOS PAC ID: 0244267615 Enrollment ID: I20050719000027 |
| Provider Name | Rachael Hynds Decoteau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689765943 PECOS PAC ID: 7315976321 Enrollment ID: I20050810000608 |
| Provider Name | Maria E Carey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518061910 PECOS PAC ID: 2062444755 Enrollment ID: I20050901000795 |
| Provider Name | Timothy J Lepore |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720041023 PECOS PAC ID: 1850323114 Enrollment ID: I20050926001037 |
| Provider Name | Benjamin Miller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902950207 PECOS PAC ID: 4385679679 Enrollment ID: I20051005000999 |
| Provider Name | Phillip D Mccrary |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861488967 PECOS PAC ID: 6103860952 Enrollment ID: I20051029000161 |
| Provider Name | Andrew W Chapman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1144214776 PECOS PAC ID: 5193743565 Enrollment ID: I20051103000857 |
| Provider Name | Jennifer N Skolnick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114975380 PECOS PAC ID: 7012935257 Enrollment ID: I20051107000669 |
| Provider Name | Katayoon Goodarzi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518073345 PECOS PAC ID: 2668499880 Enrollment ID: I20051114000603 |
| Provider Name | Alfred J Phillips |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1982727129 PECOS PAC ID: 7315967684 Enrollment ID: I20051201000223 |
| Provider Name | Steven a Kohler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134170194 PECOS PAC ID: 7113947433 Enrollment ID: I20051201000650 |
| Provider Name | Michele M Herrera |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093888257 PECOS PAC ID: 3274554712 Enrollment ID: I20051213000392 |
| Provider Name | Dale Weldon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316004989 PECOS PAC ID: 8628086527 Enrollment ID: I20060404000675 |
| Provider Name | Regina M Mostone |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528049772 PECOS PAC ID: 9931117736 Enrollment ID: I20060404000745 |
| Provider Name | Pieter M Pil |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396743209 PECOS PAC ID: 1052323599 Enrollment ID: I20060626000268 |
| Provider Name | Elene T Viscosi-spieler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033214978 PECOS PAC ID: 7012913072 Enrollment ID: I20061013000460 |
| Provider Name | John a Kalin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295783447 PECOS PAC ID: 9335141902 Enrollment ID: I20070210000112 |
| Provider Name | James Morse |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548298243 PECOS PAC ID: 6305937897 Enrollment ID: I20070813000726 |
| Provider Name | Michelle F Costa |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1962548941 PECOS PAC ID: 3274625157 Enrollment ID: I20070823000166 |
| Provider Name | Christa Fratino |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386862274 PECOS PAC ID: 1254423932 Enrollment ID: I20070827000194 |
| Provider Name | Zoe Ann Simonton |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1023203189 PECOS PAC ID: 4981786720 Enrollment ID: I20080131000571 |
| Provider Name | Kimberlyn C Grams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841476207 PECOS PAC ID: 3072696590 Enrollment ID: I20080207000065 |
| Provider Name | Jennifer M Viano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104007905 PECOS PAC ID: 1759466899 Enrollment ID: I20080313000073 |
| Provider Name | Leslie S Kerzner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932188034 PECOS PAC ID: 1456438670 Enrollment ID: I20080411000162 |
| Provider Name | Donna M Collins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003805235 PECOS PAC ID: 2769552587 Enrollment ID: I20080605000739 |
| Provider Name | Christopher H Hashikawa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770688160 PECOS PAC ID: 7214008291 Enrollment ID: I20080618000746 |
| Provider Name | Elizabeth Holby |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891795720 PECOS PAC ID: 6507866282 Enrollment ID: I20080917000748 |
| Provider Name | Brian Ghoshhajra |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558539080 PECOS PAC ID: 1557438710 Enrollment ID: I20080930000449 |
| Provider Name | Elton Fennell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497705891 PECOS PAC ID: 7012950926 Enrollment ID: I20081010000243 |
| Provider Name | Raymond R. Monto |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689634545 PECOS PAC ID: 2668414673 Enrollment ID: I20090310000037 |
| Provider Name | Faith Holden Frable |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063526697 PECOS PAC ID: 7517962681 Enrollment ID: I20090421000482 |
| Provider Name | Martin M Dolan |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1326088386 PECOS PAC ID: 5092711184 Enrollment ID: I20090505000049 |
| Provider Name | Margaret M Koehm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255315545 PECOS PAC ID: 1557446416 Enrollment ID: I20090901000011 |
| Provider Name | Joel J Hass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396741963 PECOS PAC ID: 5294715850 Enrollment ID: I20100602000061 |
| Provider Name | Jeffrey a Barnes |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1326238411 PECOS PAC ID: 4981738176 Enrollment ID: I20100810000140 |
| Provider Name | Scot Millay |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518176965 PECOS PAC ID: 7214061100 Enrollment ID: I20100813000675 |
| Provider Name | Brittany Weber |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720200819 PECOS PAC ID: 0648395004 Enrollment ID: I20100909000340 |
| Provider Name | Emmanuel Kanyi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467773382 PECOS PAC ID: 6002008976 Enrollment ID: I20101011000444 |
| Provider Name | Jeffrey Lawrence Ecker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770573115 PECOS PAC ID: 9537352679 Enrollment ID: I20101020001472 |
| Provider Name | Glenn Michael Colassi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891019907 PECOS PAC ID: 7113041203 Enrollment ID: I20101110000423 |
| Provider Name | Margaret F Lippincott |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1750548863 PECOS PAC ID: 4082801584 Enrollment ID: I20101209000955 |
| Provider Name | Alfred W Hanmer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285739649 PECOS PAC ID: 3577530047 Enrollment ID: I20110125001286 |
| Provider Name | Raghu Seethala |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1437317096 PECOS PAC ID: 9436200656 Enrollment ID: I20110513000246 |
| Provider Name | Michael J Gray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316033871 PECOS PAC ID: 3274711668 Enrollment ID: I20110708000006 |
| Provider Name | Richard E Heywood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336118066 PECOS PAC ID: 7012196819 Enrollment ID: I20110826000489 |
| Provider Name | Yongli Ji |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1659526812 PECOS PAC ID: 1658538764 Enrollment ID: I20120201000362 |
| Provider Name | Stephen Kelly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558504258 PECOS PAC ID: 7113185117 Enrollment ID: I20120222000466 |
| Provider Name | Andrew L Lundquist |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1174728794 PECOS PAC ID: 2466619846 Enrollment ID: I20120705000670 |
| Provider Name | Tiffany L Blake Lamb |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043473622 PECOS PAC ID: 4486812856 Enrollment ID: I20120813000219 |
| Provider Name | Penne Traci Greer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487991725 PECOS PAC ID: 1254576176 Enrollment ID: I20130418000163 |
| Provider Name | Jason Matthew Parente |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639428899 PECOS PAC ID: 7416198007 Enrollment ID: I20130724000414 |
| Provider Name | Michael C Lee |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447442009 PECOS PAC ID: 6901061522 Enrollment ID: I20130730000786 |
| Provider Name | Arianne S Kourosh |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1417181801 PECOS PAC ID: 1557503984 Enrollment ID: I20130814000105 |
| Provider Name | Lisa M Vieira-salvatore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437175106 PECOS PAC ID: 0042394835 Enrollment ID: I20130923000020 |
| Provider Name | Samantha L Elich |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1518304567 PECOS PAC ID: 2264666338 Enrollment ID: I20131002000483 |
| Provider Name | William M Perry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306847520 PECOS PAC ID: 2567447535 Enrollment ID: I20140114001157 |
| Provider Name | Joy N Tsai |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710134929 PECOS PAC ID: 6406041599 Enrollment ID: I20140620000032 |
| Provider Name | Leo L Tsai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720250228 PECOS PAC ID: 6800011974 Enrollment ID: I20140703000066 |
| Provider Name | Michael P Bowley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861620247 PECOS PAC ID: 2466628375 Enrollment ID: I20140714002361 |
| Provider Name | Janine C Albert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629395991 PECOS PAC ID: 1658514583 Enrollment ID: I20140715000600 |
| Provider Name | Maurine Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669766879 PECOS PAC ID: 7012138175 Enrollment ID: I20141015001058 |
| Provider Name | Christopher Burns |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952379141 PECOS PAC ID: 3577785849 Enrollment ID: I20141121000630 |
| Provider Name | Maria Clara Ana Vaz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164792685 PECOS PAC ID: 2264692334 Enrollment ID: I20141210002197 |
| Provider Name | Steven E Feder |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952397572 PECOS PAC ID: 5890717565 Enrollment ID: I20150123000719 |
| Provider Name | Kassem Safa |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1336397231 PECOS PAC ID: 1557524675 Enrollment ID: I20150616002250 |
| Provider Name | Gillian L Mccafferty |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629335914 PECOS PAC ID: 5294969200 Enrollment ID: I20150625001165 |
| Provider Name | Thomas H Wuerz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619141496 PECOS PAC ID: 2062655145 Enrollment ID: I20150831001836 |
| Provider Name | Kenya Hanspard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932170305 PECOS PAC ID: 9739072984 Enrollment ID: I20160318000840 |
| Provider Name | Anna L Konigsmark |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245592799 PECOS PAC ID: 0446408827 Enrollment ID: I20160718001919 |
| Provider Name | Annette M Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164877635 PECOS PAC ID: 6901192525 Enrollment ID: I20160908001092 |
| Provider Name | Colleen M Harrington |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952577025 PECOS PAC ID: 8224224902 Enrollment ID: I20160926000071 |
| Provider Name | Artemis D Panagopoulos |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164801486 PECOS PAC ID: 6800176280 Enrollment ID: I20161130000941 |
| Provider Name | Jayne D Culkins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811053366 PECOS PAC ID: 6305898420 Enrollment ID: I20161216001026 |
| Provider Name | Kaavya Paruchuri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073952792 PECOS PAC ID: 9133418023 Enrollment ID: I20170119002004 |
| Provider Name | Seth a Wander |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1790123792 PECOS PAC ID: 0648408526 Enrollment ID: I20170306001604 |
| Provider Name | Caitlin Kaplan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609313204 PECOS PAC ID: 7618253667 Enrollment ID: I20170406000707 |
| Provider Name | Aimee C Reilly |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245391150 PECOS PAC ID: 8022316579 Enrollment ID: I20170530002050 |
| Provider Name | Nicole Nadeau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184915233 PECOS PAC ID: 5597981670 Enrollment ID: I20170621002059 |
| Provider Name | Nicole Megazzini |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255856902 PECOS PAC ID: 9335412733 Enrollment ID: I20170907000228 |
| Provider Name | Jonathan a Casey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639139819 PECOS PAC ID: 0547361222 Enrollment ID: I20170918000990 |
| Provider Name | Evin Yucel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942436712 PECOS PAC ID: 3577870328 Enrollment ID: I20170922003120 |
| Provider Name | Brittany D Guest |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083065478 PECOS PAC ID: 5799064838 Enrollment ID: I20171027000133 |
| Provider Name | Duncan Daviau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013432582 PECOS PAC ID: 0547526865 Enrollment ID: I20171102000266 |
| Provider Name | Andrew Robert Branagan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1679707053 PECOS PAC ID: 0042531527 Enrollment ID: I20171207000592 |
| Provider Name | Francis X O Connor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306819867 PECOS PAC ID: 7618158742 Enrollment ID: I20171214002577 |
| Provider Name | Sean Kevin Piechocki |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316902489 PECOS PAC ID: 7113180217 Enrollment ID: I20180113000065 |
| Provider Name | Derek a Andelloux |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013145275 PECOS PAC ID: 0244488823 Enrollment ID: I20180418001055 |
| Provider Name | Candy Bernier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376020099 PECOS PAC ID: 2961747365 Enrollment ID: I20181212002679 |
| Provider Name | Conor Patrick Birmingham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417439555 PECOS PAC ID: 3173868809 Enrollment ID: I20181227000290 |
| Provider Name | Rhondine King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891264263 PECOS PAC ID: 7618214610 Enrollment ID: I20190129003559 |
| Provider Name | Kellie E Wheeler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629590187 PECOS PAC ID: 5991066441 Enrollment ID: I20190227002482 |
| Provider Name | Jared J Conley |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144615717 PECOS PAC ID: 4284949215 Enrollment ID: I20190520000979 |
| Provider Name | Lauren Almeida |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1386118859 PECOS PAC ID: 0749523439 Enrollment ID: I20190521001455 |
| Provider Name | Meredith H Lepore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770772881 PECOS PAC ID: 9537346697 Enrollment ID: I20190604000399 |
| Provider Name | Paul Jansson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003205956 PECOS PAC ID: 2163737958 Enrollment ID: I20190606002508 |
| Provider Name | Sara Bouberhan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1487929634 PECOS PAC ID: 0547572380 Enrollment ID: I20190611001589 |
| Provider Name | Peter Carsten Allfather |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1780078956 PECOS PAC ID: 8729311147 Enrollment ID: I20190617002360 |
| Provider Name | Adam J Kaye |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942658190 PECOS PAC ID: 7214261338 Enrollment ID: I20190624002731 |
| Provider Name | Vincent a Marino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093791691 PECOS PAC ID: 1850314857 Enrollment ID: I20190723001500 |
| Provider Name | Gayatri V Jayaraman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942439690 PECOS PAC ID: 0941450613 Enrollment ID: I20190820000269 |
| Provider Name | Joanne S Chiu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659515344 PECOS PAC ID: 8224317771 Enrollment ID: I20190910000185 |
| Provider Name | James Mullen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770663312 PECOS PAC ID: 5294728093 Enrollment ID: I20200109001185 |
| Provider Name | Guy Nuki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346209582 PECOS PAC ID: 3971577487 Enrollment ID: I20200109001682 |
| Provider Name | Maureen K Nothnagle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841849478 PECOS PAC ID: 2769817287 Enrollment ID: I20200110000897 |
| Provider Name | Sondra E Nantes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689972440 PECOS PAC ID: 9739364225 Enrollment ID: I20200207002193 |
| Provider Name | Molly Harding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679126494 PECOS PAC ID: 7810326899 Enrollment ID: I20200327000501 |
| Provider Name | Lydia L Shook |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629414511 PECOS PAC ID: 6204157811 Enrollment ID: I20200419000393 |
| Provider Name | Brandon E Giberson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265886956 PECOS PAC ID: 6800129545 Enrollment ID: I20200514001545 |
| Provider Name | Mary E Meinke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780117168 PECOS PAC ID: 8123442381 Enrollment ID: I20200721001668 |
| Provider Name | Sergi Martinez Ramirez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396125217 PECOS PAC ID: 8729395777 Enrollment ID: I20200730002757 |
| Provider Name | Matthew D Dalke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861842726 PECOS PAC ID: 2668721671 Enrollment ID: I20200806001436 |
| Provider Name | Katherine Helen Albutt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952749509 PECOS PAC ID: 0244468247 Enrollment ID: I20200910001803 |
| Provider Name | Barbara N Malone |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1831135193 PECOS PAC ID: 7113976127 Enrollment ID: I20200923003263 |
| Provider Name | Katherine M Nichols |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396158143 PECOS PAC ID: 5395037980 Enrollment ID: I20201120001990 |
| Provider Name | Shelby a Ford |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295375020 PECOS PAC ID: 3971911231 Enrollment ID: I20210427000020 |
| Provider Name | Michele L Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184238438 PECOS PAC ID: 4183023948 Enrollment ID: I20210621000632 |
| Provider Name | John Chiosi |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1306231097 PECOS PAC ID: 6103106299 Enrollment ID: I20210721003052 |
| Provider Name | Janice Thai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568691392 PECOS PAC ID: 1759626294 Enrollment ID: I20210823000362 |
| Provider Name | Anna E Goodheart |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235510645 PECOS PAC ID: 6204144991 Enrollment ID: I20210823000474 |
| Provider Name | Thuan Ly |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487697637 PECOS PAC ID: 0840181251 Enrollment ID: I20211115001041 |
| Provider Name | Paul Schneider |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528649902 PECOS PAC ID: 8527457340 Enrollment ID: I20211117001803 |
| Provider Name | Nadeem Ali |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053351528 PECOS PAC ID: 3870568686 Enrollment ID: I20211209000505 |
| Provider Name | Alexinna C Johns |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073731006 PECOS PAC ID: 0042381410 Enrollment ID: I20211230001806 |
| Provider Name | Nicole J. Sleiman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1831370402 PECOS PAC ID: 6305996687 Enrollment ID: I20220104001597 |
| Provider Name | Michael Molta |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740897396 PECOS PAC ID: 8426441502 Enrollment ID: I20220214001326 |
| Provider Name | Erin R O'day |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578144911 PECOS PAC ID: 2961896634 Enrollment ID: I20220222001914 |
| Provider Name | Caroline Rizzo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437742269 PECOS PAC ID: 8820482144 Enrollment ID: I20220303000562 |
| Provider Name | Matthew Richard Strickland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295197762 PECOS PAC ID: 1951696368 Enrollment ID: I20220307001704 |
| Provider Name | Deborah Moss-gail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184947947 PECOS PAC ID: 1254523251 Enrollment ID: I20220308002637 |
| Provider Name | John Hower |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871734194 PECOS PAC ID: 9133273758 Enrollment ID: I20220506000417 |
| Provider Name | Claire Conklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790268753 PECOS PAC ID: 9537590294 Enrollment ID: I20220506000558 |
| Provider Name | Rachel Mulholland Hammerschmidt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073042016 PECOS PAC ID: 4789916347 Enrollment ID: I20220509001641 |
| Provider Name | Anders Knutzen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912985037 PECOS PAC ID: 0648184333 Enrollment ID: I20220607002127 |
| Provider Name | Jonathan Rose |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033566682 PECOS PAC ID: 5092009951 Enrollment ID: I20220630002745 |
| Provider Name | Joy Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457738510 PECOS PAC ID: 3274833728 Enrollment ID: I20220909000681 |
| Provider Name | Erica Lee Ditkoff |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1285165589 PECOS PAC ID: 5092190017 Enrollment ID: I20220912002489 |
| Provider Name | Sonal Bhavesh Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184233066 PECOS PAC ID: 5193192979 Enrollment ID: I20221108001403 |
| Provider Name | Douglas Campbell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093100646 PECOS PAC ID: 7719295062 Enrollment ID: I20221110002013 |
| Provider Name | H Brandon Ayre |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548206428 PECOS PAC ID: 0345275004 Enrollment ID: I20221115001660 |
| Provider Name | Alexandra Nicole Wolfe |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003499955 PECOS PAC ID: 7012385578 Enrollment ID: I20221115001769 |
| Provider Name | Katie L Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346609682 PECOS PAC ID: 1658663950 Enrollment ID: I20221115001996 |
| Provider Name | Kendra Christine Jarrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174566681 PECOS PAC ID: 3072795129 Enrollment ID: I20221219002935 |
| Provider Name | Allison Marie Ebrahimi Gold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225689763 PECOS PAC ID: 3072945252 Enrollment ID: I20230313001649 |
| Provider Name | Courtney Allison Barrett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093413791 PECOS PAC ID: 5597139253 Enrollment ID: I20230320001368 |
| Provider Name | Daniel Tran |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427080647 PECOS PAC ID: 1850499732 Enrollment ID: I20230508001209 |
| Provider Name | Bita Zahedi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1821520859 PECOS PAC ID: 2769755750 Enrollment ID: I20230511000247 |
| Provider Name | Stephen J Skinner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790128155 PECOS PAC ID: 7214237684 Enrollment ID: I20230607003019 |
| Provider Name | Shawne Broderick |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215183363 PECOS PAC ID: 6406916782 Enrollment ID: I20230703001635 |
| Provider Name | Stephen Jason Sasso |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760035547 PECOS PAC ID: 6103258793 Enrollment ID: I20230718003092 |
| Provider Name | Michael Samuel Tcheyan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1972162881 PECOS PAC ID: 7911231899 Enrollment ID: I20230803003935 |
| Provider Name | Francine Hughes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235219718 PECOS PAC ID: 0345145959 Enrollment ID: I20230815000319 |
| Provider Name | Morgan Walker |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043942147 PECOS PAC ID: 9931585916 Enrollment ID: I20230926003269 |
| Provider Name | Margaret Esther Schifano |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851857940 PECOS PAC ID: 1052749223 Enrollment ID: I20231106003002 |
| Provider Name | Joseph Meyer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558755462 PECOS PAC ID: 9436478997 Enrollment ID: I20231212002081 |
| Provider Name | Ashlee Taylor Belliveau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215452792 PECOS PAC ID: 7416349709 Enrollment ID: I20240124002754 |
| Provider Name | Robert C Kelly |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1336402452 PECOS PAC ID: 0749419620 Enrollment ID: I20240131001861 |
| Provider Name | Tamara R Dildy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306804000 PECOS PAC ID: 9931195088 Enrollment ID: I20240319002477 |
| Provider Name | Alison M Fassnacht |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740598861 PECOS PAC ID: 5395920714 Enrollment ID: I20240411004240 |
| Provider Name | Michael Alexander Diiorio |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1598224859 PECOS PAC ID: 4688016231 Enrollment ID: I20240528002440 |
| Provider Name | Christopher Fox Calahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558821983 PECOS PAC ID: 0345782298 Enrollment ID: I20240606001154 |
| Provider Name | Nirali Butala |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598320467 PECOS PAC ID: 3173905544 Enrollment ID: I20240619000178 |
| Provider Name | Mimi C Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750341756 PECOS PAC ID: 6406893130 Enrollment ID: I20240621002405 |
| Provider Name | Dana L Worley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184663841 PECOS PAC ID: 5698706893 Enrollment ID: I20240627002475 |
| Provider Name | Arjun Balakumar |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1619504115 PECOS PAC ID: 5294180105 Enrollment ID: I20240724003054 |
| Provider Name | Cynthia J Bolles |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326085267 PECOS PAC ID: 5799781308 Enrollment ID: I20240801002219 |
| Provider Name | Michael Hudson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659399293 PECOS PAC ID: 4183724297 Enrollment ID: I20240807002829 |
| Provider Name | Scott T. Kelley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811938996 PECOS PAC ID: 3274588595 Enrollment ID: I20241016002241 |
| Provider Name | Ricky Phelps |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1518943315 PECOS PAC ID: 7012939010 Enrollment ID: I20241103000065 |
| Provider Name | Sarah Fulham Russell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417241415 PECOS PAC ID: 5698097889 Enrollment ID: I20241219003286 |
| Provider Name | David B Lieberman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235591991 PECOS PAC ID: 0143555003 Enrollment ID: I20250219000079 |
| Provider Name | Stephanie a Beer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437450301 PECOS PAC ID: 4486837663 Enrollment ID: I20250616001596 |
| Provider Name | Marc Todd Silver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902802945 PECOS PAC ID: 4587603261 Enrollment ID: I20250723002216 |
| Provider Name | Doreen Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942831565 PECOS PAC ID: 8123424181 Enrollment ID: I20250805000450 |
| Provider Name | Andrew Peters |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295763167 PECOS PAC ID: 3476684325 Enrollment ID: I20251113000643 |
| Provider Name | Mary Meyers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063517159 PECOS PAC ID: 5799889309 Enrollment ID: I20251126000108 |
| Provider Name | Karen Renee Pyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659067049 PECOS PAC ID: 7315305372 Enrollment ID: I20251231001119 |
| Provider Name | Allison Platt Rothfleisch |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740220318 PECOS PAC ID: 1557383338 Enrollment ID: I20260317003312 |
| Provider Name | Emma Caitlin Yi Ying Berman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386503399 PECOS PAC ID: 2062987480 Enrollment ID: I20260413003044 |
| Provider Name | Tayla Spezzano |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467262055 PECOS PAC ID: 5799254892 Enrollment ID: I20260519001130 |
| Provider Name | Maria M Diaz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1013142959 PECOS PAC ID: 1254523988 Enrollment ID: I20260617003759 |
Nantucket Cottage Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 57 Prospect St, Nantucket, MA 02554 Phone: 508-825-8100 |