| Pai Participant 9 Pa | |
|
1373 N Avenue C Elgin TX 78621-1528 | |
| (512) 285-2457 | |
| Not Available |
| Full Name | Pai Participant 9 Pa |
|---|---|
| Speciality | Internal Medicine |
| Location | 1373 N Avenue C, Elgin, Texas |
| Authorized Official Name and Position | Jill Ford (DIRECTOR OF CREDENTIALING) |
| Authorized Official Contact | 8592914800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pai Participant 9 Pa Po Box 639676 Cincinnati OH 45263-9676 Ph: (859) 291-4800 | Pai Participant 9 Pa 1373 N Avenue C Elgin TX 78621-1528 Ph: (512) 285-2457 |
| NPI Number | 1679135420 |
|---|---|
| Provider Enumeration Date | 07/02/2019 |
| Last Update Date | 08/02/2025 |
| Medicare PECOS PAC ID | 7113254277 |
|---|---|
| Medicare Enrollment ID | O20190812003650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679135420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Daniel Y Levesque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033125307 PECOS PAC ID: 4082659552 Enrollment ID: I20050624000433 |
| Provider Name | Zahir A Momin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073529327 PECOS PAC ID: 5294750576 Enrollment ID: I20051006000511 |
| Provider Name | Suma S Gowda |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174558605 PECOS PAC ID: 7517051600 Enrollment ID: I20070920000173 |
| Provider Name | David Dmitry Boltan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447468624 PECOS PAC ID: 5698846194 Enrollment ID: I20080611000057 |
| Provider Name | Philip C Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306852678 PECOS PAC ID: 7810068699 Enrollment ID: I20080623000227 |
| Provider Name | Mary Z Blackburn |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1699930628 PECOS PAC ID: 0446327233 Enrollment ID: I20080919000436 |
| Provider Name | Ricardo Cruz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164438446 PECOS PAC ID: 5092883272 Enrollment ID: I20081002000035 |
| Provider Name | Lindsay Boltan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538379433 PECOS PAC ID: 1254480577 Enrollment ID: I20090515000501 |
| Provider Name | Laurie A Ferraro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720310436 PECOS PAC ID: 8921136219 Enrollment ID: I20100506000610 |
| Provider Name | Jason L Martin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447441639 PECOS PAC ID: 2163616947 Enrollment ID: I20101105000526 |
| Provider Name | Mauricio A Sardan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902005523 PECOS PAC ID: 9931271509 Enrollment ID: I20101115000375 |
| Provider Name | Jo Ann Cardenas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518997121 PECOS PAC ID: 2466466974 Enrollment ID: I20101123001108 |
| Provider Name | Jeremy L Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144557679 PECOS PAC ID: 2769656628 Enrollment ID: I20111111000114 |
| Provider Name | Nabanita Basu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417118522 PECOS PAC ID: 6103090816 Enrollment ID: I20111115000389 |
| Provider Name | Neelima Gowrigari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205097318 PECOS PAC ID: 8527224757 Enrollment ID: I20120716000493 |
| Provider Name | Aneesh George |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104051382 PECOS PAC ID: 9436305091 Enrollment ID: I20120814000425 |
| Provider Name | Krystle F Garrett Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457669210 PECOS PAC ID: 5496901977 Enrollment ID: I20120816000346 |
| Provider Name | Raeeda M Gheewala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851507115 PECOS PAC ID: 8022275346 Enrollment ID: I20120906000430 |
| Provider Name | Laura Martinez-colon |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1164869285 PECOS PAC ID: 5496995607 Enrollment ID: I20130711000819 |
| Provider Name | Phillip E Silva |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1932424769 PECOS PAC ID: 6002047180 Enrollment ID: I20140403000476 |
| Provider Name | Michael Joseph Gutierrez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174810048 PECOS PAC ID: 4688892276 Enrollment ID: I20140822001670 |
| Provider Name | Scott W Tolan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1821313610 PECOS PAC ID: 3678890449 Enrollment ID: I20150317000528 |
| Provider Name | Khris Randy Ramdeen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861652471 PECOS PAC ID: 2668628793 Enrollment ID: I20150604000079 |
| Provider Name | Prasanthi K Arety |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528333713 PECOS PAC ID: 3274845938 Enrollment ID: I20150709000066 |
| Provider Name | Laura Moerbe Brynestad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649510785 PECOS PAC ID: 0244478212 Enrollment ID: I20150731015195 |
| Provider Name | Samira Shahnaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134495575 PECOS PAC ID: 9830407097 Enrollment ID: I20151007003142 |
| Provider Name | Sherri Cook-rousey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295107142 PECOS PAC ID: 6608177969 Enrollment ID: I20151211000037 |
| Provider Name | Jess Siby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215302450 PECOS PAC ID: 9830491372 Enrollment ID: I20151230001136 |
| Provider Name | Christine Koestel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891152948 PECOS PAC ID: 1557667250 Enrollment ID: I20160307000882 |
| Provider Name | Berril Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649726563 PECOS PAC ID: 0941588859 Enrollment ID: I20161027002011 |
| Provider Name | Anu Antony |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780132886 PECOS PAC ID: 2769760990 Enrollment ID: I20161111001328 |
| Provider Name | Mangesh Bhatta |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588921597 PECOS PAC ID: 8325351463 Enrollment ID: I20170208002451 |
| Provider Name | Albert Arthur |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720499668 PECOS PAC ID: 1254655897 Enrollment ID: I20171019001021 |
| Provider Name | Amita Aghera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518460930 PECOS PAC ID: 9931456910 Enrollment ID: I20180723000289 |
| Provider Name | Carolyn Diane Crispell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306069265 PECOS PAC ID: 0941394894 Enrollment ID: I20180904001524 |
| Provider Name | Sayf Yassin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043605371 PECOS PAC ID: 8224334677 Enrollment ID: I20181017000479 |
| Provider Name | Marica Baricuatro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689156812 PECOS PAC ID: 3476807686 Enrollment ID: I20181106002913 |
| Provider Name | Edith P Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205374279 PECOS PAC ID: 3274870720 Enrollment ID: I20190123000386 |
| Provider Name | Zarintaj M Ali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760024038 PECOS PAC ID: 4385078583 Enrollment ID: I20191220002185 |
| Provider Name | Soumya Mohanan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255971214 PECOS PAC ID: 6406283233 Enrollment ID: I20200217003418 |
| Provider Name | Loveleen M Swami |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255973558 PECOS PAC ID: 6103253638 Enrollment ID: I20200224001033 |
| Provider Name | Jason Shi-jiang Woo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962744573 PECOS PAC ID: 4082855440 Enrollment ID: I20200415000153 |
| Provider Name | Stella Marquardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083256416 PECOS PAC ID: 8022449347 Enrollment ID: I20200520001871 |
| Provider Name | Michael Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043659956 PECOS PAC ID: 3274828173 Enrollment ID: I20201207000134 |
| Provider Name | Lindsey Karka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174133268 PECOS PAC ID: 5597172361 Enrollment ID: I20210323000005 |
| Provider Name | Kellie Soria |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801496328 PECOS PAC ID: 7810305844 Enrollment ID: I20210412002695 |
| Provider Name | Katherine Ann Mayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942886114 PECOS PAC ID: 1557760824 Enrollment ID: I20210519001700 |
| Provider Name | Emily Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871163832 PECOS PAC ID: 4284037573 Enrollment ID: I20210723002186 |
| Provider Name | Marc Duke |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1659943322 PECOS PAC ID: 4688078322 Enrollment ID: I20210803002221 |
| Provider Name | Stephen Berry |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1255903639 PECOS PAC ID: 6406250042 Enrollment ID: I20210804002602 |
| Provider Name | Emilie Anne Boline |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598334195 PECOS PAC ID: 8527462001 Enrollment ID: I20210805000417 |
| Provider Name | Haley Walker Everett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174194864 PECOS PAC ID: 3678971967 Enrollment ID: I20211018002991 |
| Provider Name | Teena Thayil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548807654 PECOS PAC ID: 5496143398 Enrollment ID: I20211026002187 |
| Provider Name | Julie Kristine Thielke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861156127 PECOS PAC ID: 8921497264 Enrollment ID: I20211108002262 |
| Provider Name | Yagya Bimali |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316609639 PECOS PAC ID: 4183012776 Enrollment ID: I20211130002266 |
| Provider Name | Sukyong Chun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528722352 PECOS PAC ID: 7719379981 Enrollment ID: I20220120000480 |
| Provider Name | Kerry F Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366108433 PECOS PAC ID: 3274910922 Enrollment ID: I20220518000978 |
| Provider Name | Caroline Igharoro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841960499 PECOS PAC ID: 9436537743 Enrollment ID: I20220527000355 |
| Provider Name | Januka Banjara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528706553 PECOS PAC ID: 7911388038 Enrollment ID: I20220721000863 |
| Provider Name | Steven J Ramdeen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679924781 PECOS PAC ID: 3779876859 Enrollment ID: I20230103000661 |
| Provider Name | Cynthia Kuan Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053081869 PECOS PAC ID: 0143691998 Enrollment ID: I20230114000049 |
| Provider Name | Lynn Lokelani Shehan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205542131 PECOS PAC ID: 9931564531 Enrollment ID: I20230504001159 |
| Provider Name | Leanne Marie Cowles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407548357 PECOS PAC ID: 2860850781 Enrollment ID: I20230623002526 |
| Provider Name | Dewanna Evette Brandon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487333761 PECOS PAC ID: 9234591041 Enrollment ID: I20230810002917 |
| Provider Name | Osariemen Faith Idehen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629859095 PECOS PAC ID: 0840647095 Enrollment ID: I20231108003793 |
| Provider Name | Gina Jacobson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245918028 PECOS PAC ID: 8426492406 Enrollment ID: I20240217000503 |
| Provider Name | Koe Sierra Alvarez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992569917 PECOS PAC ID: 5698110237 Enrollment ID: I20240305002129 |
| Provider Name | Barbara Denise Lloyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376300186 PECOS PAC ID: 7416395785 Enrollment ID: I20240404004280 |
| Provider Name | Jennifer Lynn Roesner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972333078 PECOS PAC ID: 0345781043 Enrollment ID: I20240921000602 |
| Provider Name | Demarco Livingston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003642661 PECOS PAC ID: 7911439591 Enrollment ID: I20241021003336 |
| Provider Name | Jackqueline L Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760214100 PECOS PAC ID: 6901889633 Enrollment ID: I20241107002641 |
| Provider Name | Anusha Dhakal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063228831 PECOS PAC ID: 5597293720 Enrollment ID: I20250115001785 |
Elgin Medical Center,pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 209 E 2nd St, Elgin, TX 78621 Phone: 512-285-3315 Fax: 512-281-2872 | |
Serve All Medical Elgin Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 706 W 11th St, Elgin, TX 78621 Phone: 512-229-3093 | |
Ascension Seton Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 200 Roy Rivers Rd, Elgin, TX 78621 Phone: 512-237-5777 | |
Community Health Centers Of South Central Texas Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 711 W 10th St., Elgin, TX 78621 Phone: 512-229-3334 | |
T-lifebio Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18304 Willow Sage Ln, Elgin, TX 78621 Phone: 512-817-6774 | |
Healing Branches Pastoral Care And Counseling Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 113 Four Star Dr, Elgin, TX 78621 Phone: 512-213-2366 |