| Peacehealth Medical Group | |
|
1200 Hilyard St Eugene OR 97401-8122 | |
| (541) 687-6217 | |
| Not Available |
| Full Name | Peacehealth Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 1200 Hilyard St, Eugene, Oregon |
| Authorized Official Name and Position | Lori Kettler (PROVIDER ENROLLMENT LEAD) |
| Authorized Official Contact | 3607291411 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peacehealth Medical Group Po Box 24410 Eugene OR 97402-0451 | Peacehealth Medical Group 1200 Hilyard St Eugene OR 97401-8122 Ph: (541) 687-6217 |
| NPI Number | 1447207287 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 02/13/2026 |
| Certification Date | 02/13/2026 |
| Medicare PECOS PAC ID | 9032023270 |
|---|---|
| Medicare Enrollment ID | O20031113000097 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447207287 | NPI | - | NPPES |
| 071634 | Medicaid | OR |
| Provider Name | Richard a Barnhart |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861471054 PECOS PAC ID: 5193638435 Enrollment ID: I20031111000891 |
| Provider Name | Mohammad H Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295702850 PECOS PAC ID: 5799698965 Enrollment ID: I20031112000640 |
| Provider Name | Jon Ekstrom |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407871163 PECOS PAC ID: 9133033046 Enrollment ID: I20031114000651 |
| Provider Name | Robert E Gunderman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497787485 PECOS PAC ID: 5890695043 Enrollment ID: I20040113000105 |
| Provider Name | Sean T Rabacal |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033283627 PECOS PAC ID: 0648160697 Enrollment ID: I20040316000300 |
| Provider Name | Erin P Reilly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285602086 PECOS PAC ID: 4385639277 Enrollment ID: I20040419001598 |
| Provider Name | Paul R Stauffer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649208422 PECOS PAC ID: 1658359955 Enrollment ID: I20040713000282 |
| Provider Name | Rajeev L Alexander |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1497725808 PECOS PAC ID: 3678553278 Enrollment ID: I20040723000532 |
| Provider Name | Garret S Zallen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518972025 PECOS PAC ID: 8426020165 Enrollment ID: I20040812000037 |
| Provider Name | Julie Hughes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740250588 PECOS PAC ID: 5294707873 Enrollment ID: I20040812001052 |
| Provider Name | Michael J Kraynyak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225005093 PECOS PAC ID: 0345214987 Enrollment ID: I20040820000520 |
| Provider Name | Camille E Leider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972548766 PECOS PAC ID: 9739158346 Enrollment ID: I20040930000378 |
| Provider Name | Jeffrey G Baxter |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1053383893 PECOS PAC ID: 0749240596 Enrollment ID: I20041015000270 |
| Provider Name | Andrew J Kokkino |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1780628719 PECOS PAC ID: 7618933391 Enrollment ID: I20041203000923 |
| Provider Name | Bernardo H Isuani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881630861 PECOS PAC ID: 4880651827 Enrollment ID: I20041211000191 |
| Provider Name | Damon W Sevart |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639278294 PECOS PAC ID: 3577520204 Enrollment ID: I20041214001226 |
| Provider Name | Amy L Howard |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1548244049 PECOS PAC ID: 7719936657 Enrollment ID: I20050118000422 |
| Provider Name | Angela M Bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588633523 PECOS PAC ID: 9436103132 Enrollment ID: I20050305000024 |
| Provider Name | Abraham G Abu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710036587 PECOS PAC ID: 2365497351 Enrollment ID: I20050311000952 |
| Provider Name | Akshay Satyarthi Gupta |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326084377 PECOS PAC ID: 1456333152 Enrollment ID: I20050415000819 |
| Provider Name | Doherty B Gilchrist |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518942093 PECOS PAC ID: 9638112642 Enrollment ID: I20050609000673 |
| Provider Name | David Tsai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265478499 PECOS PAC ID: 2567359185 Enrollment ID: I20050615000297 |
| Provider Name | Stephan Thiede |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346277399 PECOS PAC ID: 2062494438 Enrollment ID: I20050624000706 |
| Provider Name | James T Akins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366478166 PECOS PAC ID: 0648215145 Enrollment ID: I20050624000738 |
| Provider Name | Steven M Yoder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871561456 PECOS PAC ID: 6507892312 Enrollment ID: I20050713000440 |
| Provider Name | William E Cox |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1992778443 PECOS PAC ID: 1951337583 Enrollment ID: I20050714000391 |
| Provider Name | Hsiang-sen R Yeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770698490 PECOS PAC ID: 4587698048 Enrollment ID: I20050923000323 |
| Provider Name | Sandra E Rood |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215915848 PECOS PAC ID: 4486688983 Enrollment ID: I20050923000661 |
| Provider Name | James a Christon |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1619984853 PECOS PAC ID: 7517943798 Enrollment ID: I20060104000153 |
| Provider Name | James P Kyser |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972584753 PECOS PAC ID: 8921997446 Enrollment ID: I20060127000544 |
| Provider Name | Julie C Scalisi |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1396773032 PECOS PAC ID: 4486660537 Enrollment ID: I20060227000327 |
| Provider Name | Stewart L Mones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144277559 PECOS PAC ID: 6406872357 Enrollment ID: I20060407000102 |
| Provider Name | Jodi N Hanauska |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1811997000 PECOS PAC ID: 5395757785 Enrollment ID: I20060629000383 |
| Provider Name | Karthik P Mahadevan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1144285263 PECOS PAC ID: 5799749552 Enrollment ID: I20060815000155 |
| Provider Name | Adrienne Nicklin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326036211 PECOS PAC ID: 0941286017 Enrollment ID: I20061003000081 |
| Provider Name | Melissa S Defreest |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407960388 PECOS PAC ID: 1850398884 Enrollment ID: I20061103000280 |
| Provider Name | Peter H Chang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003926189 PECOS PAC ID: 2860492378 Enrollment ID: I20070108000185 |
| Provider Name | Rosemary J Rifino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346384500 PECOS PAC ID: 1759486186 Enrollment ID: I20070413000276 |
| Provider Name | Paula J Wutte |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588793558 PECOS PAC ID: 3173622933 Enrollment ID: I20070620000482 |
| Provider Name | Leslie R Pelinka |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275643645 PECOS PAC ID: 3476523432 Enrollment ID: I20070621000325 |
| Provider Name | Lorna J Wong |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245208156 PECOS PAC ID: 3870692452 Enrollment ID: I20070622000007 |
| Provider Name | Katherine K Swank |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568578870 PECOS PAC ID: 7214946342 Enrollment ID: I20070821000345 |
| Provider Name | Jonathan Sims |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124075122 PECOS PAC ID: 6103839535 Enrollment ID: I20070918000562 |
| Provider Name | James H Kiley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861694861 PECOS PAC ID: 1456446012 Enrollment ID: I20070927000849 |
| Provider Name | Julia N.E. Sunkomat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326237488 PECOS PAC ID: 8022107507 Enrollment ID: I20071207000006 |
| Provider Name | Christopher C Hammond |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588679039 PECOS PAC ID: 5991785552 Enrollment ID: I20071211000714 |
| Provider Name | Jeffrey H Mcdonald |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1447298716 PECOS PAC ID: 2961435482 Enrollment ID: I20071227000079 |
| Provider Name | Christopher a Webb |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417903691 PECOS PAC ID: 6507763687 Enrollment ID: I20080508000470 |
| Provider Name | Erik J Young |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1558484238 PECOS PAC ID: 2062511389 Enrollment ID: I20080614000060 |
| Provider Name | Lorne E Bigley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922029289 PECOS PAC ID: 5395817480 Enrollment ID: I20080707000468 |
| Provider Name | John MD Dohrman |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1508030909 PECOS PAC ID: 5597837609 Enrollment ID: I20080707000656 |
| Provider Name | David J Vanscoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689722654 PECOS PAC ID: 1658446901 Enrollment ID: I20080820000702 |
| Provider Name | William Frank Foster |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225048325 PECOS PAC ID: 4486547726 Enrollment ID: I20080922000402 |
| Provider Name | Sara F Stanford |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437306628 PECOS PAC ID: 7012084569 Enrollment ID: I20080924000713 |
| Provider Name | Paul E Evans |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962480871 PECOS PAC ID: 5698791929 Enrollment ID: I20081023000561 |
| Provider Name | Natasa Petrac |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1578508214 PECOS PAC ID: 2769430586 Enrollment ID: I20081106000585 |
| Provider Name | Michelle a Radley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164676441 PECOS PAC ID: 5092877597 Enrollment ID: I20081217000357 |
| Provider Name | Suzanne T Temple |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932179546 PECOS PAC ID: 2668536491 Enrollment ID: I20090122000697 |
| Provider Name | Christine K Wung |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1043408024 PECOS PAC ID: 0840356473 Enrollment ID: I20090306000277 |
| Provider Name | Robert K Pelz |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1235106386 PECOS PAC ID: 8729138664 Enrollment ID: I20090615000349 |
| Provider Name | Sara S Batya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801084116 PECOS PAC ID: 0446301345 Enrollment ID: I20090707000292 |
| Provider Name | Patrick G Tandingan |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1992859623 PECOS PAC ID: 5193871689 Enrollment ID: I20090924000664 |
| Provider Name | Kialing P Perez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1952501744 PECOS PAC ID: 0446396170 Enrollment ID: I20091008000679 |
| Provider Name | Graham S Kaiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598731903 PECOS PAC ID: 0143360172 Enrollment ID: I20091222000556 |
| Provider Name | Peter S Kosek |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1639120801 PECOS PAC ID: 7315939964 Enrollment ID: I20100223000876 |
| Provider Name | Michael a Laurie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619944022 PECOS PAC ID: 0042355067 Enrollment ID: I20100302000726 |
| Provider Name | Daniel S Hutton |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1346365871 PECOS PAC ID: 3072665553 Enrollment ID: I20100310000221 |
| Provider Name | Katherine L Beckstrand |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982676730 PECOS PAC ID: 7012052483 Enrollment ID: I20100310000245 |
| Provider Name | William Mark Dukeminier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154394450 PECOS PAC ID: 4789710005 Enrollment ID: I20100325000934 |
| Provider Name | Mark B Lyon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447227434 PECOS PAC ID: 9830225168 Enrollment ID: I20100325000993 |
| Provider Name | John B Holtzapple |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588638852 PECOS PAC ID: 4284760513 Enrollment ID: I20100325000998 |
| Provider Name | John E Dunphy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821061029 PECOS PAC ID: 9133255409 Enrollment ID: I20100326000233 |
| Provider Name | Robert C Brasted |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447223862 PECOS PAC ID: 8820124753 Enrollment ID: I20100331000036 |
| Provider Name | Carolyn M Hartman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194799718 PECOS PAC ID: 7618003443 Enrollment ID: I20100331000081 |
| Provider Name | Geoffrey S Simmons |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295703825 PECOS PAC ID: 3072649870 Enrollment ID: I20100331000786 |
| Provider Name | Jennifer L Difrancesco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821067703 PECOS PAC ID: 9830225507 Enrollment ID: I20100405000364 |
| Provider Name | Matthew B Walter |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093722217 PECOS PAC ID: 3870622509 Enrollment ID: I20100518000871 |
| Provider Name | Indulal K Rughani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1639185242 PECOS PAC ID: 1951430685 Enrollment ID: I20100518000879 |
| Provider Name | Harold E Whiteley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942278817 PECOS PAC ID: 3577692045 Enrollment ID: I20100520000807 |
| Provider Name | Binaya Rimal |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1942229117 PECOS PAC ID: 1153345459 Enrollment ID: I20100521000871 |
| Provider Name | William R Macmaster |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164557054 PECOS PAC ID: 4688705130 Enrollment ID: I20100626000383 |
| Provider Name | David R Dehaas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417986761 PECOS PAC ID: 5294731840 Enrollment ID: I20100712000701 |
| Provider Name | Thomas H Bascom |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790714046 PECOS PAC ID: 1759387301 Enrollment ID: I20100713000181 |
| Provider Name | Craig S Seidman |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1811926223 PECOS PAC ID: 8921004573 Enrollment ID: I20100713000215 |
| Provider Name | Mark E Snider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639102619 PECOS PAC ID: 2264528413 Enrollment ID: I20100907000852 |
| Provider Name | Benjamin R Bock |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1982753810 PECOS PAC ID: 5799974093 Enrollment ID: I20110118000366 |
| Provider Name | Margaret N Njonjo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427239334 PECOS PAC ID: 8921287590 Enrollment ID: I20110127001215 |
| Provider Name | Juanita P Doerksen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679546162 PECOS PAC ID: 8820278120 Enrollment ID: I20110203000349 |
| Provider Name | Daniel a Cusati |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134210370 PECOS PAC ID: 3678570710 Enrollment ID: I20110520000248 |
| Provider Name | Serena S Black |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508007675 PECOS PAC ID: 2466620042 Enrollment ID: I20110726000687 |
| Provider Name | Michael a Carnevale |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1164425534 PECOS PAC ID: 6406740646 Enrollment ID: I20110809000446 |
| Provider Name | Eric J Lester |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730102583 PECOS PAC ID: 8325217813 Enrollment ID: I20110818000398 |
| Provider Name | Haidee D Zamora |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1316188857 PECOS PAC ID: 3971774761 Enrollment ID: I20110928000218 |
| Provider Name | James E Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467693093 PECOS PAC ID: 8628047172 Enrollment ID: I20111123000665 |
| Provider Name | Kara D Myers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306043252 PECOS PAC ID: 5193992568 Enrollment ID: I20120125000925 |
| Provider Name | Kathryn M Kernan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710250329 PECOS PAC ID: 7416118104 Enrollment ID: I20120405000018 |
| Provider Name | Janjan a Reforma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487986469 PECOS PAC ID: 7618133612 Enrollment ID: I20120718000973 |
| Provider Name | Cameron Erin Derbyshire |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609130269 PECOS PAC ID: 7012173636 Enrollment ID: I20120726000503 |
| Provider Name | Valerie C Coon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407026263 PECOS PAC ID: 5092961219 Enrollment ID: I20120803000291 |
| Provider Name | Brenda M Ormesher |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1922267384 PECOS PAC ID: 3577719574 Enrollment ID: I20120807000575 |
| Provider Name | Douglas Graham York |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518161538 PECOS PAC ID: 8820244205 Enrollment ID: I20120820000393 |
| Provider Name | Wendy M Feldhoff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548497894 PECOS PAC ID: 5799932299 Enrollment ID: I20120905000314 |
| Provider Name | Loan T Duong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255568515 PECOS PAC ID: 8628231982 Enrollment ID: I20120927000849 |
| Provider Name | Jared D Grose |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497913834 PECOS PAC ID: 8820247190 Enrollment ID: I20121001000459 |
| Provider Name | Kevin a Modeste |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1942447032 PECOS PAC ID: 8426208109 Enrollment ID: I20121016000386 |
| Provider Name | Eric Nathaniel Leong |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851475099 PECOS PAC ID: 1557511672 Enrollment ID: I20121026000443 |
| Provider Name | Robbin a Sebastiani |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356539142 PECOS PAC ID: 2860643434 Enrollment ID: I20121107000275 |
| Provider Name | John Daniel Horton |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487690889 PECOS PAC ID: 9133373988 Enrollment ID: I20130204000328 |
| Provider Name | Priya Kansal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699931212 PECOS PAC ID: 5395896641 Enrollment ID: I20130204000496 |
| Provider Name | Michelle Davila |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518274414 PECOS PAC ID: 2961647805 Enrollment ID: I20130326000312 |
| Provider Name | Shanna M Bunce |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952414989 PECOS PAC ID: 8628060035 Enrollment ID: I20130515000282 |
| Provider Name | Steven B Smith |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1205824703 PECOS PAC ID: 8729068366 Enrollment ID: I20130619000663 |
| Provider Name | Jennifer a Olson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336300862 PECOS PAC ID: 5890980387 Enrollment ID: I20130802000416 |
| Provider Name | Alexander Schabel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801978481 PECOS PAC ID: 5698921609 Enrollment ID: I20130808000149 |
| Provider Name | Malgorzata a Zukowska |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427219633 PECOS PAC ID: 6305016411 Enrollment ID: I20130910000656 |
| Provider Name | Chong Wee Foo |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1588861058 PECOS PAC ID: 7113161662 Enrollment ID: I20130923000833 |
| Provider Name | Cassandra M Wolanin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972802148 PECOS PAC ID: 6901041334 Enrollment ID: I20131028000295 |
| Provider Name | Nathan P Christensen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1952324907 PECOS PAC ID: 0244415917 Enrollment ID: I20131111001287 |
| Provider Name | Jason D Cronin |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346260379 PECOS PAC ID: 9931103702 Enrollment ID: I20131122001757 |
| Provider Name | Alba Virginia Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801164926 PECOS PAC ID: 3173799392 Enrollment ID: I20131203001548 |
| Provider Name | Jennifer L Saxer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336130103 PECOS PAC ID: 7911080080 Enrollment ID: I20140429000440 |
| Provider Name | Kevin J Tyndall |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316358393 PECOS PAC ID: 7911121389 Enrollment ID: I20140605001284 |
| Provider Name | Leita Marie Dzubay |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871566000 PECOS PAC ID: 1052535036 Enrollment ID: I20140612002201 |
| Provider Name | Alan Garcin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063849024 PECOS PAC ID: 8921223223 Enrollment ID: I20140630000687 |
| Provider Name | Rechelle L Asirot |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902118417 PECOS PAC ID: 1153546858 Enrollment ID: I20140714002492 |
| Provider Name | Matthew J Kaiser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720374069 PECOS PAC ID: 6709019631 Enrollment ID: I20140716000165 |
| Provider Name | Elizabeth a Mokrohisky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720195233 PECOS PAC ID: 9133153216 Enrollment ID: I20140905002040 |
| Provider Name | Hang Pham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831486471 PECOS PAC ID: 7416176912 Enrollment ID: I20140916000865 |
| Provider Name | Nandakumar Srinivasan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235270927 PECOS PAC ID: 6103950530 Enrollment ID: I20140916001687 |
| Provider Name | Thomas D Koehler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1720405145 PECOS PAC ID: 9335369362 Enrollment ID: I20140925001354 |
| Provider Name | Matthew a Payne |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528399714 PECOS PAC ID: 6507027331 Enrollment ID: I20141201002183 |
| Provider Name | Jason L Olson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932505765 PECOS PAC ID: 2860715679 Enrollment ID: I20150102000014 |
| Provider Name | Diego Muilenburg |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295716926 PECOS PAC ID: 7719034065 Enrollment ID: I20150107000222 |
| Provider Name | Brittany J Farro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1134472533 PECOS PAC ID: 7719138270 Enrollment ID: I20150209002020 |
| Provider Name | Cathleen M Fritz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1407254014 PECOS PAC ID: 7517283096 Enrollment ID: I20150226002294 |
| Provider Name | Ilona E Stobaugh |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467855627 PECOS PAC ID: 0244556702 Enrollment ID: I20150302000028 |
| Provider Name | Sean C Mcelligott |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1669785820 PECOS PAC ID: 0547488553 Enrollment ID: I20150311001432 |
| Provider Name | Carly L Moe |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457428484 PECOS PAC ID: 1658682695 Enrollment ID: I20150617003186 |
| Provider Name | Sarah J Brinkman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528451911 PECOS PAC ID: 7911219985 Enrollment ID: I20150703000028 |
| Provider Name | Clifton Burt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972824043 PECOS PAC ID: 7517191232 Enrollment ID: I20150707003456 |
| Provider Name | Jerrell Ingalls |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851517999 PECOS PAC ID: 8123176104 Enrollment ID: I20150713002033 |
| Provider Name | Nichole Ingalls |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1235357104 PECOS PAC ID: 5890848659 Enrollment ID: I20150728006596 |
| Provider Name | Cecelia N Jacobson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1528447026 PECOS PAC ID: 5092020925 Enrollment ID: I20150820011260 |
| Provider Name | Andrea L Childress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710211768 PECOS PAC ID: 0547308165 Enrollment ID: I20150820011704 |
| Provider Name | Micah Lundstedt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124428032 PECOS PAC ID: 3678880804 Enrollment ID: I20150921000387 |
| Provider Name | Lauren Forrester Clancey |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1265809966 PECOS PAC ID: 6709194723 Enrollment ID: I20150924001665 |
| Provider Name | Erik W Young |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891059333 PECOS PAC ID: 8325356785 Enrollment ID: I20151005000960 |
| Provider Name | Heidi R Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235291808 PECOS PAC ID: 4082923222 Enrollment ID: I20151029000048 |
| Provider Name | Kristina M Wallace |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1417326984 PECOS PAC ID: 3072823335 Enrollment ID: I20151117001760 |
| Provider Name | John M Malleis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144511643 PECOS PAC ID: 7315183910 Enrollment ID: I20151223000525 |
| Provider Name | Kemble Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205292703 PECOS PAC ID: 5597062398 Enrollment ID: I20160322001731 |
| Provider Name | Michael J Wilder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982861191 PECOS PAC ID: 1254487341 Enrollment ID: I20160415000374 |
| Provider Name | Orlene Hoskinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396078937 PECOS PAC ID: 1759697980 Enrollment ID: I20160502000991 |
| Provider Name | Maggie T Ankeny |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265899710 PECOS PAC ID: 2163721572 Enrollment ID: I20160505000988 |
| Provider Name | Linda F Mcintyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437510765 PECOS PAC ID: 9335438019 Enrollment ID: I20160519001077 |
| Provider Name | Kiran K Aulakh |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750725685 PECOS PAC ID: 3173845633 Enrollment ID: I20160615002645 |
| Provider Name | Morgan C Garvin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558676049 PECOS PAC ID: 7911148861 Enrollment ID: I20160707002497 |
| Provider Name | Tiffany Debra Kamrath |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942586417 PECOS PAC ID: 3870738297 Enrollment ID: I20160708000227 |
| Provider Name | Katelyn a Clark |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366732729 PECOS PAC ID: 7911143201 Enrollment ID: I20160727000078 |
| Provider Name | Edmund Yang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629165741 PECOS PAC ID: 0840347878 Enrollment ID: I20160815000631 |
| Provider Name | Shereen Underwood |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083807077 PECOS PAC ID: 6406937572 Enrollment ID: I20160831001822 |
| Provider Name | Kenneth Mccarley |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1235230707 PECOS PAC ID: 7911171129 Enrollment ID: I20160908001112 |
| Provider Name | Mariko a Ferronato |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528357795 PECOS PAC ID: 7012153752 Enrollment ID: I20160908001947 |
| Provider Name | Mailynn a Mitchell-sanchez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205157757 PECOS PAC ID: 5799947081 Enrollment ID: I20160908002928 |
| Provider Name | Marlene E Dietrich |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1124088406 PECOS PAC ID: 8426945635 Enrollment ID: I20161005001706 |
| Provider Name | Leda Mae T Rabot Cura |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154515781 PECOS PAC ID: 0143530840 Enrollment ID: I20161016000003 |
| Provider Name | Titus B Kosgei |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376099572 PECOS PAC ID: 9931487949 Enrollment ID: I20161026001283 |
| Provider Name | Christopher a Maier |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124410121 PECOS PAC ID: 5395052831 Enrollment ID: I20161101000495 |
| Provider Name | Paul G Bouressa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366414047 PECOS PAC ID: 9032498266 Enrollment ID: I20161110002470 |
| Provider Name | Samantha M Radel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548713399 PECOS PAC ID: 0941589493 Enrollment ID: I20161128001153 |
| Provider Name | Gretta M Freyermuth Lundgren |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598207409 PECOS PAC ID: 8123300506 Enrollment ID: I20170119001165 |
| Provider Name | Morgan K Shasteen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851707814 PECOS PAC ID: 9436468600 Enrollment ID: I20170220001037 |
| Provider Name | Courtney L Apker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104363878 PECOS PAC ID: 1951686195 Enrollment ID: I20170330000782 |
| Provider Name | Margareth Saldanha |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1235387291 PECOS PAC ID: 0143345827 Enrollment ID: I20170508002069 |
| Provider Name | Logan J Mcghan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689965204 PECOS PAC ID: 7113229865 Enrollment ID: I20170517000006 |
| Provider Name | Angela O Loveless |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508099433 PECOS PAC ID: 8628116043 Enrollment ID: I20170526000942 |
| Provider Name | Amber Vester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942629126 PECOS PAC ID: 9638447410 Enrollment ID: I20170620001585 |
| Provider Name | Natalia Hicks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033645213 PECOS PAC ID: 7214205962 Enrollment ID: I20170621001362 |
| Provider Name | Tyler D Grissom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700168804 PECOS PAC ID: 2163790833 Enrollment ID: I20170621002049 |
| Provider Name | Miranda D Lanning |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609219989 PECOS PAC ID: 6406126804 Enrollment ID: I20170718001530 |
| Provider Name | Tracy L Schmitz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629143367 PECOS PAC ID: 3678844404 Enrollment ID: I20170811002461 |
| Provider Name | Janice R Howard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861946188 PECOS PAC ID: 2567736093 Enrollment ID: I20170922001053 |
| Provider Name | Kelly R Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639456379 PECOS PAC ID: 8729253398 Enrollment ID: I20171018002428 |
| Provider Name | Rachel a Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104282102 PECOS PAC ID: 6608133871 Enrollment ID: I20171122002085 |
| Provider Name | Holly Mcnew |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548601313 PECOS PAC ID: 4587895867 Enrollment ID: I20171130002304 |
| Provider Name | Beth Ellen Erickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1184146417 PECOS PAC ID: 1557628377 Enrollment ID: I20171204002847 |
| Provider Name | Hannah D Beeching |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467576272 PECOS PAC ID: 8527327030 Enrollment ID: I20180108003177 |
| Provider Name | Kenten D Woolhiser |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669470670 PECOS PAC ID: 6901891266 Enrollment ID: I20180109002454 |
| Provider Name | Angela R Zallen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871737726 PECOS PAC ID: 8820358906 Enrollment ID: I20180209001691 |
| Provider Name | Sara T Degler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114374584 PECOS PAC ID: 1254691611 Enrollment ID: I20180212002880 |
| Provider Name | Virginia L Dimitre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972021707 PECOS PAC ID: 4880954767 Enrollment ID: I20180214002756 |
| Provider Name | Ryan Wesneski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306298864 PECOS PAC ID: 2163783648 Enrollment ID: I20180223002373 |
| Provider Name | Monique Graves |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679851182 PECOS PAC ID: 6608135678 Enrollment ID: I20180402000862 |
| Provider Name | Ashley O Schmieding |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871972141 PECOS PAC ID: 1951666734 Enrollment ID: I20180525002175 |
| Provider Name | Mark Schuchman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467517300 PECOS PAC ID: 2961683487 Enrollment ID: I20180531002299 |
| Provider Name | Finn J Joehnk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588630073 PECOS PAC ID: 7315294659 Enrollment ID: I20180718001864 |
| Provider Name | Chen-wen C Heh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467449629 PECOS PAC ID: 6507885670 Enrollment ID: I20180721000132 |
| Provider Name | Julien Succar |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1700220811 PECOS PAC ID: 8820345705 Enrollment ID: I20180724001162 |
| Provider Name | Devin Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790125649 PECOS PAC ID: 1052689163 Enrollment ID: I20180907000638 |
| Provider Name | Jennifer L Mitchell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508244260 PECOS PAC ID: 6608169354 Enrollment ID: I20181107001291 |
| Provider Name | Glacel a Salagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962985408 PECOS PAC ID: 3577807957 Enrollment ID: I20181212001648 |
| Provider Name | Katherine Kinser |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326586926 PECOS PAC ID: 1456690205 Enrollment ID: I20190222001115 |
| Provider Name | Leigha Tingey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1437627890 PECOS PAC ID: 3274873930 Enrollment ID: I20190318000850 |
| Provider Name | Brock D Bernsten |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528070752 PECOS PAC ID: 5890036115 Enrollment ID: I20190412001784 |
| Provider Name | Susan R Austin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811032386 PECOS PAC ID: 0840523551 Enrollment ID: I20190612002169 |
| Provider Name | Rachel L Zubko |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578737342 PECOS PAC ID: 7012189889 Enrollment ID: I20190909003266 |
| Provider Name | Krista Dae Stieglitz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114392842 PECOS PAC ID: 5193054591 Enrollment ID: I20190910003635 |
| Provider Name | Jeffrey D Crawford |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1003106071 PECOS PAC ID: 2769627462 Enrollment ID: I20190913000380 |
| Provider Name | Maile E Parker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366880486 PECOS PAC ID: 6406096502 Enrollment ID: I20191002003285 |
| Provider Name | Cierra B Hibbs Porter Rogge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033762901 PECOS PAC ID: 4981935988 Enrollment ID: I20191004002316 |
| Provider Name | Heidi a Grove |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952956492 PECOS PAC ID: 8325379258 Enrollment ID: I20191008001834 |
| Provider Name | Nicole F Drahuschak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144518788 PECOS PAC ID: 9537330162 Enrollment ID: I20191011001142 |
| Provider Name | Keely M Beach |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407280134 PECOS PAC ID: 4981936143 Enrollment ID: I20191022000637 |
| Provider Name | Dustin K Mckague |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427618974 PECOS PAC ID: 6406188291 Enrollment ID: I20191028003162 |
| Provider Name | Jayme S Mcallister |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235589136 PECOS PAC ID: 0345536215 Enrollment ID: I20191113001039 |
| Provider Name | Haley Grace Ruljancich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821647173 PECOS PAC ID: 8820420292 Enrollment ID: I20191125000243 |
| Provider Name | Katherine E Omernick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316396385 PECOS PAC ID: 9234424037 Enrollment ID: I20191125000695 |
| Provider Name | Alysha L Bennett |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902217748 PECOS PAC ID: 2769815190 Enrollment ID: I20191126000013 |
| Provider Name | Timothy P Landry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700340270 PECOS PAC ID: 3274967674 Enrollment ID: I20191217002915 |
| Provider Name | Habib Mo Fanny |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1164837639 PECOS PAC ID: 4587881099 Enrollment ID: I20200305001626 |
| Provider Name | Margie N L Tucker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477725794 PECOS PAC ID: 2769608397 Enrollment ID: I20200403002337 |
| Provider Name | Inga Marie Giske |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912471228 PECOS PAC ID: 1153752621 Enrollment ID: I20200518000683 |
| Provider Name | Sarbmeet S Mann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902320039 PECOS PAC ID: 0749602738 Enrollment ID: I20200619002148 |
| Provider Name | Sidra Manzoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821510504 PECOS PAC ID: 6800218850 Enrollment ID: I20200626001953 |
| Provider Name | Richard a Mcewen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386968303 PECOS PAC ID: 4486928496 Enrollment ID: I20200713002392 |
| Provider Name | Sean Malanowski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598139800 PECOS PAC ID: 5799108015 Enrollment ID: I20200716002163 |
| Provider Name | Ashley Nicole Rivera |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457745200 PECOS PAC ID: 1254682941 Enrollment ID: I20200728003958 |
| Provider Name | Alanna Hannegraf |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710332986 PECOS PAC ID: 5294153904 Enrollment ID: I20200911002555 |
| Provider Name | Emily M Jaksich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336510635 PECOS PAC ID: 2062721830 Enrollment ID: I20201106001461 |
| Provider Name | Rachel a Hadley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477836351 PECOS PAC ID: 8820409212 Enrollment ID: I20201116000449 |
| Provider Name | Seth E Cohen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508013269 PECOS PAC ID: 3779995121 Enrollment ID: I20201209001662 |
| Provider Name | William G Tooze |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770188302 PECOS PAC ID: 0042624736 Enrollment ID: I20210120001248 |
| Provider Name | Emily M Griffith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083276307 PECOS PAC ID: 3678804176 Enrollment ID: I20210224002585 |
| Provider Name | Brian J Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336461813 PECOS PAC ID: 3072644228 Enrollment ID: I20210524000565 |
| Provider Name | Tamara K Barstow |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184696924 PECOS PAC ID: 2860892973 Enrollment ID: I20210610003571 |
| Provider Name | Ame Phitwong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255858247 PECOS PAC ID: 3375819675 Enrollment ID: I20210616000530 |
| Provider Name | Abhinav Tiwari |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1225411598 PECOS PAC ID: 9830494558 Enrollment ID: I20210629003471 |
| Provider Name | Arissa R Walberg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891185286 PECOS PAC ID: 2062709660 Enrollment ID: I20210723003226 |
| Provider Name | Paul C Benda |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790757557 PECOS PAC ID: 1850794611 Enrollment ID: I20210730002083 |
| Provider Name | Susan M Bertilson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639208291 PECOS PAC ID: 5193129559 Enrollment ID: I20210806000841 |
| Provider Name | Shawn J John |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801374483 PECOS PAC ID: 1355693904 Enrollment ID: I20210810001571 |
| Provider Name | Suchita Kotnala |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558854539 PECOS PAC ID: 0648674804 Enrollment ID: I20210810001953 |
| Provider Name | Maura R Munoz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720407364 PECOS PAC ID: 8729206529 Enrollment ID: I20210813000754 |
| Provider Name | Irena Kuca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366931644 PECOS PAC ID: 5092110940 Enrollment ID: I20210816003532 |
| Provider Name | Sarah M Holtschlag |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326521196 PECOS PAC ID: 8224435573 Enrollment ID: I20210929001160 |
| Provider Name | Diana Spann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366055113 PECOS PAC ID: 5991103731 Enrollment ID: I20211008002815 |
| Provider Name | Desirae Bloomquist |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699267963 PECOS PAC ID: 7618216300 Enrollment ID: I20211011002415 |
| Provider Name | Kirsten D Thompson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013400555 PECOS PAC ID: 7618205287 Enrollment ID: I20211018001084 |
| Provider Name | Brett White |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124538905 PECOS PAC ID: 6709144298 Enrollment ID: I20211103001457 |
| Provider Name | Matthew Thomas Gust |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1629432422 PECOS PAC ID: 0648566208 Enrollment ID: I20211103002247 |
| Provider Name | Jorge Francisco Ganem |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306075395 PECOS PAC ID: 4880851237 Enrollment ID: I20211130002277 |
| Provider Name | Andrew James Henderson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164043972 PECOS PAC ID: 7214327881 Enrollment ID: I20211214002163 |
| Provider Name | Shawna M Jensen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1083949697 PECOS PAC ID: 0244626364 Enrollment ID: I20220329002311 |
| Provider Name | Nicholas D Crall |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316262645 PECOS PAC ID: 3274761333 Enrollment ID: I20220421001341 |
| Provider Name | Julie a Tenbrook |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164417606 PECOS PAC ID: 6709876279 Enrollment ID: I20220425002464 |
| Provider Name | Lindsey Leighton |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1649638792 PECOS PAC ID: 4082001623 Enrollment ID: I20220428001245 |
| Provider Name | Aaron Gabriel Jacobs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609395912 PECOS PAC ID: 8325425507 Enrollment ID: I20220509000943 |
| Provider Name | Alp Ozpinar |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1417397233 PECOS PAC ID: 9436538774 Enrollment ID: I20220616002796 |
| Provider Name | Gabriela Prieto |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255983995 PECOS PAC ID: 0345667069 Enrollment ID: I20220706002703 |
| Provider Name | Kristi Mckenzie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265742811 PECOS PAC ID: 1254712672 Enrollment ID: I20220718000690 |
| Provider Name | Shanna Swezey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265827265 PECOS PAC ID: 6204217045 Enrollment ID: I20220725003014 |
| Provider Name | Eric Meyer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982719589 PECOS PAC ID: 2466414495 Enrollment ID: I20220726000593 |
| Provider Name | Palak Dwarkesh Parikh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295909331 PECOS PAC ID: 2668629205 Enrollment ID: I20220815000887 |
| Provider Name | Victoria Winter Anderson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316682958 PECOS PAC ID: 6305229675 Enrollment ID: I20220818003217 |
| Provider Name | Megan Dorenkamp |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1417307042 PECOS PAC ID: 5395129027 Enrollment ID: I20220830002730 |
| Provider Name | Sally L Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134850043 PECOS PAC ID: 5092199745 Enrollment ID: I20220830003856 |
| Provider Name | Vanessa Franson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275938755 PECOS PAC ID: 1759604903 Enrollment ID: I20220914002443 |
| Provider Name | Khuram Ameen |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1881600450 PECOS PAC ID: 6406800192 Enrollment ID: I20220915003935 |
| Provider Name | Sabo Uba |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508106873 PECOS PAC ID: 4385889849 Enrollment ID: I20221003000681 |
| Provider Name | Wendy Maurer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588093264 PECOS PAC ID: 9537545256 Enrollment ID: I20221004002599 |
| Provider Name | Robert Elder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740635531 PECOS PAC ID: 8527471259 Enrollment ID: I20221014002623 |
| Provider Name | Maximilian Taylor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699206193 PECOS PAC ID: 4284961525 Enrollment ID: I20221017001868 |
| Provider Name | Sophie Claire Feller |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134514540 PECOS PAC ID: 0446580260 Enrollment ID: I20221114000251 |
| Provider Name | Audra Michelle Landry |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770728701 PECOS PAC ID: 2062880438 Enrollment ID: I20221116002631 |
| Provider Name | Ashna Wadhawan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366002776 PECOS PAC ID: 6608102579 Enrollment ID: I20221117000129 |
| Provider Name | Margaret Hause |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114592995 PECOS PAC ID: 2567831084 Enrollment ID: I20221205003379 |
| Provider Name | Jessica Hammond |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811329105 PECOS PAC ID: 5294104485 Enrollment ID: I20221209001944 |
| Provider Name | Angie Lynn Wharfield |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376561548 PECOS PAC ID: 0345610242 Enrollment ID: I20230111000951 |
| Provider Name | Jeffrey S Jagiello |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710522941 PECOS PAC ID: 3678904612 Enrollment ID: I20230126002826 |
| Provider Name | Irma Magdalena Moody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831861335 PECOS PAC ID: 1658743141 Enrollment ID: I20230209001430 |
| Provider Name | Byron Patrick Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538819990 PECOS PAC ID: 2264804244 Enrollment ID: I20230221002612 |
| Provider Name | Cassidy Bachelot |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1962114074 PECOS PAC ID: 6406229939 Enrollment ID: I20230303002213 |
| Provider Name | Allison Lynn Foster |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982824108 PECOS PAC ID: 9638356017 Enrollment ID: I20230307002978 |
| Provider Name | Benjamin J Smith |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1760730907 PECOS PAC ID: 3779852892 Enrollment ID: I20230407000522 |
| Provider Name | Beata Esther Stein |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891323267 PECOS PAC ID: 1355716820 Enrollment ID: I20230414001101 |
| Provider Name | Mashael Don-nell Brown |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689833196 PECOS PAC ID: 8325403017 Enrollment ID: I20230502003243 |
| Provider Name | Donald Lee Pierce |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790197523 PECOS PAC ID: 4880811264 Enrollment ID: I20230517002436 |
| Provider Name | Anna Higgins Nothum |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1336843960 PECOS PAC ID: 5294191979 Enrollment ID: I20230523000999 |
| Provider Name | Joshua a Skufca |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760863369 PECOS PAC ID: 9032423181 Enrollment ID: I20230523001042 |
| Provider Name | Tarun Mullick |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912906462 PECOS PAC ID: 9032161054 Enrollment ID: I20230531001047 |
| Provider Name | Leah Fertig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871293886 PECOS PAC ID: 0749647964 Enrollment ID: I20230602002255 |
| Provider Name | Kodjovi Kodjo |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780100958 PECOS PAC ID: 7517203177 Enrollment ID: I20230607001792 |
| Provider Name | Denise J White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477624294 PECOS PAC ID: 4880921667 Enrollment ID: I20230613001382 |
| Provider Name | Frank Chen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841670007 PECOS PAC ID: 8022310093 Enrollment ID: I20230629003158 |
| Provider Name | Chalapathi Rao Medavarapu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1750876868 PECOS PAC ID: 8325407547 Enrollment ID: I20230706002832 |
| Provider Name | Michael Zammit |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841251188 PECOS PAC ID: 5496658213 Enrollment ID: I20230724001398 |
| Provider Name | Elijah John Strong Lotz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1437542446 PECOS PAC ID: 7416223383 Enrollment ID: I20230821001968 |
| Provider Name | Judith Raboy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447706841 PECOS PAC ID: 4587943436 Enrollment ID: I20230823002926 |
| Provider Name | Jose Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669086641 PECOS PAC ID: 4183043383 Enrollment ID: I20230824002628 |
| Provider Name | Cory Scott |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073037495 PECOS PAC ID: 3375805260 Enrollment ID: I20230829004470 |
| Provider Name | David James Nestor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306481916 PECOS PAC ID: 6608232780 Enrollment ID: I20230906001211 |
| Provider Name | Sherifat I Forcey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043861438 PECOS PAC ID: 8022442235 Enrollment ID: I20230925000635 |
| Provider Name | Allan Young |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659514321 PECOS PAC ID: 8426338872 Enrollment ID: I20230929001370 |
| Provider Name | Jeff Wong |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1205369485 PECOS PAC ID: 3476953712 Enrollment ID: I20231003001934 |
| Provider Name | Nicholas Bryce Woods |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699126011 PECOS PAC ID: 7315392867 Enrollment ID: I20231018002659 |
| Provider Name | Jeffry Jacobs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1063477545 PECOS PAC ID: 7113961012 Enrollment ID: I20231222002631 |
| Provider Name | Kelly Grace Shaw |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1962068650 PECOS PAC ID: 3375993579 Enrollment ID: I20240101000368 |
| Provider Name | Shirley Ann Spencer |
|---|---|
| Provider Type | Practitioner - Other (non-physician) |
| Provider Identifiers | NPI Number: 1306397666 PECOS PAC ID: 5496106957 Enrollment ID: I20240109002268 |
| Provider Name | Paul Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1447662796 PECOS PAC ID: 1759732969 Enrollment ID: I20240111002260 |
| Provider Name | Brandon Pipkin |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1356659395 PECOS PAC ID: 8022355700 Enrollment ID: I20240112002669 |
| Provider Name | Candice Anne Elliott |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1225312929 PECOS PAC ID: 7911359641 Enrollment ID: I20240118002497 |
| Provider Name | Thomas Dale Brieske |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144948803 PECOS PAC ID: 2860844255 Enrollment ID: I20240122002714 |
| Provider Name | Anthony Louis Rios |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194952911 PECOS PAC ID: 0244500742 Enrollment ID: I20240124002858 |
| Provider Name | Nicholas Hamilton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811013840 PECOS PAC ID: 0143384370 Enrollment ID: I20240206001669 |
| Provider Name | Chaine Mabray |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1679974166 PECOS PAC ID: 5799129839 Enrollment ID: I20240216002779 |
| Provider Name | William David Chance Young |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1386267516 PECOS PAC ID: 8921442856 Enrollment ID: I20240220001346 |
| Provider Name | Gabriele Morrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356054118 PECOS PAC ID: 1052755691 Enrollment ID: I20240222000375 |
| Provider Name | Madalyn Taylor |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699538777 PECOS PAC ID: 5597100800 Enrollment ID: I20240227000806 |
| Provider Name | Mark Morasch |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1790719219 PECOS PAC ID: 0648300533 Enrollment ID: I20240229001895 |
| Provider Name | Andria Miller |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1457502486 PECOS PAC ID: 7810332491 Enrollment ID: I20240305003636 |
| Provider Name | Shelly Kennedy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689044026 PECOS PAC ID: 4385947589 Enrollment ID: I20240311002187 |
| Provider Name | Benjamin Fiore |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114330404 PECOS PAC ID: 4385994581 Enrollment ID: I20240315003702 |
| Provider Name | Rodney James Deaton |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003934274 PECOS PAC ID: 8921240425 Enrollment ID: I20240401003225 |
| Provider Name | Tabbie Day |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1336123447 PECOS PAC ID: 8628003548 Enrollment ID: I20240412001378 |
| Provider Name | Ryan Hargraves |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306983556 PECOS PAC ID: 9234500745 Enrollment ID: I20240412003934 |
| Provider Name | Erin Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376982678 PECOS PAC ID: 1557700598 Enrollment ID: I20240423003271 |
| Provider Name | Amber Heise |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013077478 PECOS PAC ID: 7416028477 Enrollment ID: I20240429003172 |
| Provider Name | Eric Johnsen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1750140711 PECOS PAC ID: 1759722176 Enrollment ID: I20240515003427 |
| Provider Name | Camille Claire Rain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346891603 PECOS PAC ID: 7012330400 Enrollment ID: I20240518000421 |
| Provider Name | Andrei Gasic |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184623407 PECOS PAC ID: 3779550009 Enrollment ID: I20240520002042 |
| Provider Name | Robert Louis Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285254136 PECOS PAC ID: 0547683799 Enrollment ID: I20240531002130 |
| Provider Name | Joshua Balderman |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1306285325 PECOS PAC ID: 4981942919 Enrollment ID: I20240618002500 |
| Provider Name | Christopher T Perry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326109455 PECOS PAC ID: 0446589956 Enrollment ID: I20240618003700 |
| Provider Name | Emiliano Valles |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932429453 PECOS PAC ID: 9335456029 Enrollment ID: I20240618003796 |
| Provider Name | Benjamin Upton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487116976 PECOS PAC ID: 2062742125 Enrollment ID: I20240626003326 |
| Provider Name | Aleksandra Sliwinska |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1124683941 PECOS PAC ID: 9234460353 Enrollment ID: I20240626003388 |
| Provider Name | Yu Kyung Son |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528801958 PECOS PAC ID: 2062957202 Enrollment ID: I20240712000610 |
| Provider Name | Ali Syed |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023436037 PECOS PAC ID: 4587962055 Enrollment ID: I20240715001357 |
| Provider Name | Adam Burch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205213246 PECOS PAC ID: 1355637323 Enrollment ID: I20240807003632 |
| Provider Name | Phillip M Percy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306178512 PECOS PAC ID: 9436696416 Enrollment ID: I20240808001155 |
| Provider Name | Amanda M Canario |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720615875 PECOS PAC ID: 2466875620 Enrollment ID: I20240820003336 |
| Provider Name | Dennis Hopkinson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1588051809 PECOS PAC ID: 0345557435 Enrollment ID: I20240821002332 |
| Provider Name | James D Panetta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376721142 PECOS PAC ID: 0446397434 Enrollment ID: I20240826002949 |
| Provider Name | Huriye Hande Aydinli |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174011332 PECOS PAC ID: 1557800240 Enrollment ID: I20240826003112 |
| Provider Name | Lenore Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184401093 PECOS PAC ID: 0042759508 Enrollment ID: I20240828001796 |
| Provider Name | Chris Webb |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861487084 PECOS PAC ID: 0446226302 Enrollment ID: I20240830002655 |
| Provider Name | Virginia Gail Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164528816 PECOS PAC ID: 0840350062 Enrollment ID: I20240904000146 |
| Provider Name | Richard Haycock |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326443417 PECOS PAC ID: 1759638919 Enrollment ID: I20240909001118 |
| Provider Name | Mabel Chu |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1285880708 PECOS PAC ID: 6406177203 Enrollment ID: I20240909002433 |
| Provider Name | Andrea Soto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649400318 PECOS PAC ID: 1658811211 Enrollment ID: I20240910001632 |
| Provider Name | Ifeoma Oriaku |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417319526 PECOS PAC ID: 6901131812 Enrollment ID: I20240911003123 |
| Provider Name | Juan Carlos Nuno |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275018152 PECOS PAC ID: 7315488079 Enrollment ID: I20240920002521 |
| Provider Name | Amanda Wruble |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1568839215 PECOS PAC ID: 1456882646 Enrollment ID: I20240927003012 |
| Provider Name | Paul D Schroeder |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306461496 PECOS PAC ID: 4789007170 Enrollment ID: I20240930001645 |
| Provider Name | Hillary Falburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104372531 PECOS PAC ID: 0840721700 Enrollment ID: I20241002001907 |
| Provider Name | Jason P Jarria |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1639798333 PECOS PAC ID: 6800211756 Enrollment ID: I20241003002925 |
| Provider Name | Tiffany Crystal Cordova |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679888366 PECOS PAC ID: 9931630738 Enrollment ID: I20241003003342 |
| Provider Name | Jillian L Ford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629806401 PECOS PAC ID: 0446782619 Enrollment ID: I20241011003498 |
| Provider Name | Jessica Niles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740785450 PECOS PAC ID: 0648697300 Enrollment ID: I20241016003889 |
| Provider Name | Hong Zheng |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1811282775 PECOS PAC ID: 4385999556 Enrollment ID: I20241018002355 |
| Provider Name | Yesenia Farr |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1134632920 PECOS PAC ID: 5991041667 Enrollment ID: I20241104002283 |
| Provider Name | Devin Robert Gaines |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1538573464 PECOS PAC ID: 5799219325 Enrollment ID: I20241105002836 |
| Provider Name | Robin Alana Lewis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1144512138 PECOS PAC ID: 9739613381 Enrollment ID: I20241105003537 |
| Provider Name | Jessica Marie Colon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396582573 PECOS PAC ID: 2163956665 Enrollment ID: I20241106001853 |
| Provider Name | Amanda Phillips |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1205286283 PECOS PAC ID: 0648625095 Enrollment ID: I20241107003625 |
| Provider Name | Salim Zulfiqar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790983328 PECOS PAC ID: 6507982212 Enrollment ID: I20241111002044 |
| Provider Name | Nathan Zuck |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487410692 PECOS PAC ID: 7416481460 Enrollment ID: I20241113001554 |
| Provider Name | Mackenzie Nightingale Caum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639996275 PECOS PAC ID: 5395270664 Enrollment ID: I20241122002637 |
| Provider Name | Mckenzie Furgason |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1568083160 PECOS PAC ID: 1153856208 Enrollment ID: I20241126001328 |
| Provider Name | Jacqueline L. Hurst |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366752974 PECOS PAC ID: 2860927860 Enrollment ID: I20241127003663 |
| Provider Name | Alisha Renee Wells |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811531577 PECOS PAC ID: 9234664186 Enrollment ID: I20241202001099 |
| Provider Name | Hira Irfan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407378714 PECOS PAC ID: 5890069439 Enrollment ID: I20241204003366 |
| Provider Name | Adrienne Louise Dombrosky |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1366849879 PECOS PAC ID: 6901334564 Enrollment ID: I20250115000794 |
| Provider Name | Monica Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174150999 PECOS PAC ID: 7012394828 Enrollment ID: I20250123000446 |
| Provider Name | Monica Eugenia Hutanu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356163240 PECOS PAC ID: 5597294314 Enrollment ID: I20250123002545 |
| Provider Name | Monica M Hegedus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285993238 PECOS PAC ID: 4688969504 Enrollment ID: I20250124001556 |
| Provider Name | Tammy Wiscovitch |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1891501748 PECOS PAC ID: 6709315492 Enrollment ID: I20250124002125 |
| Provider Name | Megan Doty |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285924829 PECOS PAC ID: 8527350347 Enrollment ID: I20250129002890 |
| Provider Name | Elizabeth Field |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740022516 PECOS PAC ID: 8921537374 Enrollment ID: I20250129003008 |
| Provider Name | Jessica Hope Swensen |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891143285 PECOS PAC ID: 4082143474 Enrollment ID: I20250130001185 |
| Provider Name | Casey Ward |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164765590 PECOS PAC ID: 4284868860 Enrollment ID: I20250203003547 |
| Provider Name | Lindsey Leigh Gardner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992185987 PECOS PAC ID: 5395275374 Enrollment ID: I20250205003257 |
| Provider Name | Ashley Marie Kincaid |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497362040 PECOS PAC ID: 4587194493 Enrollment ID: I20250207000392 |
| Provider Name | Michelle Montgomery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700279106 PECOS PAC ID: 8628599024 Enrollment ID: I20250228003016 |
| Provider Name | Arielle Perez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548556533 PECOS PAC ID: 0749416402 Enrollment ID: I20250310001275 |
| Provider Name | Dayna Garcia De Alba |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881375079 PECOS PAC ID: 2062934201 Enrollment ID: I20250318000979 |
| Provider Name | Adam Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790209963 PECOS PAC ID: 5395267058 Enrollment ID: I20250321002940 |
| Provider Name | Mijung Huh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740086982 PECOS PAC ID: 1456874320 Enrollment ID: I20250401002268 |
| Provider Name | Julia Farquhar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467942292 PECOS PAC ID: 4981959707 Enrollment ID: I20250415000964 |
| Provider Name | Joshua Dane Shafer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487926515 PECOS PAC ID: 0840715132 Enrollment ID: I20250418002025 |
| Provider Name | Ling Jin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386138956 PECOS PAC ID: 4587059654 Enrollment ID: I20250512001632 |
| Provider Name | Lakshmeeramya Malladi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609455583 PECOS PAC ID: 2860934163 Enrollment ID: I20250515003205 |
| Provider Name | Matthew a Bzdega |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881957876 PECOS PAC ID: 1759524275 Enrollment ID: I20250528003480 |
| Provider Name | Gautam Madhu Nayar |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1336630227 PECOS PAC ID: 5496000903 Enrollment ID: I20250530001303 |
| Provider Name | Jennifer Marie Gordon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801687314 PECOS PAC ID: 5092225631 Enrollment ID: I20250611003218 |
| Provider Name | Katherine Anne Wright |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1790362564 PECOS PAC ID: 1254842545 Enrollment ID: I20250613002445 |
| Provider Name | Jessica Elizabeth Howell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962241711 PECOS PAC ID: 7315459369 Enrollment ID: I20250625000996 |
| Provider Name | Marianne Johnstone-petty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871896894 PECOS PAC ID: 2567644453 Enrollment ID: I20250626001439 |
| Provider Name | Pranab Dahal |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235704909 PECOS PAC ID: 3375056138 Enrollment ID: I20250703001249 |
| Provider Name | Matthew C Neal |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184231854 PECOS PAC ID: 3072029008 Enrollment ID: I20250717003798 |
| Provider Name | Abdul-qader Alarhayem |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1053676049 PECOS PAC ID: 5799102737 Enrollment ID: I20250724002539 |
| Provider Name | Anna Janecek |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275282097 PECOS PAC ID: 5991183097 Enrollment ID: I20250725003254 |
| Provider Name | Alex Swanson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013554526 PECOS PAC ID: 6901232560 Enrollment ID: I20250804001974 |
| Provider Name | Haley Jasmyn Norris |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1255912952 PECOS PAC ID: 1153829148 Enrollment ID: I20250808002985 |
| Provider Name | Komal Preet Kaur |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1548751225 PECOS PAC ID: 2264930262 Enrollment ID: I20250808003204 |
| Provider Name | Megan Kunkel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902483795 PECOS PAC ID: 0648673152 Enrollment ID: I20250808003937 |
| Provider Name | Gino Gaddini |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992169205 PECOS PAC ID: 3476898206 Enrollment ID: I20250813001132 |
| Provider Name | Caroline Means |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588551899 PECOS PAC ID: 3971005885 Enrollment ID: I20250909000324 |
| Provider Name | Mara Araxie Darian |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972184349 PECOS PAC ID: 4688052897 Enrollment ID: I20250912001783 |
| Provider Name | Alex Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336607142 PECOS PAC ID: 1355740325 Enrollment ID: I20250930001854 |
| Provider Name | Cindy Lee Rasavage |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609766054 PECOS PAC ID: 0345747788 Enrollment ID: I20251009004804 |
| Provider Name | Lee Mckoin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952043150 PECOS PAC ID: 4082102587 Enrollment ID: I20251024001739 |
| Provider Name | Rebecca Gibbon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174004964 PECOS PAC ID: 9335561869 Enrollment ID: I20251027000574 |
| Provider Name | John Rower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053131276 PECOS PAC ID: 2264921477 Enrollment ID: I20251028004935 |
| Provider Name | Neelendu Dey |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1154575892 PECOS PAC ID: 3779748512 Enrollment ID: I20251031000667 |
| Provider Name | Brett Sadowski |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669810701 PECOS PAC ID: 7719107838 Enrollment ID: I20251031001097 |
| Provider Name | Laurie Gray |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508060179 PECOS PAC ID: 0042362915 Enrollment ID: I20251103003214 |
| Provider Name | Jenniffer Janowiecki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871051730 PECOS PAC ID: 1355754425 Enrollment ID: I20251106004613 |
| Provider Name | Melanie Maples |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881069185 PECOS PAC ID: 2567952591 Enrollment ID: I20251106005397 |
| Provider Name | Shannon Beatty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558721746 PECOS PAC ID: 1355831231 Enrollment ID: I20251107004235 |
| Provider Name | Charisse N Williams-stewart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740948470 PECOS PAC ID: 2860871126 Enrollment ID: I20251119001709 |
| Provider Name | Jared Davis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487095659 PECOS PAC ID: 5395049134 Enrollment ID: I20251128000739 |
| Provider Name | Long T Vu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1477973535 PECOS PAC ID: 1850693052 Enrollment ID: I20251211002130 |
| Provider Name | Malinda Whitfield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942293998 PECOS PAC ID: 0042357998 Enrollment ID: I20251223003736 |
| Provider Name | Colin C Grey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881306215 PECOS PAC ID: 1759877558 Enrollment ID: I20251231002193 |
| Provider Name | Tiffany Chaille |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932655982 PECOS PAC ID: 3476840455 Enrollment ID: I20251231002671 |
| Provider Name | Alyssa Marie Leal |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992496160 PECOS PAC ID: 9537646708 Enrollment ID: I20260119000604 |
| Provider Name | Zachary Schreiber |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1982445219 PECOS PAC ID: 8325525595 Enrollment ID: I20260119000774 |
| Provider Name | Janaka S Sarathchandra |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700148871 PECOS PAC ID: 0244533438 Enrollment ID: I20260123002556 |
| Provider Name | Nazia Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285924258 PECOS PAC ID: 7416246954 Enrollment ID: I20260128002338 |
| Provider Name | Sheryl S Fisher |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1194013441 PECOS PAC ID: 2668951286 Enrollment ID: I20260204002504 |
| Provider Name | Virginia Ramos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871098665 PECOS PAC ID: 1850641812 Enrollment ID: I20260210000716 |
| Provider Name | Cadence Nadine Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689533440 PECOS PAC ID: 3971083668 Enrollment ID: I20260212002076 |
| Provider Name | John Kennedy |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1700943545 PECOS PAC ID: 5799739637 Enrollment ID: I20260224000119 |
| Provider Name | Kuvera Sikhakhane |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215676739 PECOS PAC ID: 3577946813 Enrollment ID: I20260225002505 |
| Provider Name | Joshua Logan Ford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538783188 PECOS PAC ID: 3577046135 Enrollment ID: I20260311003262 |
| Provider Name | Nicole Renee Bailey |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235967498 PECOS PAC ID: 4183107402 Enrollment ID: I20260313002913 |
| Provider Name | Sharon Lee Hodges |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275363855 PECOS PAC ID: 0143704726 Enrollment ID: I20260320003800 |
| Provider Name | Bryan B Nilsen |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1770662736 PECOS PAC ID: 1254816622 Enrollment ID: I20260402003166 |
| Provider Name | Maija Ryan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063779668 PECOS PAC ID: 1850867714 Enrollment ID: I20260417001251 |
| Provider Name | Chang Liu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205678745 PECOS PAC ID: 6204302128 Enrollment ID: I20260417002904 |
| Provider Name | Elizabeth Emily Bailey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225406671 PECOS PAC ID: 4789151168 Enrollment ID: I20260422002795 |
| Provider Name | Suzanne Campiche |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1467080499 PECOS PAC ID: 5294126876 Enrollment ID: I20260501000771 |
| Provider Name | Kim M Almodovar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831160316 PECOS PAC ID: 7618031782 Enrollment ID: I20260504006847 |
| Provider Name | Tara Beairsto Mccullers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841515939 PECOS PAC ID: 9234607607 Enrollment ID: I20260504007429 |
| Provider Name | Alyssa Baltrusch |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598575136 PECOS PAC ID: 2163992934 Enrollment ID: I20260522000342 |
| Provider Name | Jennifer Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730531203 PECOS PAC ID: 4385930726 Enrollment ID: I20260522000698 |
| Provider Name | Chedric Robert Monahan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1669902599 PECOS PAC ID: 0547731911 Enrollment ID: I20260605002949 |
| Provider Name | Narayan Prasad Osti |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063025963 PECOS PAC ID: 9133691884 Enrollment ID: I20260615001174 |
| Provider Name | Elizabeth Bhatta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447792981 PECOS PAC ID: 4587940556 Enrollment ID: I20260615002341 |
Bello LLC. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2746 Shadow View Dr, Eugene, OR 97408 Phone: 541-345-0551 Fax: 541-465-3831 |
Healing Spirit Integrative Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1355 Oak St Ste 100, Eugene, OR 97401 Phone: 541-683-1125 Fax: 541-683-2049 |
David A. Bove, ND PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1161 Lincoln St, Eugene, OR 97401 Phone: 541-683-2126 |
Scarborough Medical Care LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1180 Patterson St Ste 2-b, Eugene, OR 97401 Phone: 541-687-6508 |
Joyous Doctors Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 207 E 5th Ave Ste 247, Eugene, OR 97401 Phone: 503-459-3323 |
Chiropractic Pain & Prevention Center P.C. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1902 Jefferson St, Ste 1, Eugene, OR 97405 Phone: 541-687-2772 Fax: 888-857-2772 |