| Providence Medford Medical Center | |
|
1111 Crater Lake Ave Medford OR 97504-6241 | |
| (541) 732-5250 | |
| (541) 732-5251 |
| Full Name | Providence Medford Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1111 Crater Lake Ave, Medford, Oregon |
| Authorized Official Name and Position | Donald Wayne Anderson (ASST SEC FOR ENROLLMENT/DIR REIMB S) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medford Medical Center Po Box 3308 Portland OR 97208-3308 Ph: (541) 732-5250 | Providence Medford Medical Center 1111 Crater Lake Ave Medford OR 97504-6241 Ph: (541) 732-5250 |
| NPI Number | 1093976243 |
|---|---|
| Provider Enumeration Date | 06/20/2008 |
| Last Update Date | 12/27/2021 |
| Medicare PECOS PAC ID | 3476450560 |
|---|---|
| Medicare Enrollment ID | O20031217000186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093976243 | NPI | - | NPPES |
| 500617088 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Oregon) | Primary |
| Provider Name | Kay E Case |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952372831 PECOS PAC ID: 4486567773 Enrollment ID: I20040102000152 |
| Provider Name | Richard S Urbanski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245307651 PECOS PAC ID: 7012810880 Enrollment ID: I20040129000483 |
| Provider Name | Su Wang |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1730300641 PECOS PAC ID: 3678468667 Enrollment ID: I20040218000711 |
| Provider Name | Brian E Winkler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265432256 PECOS PAC ID: 7315839628 Enrollment ID: I20040329001733 |
| Provider Name | Jeffrey D Harter |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1275754970 PECOS PAC ID: 8224024450 Enrollment ID: I20040422001547 |
| Provider Name | Perry Holbrook Howard |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1760603567 PECOS PAC ID: 9830185883 Enrollment ID: I20040423000759 |
| Provider Name | Xiaohong Cai |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1245451038 PECOS PAC ID: 4981692852 Enrollment ID: I20040501000228 |
| Provider Name | Brandan A Hull |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184719882 PECOS PAC ID: 3274523352 Enrollment ID: I20040512001540 |
| Provider Name | Eric M Perry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750387825 PECOS PAC ID: 7113918491 Enrollment ID: I20040524001356 |
| Provider Name | Amy E Schmitt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942271986 PECOS PAC ID: 9133101512 Enrollment ID: I20040601001404 |
| Provider Name | Richard H Sohn |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1609818939 PECOS PAC ID: 0143202499 Enrollment ID: I20040602000390 |
| Provider Name | Monique Gedenk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740226745 PECOS PAC ID: 4385627538 Enrollment ID: I20040609001337 |
| Provider Name | Aly Rahimtoola |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750373056 PECOS PAC ID: 8123005915 Enrollment ID: I20040630000352 |
| Provider Name | James B Durham |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1578784369 PECOS PAC ID: 1759368947 Enrollment ID: I20040706000937 |
| Provider Name | Michael A Davis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629150420 PECOS PAC ID: 9931187960 Enrollment ID: I20040707001436 |
| Provider Name | Michael L Potter |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1457388191 PECOS PAC ID: 7618955642 Enrollment ID: I20040707001469 |
| Provider Name | Daniel R Brandenburg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255427290 PECOS PAC ID: 4880674001 Enrollment ID: I20040720001106 |
| Provider Name | Nancy Hagloch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184711749 PECOS PAC ID: 3870565476 Enrollment ID: I20040812000469 |
| Provider Name | Matthew J Gadbaw |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558392969 PECOS PAC ID: 8224001599 Enrollment ID: I20040816000337 |
| Provider Name | Tracy L Haley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407943889 PECOS PAC ID: 1850349010 Enrollment ID: I20050105000318 |
| Provider Name | William B Craft |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689760506 PECOS PAC ID: 1456392489 Enrollment ID: I20050519000394 |
| Provider Name | Melissa K Li |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1134348543 PECOS PAC ID: 8820040439 Enrollment ID: I20050808001097 |
| Provider Name | Robert Arthur Egan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396771358 PECOS PAC ID: 9436184751 Enrollment ID: I20051005000431 |
| Provider Name | Amy D Carolan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295762946 PECOS PAC ID: 0749208668 Enrollment ID: I20051109000086 |
| Provider Name | Stephen Christensen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043271869 PECOS PAC ID: 9537187414 Enrollment ID: I20051109000563 |
| Provider Name | Michael A Wilson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1871539973 PECOS PAC ID: 8325948235 Enrollment ID: I20051116000893 |
| Provider Name | Todd A Caulfield |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1710921085 PECOS PAC ID: 4284661158 Enrollment ID: I20051205000112 |
| Provider Name | Geoffrey M Wilson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336185438 PECOS PAC ID: 3870493786 Enrollment ID: I20051219000124 |
| Provider Name | Christel A Steffen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982605689 PECOS PAC ID: 7810943735 Enrollment ID: I20051220000617 |
| Provider Name | Cory L Bergey |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982826137 PECOS PAC ID: 3870515455 Enrollment ID: I20051222000742 |
| Provider Name | Jason R Wollmuth |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164498499 PECOS PAC ID: 1951312255 Enrollment ID: I20060530000217 |
| Provider Name | Tyler Justin Gluckman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790749422 PECOS PAC ID: 2466464862 Enrollment ID: I20060630000075 |
| Provider Name | James G Beckerman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487697488 PECOS PAC ID: 4789630385 Enrollment ID: I20060807000363 |
| Provider Name | Marc D Legras |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881675221 PECOS PAC ID: 1355355462 Enrollment ID: I20060927000566 |
| Provider Name | Shannon C Fife |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639282148 PECOS PAC ID: 3274539085 Enrollment ID: I20061018000100 |
| Provider Name | Molly M Gramley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710091715 PECOS PAC ID: 1557347309 Enrollment ID: I20061027000042 |
| Provider Name | Laurie Leigh Callahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194821751 PECOS PAC ID: 0042210049 Enrollment ID: I20061221000335 |
| Provider Name | Gabriel R Mayland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669586467 PECOS PAC ID: 6406864263 Enrollment ID: I20070102000116 |
| Provider Name | Alicia M Ross |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1811053911 PECOS PAC ID: 4789686189 Enrollment ID: I20070214000258 |
| Provider Name | Nicole L Bishop-perdue |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275641060 PECOS PAC ID: 5496857245 Enrollment ID: I20070225000002 |
| Provider Name | Shannon E Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558301168 PECOS PAC ID: 0446352827 Enrollment ID: I20070305000236 |
| Provider Name | James C Cook |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134103344 PECOS PAC ID: 6709773245 Enrollment ID: I20070307000405 |
| Provider Name | Lisa Kay Keller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497780795 PECOS PAC ID: 6709782592 Enrollment ID: I20070404000082 |
| Provider Name | Willscott E Naugler |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1689698342 PECOS PAC ID: 6507868767 Enrollment ID: I20070803000179 |
| Provider Name | Emilia Arden |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114123684 PECOS PAC ID: 8123110285 Enrollment ID: I20070821000009 |
| Provider Name | Jason M Kuhl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659449296 PECOS PAC ID: 3072605799 Enrollment ID: I20070824000595 |
| Provider Name | Matthew C Frank |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1023229838 PECOS PAC ID: 7911092267 Enrollment ID: I20071001000747 |
| Provider Name | Yaping Wu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1164504171 PECOS PAC ID: 9739139601 Enrollment ID: I20071009000100 |
| Provider Name | Vassil B Kaimaktchiev |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1720284623 PECOS PAC ID: 7517048580 Enrollment ID: I20080116000028 |
| Provider Name | Ryan Garrett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114149390 PECOS PAC ID: 5799719266 Enrollment ID: I20080128000523 |
| Provider Name | Ee Lin Wan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558532317 PECOS PAC ID: 5395815641 Enrollment ID: I20080529000633 |
| Provider Name | Paula Gerber-gore |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518156504 PECOS PAC ID: 0143392464 Enrollment ID: I20080702000197 |
| Provider Name | Curtis Oddo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356400618 PECOS PAC ID: 8224100425 Enrollment ID: I20080703000263 |
| Provider Name | Robert F Quintos |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750324653 PECOS PAC ID: 5890737886 Enrollment ID: I20080710000300 |
| Provider Name | Tanja B Pejovic |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1770598278 PECOS PAC ID: 7315010840 Enrollment ID: I20080716000835 |
| Provider Name | Sanaa Hussain |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1619990702 PECOS PAC ID: 2961428164 Enrollment ID: I20080724000065 |
| Provider Name | Jeffrey Martin Bluhm |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1730125022 PECOS PAC ID: 9133151525 Enrollment ID: I20080813000445 |
| Provider Name | Sheila S Zia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811151368 PECOS PAC ID: 1557436839 Enrollment ID: I20080821000065 |
| Provider Name | Julian W Bell |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497840813 PECOS PAC ID: 3173557493 Enrollment ID: I20080827000167 |
| Provider Name | Richard L Julyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518048438 PECOS PAC ID: 1850468745 Enrollment ID: I20080918000200 |
| Provider Name | Aileen H Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255360657 PECOS PAC ID: 5395812283 Enrollment ID: I20080918000209 |
| Provider Name | Mathew S Greenberg |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1083819551 PECOS PAC ID: 4688732258 Enrollment ID: I20081027000207 |
| Provider Name | Gregory Robert Flick |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417991969 PECOS PAC ID: 3870525264 Enrollment ID: I20081113000712 |
| Provider Name | Maritza Martel |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1558342857 PECOS PAC ID: 4486551744 Enrollment ID: I20081205000194 |
| Provider Name | Bryan D Walls |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710982129 PECOS PAC ID: 7719040708 Enrollment ID: I20090119000042 |
| Provider Name | Carlo B Bifulco |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1528057155 PECOS PAC ID: 5092612366 Enrollment ID: I20090120000431 |
| Provider Name | Carl Anthony Riddick |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1093751372 PECOS PAC ID: 8224060629 Enrollment ID: I20090120000501 |
| Provider Name | Allan R Sacker |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1942429345 PECOS PAC ID: 8224189741 Enrollment ID: I20090624000013 |
| Provider Name | Brett M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053561241 PECOS PAC ID: 3375603061 Enrollment ID: I20090702000653 |
| Provider Name | Walter G Carlini |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770583338 PECOS PAC ID: 2860440617 Enrollment ID: I20090714000596 |
| Provider Name | Amit A Barve |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760667059 PECOS PAC ID: 2567510787 Enrollment ID: I20090729000503 |
| Provider Name | Alexi P Zemsky |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1598944928 PECOS PAC ID: 3173677192 Enrollment ID: I20090810000651 |
| Provider Name | Ethan Korngold |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1568452738 PECOS PAC ID: 0345248464 Enrollment ID: I20090826000937 |
| Provider Name | Jay B Ham |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760659627 PECOS PAC ID: 7113072943 Enrollment ID: I20090831000689 |
| Provider Name | Kamara M Dodd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114159068 PECOS PAC ID: 7012063589 Enrollment ID: I20090924000459 |
| Provider Name | Fareha A Nawaz |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1770702839 PECOS PAC ID: 8628114717 Enrollment ID: I20091002000313 |
| Provider Name | Sophana Karnchanasorn |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710165303 PECOS PAC ID: 6800933276 Enrollment ID: I20091019000102 |
| Provider Name | Andrew D Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376639245 PECOS PAC ID: 6709929540 Enrollment ID: I20100202000862 |
| Provider Name | John B Bateman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831369966 PECOS PAC ID: 4880754308 Enrollment ID: I20100209000759 |
| Provider Name | Neil M Olsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942396676 PECOS PAC ID: 1557404662 Enrollment ID: I20100211000158 |
| Provider Name | Eric Webb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306920087 PECOS PAC ID: 1850434937 Enrollment ID: I20100211000696 |
| Provider Name | Jian Shen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1104928522 PECOS PAC ID: 3476651605 Enrollment ID: I20100630000291 |
| Provider Name | Minette C Lukban |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518287739 PECOS PAC ID: 7315139029 Enrollment ID: I20101012001259 |
| Provider Name | Andrean Andreev Gurov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972551703 PECOS PAC ID: 2961405337 Enrollment ID: I20101019000741 |
| Provider Name | Craig Thalacker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558361378 PECOS PAC ID: 4688621303 Enrollment ID: I20101101000660 |
| Provider Name | Mohamed Siyad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780862391 PECOS PAC ID: 1254525066 Enrollment ID: I20101104001356 |
| Provider Name | Gennadiy Bakis |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184614455 PECOS PAC ID: 0749221042 Enrollment ID: I20101104001447 |
| Provider Name | Tamara R Stewart |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467674689 PECOS PAC ID: 2769677699 Enrollment ID: I20101117000504 |
| Provider Name | Paul Fritz Schleinitz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437129087 PECOS PAC ID: 5092784090 Enrollment ID: I20101118000653 |
| Provider Name | David Levin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770750275 PECOS PAC ID: 0941470470 Enrollment ID: I20110819000122 |
| Provider Name | Jared A Shipley |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1194933770 PECOS PAC ID: 4284820275 Enrollment ID: I20110906000167 |
| Provider Name | Timothy Hutchings |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1144345455 PECOS PAC ID: 9931206208 Enrollment ID: I20110908001846 |
| Provider Name | Marjorie N Harvill-brooks |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1831148196 PECOS PAC ID: 8224040290 Enrollment ID: I20110913000278 |
| Provider Name | Lian R Shaw |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154379576 PECOS PAC ID: 6002807724 Enrollment ID: I20110921000884 |
| Provider Name | Laurie Ann Dutkiewicz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952514143 PECOS PAC ID: 2769554906 Enrollment ID: I20111013000661 |
| Provider Name | Shaik I Basha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578712378 PECOS PAC ID: 0244403723 Enrollment ID: I20111027000862 |
| Provider Name | Deborah J Kerneen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588931372 PECOS PAC ID: 0547429649 Enrollment ID: I20120308000841 |
| Provider Name | Veselina Borisova Korcheva |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1487864583 PECOS PAC ID: 5193985364 Enrollment ID: I20120326000333 |
| Provider Name | David Liss |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447294244 PECOS PAC ID: 7911905955 Enrollment ID: I20120402000194 |
| Provider Name | Amit C Kansara |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104093665 PECOS PAC ID: 4486817541 Enrollment ID: I20120530000096 |
| Provider Name | Puneet Bandi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801030382 PECOS PAC ID: 2466608062 Enrollment ID: I20120815000194 |
| Provider Name | Denise M Janetos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467497073 PECOS PAC ID: 9335121672 Enrollment ID: I20120820001208 |
| Provider Name | Molly L Olsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407050933 PECOS PAC ID: 9234298241 Enrollment ID: I20120907000075 |
| Provider Name | Bryce Pulliam |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992933642 PECOS PAC ID: 6507837697 Enrollment ID: I20120921000070 |
| Provider Name | Scott C Brancato |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1184849762 PECOS PAC ID: 9931358629 Enrollment ID: I20121015000084 |
| Provider Name | Hong Xiao |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1487806790 PECOS PAC ID: 9830377118 Enrollment ID: I20121015000744 |
| Provider Name | Kathrine L Lohrfink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285996405 PECOS PAC ID: 1759534506 Enrollment ID: I20130104000106 |
| Provider Name | Mark C Mason |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336124510 PECOS PAC ID: 1355363391 Enrollment ID: I20130104000266 |
| Provider Name | Alan R Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174700215 PECOS PAC ID: 4183877400 Enrollment ID: I20130116000343 |
| Provider Name | Christian P Lanciault |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1124293626 PECOS PAC ID: 6800032459 Enrollment ID: I20130426000272 |
| Provider Name | Steven Stephanides |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063436012 PECOS PAC ID: 0547211856 Enrollment ID: I20130508000553 |
| Provider Name | Deborah Ann Volk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174574081 PECOS PAC ID: 4880596311 Enrollment ID: I20130606000594 |
| Provider Name | Lori M Tam |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306036108 PECOS PAC ID: 4981844420 Enrollment ID: I20130708000029 |
| Provider Name | Minal B Jaju |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427491620 PECOS PAC ID: 1052551421 Enrollment ID: I20130708000402 |
| Provider Name | Hataya Kristy Poonyagariyagorn |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1720264476 PECOS PAC ID: 5294800686 Enrollment ID: I20130723000953 |
| Provider Name | Erika Maria Moseson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790010387 PECOS PAC ID: 9133305337 Enrollment ID: I20130801000886 |
| Provider Name | Joshua D Remick |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1861697682 PECOS PAC ID: 2264698695 Enrollment ID: I20130802000124 |
| Provider Name | Jennifer Veit Hall Jackson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174784367 PECOS PAC ID: 1052567674 Enrollment ID: I20130904000797 |
| Provider Name | Brian T Bonner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902034416 PECOS PAC ID: 7810131232 Enrollment ID: I20130924000767 |
| Provider Name | Anna L Akita |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942521372 PECOS PAC ID: 2062656457 Enrollment ID: I20130925000630 |
| Provider Name | Stephen M Badke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194041160 PECOS PAC ID: 3678717063 Enrollment ID: I20130925000670 |
| Provider Name | Jessica L Luckman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750703559 PECOS PAC ID: 1951533561 Enrollment ID: I20140414001962 |
| Provider Name | William L Boyan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1124119144 PECOS PAC ID: 7012947377 Enrollment ID: I20140611000902 |
| Provider Name | Cihan Cevik |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619169596 PECOS PAC ID: 4082839139 Enrollment ID: I20140702002120 |
| Provider Name | Jason Kephart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699033597 PECOS PAC ID: 4284853466 Enrollment ID: I20140922000153 |
| Provider Name | Eric Lynn Wickard |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730432378 PECOS PAC ID: 7315198553 Enrollment ID: I20141021002065 |
| Provider Name | Andrew T Young |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013273804 PECOS PAC ID: 4385899038 Enrollment ID: I20141111000001 |
| Provider Name | William Davis Ryan |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1659694735 PECOS PAC ID: 5991960411 Enrollment ID: I20141204002495 |
| Provider Name | David E Harris |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1154588416 PECOS PAC ID: 5799832630 Enrollment ID: I20150102001041 |
| Provider Name | Wesley T Ramoso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649591223 PECOS PAC ID: 4385873322 Enrollment ID: I20150209002206 |
| Provider Name | Christine Y Huang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457514903 PECOS PAC ID: 7416112420 Enrollment ID: I20150417001893 |
| Provider Name | Brian R Floyd |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144355900 PECOS PAC ID: 4688732886 Enrollment ID: I20150504001314 |
| Provider Name | Hannah I Rose |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174880470 PECOS PAC ID: 4789829631 Enrollment ID: I20150602001426 |
| Provider Name | Rebecca Samet |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477509503 PECOS PAC ID: 8729012943 Enrollment ID: I20150623000844 |
| Provider Name | Cynthia L Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811393648 PECOS PAC ID: 7911219035 Enrollment ID: I20150702000790 |
| Provider Name | Kristin E Inger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003161811 PECOS PAC ID: 4385956374 Enrollment ID: I20150706000446 |
| Provider Name | Alicia Bond |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1457646887 PECOS PAC ID: 1153350731 Enrollment ID: I20150709002522 |
| Provider Name | Babbette Lemar Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407294853 PECOS PAC ID: 6204079767 Enrollment ID: I20150716003229 |
| Provider Name | Aaron D Williams |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1578541710 PECOS PAC ID: 0840518023 Enrollment ID: I20150720001831 |
| Provider Name | Pedro Campos |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760755086 PECOS PAC ID: 9931362753 Enrollment ID: I20150811005915 |
| Provider Name | Frances A Derook |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1922098060 PECOS PAC ID: 2668453929 Enrollment ID: I20151023001133 |
| Provider Name | Carla N Overstreet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154795508 PECOS PAC ID: 5496056798 Enrollment ID: I20151210000788 |
| Provider Name | Alexander M Morss |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225096167 PECOS PAC ID: 0648240226 Enrollment ID: I20160118000506 |
| Provider Name | Robin Campos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891928651 PECOS PAC ID: 3274672563 Enrollment ID: I20160205002411 |
| Provider Name | Ramon Anel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467547711 PECOS PAC ID: 2769377423 Enrollment ID: I20160315001951 |
| Provider Name | Michelle D Pies |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700224516 PECOS PAC ID: 2769772664 Enrollment ID: I20160606001427 |
| Provider Name | Sara E Walz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154687259 PECOS PAC ID: 9739311721 Enrollment ID: I20160615001455 |
| Provider Name | Vipul Mahajan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467795864 PECOS PAC ID: 9436450210 Enrollment ID: I20160811000828 |
| Provider Name | Rebecca Rose |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1174634794 PECOS PAC ID: 2264621119 Enrollment ID: I20160812000240 |
| Provider Name | Rebecca M Mueller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902048580 PECOS PAC ID: 9133398571 Enrollment ID: I20160822002101 |
| Provider Name | Sivajothi Kanagalingam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1952616369 PECOS PAC ID: 1254633019 Enrollment ID: I20160825000046 |
| Provider Name | Paul S Gilmore |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1487621389 PECOS PAC ID: 8426003401 Enrollment ID: I20160901001445 |
| Provider Name | Gabrielle M Fey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578918546 PECOS PAC ID: 5294021721 Enrollment ID: I20160909001851 |
| Provider Name | Elisabeth Anacius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003109828 PECOS PAC ID: 7810155090 Enrollment ID: I20161109001708 |
| Provider Name | Whitney A Serafini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770033474 PECOS PAC ID: 2567741754 Enrollment ID: I20161110001448 |
| Provider Name | Pawani Sachar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689955536 PECOS PAC ID: 9234421413 Enrollment ID: I20161121000373 |
| Provider Name | Christine Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619125689 PECOS PAC ID: 4789577503 Enrollment ID: I20170202000570 |
| Provider Name | Michael M Marvi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205054129 PECOS PAC ID: 9436203858 Enrollment ID: I20170317000802 |
| Provider Name | Lindsey R Mckinley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265845754 PECOS PAC ID: 8022233279 Enrollment ID: I20170502002710 |
| Provider Name | Mathias L Stoenescu |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1245232776 PECOS PAC ID: 0749214450 Enrollment ID: I20170503001914 |
| Provider Name | Siva Rama Krishna Marri |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1366755126 PECOS PAC ID: 5294030300 Enrollment ID: I20170517001848 |
| Provider Name | Son T Do |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1285668822 PECOS PAC ID: 2668371337 Enrollment ID: I20170626001871 |
| Provider Name | Vadim Leyenson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1427052851 PECOS PAC ID: 7214830298 Enrollment ID: I20170830003768 |
| Provider Name | Fouad Otaki |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013229996 PECOS PAC ID: 8426349614 Enrollment ID: I20170907003101 |
| Provider Name | Alexander A Grimaldi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801137682 PECOS PAC ID: 4789815010 Enrollment ID: I20170929002429 |
| Provider Name | Jeanette Grimaldi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669797023 PECOS PAC ID: 9032340161 Enrollment ID: I20171010001063 |
| Provider Name | Geraldine A Peterdy |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1104864792 PECOS PAC ID: 2668562968 Enrollment ID: I20171018003440 |
| Provider Name | Amitabh Gupta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174660278 PECOS PAC ID: 8224203575 Enrollment ID: I20171107001765 |
| Provider Name | Suzanne E Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770005407 PECOS PAC ID: 2264799113 Enrollment ID: I20171130001358 |
| Provider Name | Jennifer M Foltz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578089108 PECOS PAC ID: 3173880085 Enrollment ID: I20171201000829 |
| Provider Name | Carol Jean Wilder |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1801982749 PECOS PAC ID: 5294717310 Enrollment ID: I20171214000434 |
| Provider Name | Gheorghe Ciprian Cazan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801151568 PECOS PAC ID: 3274849914 Enrollment ID: I20171218000038 |
| Provider Name | Aravind Chandra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255742466 PECOS PAC ID: 3375809080 Enrollment ID: I20180118001601 |
| Provider Name | Andrew D Michaels |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588618250 PECOS PAC ID: 9234132317 Enrollment ID: I20180406002127 |
| Provider Name | Andrew S Tang |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1356769798 PECOS PAC ID: 7810292638 Enrollment ID: I20180615001716 |
| Provider Name | Travis Adam Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912333451 PECOS PAC ID: 5890924252 Enrollment ID: I20180626001391 |
| Provider Name | Timothy James Muhonen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780752469 PECOS PAC ID: 3971586512 Enrollment ID: I20180712002517 |
| Provider Name | Lindsey Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629588504 PECOS PAC ID: 0941567721 Enrollment ID: I20180802001724 |
| Provider Name | Casey Evan Wilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487048815 PECOS PAC ID: 6800146697 Enrollment ID: I20180828003154 |
| Provider Name | Tracie Lynn Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093292971 PECOS PAC ID: 2365795309 Enrollment ID: I20181022001962 |
| Provider Name | Rupinder K Sandhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962498741 PECOS PAC ID: 3173557881 Enrollment ID: I20181030001831 |
| Provider Name | Ted Hideki Yamamoto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689012015 PECOS PAC ID: 2466737960 Enrollment ID: I20181130000136 |
| Provider Name | Fabian A Lopez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518041029 PECOS PAC ID: 2466559208 Enrollment ID: I20181211003221 |
| Provider Name | Ayodeji A Oduola |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942530266 PECOS PAC ID: 6305009077 Enrollment ID: I20190110000750 |
| Provider Name | Uzomechine Thabiso Chiedozi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699160903 PECOS PAC ID: 1759680721 Enrollment ID: I20190212001243 |
| Provider Name | Gritz Pierre |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215319140 PECOS PAC ID: 2961718259 Enrollment ID: I20190311000280 |
| Provider Name | Andrea L Purtzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447702428 PECOS PAC ID: 6204116866 Enrollment ID: I20190401002237 |
| Provider Name | Jesse Akaki Hodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518435585 PECOS PAC ID: 7911248174 Enrollment ID: I20190416002457 |
| Provider Name | Dana A Teszler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124582820 PECOS PAC ID: 9537401443 Enrollment ID: I20190424003047 |
| Provider Name | Arezoo Taheri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215917992 PECOS PAC ID: 3971531690 Enrollment ID: I20190513002592 |
| Provider Name | Arnold Cha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811320179 PECOS PAC ID: 0749505998 Enrollment ID: I20190522000408 |
| Provider Name | Isaac Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801243530 PECOS PAC ID: 9335431824 Enrollment ID: I20190607000492 |
| Provider Name | Eliot Hill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124481346 PECOS PAC ID: 6204122724 Enrollment ID: I20190624001498 |
| Provider Name | Kamika Gower-allum |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790238657 PECOS PAC ID: 3072849967 Enrollment ID: I20190730004729 |
| Provider Name | Sanjog Bastola |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922459064 PECOS PAC ID: 4981996253 Enrollment ID: I20190731004037 |
| Provider Name | Anu Sharma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689228231 PECOS PAC ID: 2264761022 Enrollment ID: I20190904003025 |
| Provider Name | Greg D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194255950 PECOS PAC ID: 1456621325 Enrollment ID: I20190913001684 |
| Provider Name | Rajpreet Singh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316391956 PECOS PAC ID: 8022305473 Enrollment ID: I20191001001964 |
| Provider Name | Shelley Renee Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366608226 PECOS PAC ID: 5799954822 Enrollment ID: I20191022001102 |
| Provider Name | Grant A Jolliffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699325092 PECOS PAC ID: 9739411133 Enrollment ID: I20191105001565 |
| Provider Name | Jacob P Benford |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063467595 PECOS PAC ID: 6608833983 Enrollment ID: I20191118000824 |
| Provider Name | Michael J Strowbridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639727621 PECOS PAC ID: 0143652602 Enrollment ID: I20191121001755 |
| Provider Name | Nancy A Knechel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871757211 PECOS PAC ID: 6305909995 Enrollment ID: I20191125003123 |
| Provider Name | James J Boylan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538159546 PECOS PAC ID: 0446243927 Enrollment ID: I20200121000908 |
| Provider Name | Maria Elena Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356977144 PECOS PAC ID: 5496184566 Enrollment ID: I20200413000070 |
| Provider Name | Erica N Dickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881166627 PECOS PAC ID: 2961833132 Enrollment ID: I20200504002304 |
| Provider Name | Kendra M Bloomfield |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609118900 PECOS PAC ID: 0648586297 Enrollment ID: I20200505000310 |
| Provider Name | Rebecca E Elliott |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942697669 PECOS PAC ID: 7517261670 Enrollment ID: I20200519001927 |
| Provider Name | Jason A Primus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649684309 PECOS PAC ID: 6709005549 Enrollment ID: I20200604001070 |
| Provider Name | Jason Shawn Nathanael Bensch |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164765111 PECOS PAC ID: 0648411165 Enrollment ID: I20200615000811 |
| Provider Name | Julie Ann Mondz-kleinman |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1598244402 PECOS PAC ID: 1658793526 Enrollment ID: I20200623000322 |
| Provider Name | Neha Garg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629590419 PECOS PAC ID: 2163845934 Enrollment ID: I20200713001373 |
| Provider Name | Humza Saleem Maqbool |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003334368 PECOS PAC ID: 0244654986 Enrollment ID: I20200728001169 |
| Provider Name | David R Thornberry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154855856 PECOS PAC ID: 9032462791 Enrollment ID: I20200828002354 |
| Provider Name | Kristi A Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083156277 PECOS PAC ID: 5092070649 Enrollment ID: I20201019000742 |
| Provider Name | Jasmine B Barnhart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346847332 PECOS PAC ID: 8729408307 Enrollment ID: I20201020003531 |
| Provider Name | Annabel M Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447865464 PECOS PAC ID: 4183044431 Enrollment ID: I20201026002685 |
| Provider Name | Shasta M Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417312315 PECOS PAC ID: 1254638828 Enrollment ID: I20201203001261 |
| Provider Name | Leah Burke Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487251773 PECOS PAC ID: 6305258476 Enrollment ID: I20201214002308 |
| Provider Name | Douglas P Blackall |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1891885380 PECOS PAC ID: 0840192274 Enrollment ID: I20210114001726 |
| Provider Name | James Alan Frierson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1730144221 PECOS PAC ID: 7911311964 Enrollment ID: I20210202002494 |
| Provider Name | Thomas David Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275171316 PECOS PAC ID: 3971912726 Enrollment ID: I20210506001364 |
| Provider Name | Sandeep S Jhajj |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1174962369 PECOS PAC ID: 8022369941 Enrollment ID: I20210520003155 |
| Provider Name | Joshua Genstler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669963716 PECOS PAC ID: 5294081949 Enrollment ID: I20210623001518 |
| Provider Name | Sarah K Min |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083091466 PECOS PAC ID: 4880943794 Enrollment ID: I20210730002590 |
| Provider Name | Jacob T Abel |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1083095319 PECOS PAC ID: 8820324304 Enrollment ID: I20210811001211 |
| Provider Name | Elisa F Akagi Fukushima |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1730568080 PECOS PAC ID: 9537462460 Enrollment ID: I20210924001735 |
| Provider Name | Dipal Dilipbhai Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780981563 PECOS PAC ID: 8022338268 Enrollment ID: I20211102001970 |
| Provider Name | Shruti Vakil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720391493 PECOS PAC ID: 1951531904 Enrollment ID: I20211202002453 |
| Provider Name | Aaron J Kramer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1861843625 PECOS PAC ID: 9931494473 Enrollment ID: I20211215002444 |
| Provider Name | Ryan Michael Sandoval |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285053041 PECOS PAC ID: 3375816853 Enrollment ID: I20211227001028 |
| Provider Name | Leigh Anne Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558015099 PECOS PAC ID: 2264825330 Enrollment ID: I20220214000776 |
| Provider Name | Dikshya Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639581226 PECOS PAC ID: 4688090418 Enrollment ID: I20220321001754 |
| Provider Name | Patrick W Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164879649 PECOS PAC ID: 7113218058 Enrollment ID: I20220404002101 |
| Provider Name | Ashley Marie Twyman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003311291 PECOS PAC ID: 2567799398 Enrollment ID: I20220407000279 |
| Provider Name | Matthew C Fischer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811382922 PECOS PAC ID: 5698068195 Enrollment ID: I20220411001580 |
| Provider Name | Courtney J Van Valkenburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891249637 PECOS PAC ID: 7911286729 Enrollment ID: I20220421001741 |
| Provider Name | Ozheh Aghdasi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710413679 PECOS PAC ID: 7214349661 Enrollment ID: I20220429000225 |
| Provider Name | Ahern O Geilenfeldt |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1316384068 PECOS PAC ID: 1153637913 Enrollment ID: I20220429001572 |
| Provider Name | Sujan Jamarkattel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255852521 PECOS PAC ID: 7810384336 Enrollment ID: I20220429002018 |
| Provider Name | Alexis A Tracy |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1689870750 PECOS PAC ID: 5294906103 Enrollment ID: I20220510000336 |
| Provider Name | Penny J Williams |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1588649453 PECOS PAC ID: 6305832452 Enrollment ID: I20220516000179 |
| Provider Name | Juan C Iregui |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1336191618 PECOS PAC ID: 1254318009 Enrollment ID: I20220517002204 |
| Provider Name | Michael A Bressler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316507171 PECOS PAC ID: 3375878903 Enrollment ID: I20220606001464 |
| Provider Name | Christine Moung-wen |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1629237730 PECOS PAC ID: 9032385661 Enrollment ID: I20220613001781 |
| Provider Name | Nathan J Paulson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1518494517 PECOS PAC ID: 1759625767 Enrollment ID: I20220620000449 |
| Provider Name | Sophie A Westrud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396485371 PECOS PAC ID: 4981083136 Enrollment ID: I20220620000582 |
| Provider Name | David B Trowbridge |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356367007 PECOS PAC ID: 9335338706 Enrollment ID: I20220620001376 |
| Provider Name | Chella Bhagyam |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1255836128 PECOS PAC ID: 7911335765 Enrollment ID: I20220627002270 |
| Provider Name | Alexandra Julienne Wiggins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376004077 PECOS PAC ID: 6507109493 Enrollment ID: I20220628003472 |
| Provider Name | Caleb B Nyone |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1346731874 PECOS PAC ID: 3375975733 Enrollment ID: I20220805001788 |
| Provider Name | Najia Sayedy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174978217 PECOS PAC ID: 8921345349 Enrollment ID: I20220812002563 |
| Provider Name | Douglas J Ammerman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740622604 PECOS PAC ID: 1153688825 Enrollment ID: I20220812002876 |
| Provider Name | Raagav Mohanakrishnan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750841193 PECOS PAC ID: 8022347236 Enrollment ID: I20220823002256 |
| Provider Name | Logan L Vincent |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164764288 PECOS PAC ID: 4688991946 Enrollment ID: I20220829003393 |
| Provider Name | Karen D Banks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083998371 PECOS PAC ID: 4587899570 Enrollment ID: I20220920001476 |
| Provider Name | Marcia E Hoffheimer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689946451 PECOS PAC ID: 8729375225 Enrollment ID: I20221003002427 |
| Provider Name | Shannon M Teszler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306570452 PECOS PAC ID: 0749666444 Enrollment ID: I20221004001549 |
| Provider Name | Yunus A Moosa |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1548280464 PECOS PAC ID: 3072591494 Enrollment ID: I20221104000864 |
| Provider Name | Angela G Duke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841243169 PECOS PAC ID: 1557365079 Enrollment ID: I20221104002223 |
| Provider Name | Robert S Emerick |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1255315495 PECOS PAC ID: 1850332842 Enrollment ID: I20221114002549 |
| Provider Name | Sandra K Birchem |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902888241 PECOS PAC ID: 3779530720 Enrollment ID: I20221116002234 |
| Provider Name | James E Rafferty |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1821160466 PECOS PAC ID: 2466548995 Enrollment ID: I20221118001244 |
| Provider Name | Asad Sattar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578925863 PECOS PAC ID: 2466784582 Enrollment ID: I20221207002273 |
| Provider Name | Steven Miller |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669477287 PECOS PAC ID: 1951492248 Enrollment ID: I20221208002641 |
| Provider Name | Olivia R Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326773854 PECOS PAC ID: 7416326376 Enrollment ID: I20221215001683 |
| Provider Name | Mary Ebueku-smith |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639514805 PECOS PAC ID: 8426329897 Enrollment ID: I20221219002373 |
| Provider Name | Srikrishna Vulava |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821301367 PECOS PAC ID: 7517108889 Enrollment ID: I20230203000957 |
| Provider Name | Amanda M Bujaucius |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891205134 PECOS PAC ID: 4789940529 Enrollment ID: I20230215001079 |
| Provider Name | Trung T Nguyen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639631492 PECOS PAC ID: 8325377815 Enrollment ID: I20230417001438 |
| Provider Name | William W Rowe |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164414595 PECOS PAC ID: 6608763479 Enrollment ID: I20230419000307 |
| Provider Name | Dipesh K C Ghimire |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295106169 PECOS PAC ID: 4880941848 Enrollment ID: I20230420000965 |
| Provider Name | Alexei Zhadkevich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760642268 PECOS PAC ID: 5698078533 Enrollment ID: I20230424000058 |
| Provider Name | Amanda K Elsome |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346854759 PECOS PAC ID: 1456765668 Enrollment ID: I20230424002568 |
| Provider Name | Dipak B K C |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013146422 PECOS PAC ID: 3577617406 Enrollment ID: I20230425000989 |
| Provider Name | Zachary Fleischner |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1104204189 PECOS PAC ID: 2860819547 Enrollment ID: I20230517001058 |
| Provider Name | Ahmar Jafary |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881855377 PECOS PAC ID: 7214179175 Enrollment ID: I20230522002004 |
| Provider Name | Kuldeep Kc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669814760 PECOS PAC ID: 4082071667 Enrollment ID: I20230613002944 |
| Provider Name | Candice M Dolbier |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629333893 PECOS PAC ID: 8325271661 Enrollment ID: I20230614004018 |
| Provider Name | Sandra Louise Drager |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205802097 PECOS PAC ID: 9436325354 Enrollment ID: I20230616001707 |
| Provider Name | Sirikarn Napan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609005370 PECOS PAC ID: 4082879499 Enrollment ID: I20230621002315 |
| Provider Name | Ismaila Bello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679803274 PECOS PAC ID: 8325360449 Enrollment ID: I20230725001931 |
| Provider Name | Mai Thuy Murphy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962968503 PECOS PAC ID: 1951787894 Enrollment ID: I20230804003265 |
| Provider Name | Durga P Vedati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821288499 PECOS PAC ID: 4880731124 Enrollment ID: I20230818000711 |
| Provider Name | Jessica L Visser |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912249756 PECOS PAC ID: 6901185784 Enrollment ID: I20230818002523 |
| Provider Name | Pankhuri Malhotra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518587187 PECOS PAC ID: 1254762867 Enrollment ID: I20230828001649 |
| Provider Name | Niba F Nchotu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366709792 PECOS PAC ID: 3274854153 Enrollment ID: I20230830001367 |
| Provider Name | Brian Berg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669962841 PECOS PAC ID: 2860749017 Enrollment ID: I20230920003270 |
| Provider Name | Bernadette A Tan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063919702 PECOS PAC ID: 5991136558 Enrollment ID: I20231023003550 |
| Provider Name | Melinda M Mantooth |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639708175 PECOS PAC ID: 3476972381 Enrollment ID: I20231101000583 |
| Provider Name | Vicky Sandhu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316407596 PECOS PAC ID: 4688093867 Enrollment ID: I20231104000531 |
| Provider Name | Ruth Spector |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1104815497 PECOS PAC ID: 5092707273 Enrollment ID: I20231106000351 |
| Provider Name | Jesse Sabiiti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932392693 PECOS PAC ID: 3678660008 Enrollment ID: I20231108001466 |
| Provider Name | Juan Weksler |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316919723 PECOS PAC ID: 2365482759 Enrollment ID: I20231122002076 |
| Provider Name | Teja V Surapaneni |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275875130 PECOS PAC ID: 2163717091 Enrollment ID: I20231127002587 |
| Provider Name | Stefanie A Colavito |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548282916 PECOS PAC ID: 1355393034 Enrollment ID: I20231129003133 |
| Provider Name | Tara R Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710226204 PECOS PAC ID: 4082912753 Enrollment ID: I20240117002624 |
Ups Medford (cdrc - Expansion) Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2825 E Barnett Rd, Medford, OR 97504 Phone: 503-494-9000 | |
Rogue Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 E Main St, Medford, OR 97504 Phone: 541-842-7705 Fax: 541-842-7640 | |
Columbiacare Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3200 Juanipero Way, Medford, OR 97504 Phone: 541-858-8170 Fax: 541-858-8167 | |
Pmg Medford Physiatry Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 920 Royal Ave, Medford, OR 97504 Phone: 541-732-8400 Fax: 541-732-8401 | |
Pmg South Heart Rhythm Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504 Phone: 541-732-7850 Fax: 541-732-7851 | |
Complete Integrative Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3156 State St, Medford, OR 97504 Phone: 541-773-5772 Fax: 541-773-1113 | |
La Clinica Acute Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 616 Market St, Medford, OR 97504 Phone: 541-494-3840 Fax: 541-494-1789 |