| Skagit Regional Health | |
|
1400 E Kincaid St Mount Vernon WA 98274-4127 | |
| (360) 428-2500 | |
| (360) 424-2522 |
| Full Name | Skagit Regional Health |
|---|---|
| Speciality | General Practice |
| Location | 1400 E Kincaid St, Mount Vernon, Washington |
| Authorized Official Name and Position | Amy L Bishop (PFS COORDINATOR) |
| Authorized Official Contact | 3608146451 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Skagit Regional Health 1400 E Kincaid St Mount Vernon WA 98274-4127 Ph: (360) 814-6451 | Skagit Regional Health 1400 E Kincaid St Mount Vernon WA 98274-4127 Ph: (360) 428-2500 |
| NPI Number | 1023332749 |
|---|---|
| Provider Enumeration Date | 03/24/2010 |
| Last Update Date | 03/14/2024 |
| Medicare PECOS PAC ID | 6800793522 |
|---|---|
| Medicare Enrollment ID | O20040309001059 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023332749 | NPI | - | NPPES |
| 0263452 | Other | WA | LABOR & INDUSTRIES |
| 2007916 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 261QU0200X | Clinic/center - Urgent Care | (* (Not Available)) | Secondary |
| Provider Name | Khaled Abdel-rahman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1881731370 PECOS PAC ID: 7911811815 Enrollment ID: I20031114000576 |
| Provider Name | Eben E Tucker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437273166 PECOS PAC ID: 2365356847 Enrollment ID: I20031118000829 |
| Provider Name | Jean M Marine |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942226774 PECOS PAC ID: 8921903907 Enrollment ID: I20031203000380 |
| Provider Name | Tomas A Hernandez Mejia |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306825021 PECOS PAC ID: 5193638823 Enrollment ID: I20031215000517 |
| Provider Name | Sarosh F Siddiqi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1225175714 PECOS PAC ID: 2668362229 Enrollment ID: I20040317000978 |
| Provider Name | Kirk Brownell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326077710 PECOS PAC ID: 8729979505 Enrollment ID: I20040322001310 |
| Provider Name | Matthew F Russell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932138385 PECOS PAC ID: 5597656397 Enrollment ID: I20040322001510 |
| Provider Name | Carlton K Mcqueen |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1659323657 PECOS PAC ID: 8729979075 Enrollment ID: I20040324000685 |
| Provider Name | David M Lauter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689752883 PECOS PAC ID: 1658260237 Enrollment ID: I20040329001407 |
| Provider Name | Bruce L Davidson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1619932092 PECOS PAC ID: 5193718013 Enrollment ID: I20040406001552 |
| Provider Name | Sanjeev Vaderah |
|---|---|
| Provider Type | Practitioner - Peripheral Vascular Disease |
| Provider Identifiers | NPI Number: 1790738532 PECOS PAC ID: 3375537046 Enrollment ID: I20040414000648 |
| Provider Name | Michael B Riojas |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1225079478 PECOS PAC ID: 5193710408 Enrollment ID: I20040416000760 |
| Provider Name | David M Mourning |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033150420 PECOS PAC ID: 1850380395 Enrollment ID: I20040510000735 |
| Provider Name | Patti Jo Brettell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215998125 PECOS PAC ID: 8820089089 Enrollment ID: I20040518001375 |
| Provider Name | Richard Joseph Leone |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1821058850 PECOS PAC ID: 1254322142 Enrollment ID: I20040519001594 |
| Provider Name | Milan J Stefanec |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639388234 PECOS PAC ID: 9335123744 Enrollment ID: I20040615000175 |
| Provider Name | Tomasz M Ziedalski |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1265473854 PECOS PAC ID: 8426039520 Enrollment ID: I20040623000672 |
| Provider Name | Ernest O Kanu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437261179 PECOS PAC ID: 2264411479 Enrollment ID: I20040720000139 |
| Provider Name | Andrew T Coletti |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1255381109 PECOS PAC ID: 5294705836 Enrollment ID: I20040802000987 |
| Provider Name | April L Wolanek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518988542 PECOS PAC ID: 3678549144 Enrollment ID: I20040907000463 |
| Provider Name | Gary L Schillhammer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396735437 PECOS PAC ID: 9537135835 Enrollment ID: I20040908000950 |
| Provider Name | James H Swegle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700882875 PECOS PAC ID: 4587631098 Enrollment ID: I20040914000867 |
| Provider Name | Donald G Spielmann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487618500 PECOS PAC ID: 9234107624 Enrollment ID: I20040923000192 |
| Provider Name | Jeffrey Ellis Feld |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1538105812 PECOS PAC ID: 0143289314 Enrollment ID: I20041005000484 |
| Provider Name | Seyed A Hejazi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1770502841 PECOS PAC ID: 9537128475 Enrollment ID: I20041006001466 |
| Provider Name | Robert R Jacobsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205890944 PECOS PAC ID: 0042270167 Enrollment ID: I20041013000903 |
| Provider Name | Robert Harding Palmer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992730790 PECOS PAC ID: 5890691448 Enrollment ID: I20041118000490 |
| Provider Name | Julie R Wood-mcclure |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962459719 PECOS PAC ID: 5496741456 Enrollment ID: I20041119000733 |
| Provider Name | L. Sloane Winkes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497720304 PECOS PAC ID: 5698730299 Enrollment ID: I20041123000502 |
| Provider Name | Karen Ann Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396821401 PECOS PAC ID: 1850359753 Enrollment ID: I20041223000136 |
| Provider Name | David F Hoeft |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164489076 PECOS PAC ID: 8224086004 Enrollment ID: I20050107000844 |
| Provider Name | J. William Hartley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972508836 PECOS PAC ID: 4880689330 Enrollment ID: I20050127000108 |
| Provider Name | Kamol Lohavanichbutr |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1306880638 PECOS PAC ID: 8820046618 Enrollment ID: I20050217000352 |
| Provider Name | Robert B Stewart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578599445 PECOS PAC ID: 6406802958 Enrollment ID: I20050328000681 |
| Provider Name | Jennifer K Benson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801899182 PECOS PAC ID: 9335196112 Enrollment ID: I20050404000913 |
| Provider Name | Allen L Johnson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528035565 PECOS PAC ID: 7719925593 Enrollment ID: I20050421000972 |
| Provider Name | Audrey K Warolin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235133570 PECOS PAC ID: 7315982907 Enrollment ID: I20050627000962 |
| Provider Name | Jonathan K Ploudre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104827435 PECOS PAC ID: 6800823725 Enrollment ID: I20050722000345 |
| Provider Name | Stacey E Okinsella |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1578530697 PECOS PAC ID: 6800888199 Enrollment ID: I20050906000956 |
| Provider Name | Emmanuel M Yruma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1982642567 PECOS PAC ID: 7113952615 Enrollment ID: I20051004000476 |
| Provider Name | Cheryl L Costomiris |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1770233173 PECOS PAC ID: 3678465127 Enrollment ID: I20051024000070 |
| Provider Name | Gary B Blume |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447318274 PECOS PAC ID: 0547252884 Enrollment ID: I20051025000640 |
| Provider Name | Marshall W Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417942038 PECOS PAC ID: 4981622552 Enrollment ID: I20051103000018 |
| Provider Name | David C Bruce |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1740203330 PECOS PAC ID: 5799731600 Enrollment ID: I20051129000626 |
| Provider Name | David J Roesel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073693065 PECOS PAC ID: 6608897640 Enrollment ID: I20051219000083 |
| Provider Name | Sara C Rowland |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639143555 PECOS PAC ID: 9830113778 Enrollment ID: I20060119000038 |
| Provider Name | Judith L Chilcote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386618205 PECOS PAC ID: 0648294587 Enrollment ID: I20060119000050 |
| Provider Name | Stephen F Slack |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619080835 PECOS PAC ID: 2860416427 Enrollment ID: I20060123000165 |
| Provider Name | Janet C West |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447299284 PECOS PAC ID: 0143237628 Enrollment ID: I20060308000181 |
| Provider Name | Duane D Webb |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881637742 PECOS PAC ID: 4789641044 Enrollment ID: I20060403000091 |
| Provider Name | Kenneth I Stone |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1982641767 PECOS PAC ID: 6709878176 Enrollment ID: I20060417000712 |
| Provider Name | Gilson R Girotto |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1083690333 PECOS PAC ID: 2961412671 Enrollment ID: I20060426000123 |
| Provider Name | Sarah M Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306801311 PECOS PAC ID: 6901816172 Enrollment ID: I20060502000815 |
| Provider Name | Stephen P Roesler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689626160 PECOS PAC ID: 1254343395 Enrollment ID: I20060608000106 |
| Provider Name | Nora B Kirschner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174577597 PECOS PAC ID: 6002847035 Enrollment ID: I20060613000046 |
| Provider Name | Mark A Friedman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386690691 PECOS PAC ID: 9335151240 Enrollment ID: I20060614000235 |
| Provider Name | Hyung U Park |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023044187 PECOS PAC ID: 2668477597 Enrollment ID: I20060927000067 |
| Provider Name | Paul D Schneider |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1821086208 PECOS PAC ID: 5890682637 Enrollment ID: I20061004000393 |
| Provider Name | Rico V Romano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407879091 PECOS PAC ID: 9638176308 Enrollment ID: I20061024000009 |
| Provider Name | Patricia A Franklin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053307017 PECOS PAC ID: 6608874268 Enrollment ID: I20061116000068 |
| Provider Name | Griffith M Blackmon |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1609836824 PECOS PAC ID: 1052332178 Enrollment ID: I20061127000140 |
| Provider Name | Brian A Kendregan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841295870 PECOS PAC ID: 2062491434 Enrollment ID: I20070305000413 |
| Provider Name | Susan A Baerg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255376596 PECOS PAC ID: 4183728470 Enrollment ID: I20070326000450 |
| Provider Name | Rae Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144225236 PECOS PAC ID: 0042248353 Enrollment ID: I20070409000196 |
| Provider Name | Donald E Wakelin |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1790820546 PECOS PAC ID: 5193825982 Enrollment ID: I20070709000475 |
| Provider Name | Philip J Zylstra |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659335602 PECOS PAC ID: 6800996562 Enrollment ID: I20070710000638 |
| Provider Name | Lisa M. Kohler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083699771 PECOS PAC ID: 5395727556 Enrollment ID: I20070711000154 |
| Provider Name | Jhoanna M Santos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902017239 PECOS PAC ID: 9638261431 Enrollment ID: I20070824000365 |
| Provider Name | Edward W Eissmann |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558466029 PECOS PAC ID: 1658451406 Enrollment ID: I20080107000037 |
| Provider Name | Jennifer Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366415812 PECOS PAC ID: 8325942006 Enrollment ID: I20080207000584 |
| Provider Name | Song Y Hong |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700070208 PECOS PAC ID: 0547343550 Enrollment ID: I20080214000325 |
| Provider Name | Kevin Donald Welk |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1902804925 PECOS PAC ID: 5395785406 Enrollment ID: I20080402000012 |
| Provider Name | Edwin Y Chang |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1700908019 PECOS PAC ID: 1557448495 Enrollment ID: I20080402000889 |
| Provider Name | Carol S Murakami |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1821085390 PECOS PAC ID: 2961580972 Enrollment ID: I20080416000295 |
| Provider Name | Shawna L Laursen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528137908 PECOS PAC ID: 5597844308 Enrollment ID: I20080506000066 |
| Provider Name | Michael G Thomas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326051129 PECOS PAC ID: 6204828478 Enrollment ID: I20080513000057 |
| Provider Name | Daniel James Zwiesler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1427001494 PECOS PAC ID: 5193738557 Enrollment ID: I20080708000455 |
| Provider Name | Michael J Picco |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194907337 PECOS PAC ID: 5193898294 Enrollment ID: I20080723000326 |
| Provider Name | Julie A C Valentine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144483058 PECOS PAC ID: 9436222346 Enrollment ID: I20080724000529 |
| Provider Name | Anirban Das |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083889190 PECOS PAC ID: 5890869515 Enrollment ID: I20080729000708 |
| Provider Name | Sarvesh S Thakur |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1295761328 PECOS PAC ID: 3779473244 Enrollment ID: I20080814000389 |
| Provider Name | Terry L Hergesheimer |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1518141282 PECOS PAC ID: 5294800777 Enrollment ID: I20080818000653 |
| Provider Name | Soumya Parimi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174667570 PECOS PAC ID: 5890861207 Enrollment ID: I20080909000650 |
| Provider Name | Ramy Lewez Hanna |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1073732418 PECOS PAC ID: 5597862904 Enrollment ID: I20081024000113 |
| Provider Name | Narinderpal Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285796987 PECOS PAC ID: 0446352983 Enrollment ID: I20081031000254 |
| Provider Name | Catherine D Norton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013086495 PECOS PAC ID: 8729147699 Enrollment ID: I20081106000526 |
| Provider Name | Ronnie B Burns |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629027222 PECOS PAC ID: 0648293894 Enrollment ID: I20081125000731 |
| Provider Name | Rita Ann Kostelik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003009135 PECOS PAC ID: 6507927100 Enrollment ID: I20081201000479 |
| Provider Name | Katherine J Leone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780604231 PECOS PAC ID: 9032276365 Enrollment ID: I20090331000524 |
| Provider Name | Sherry L Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134368988 PECOS PAC ID: 3870640980 Enrollment ID: I20090407000320 |
| Provider Name | Kristine E Schmaltz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932268760 PECOS PAC ID: 0648327403 Enrollment ID: I20090413000479 |
| Provider Name | Herbert E Stickle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699736637 PECOS PAC ID: 8325141591 Enrollment ID: I20090420000172 |
| Provider Name | Carolyn M Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306854757 PECOS PAC ID: 0547318602 Enrollment ID: I20090429000063 |
| Provider Name | Stanley J Chen |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1447284849 PECOS PAC ID: 8527064823 Enrollment ID: I20090713000164 |
| Provider Name | James Maeda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538162854 PECOS PAC ID: 6305818972 Enrollment ID: I20090715000518 |
| Provider Name | Oscar J Briseno |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770794331 PECOS PAC ID: 6507910148 Enrollment ID: I20090818000069 |
| Provider Name | Anisa S Pea |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1316157787 PECOS PAC ID: 5890849343 Enrollment ID: I20090818000268 |
| Provider Name | Rowena N Pusateri |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811153414 PECOS PAC ID: 3476609512 Enrollment ID: I20090915000503 |
| Provider Name | Paul B Fredette |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265670954 PECOS PAC ID: 5991851669 Enrollment ID: I20090922000179 |
| Provider Name | Malik F Fuimaono |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487884573 PECOS PAC ID: 7113063413 Enrollment ID: I20090929000655 |
| Provider Name | Bonita K Baker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336224013 PECOS PAC ID: 6800886011 Enrollment ID: I20091015000229 |
| Provider Name | Murad Y Yunusov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194992115 PECOS PAC ID: 7618038407 Enrollment ID: I20091020000505 |
| Provider Name | Mukesh K Thawani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174716427 PECOS PAC ID: 5890832810 Enrollment ID: I20091023000626 |
| Provider Name | Masoud S Taleghani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114117330 PECOS PAC ID: 3375635550 Enrollment ID: I20091111000069 |
| Provider Name | Laurence M Lee |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1104842103 PECOS PAC ID: 6002955499 Enrollment ID: I20091124000302 |
| Provider Name | Lance S Ho |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073689006 PECOS PAC ID: 7618046137 Enrollment ID: I20100108000489 |
| Provider Name | Sandeep Bal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386819449 PECOS PAC ID: 0446391486 Enrollment ID: I20100112000821 |
| Provider Name | Ryan Rommel S Guanzon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417048893 PECOS PAC ID: 7012011299 Enrollment ID: I20100119000162 |
| Provider Name | Phillip S Burk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245254473 PECOS PAC ID: 4789727579 Enrollment ID: I20100202000354 |
| Provider Name | Jennifer A Elliott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396071601 PECOS PAC ID: 8527101872 Enrollment ID: I20100209000060 |
| Provider Name | Peter W Bauer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922004910 PECOS PAC ID: 7012052061 Enrollment ID: I20100302000969 |
| Provider Name | Mariel S Castillo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326139700 PECOS PAC ID: 1759485998 Enrollment ID: I20100312001035 |
| Provider Name | Donna C Queyquep |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871633131 PECOS PAC ID: 3678672656 Enrollment ID: I20100325000576 |
| Provider Name | Carl M Berliner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881680148 PECOS PAC ID: 0143303701 Enrollment ID: I20100330000547 |
| Provider Name | Taras P Kindrat |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326205980 PECOS PAC ID: 0345311411 Enrollment ID: I20100507000400 |
| Provider Name | Julie Ann Merriam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184612962 PECOS PAC ID: 3274430905 Enrollment ID: I20100512000174 |
| Provider Name | Thomas Amankonah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780762534 PECOS PAC ID: 8325129539 Enrollment ID: I20100514000909 |
| Provider Name | Jared M Anderson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1902065733 PECOS PAC ID: 1759412018 Enrollment ID: I20100630000383 |
| Provider Name | Connie L Davis |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1043395841 PECOS PAC ID: 5698825594 Enrollment ID: I20100720000536 |
| Provider Name | Richard V Williamson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851352579 PECOS PAC ID: 5890828883 Enrollment ID: I20100727001073 |
| Provider Name | Erin A. Davidson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497071765 PECOS PAC ID: 2860525656 Enrollment ID: I20100730000290 |
| Provider Name | Deborah A W North |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1588628747 PECOS PAC ID: 4587798780 Enrollment ID: I20100810000334 |
| Provider Name | Suzanne Robertson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487619730 PECOS PAC ID: 0547292708 Enrollment ID: I20100823001109 |
| Provider Name | Gary L Brown |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1295706752 PECOS PAC ID: 2163546664 Enrollment ID: I20100907000451 |
| Provider Name | James R Gross |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1023082203 PECOS PAC ID: 5092839415 Enrollment ID: I20100907000830 |
| Provider Name | Henning Pforte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386600716 PECOS PAC ID: 2769506187 Enrollment ID: I20100907000902 |
| Provider Name | Gary K Johnson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1437129186 PECOS PAC ID: 2365336401 Enrollment ID: I20100908000252 |
| Provider Name | Kevin C Harris |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1164496808 PECOS PAC ID: 2961526348 Enrollment ID: I20100908000372 |
| Provider Name | Jonathan C Gamson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639172927 PECOS PAC ID: 7012032113 Enrollment ID: I20100913001016 |
| Provider Name | Robert H Zwick |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1699739730 PECOS PAC ID: 4981729092 Enrollment ID: I20100913001176 |
| Provider Name | Johnna K Wilcox |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205890811 PECOS PAC ID: 1153446265 Enrollment ID: I20100913001186 |
| Provider Name | Mary T Ramsbottom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326002593 PECOS PAC ID: 2062537178 Enrollment ID: I20100913001187 |
| Provider Name | Elizabeth E Repplier |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285698803 PECOS PAC ID: 1254456163 Enrollment ID: I20100915001266 |
| Provider Name | Morris G Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780673269 PECOS PAC ID: 7315020971 Enrollment ID: I20100915001271 |
| Provider Name | Jon M Dahl |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477549616 PECOS PAC ID: 3072638980 Enrollment ID: I20100915001272 |
| Provider Name | Barbara J Hahn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073500021 PECOS PAC ID: 3779666334 Enrollment ID: I20100915001274 |
| Provider Name | Mary Ann Hink |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063401768 PECOS PAC ID: 5597848150 Enrollment ID: I20100915001277 |
| Provider Name | Connie A Walton-hoskinson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740593524 PECOS PAC ID: 6305961053 Enrollment ID: I20100917000633 |
| Provider Name | Ashley E Fedan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053622720 PECOS PAC ID: 4880719392 Enrollment ID: I20100921000073 |
| Provider Name | Jennifer T Scanlon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205968765 PECOS PAC ID: 2466578588 Enrollment ID: I20100927000811 |
| Provider Name | Jaideep Shenoi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1821156233 PECOS PAC ID: 3779609730 Enrollment ID: I20100927001421 |
| Provider Name | Lynn M Handy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407843451 PECOS PAC ID: 2668664012 Enrollment ID: I20101004001523 |
| Provider Name | Yelena K Rosenberg |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568670099 PECOS PAC ID: 9234260076 Enrollment ID: I20101005000605 |
| Provider Name | Vidhu Shekhar Paliwal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952341463 PECOS PAC ID: 1254316516 Enrollment ID: I20101008001072 |
| Provider Name | Todd Carl Skiles |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1164512703 PECOS PAC ID: 7618086604 Enrollment ID: I20101012001113 |
| Provider Name | Anita M Meyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902808207 PECOS PAC ID: 0042402760 Enrollment ID: I20101012001394 |
| Provider Name | Paul E Naumann |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1639391501 PECOS PAC ID: 5991852188 Enrollment ID: I20101014000332 |
| Provider Name | Kari K Ranum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598071888 PECOS PAC ID: 4789879255 Enrollment ID: I20101110000083 |
| Provider Name | David Lawrence Goldman |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1912978560 PECOS PAC ID: 6709072630 Enrollment ID: I20101118000171 |
| Provider Name | Barry J Landau |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1053382671 PECOS PAC ID: 8022204619 Enrollment ID: I20101122000731 |
| Provider Name | Monroe C Whitman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346248861 PECOS PAC ID: 0143416354 Enrollment ID: I20101130001230 |
| Provider Name | Peter Wolff |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447258801 PECOS PAC ID: 5698961704 Enrollment ID: I20101130001355 |
| Provider Name | Sean M Burson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922312453 PECOS PAC ID: 1951598267 Enrollment ID: I20101213001072 |
| Provider Name | Charles T Chaffee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063401347 PECOS PAC ID: 3779473038 Enrollment ID: I20101214000368 |
| Provider Name | Leslie A Estep |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457354896 PECOS PAC ID: 8921296419 Enrollment ID: I20101228000579 |
| Provider Name | Linnea K Cooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942500731 PECOS PAC ID: 5799974408 Enrollment ID: I20110112000239 |
| Provider Name | David M Gran |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629215991 PECOS PAC ID: 4082808852 Enrollment ID: I20110208000869 |
| Provider Name | Seth D Hartung |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1043337751 PECOS PAC ID: 5799965422 Enrollment ID: I20110211000536 |
| Provider Name | Sandra J Hadjinian |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1003937947 PECOS PAC ID: 9335322486 Enrollment ID: I20110326000051 |
| Provider Name | Yuri Tsirulnikov |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1760693444 PECOS PAC ID: 8628143245 Enrollment ID: I20110406000669 |
| Provider Name | Krista Gaines Galitsis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467544221 PECOS PAC ID: 3678504727 Enrollment ID: I20110419000427 |
| Provider Name | Karen E Robinson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720014707 PECOS PAC ID: 4880798883 Enrollment ID: I20110428000447 |
| Provider Name | Mark A Lucianna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134114358 PECOS PAC ID: 6103716147 Enrollment ID: I20110815000197 |
| Provider Name | Catherine B Johnston |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1396779534 PECOS PAC ID: 1456537562 Enrollment ID: I20110914000153 |
| Provider Name | Joshua D. Griggs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164463378 PECOS PAC ID: 2860497500 Enrollment ID: I20110921000156 |
| Provider Name | Hoang H Dang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891835989 PECOS PAC ID: 3678638483 Enrollment ID: I20110921000885 |
| Provider Name | Yujin Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568614204 PECOS PAC ID: 4587835616 Enrollment ID: I20110922000160 |
| Provider Name | Young K Choi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336122274 PECOS PAC ID: 4284611393 Enrollment ID: I20111012000723 |
| Provider Name | Nassim Karimi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1982763314 PECOS PAC ID: 4587830781 Enrollment ID: I20120109000943 |
| Provider Name | Brian E Waiblinger |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750350443 PECOS PAC ID: 6507033990 Enrollment ID: I20120126000156 |
| Provider Name | Madeline Borhani |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063440675 PECOS PAC ID: 8224007240 Enrollment ID: I20120319000091 |
| Provider Name | Nikorn Arunakul |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811955420 PECOS PAC ID: 0840386934 Enrollment ID: I20120323000427 |
| Provider Name | Christine M Mcgrann |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619240330 PECOS PAC ID: 7517127624 Enrollment ID: I20120328000184 |
| Provider Name | Hilary Laurel Cutler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548557218 PECOS PAC ID: 2365613312 Enrollment ID: I20120611000496 |
| Provider Name | Vince N Montes |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1841266285 PECOS PAC ID: 6709789993 Enrollment ID: I20120731000676 |
| Provider Name | Mark L Jamantoc |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245403674 PECOS PAC ID: 6608022017 Enrollment ID: I20120816000849 |
| Provider Name | Michael Blue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558309393 PECOS PAC ID: 5991793135 Enrollment ID: I20120904000775 |
| Provider Name | Joshua D Hawkins |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760685416 PECOS PAC ID: 6800046970 Enrollment ID: I20121025000666 |
| Provider Name | Ha N Ta |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568437069 PECOS PAC ID: 0648312090 Enrollment ID: I20121120000566 |
| Provider Name | Vance E Sherman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487883187 PECOS PAC ID: 8022261783 Enrollment ID: I20130104000348 |
| Provider Name | Peter J. Struck |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972893238 PECOS PAC ID: 5698926129 Enrollment ID: I20130129000305 |
| Provider Name | Paul E Miller |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992744106 PECOS PAC ID: 5395744650 Enrollment ID: I20130312000419 |
| Provider Name | Mark A Carlson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851449318 PECOS PAC ID: 3476798505 Enrollment ID: I20130320000652 |
| Provider Name | Tara L Montgomery |
|---|---|
| Provider Type | Practitioner - Other (physician) |
| Provider Identifiers | NPI Number: 1306052006 PECOS PAC ID: 0042358624 Enrollment ID: I20130416000323 |
| Provider Name | Curtis Deloney |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952458812 PECOS PAC ID: 9830362433 Enrollment ID: I20130612000675 |
| Provider Name | Tony Tran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487832234 PECOS PAC ID: 6608069562 Enrollment ID: I20130710000011 |
| Provider Name | Trista L. Pendergrast |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306184874 PECOS PAC ID: 8123269073 Enrollment ID: I20130718000796 |
| Provider Name | Michael Daniel Liang |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1669675872 PECOS PAC ID: 8729221650 Enrollment ID: I20130826000310 |
| Provider Name | Scott W Fetty |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649405226 PECOS PAC ID: 6204084817 Enrollment ID: I20130920000618 |
| Provider Name | Nona L Hanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962408815 PECOS PAC ID: 9234195942 Enrollment ID: I20130924000398 |
| Provider Name | Eric G Powell |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1053623983 PECOS PAC ID: 2062656465 Enrollment ID: I20130925000770 |
| Provider Name | Jeremy Ginoza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053554154 PECOS PAC ID: 3577714419 Enrollment ID: I20130930000496 |
| Provider Name | Jeffrey Wells Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487088738 PECOS PAC ID: 0941247928 Enrollment ID: I20131001000308 |
| Provider Name | Wen Huan S Ho |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548469281 PECOS PAC ID: 7416102504 Enrollment ID: I20131010001686 |
| Provider Name | Brianna Jean Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083047369 PECOS PAC ID: 5698909109 Enrollment ID: I20131015001940 |
| Provider Name | Sarah Butsch Paxson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760818876 PECOS PAC ID: 4587890900 Enrollment ID: I20131113001178 |
| Provider Name | Nathan Allen Ullom |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1568777175 PECOS PAC ID: 6204062300 Enrollment ID: I20131120000329 |
| Provider Name | Leah J Alvis |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1922030097 PECOS PAC ID: 6305008491 Enrollment ID: I20131126000851 |
| Provider Name | Natalia S Usoltseva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144540774 PECOS PAC ID: 0042447617 Enrollment ID: I20131206000369 |
| Provider Name | Amy Meoli |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1447209218 PECOS PAC ID: 3779596663 Enrollment ID: I20131211000673 |
| Provider Name | Amy M. Arisco |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1821183856 PECOS PAC ID: 3577565589 Enrollment ID: I20131211001831 |
| Provider Name | Joseph R Barthelemy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1447567011 PECOS PAC ID: 5294960985 Enrollment ID: I20131220000787 |
| Provider Name | Sankar Suresh Alagugurusamy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1093970576 PECOS PAC ID: 5698841435 Enrollment ID: I20131226001705 |
| Provider Name | Eugene Kee Hong |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1720166812 PECOS PAC ID: 8628097649 Enrollment ID: I20140226000754 |
| Provider Name | Alex Herzberg |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629085519 PECOS PAC ID: 4183785462 Enrollment ID: I20140508001708 |
| Provider Name | Tristan M Boy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851717748 PECOS PAC ID: 3476776972 Enrollment ID: I20140602002607 |
| Provider Name | Allison Jean Porter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063654457 PECOS PAC ID: 3870739980 Enrollment ID: I20140610000857 |
| Provider Name | Lang Conteh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780095380 PECOS PAC ID: 9032334750 Enrollment ID: I20140711002203 |
| Provider Name | Wen Zhong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356381537 PECOS PAC ID: 7810980752 Enrollment ID: I20140730002861 |
| Provider Name | Samuel M. Donohoe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073806865 PECOS PAC ID: 1759521727 Enrollment ID: I20140827000816 |
| Provider Name | Samuel M. Wilson |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1477865194 PECOS PAC ID: 4880841956 Enrollment ID: I20140905001841 |
| Provider Name | Leigh R. Anderson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1376660472 PECOS PAC ID: 3678664232 Enrollment ID: I20140908000371 |
| Provider Name | Ying Liu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245541903 PECOS PAC ID: 5991925828 Enrollment ID: I20140927000502 |
| Provider Name | Joel G. Dean |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1568534915 PECOS PAC ID: 7618113531 Enrollment ID: I20141002001628 |
| Provider Name | Christopher Y. Kweon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255594834 PECOS PAC ID: 9931320785 Enrollment ID: I20141021001695 |
| Provider Name | Lora L Cork |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659789196 PECOS PAC ID: 1254553746 Enrollment ID: I20141118001842 |
| Provider Name | Diana I Bartlett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023413358 PECOS PAC ID: 4385967629 Enrollment ID: I20141218000026 |
| Provider Name | Mark R Wallace |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982683603 PECOS PAC ID: 5890715692 Enrollment ID: I20150128000083 |
| Provider Name | Mark G Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629129168 PECOS PAC ID: 2466469341 Enrollment ID: I20150225002305 |
| Provider Name | Rachael J Nikkola |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881645059 PECOS PAC ID: 0345276051 Enrollment ID: I20150519000896 |
| Provider Name | Annalee Lynn Paul |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760681340 PECOS PAC ID: 2668783291 Enrollment ID: I20150623001373 |
| Provider Name | Chinnaya Parimi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437293834 PECOS PAC ID: 8820300940 Enrollment ID: I20150702000801 |
| Provider Name | David M Escobar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639432537 PECOS PAC ID: 8325282478 Enrollment ID: I20150728006059 |
| Provider Name | Nellie Nanda |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346285855 PECOS PAC ID: 7416978242 Enrollment ID: I20150826002114 |
| Provider Name | Gary Rhett Andelin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255693909 PECOS PAC ID: 0446480651 Enrollment ID: I20150828002171 |
| Provider Name | George J Ang |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1396737326 PECOS PAC ID: 3971521477 Enrollment ID: I20150901002911 |
| Provider Name | Justin Gill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174903603 PECOS PAC ID: 8921314121 Enrollment ID: I20150902002925 |
| Provider Name | Bhrigu R. Parmar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801025812 PECOS PAC ID: 2769614759 Enrollment ID: I20150903001382 |
| Provider Name | Navid Hasani Mehraban |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1568775922 PECOS PAC ID: 6103067681 Enrollment ID: I20151021000115 |
| Provider Name | Amanda C Savery |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093000101 PECOS PAC ID: 4385868835 Enrollment ID: I20151028001663 |
| Provider Name | David B Liang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619178027 PECOS PAC ID: 6800948456 Enrollment ID: I20151116002361 |
| Provider Name | Mark D Baldwin |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1477656304 PECOS PAC ID: 2769390228 Enrollment ID: I20160208001553 |
| Provider Name | Robert Brenner |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437254075 PECOS PAC ID: 7719955178 Enrollment ID: I20160212000182 |
| Provider Name | Jimmy B. Dang |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689839011 PECOS PAC ID: 1759442791 Enrollment ID: I20160303000515 |
| Provider Name | Steven R Bialkin |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1497757769 PECOS PAC ID: 3971600743 Enrollment ID: I20160608001755 |
| Provider Name | Michael N Murphy |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1720081490 PECOS PAC ID: 6002889052 Enrollment ID: I20160610000084 |
| Provider Name | Larry Sokolic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265559785 PECOS PAC ID: 3779723697 Enrollment ID: I20160623002299 |
| Provider Name | Ashleigh E Adkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891147500 PECOS PAC ID: 1658664479 Enrollment ID: I20160801001057 |
| Provider Name | Birendra S Huja |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386625630 PECOS PAC ID: 2365436490 Enrollment ID: I20160801001497 |
| Provider Name | John S. Dew |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740244193 PECOS PAC ID: 1658311618 Enrollment ID: I20160902000298 |
| Provider Name | Michael Mirzoyan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1073787545 PECOS PAC ID: 9931230562 Enrollment ID: I20160915000135 |
| Provider Name | William B Haynal |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1114218120 PECOS PAC ID: 5597063271 Enrollment ID: I20160916002070 |
| Provider Name | Wendy Wan Anan |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1669673448 PECOS PAC ID: 8628224672 Enrollment ID: I20160928000665 |
| Provider Name | Mallorie K Smith |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073864997 PECOS PAC ID: 5799935771 Enrollment ID: I20161004001371 |
| Provider Name | Christopher L. Sheu |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659508299 PECOS PAC ID: 0840505160 Enrollment ID: I20161012000782 |
| Provider Name | Trisha Halvorsen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245585959 PECOS PAC ID: 9739477241 Enrollment ID: I20161017002360 |
| Provider Name | Roger Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619230281 PECOS PAC ID: 8729392055 Enrollment ID: I20161021001876 |
| Provider Name | Jasanjot J Parmar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255772406 PECOS PAC ID: 9638457849 Enrollment ID: I20161021002148 |
| Provider Name | Jacqueline Berg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1720533961 PECOS PAC ID: 8426336199 Enrollment ID: I20161031002568 |
| Provider Name | Nathan Parker |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1013232560 PECOS PAC ID: 7012225642 Enrollment ID: I20161130002005 |
| Provider Name | Irene Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699137406 PECOS PAC ID: 4880974088 Enrollment ID: I20161205002179 |
| Provider Name | Allison Lea Abresch-meyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235492596 PECOS PAC ID: 1951681527 Enrollment ID: I20161219000228 |
| Provider Name | Jeremiah P Donovan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1164406500 PECOS PAC ID: 2264461862 Enrollment ID: I20161229001965 |
| Provider Name | Janice M Gatzke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790195436 PECOS PAC ID: 3072894252 Enrollment ID: I20161230000130 |
| Provider Name | Mark Litton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255775789 PECOS PAC ID: 6103060256 Enrollment ID: I20170119001327 |
| Provider Name | Kelli Kraft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568846558 PECOS PAC ID: 2860707163 Enrollment ID: I20170201002878 |
| Provider Name | Hannah Christensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346785656 PECOS PAC ID: 3375827017 Enrollment ID: I20170224001814 |
| Provider Name | Paula F Wolff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033525712 PECOS PAC ID: 7012139827 Enrollment ID: I20170314000837 |
| Provider Name | Jovita C Dsouza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174074017 PECOS PAC ID: 0345526794 Enrollment ID: I20170419001092 |
| Provider Name | Michael F Reidy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609950500 PECOS PAC ID: 1557363223 Enrollment ID: I20170427001156 |
| Provider Name | Glenn I Sharfin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497827919 PECOS PAC ID: 9234151622 Enrollment ID: I20170602000892 |
| Provider Name | Natasha A Dwamena |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609023308 PECOS PAC ID: 3173664737 Enrollment ID: I20170607000581 |
| Provider Name | Christopher R. England |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1104073170 PECOS PAC ID: 7517194020 Enrollment ID: I20170609001960 |
| Provider Name | Kathryn A Roberts |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487924254 PECOS PAC ID: 9739408048 Enrollment ID: I20170620002010 |
| Provider Name | Joseph E. Wilson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043338676 PECOS PAC ID: 0446292973 Enrollment ID: I20170630002027 |
| Provider Name | William R Cook |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1750344263 PECOS PAC ID: 7911811542 Enrollment ID: I20170703001080 |
| Provider Name | Jonathan Kang |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1912301631 PECOS PAC ID: 0446521884 Enrollment ID: I20170803002699 |
| Provider Name | Alyssa M. Santos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134547797 PECOS PAC ID: 3173745486 Enrollment ID: I20170908000792 |
| Provider Name | Benjamin T Mahoney |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972028355 PECOS PAC ID: 7719251339 Enrollment ID: I20170920004031 |
| Provider Name | Daniel J Cevetello |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538572151 PECOS PAC ID: 6901198316 Enrollment ID: I20170922003031 |
| Provider Name | Jennifer L. Munn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417479429 PECOS PAC ID: 5698049088 Enrollment ID: I20170925000397 |
| Provider Name | Rachel M Herrmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104187905 PECOS PAC ID: 2163643867 Enrollment ID: I20170928004242 |
| Provider Name | Karen P Landon |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1275993743 PECOS PAC ID: 0244505329 Enrollment ID: I20170929002097 |
| Provider Name | Thomas Jackson Pulliam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205898103 PECOS PAC ID: 0244260982 Enrollment ID: I20171026000777 |
| Provider Name | Michael P Delacruz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629232087 PECOS PAC ID: 0042480758 Enrollment ID: I20171106002697 |
| Provider Name | Wenyi Zhang |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1235497041 PECOS PAC ID: 8921364910 Enrollment ID: I20171107002851 |
| Provider Name | Jessica L Hurwitz |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1174046536 PECOS PAC ID: 5991061186 Enrollment ID: I20171116000939 |
| Provider Name | Cheryl Nirmali De Silva |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568801280 PECOS PAC ID: 8022304955 Enrollment ID: I20171117000592 |
| Provider Name | Madonna A. Biritwum |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1295975779 PECOS PAC ID: 5193995850 Enrollment ID: I20171117002666 |
| Provider Name | William G Murchison |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417146846 PECOS PAC ID: 6901891274 Enrollment ID: I20180525001727 |
| Provider Name | Janice H Kang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457675498 PECOS PAC ID: 3476799941 Enrollment ID: I20180601002235 |
| Provider Name | Debbie Jo Miller |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1861995524 PECOS PAC ID: 7416202122 Enrollment ID: I20180621000673 |
| Provider Name | Brianne Helen Lynch |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851668461 PECOS PAC ID: 7214283597 Enrollment ID: I20180628000924 |
| Provider Name | James K Barger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861733172 PECOS PAC ID: 9436442308 Enrollment ID: I20180718003786 |
| Provider Name | Lloyd David Hubler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215986419 PECOS PAC ID: 3173414570 Enrollment ID: I20180731001574 |
| Provider Name | Francisco J Perez Mata |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1407142664 PECOS PAC ID: 8628351319 Enrollment ID: I20180814000474 |
| Provider Name | Naseem Afrasiabi Ghazanfari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184912636 PECOS PAC ID: 8224278205 Enrollment ID: I20180823002653 |
| Provider Name | Jaya L Deelena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447749866 PECOS PAC ID: 2668722042 Enrollment ID: I20180905003055 |
| Provider Name | Grant K Cochran |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1164743035 PECOS PAC ID: 2668724972 Enrollment ID: I20181016000762 |
| Provider Name | Weslee Chew |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619310554 PECOS PAC ID: 0244474922 Enrollment ID: I20181029003185 |
| Provider Name | Gerard Mark Benecki |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457542656 PECOS PAC ID: 6608008610 Enrollment ID: I20181102001067 |
| Provider Name | Eugene V De Guzman |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1699940874 PECOS PAC ID: 9032344429 Enrollment ID: I20181102002610 |
| Provider Name | Richard Von Ho |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1457693244 PECOS PAC ID: 0941420137 Enrollment ID: I20181115001008 |
| Provider Name | Gaila M Palo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013495845 PECOS PAC ID: 9537404918 Enrollment ID: I20181213002359 |
| Provider Name | Nathan Tillotson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770670473 PECOS PAC ID: 3274589064 Enrollment ID: I20181220002997 |
| Provider Name | Richard Manos |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356451249 PECOS PAC ID: 4981761848 Enrollment ID: I20181228000605 |
| Provider Name | Devyn Nicole Nixon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205317070 PECOS PAC ID: 0446595011 Enrollment ID: I20181231001335 |
| Provider Name | Elizabeth M Poli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639650138 PECOS PAC ID: 0941546329 Enrollment ID: I20190104002414 |
| Provider Name | Jason Andrew Slate |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275648586 PECOS PAC ID: 4587636956 Enrollment ID: I20190104002576 |
| Provider Name | Matthew J Novak |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1871775122 PECOS PAC ID: 0941374110 Enrollment ID: I20190111002318 |
| Provider Name | Therese Williams Dumas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831282409 PECOS PAC ID: 6204808033 Enrollment ID: I20190124000593 |
| Provider Name | Zena I Monji |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902884539 PECOS PAC ID: 0042313132 Enrollment ID: I20190225003193 |
| Provider Name | Meggan Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770051740 PECOS PAC ID: 4981943370 Enrollment ID: I20190301000744 |
| Provider Name | Lizette Jamora Antig |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972990042 PECOS PAC ID: 4486994142 Enrollment ID: I20190318000751 |
| Provider Name | Steve Goldschmid |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1780798264 PECOS PAC ID: 9931178159 Enrollment ID: I20190326001604 |
| Provider Name | David Burke Bond |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710459953 PECOS PAC ID: 5597008003 Enrollment ID: I20190525000026 |
| Provider Name | Bruce K Waite |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851394530 PECOS PAC ID: 9335243336 Enrollment ID: I20190528001663 |
| Provider Name | Sarah L Elliott |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861812208 PECOS PAC ID: 4183958382 Enrollment ID: I20190621000936 |
| Provider Name | Niket Nathani |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1801113154 PECOS PAC ID: 3173760725 Enrollment ID: I20190621000949 |
| Provider Name | Abigail Denise Doyle |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1861755498 PECOS PAC ID: 0345462305 Enrollment ID: I20190621001227 |
| Provider Name | Dana E Sturtz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1023560505 PECOS PAC ID: 9133456155 Enrollment ID: I20190813002283 |
| Provider Name | Hannah C Spears |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669026308 PECOS PAC ID: 9335477629 Enrollment ID: I20190823003210 |
| Provider Name | Christopher Sonnier |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1598732513 PECOS PAC ID: 6608877634 Enrollment ID: I20190827002798 |
| Provider Name | Maria Victoria Cayabyab |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508165804 PECOS PAC ID: 9830405042 Enrollment ID: I20190827004175 |
| Provider Name | Eric Larsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205490661 PECOS PAC ID: 8628307519 Enrollment ID: I20190830001672 |
| Provider Name | Aaron J Arnold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871954305 PECOS PAC ID: 5890088926 Enrollment ID: I20190830001725 |
| Provider Name | Kerrie Steffan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932769007 PECOS PAC ID: 3870822620 Enrollment ID: I20190904002375 |
| Provider Name | Collin T Dela Houssaye |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1285044917 PECOS PAC ID: 4880813484 Enrollment ID: I20190906000143 |
| Provider Name | Marissa L Capasso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609238765 PECOS PAC ID: 4981997327 Enrollment ID: I20190909003218 |
| Provider Name | Ryan M. Vellinga |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295172716 PECOS PAC ID: 2961628672 Enrollment ID: I20190913000099 |
| Provider Name | Christopher O Prompuntagorn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104206812 PECOS PAC ID: 8527347707 Enrollment ID: I20191021002030 |
| Provider Name | David Alan Krass |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386290948 PECOS PAC ID: 4183056104 Enrollment ID: I20191113001848 |
| Provider Name | Andrea Barrett-hollander |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1003202607 PECOS PAC ID: 5698085447 Enrollment ID: I20191113002468 |
| Provider Name | Mary Frances Bavaro |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1508837329 PECOS PAC ID: 5294986055 Enrollment ID: I20191121002720 |
| Provider Name | Sarah Marie Gerspacher |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477190007 PECOS PAC ID: 0648604348 Enrollment ID: I20200106002961 |
| Provider Name | Shubh Ayengar |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1154641975 PECOS PAC ID: 0042438079 Enrollment ID: I20200121001022 |
| Provider Name | Oksana S Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770937831 PECOS PAC ID: 5294020061 Enrollment ID: I20200212002839 |
| Provider Name | Donna Flora Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730712779 PECOS PAC ID: 9537597620 Enrollment ID: I20200324002530 |
| Provider Name | Edgard Ivan Gonzalez Feldman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1477525202 PECOS PAC ID: 0345285557 Enrollment ID: I20200504001025 |
| Provider Name | Susie M Norris |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1417979667 PECOS PAC ID: 1951453240 Enrollment ID: I20200506001255 |
| Provider Name | Andrea Marie Phillips |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1558906008 PECOS PAC ID: 6002247830 Enrollment ID: I20200512001985 |
| Provider Name | Amy M Loughlin |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1750397253 PECOS PAC ID: 6406945021 Enrollment ID: I20200518001021 |
| Provider Name | Anna Louise Hiatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609417203 PECOS PAC ID: 4587085642 Enrollment ID: I20200528002430 |
| Provider Name | Calvin T Jones |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1659412823 PECOS PAC ID: 3274954185 Enrollment ID: I20200602000583 |
| Provider Name | Shaneen S Fernandez |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1376189555 PECOS PAC ID: 3678994506 Enrollment ID: I20200602001270 |
| Provider Name | Sarah Jacqueline Lim-dwyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154969103 PECOS PAC ID: 8729400288 Enrollment ID: I20200630000566 |
| Provider Name | Christopher M. Thomas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386038164 PECOS PAC ID: 4082038211 Enrollment ID: I20200721004003 |
| Provider Name | Richard L. Lin |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1235587494 PECOS PAC ID: 2668760083 Enrollment ID: I20200817003375 |
| Provider Name | Jeffrey A Walton |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992219455 PECOS PAC ID: 1951669555 Enrollment ID: I20200817003488 |
| Provider Name | Alexa Nicole Reyes Celerian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508219023 PECOS PAC ID: 7012261647 Enrollment ID: I20200909003101 |
| Provider Name | Carlyn P. King |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649634437 PECOS PAC ID: 8022436724 Enrollment ID: I20200911002107 |
| Provider Name | Angelica Orozco Kominsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427696236 PECOS PAC ID: 3375961535 Enrollment ID: I20200921000972 |
| Provider Name | Lauren E Clements |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1063886331 PECOS PAC ID: 8527362466 Enrollment ID: I20201111000570 |
| Provider Name | Arianne Susan Jong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023466331 PECOS PAC ID: 4082024468 Enrollment ID: I20201113002832 |
| Provider Name | Jennifer L Stahlberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730646837 PECOS PAC ID: 2163855586 Enrollment ID: I20201118001775 |
| Provider Name | Stephanie Marie Partington |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710585849 PECOS PAC ID: 6901217983 Enrollment ID: I20201123002678 |
| Provider Name | Amir Mazhari |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396795530 PECOS PAC ID: 8123072741 Enrollment ID: I20210121002367 |
| Provider Name | Savannah Lynn Keith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467051144 PECOS PAC ID: 1850705948 Enrollment ID: I20210201002528 |
| Provider Name | Mackenzie C Sproule |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376192732 PECOS PAC ID: 7719393412 Enrollment ID: I20210303003243 |
| Provider Name | Nikhil Samtani |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1588083307 PECOS PAC ID: 0941509723 Enrollment ID: I20210324001114 |
| Provider Name | Hannah Julia Carlson |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1699366336 PECOS PAC ID: 0648687301 Enrollment ID: I20210324001622 |
| Provider Name | Dorie Watkins Low |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1700818010 PECOS PAC ID: 8224934443 Enrollment ID: I20210412002451 |
| Provider Name | Mary T Barrett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902983976 PECOS PAC ID: 6002901873 Enrollment ID: I20210423002249 |
| Provider Name | Alexander R. Willis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073878088 PECOS PAC ID: 2567711898 Enrollment ID: I20210427001544 |
| Provider Name | Anthony F. Sibley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417039108 PECOS PAC ID: 1759545114 Enrollment ID: I20210503001849 |
| Provider Name | Garrick Greear |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1164873816 PECOS PAC ID: 7012326424 Enrollment ID: I20210513002939 |
| Provider Name | Margarita Mercado Medina |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790929172 PECOS PAC ID: 7012053754 Enrollment ID: I20210518000754 |
| Provider Name | Cynthia Tucker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366437998 PECOS PAC ID: 2860482122 Enrollment ID: I20210524001183 |
| Provider Name | Katrina Santos Vongsy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831359645 PECOS PAC ID: 4880826320 Enrollment ID: I20210601002626 |
| Provider Name | Rachel Allyson Tangaro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861751794 PECOS PAC ID: 3274846621 Enrollment ID: I20210621002665 |
| Provider Name | Kirsten Ann Carlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366955676 PECOS PAC ID: 4981008083 Enrollment ID: I20210811004158 |
| Provider Name | Meris F Lehecka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407480072 PECOS PAC ID: 7315341344 Enrollment ID: I20210812001085 |
| Provider Name | Jammie E Menetrey |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396951943 PECOS PAC ID: 9436322385 Enrollment ID: I20210817003648 |
| Provider Name | Samit K. Datta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1902217888 PECOS PAC ID: 7911329040 Enrollment ID: I20210823002658 |
| Provider Name | Matthew N Rosner |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1497118996 PECOS PAC ID: 0042615361 Enrollment ID: I20210825002193 |
| Provider Name | Joseph Ottolenghi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912438185 PECOS PAC ID: 8729323662 Enrollment ID: I20210831000040 |
| Provider Name | Alden Bradley Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629569231 PECOS PAC ID: 7214288901 Enrollment ID: I20210910002301 |
| Provider Name | Olga O Yudich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134742851 PECOS PAC ID: 5890191134 Enrollment ID: I20210910002488 |
| Provider Name | Jennifer D Lawrence |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003295817 PECOS PAC ID: 9830470145 Enrollment ID: I20210914001009 |
| Provider Name | Jacklyn Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376030031 PECOS PAC ID: 8325395759 Enrollment ID: I20210916001248 |
| Provider Name | Nichole Brianne Loree Baruth |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558897694 PECOS PAC ID: 7810394806 Enrollment ID: I20210917000241 |
| Provider Name | Devon R Kienzle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003313222 PECOS PAC ID: 8022362664 Enrollment ID: I20210923001379 |
| Provider Name | Michael Salama |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1518306281 PECOS PAC ID: 6901192319 Enrollment ID: I20210924002757 |
| Provider Name | Shelley Rene Brencick Higman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982191052 PECOS PAC ID: 9234483876 Enrollment ID: I20210924002774 |
| Provider Name | Jared P Lambert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932693512 PECOS PAC ID: 5991037855 Enrollment ID: I20210929003377 |
| Provider Name | Katy S Konkle |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467749978 PECOS PAC ID: 2163730417 Enrollment ID: I20210929003683 |
| Provider Name | Ruthie May U Chua |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1215208970 PECOS PAC ID: 6800108333 Enrollment ID: I20210930000704 |
| Provider Name | Michael T. Barton |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1598119737 PECOS PAC ID: 1557653433 Enrollment ID: I20211005003209 |
| Provider Name | Daniel E Leifer |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1982036141 PECOS PAC ID: 8820343718 Enrollment ID: I20211018001141 |
| Provider Name | Jimmy A Thomas |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1518288893 PECOS PAC ID: 0840503389 Enrollment ID: I20211020001626 |
| Provider Name | Emir Barbaros Safak Guven |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1366493181 PECOS PAC ID: 9133113582 Enrollment ID: I20211020001672 |
| Provider Name | Stephanie Louise Wahlgren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821764572 PECOS PAC ID: 2264820737 Enrollment ID: I20211102003408 |
| Provider Name | Xue Zeng |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558725507 PECOS PAC ID: 5092104141 Enrollment ID: I20211111002355 |
| Provider Name | Chihua Lee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1437544137 PECOS PAC ID: 8628349628 Enrollment ID: I20211221002754 |
| Provider Name | Rebekah Joy Clogston |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699235358 PECOS PAC ID: 5092106807 Enrollment ID: I20220104002697 |
| Provider Name | Kamalneel Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124594015 PECOS PAC ID: 1951640630 Enrollment ID: I20220121001481 |
| Provider Name | Smith M Meads |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124461561 PECOS PAC ID: 0345596664 Enrollment ID: I20220125001687 |
| Provider Name | Kelsey Rae Hamilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245908748 PECOS PAC ID: 6507258514 Enrollment ID: I20220125003084 |
| Provider Name | Ralph Narinedhat |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922248400 PECOS PAC ID: 7517003627 Enrollment ID: I20220209000524 |
| Provider Name | Joan Carol Pfeiffer |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1376788208 PECOS PAC ID: 4880087105 Enrollment ID: I20220209002422 |
| Provider Name | Madeline Grace Harris |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1952925729 PECOS PAC ID: 9335567866 Enrollment ID: I20220309001542 |
| Provider Name | Bjorn Sauerwein |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1457443251 PECOS PAC ID: 6608877733 Enrollment ID: I20220405001656 |
| Provider Name | Michael Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346627841 PECOS PAC ID: 5092069351 Enrollment ID: I20220422000464 |
| Provider Name | Nathan Tolley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1235666389 PECOS PAC ID: 5799163341 Enrollment ID: I20220609002513 |
| Provider Name | Martin R Curlik |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1255376166 PECOS PAC ID: 5193776722 Enrollment ID: I20220622002432 |
| Provider Name | Bob Ly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659781516 PECOS PAC ID: 9335368133 Enrollment ID: I20220630000274 |
| Provider Name | Kassi Michelle Sefton |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1720559552 PECOS PAC ID: 2860874229 Enrollment ID: I20220801002991 |
| Provider Name | Furqan M Taher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841853967 PECOS PAC ID: 5799013314 Enrollment ID: I20220824000866 |
| Provider Name | Allie W Coulter |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1710410097 PECOS PAC ID: 3971876095 Enrollment ID: I20220825002427 |
| Provider Name | Allan M Damian |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1033405386 PECOS PAC ID: 7113147307 Enrollment ID: I20220831001509 |
| Provider Name | Grace Bay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215428420 PECOS PAC ID: 1658755277 Enrollment ID: I20220831002266 |
| Provider Name | Brett M Hall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669816906 PECOS PAC ID: 7618269291 Enrollment ID: I20220913003588 |
| Provider Name | Elijah Kamermans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033672571 PECOS PAC ID: 2062897820 Enrollment ID: I20220914001463 |
| Provider Name | Chelsea Nicole Holman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902492630 PECOS PAC ID: 9537545876 Enrollment ID: I20221010002796 |
| Provider Name | Matthew Aaron Anderson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316406473 PECOS PAC ID: 7113393778 Enrollment ID: I20221021002515 |
| Provider Name | Thea Jerusha Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316685100 PECOS PAC ID: 2567839566 Enrollment ID: I20221103002980 |
| Provider Name | Emily E Kunz-brockman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407419542 PECOS PAC ID: 3173850831 Enrollment ID: I20221107001382 |
| Provider Name | Edward G Prevatt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184019325 PECOS PAC ID: 9133596703 Enrollment ID: I20221110002449 |
| Provider Name | Collin B Hafen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770146623 PECOS PAC ID: 9436489077 Enrollment ID: I20221122003562 |
| Provider Name | Mark Mcgrath |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003478033 PECOS PAC ID: 9133451453 Enrollment ID: I20221209000305 |
| Provider Name | Rehman Ukani |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1700272564 PECOS PAC ID: 9133422520 Enrollment ID: I20221230001280 |
| Provider Name | Dana Marie Fuqua |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659949626 PECOS PAC ID: 6800267097 Enrollment ID: I20230126001287 |
| Provider Name | Richard Dylan Morris |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528484417 PECOS PAC ID: 2365867710 Enrollment ID: I20230221002855 |
| Provider Name | Emily H Shin |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1831350768 PECOS PAC ID: 5193906998 Enrollment ID: I20230323001696 |
| Provider Name | Cherry Rose Vilar Santos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598023921 PECOS PAC ID: 5698130334 Enrollment ID: I20230502000708 |
| Provider Name | Ryan C Myers |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932510468 PECOS PAC ID: 3375916778 Enrollment ID: I20230622001150 |
| Provider Name | Maxwell Patrick Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851904817 PECOS PAC ID: 6103286018 Enrollment ID: I20230724001475 |
| Provider Name | Anna N Tveite |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1871285460 PECOS PAC ID: 3971964024 Enrollment ID: I20230804002637 |
| Provider Name | Mana Dissadee |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1720390206 PECOS PAC ID: 2466727037 Enrollment ID: I20230816001806 |
| Provider Name | Jordan James Kramer |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1104302447 PECOS PAC ID: 4880057116 Enrollment ID: I20230901003163 |
| Provider Name | Michael B Mullen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174029078 PECOS PAC ID: 8123358090 Enrollment ID: I20230907002470 |
| Provider Name | Gang K Zhang |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447238373 PECOS PAC ID: 5092737288 Enrollment ID: I20230913002852 |
| Provider Name | Michael A Marchetti |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1003084591 PECOS PAC ID: 8820215346 Enrollment ID: I20230914002682 |
| Provider Name | Kathleen Gayle De Asis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740819895 PECOS PAC ID: 8527422047 Enrollment ID: I20230915001557 |
| Provider Name | Jill Kristine Hilden |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316574692 PECOS PAC ID: 8820452261 Enrollment ID: I20230918003446 |
| Provider Name | Jivatesh Singh Tung |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215432521 PECOS PAC ID: 8628325230 Enrollment ID: I20230927001630 |
| Provider Name | Kara Joan Hawker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043991219 PECOS PAC ID: 1254785926 Enrollment ID: I20230928002786 |
| Provider Name | Kelsey Rae Chambers |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1124595855 PECOS PAC ID: 9739534991 Enrollment ID: I20231009003055 |
| Provider Name | Dallas Thompson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447259767 PECOS PAC ID: 4082789920 Enrollment ID: I20231010002767 |
| Provider Name | Autumn M Walker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285299321 PECOS PAC ID: 1153659529 Enrollment ID: I20231011002124 |
| Provider Name | Rhett A Bushman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861029829 PECOS PAC ID: 1658784491 Enrollment ID: I20231024002577 |
| Provider Name | Kathryn Ann Delbello |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588220081 PECOS PAC ID: 5294181376 Enrollment ID: I20231025002708 |
| Provider Name | Grace Caroline W Kamano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528845823 PECOS PAC ID: 1557719754 Enrollment ID: I20231129000683 |
| Provider Name | Courtney L Robbins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396427837 PECOS PAC ID: 5890144299 Enrollment ID: I20231211002575 |
| Provider Name | Fedor Vyacheslavovich Torchilo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053096693 PECOS PAC ID: 3375993744 Enrollment ID: I20231227001732 |
| Provider Name | Catherine R Lynch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245868421 PECOS PAC ID: 0941623367 Enrollment ID: I20240118000857 |
| Provider Name | Silvia E Mancebo |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1366836629 PECOS PAC ID: 3375878242 Enrollment ID: I20240215003840 |
| Provider Name | John M White |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1689601379 PECOS PAC ID: 0446219828 Enrollment ID: I20240229004270 |
| Provider Name | Ayah Oglat |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548644149 PECOS PAC ID: 0941538334 Enrollment ID: I20240313002104 |
Sea Mar Chc Mt Vernon Sud - College Way Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 E College Way, Mount Vernon, WA 98273 Phone: 360-428-8912 Fax: 360-424-6288 | |
Sea Mar Community Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 N 18th St Ste A, Mount Vernon, WA 98273 Phone: 360-588-5570 Fax: 360-588-5562 | |
Flexi-care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 E College Way, Mount Vernon, WA 98273 Phone: 360-770-2687 Fax: 855-450-1005 | |
Palliative Care Of The Northwest Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 227 Freeway Dr, Suite A, Mount Vernon, WA 98273 Phone: 360-814-5550 Fax: 360-814-5591 | |
Valley Roots Family Care Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 617 W. Division St., Mount Vernon, WA 98273 Phone: 360-428-1884 Fax: 360-428-1889 | |
Skagit Valley Medical Center Inc, Ps Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1400 E Kincaid St, Mount Vernon, WA 98274 Phone: 360-428-2500 Fax: 360-428-6485 |