| Corewell Health Grand Rapids Hospitals Professional | |
|
100 Michigan St Ne Mc-907 Grand Rapids MI 49503-2560 | |
| (616) 774-7377 | |
| Not Available |
| Full Name | Corewell Health Grand Rapids Hospitals Professional |
|---|---|
| Speciality | Hospitalist |
| Location | 100 Michigan St Ne, Grand Rapids, Michigan |
| Authorized Official Name and Position | Elisabeth D Lacey (MANAGER) |
| Authorized Official Contact | 6164866790 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Corewell Health Grand Rapids Hospitals Professional Po Box 2127 Grand Rapids MI 49501-2127 Ph: () - | Corewell Health Grand Rapids Hospitals Professional 100 Michigan St Ne Mc-907 Grand Rapids MI 49503-2560 Ph: (616) 774-7377 |
| NPI Number | 1558407189 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 10/30/2023 |
| Medicare PECOS PAC ID | 8921904764 |
|---|---|
| Medicare Enrollment ID | O20040120000997 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558407189 | NPI | - | NPPES |
| Provider Name | Mary Elyse Veach |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1992771398 PECOS PAC ID: 2961300603 Enrollment ID: I20031219000763 |
| Provider Name | Marianne K Melnik |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1629142658 PECOS PAC ID: 4789585845 Enrollment ID: I20040120000924 |
| Provider Name | Randy F Lovell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1245345503 PECOS PAC ID: 1850293259 Enrollment ID: I20040126000343 |
| Provider Name | Ronald D Ford |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1558310912 PECOS PAC ID: 2567364870 Enrollment ID: I20040126000479 |
| Provider Name | Bernard H Eisenga |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407820590 PECOS PAC ID: 8820989478 Enrollment ID: I20040323000683 |
| Provider Name | Robert P Roberts |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093823528 PECOS PAC ID: 5890687941 Enrollment ID: I20040325000825 |
| Provider Name | James B Fahner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245201383 PECOS PAC ID: 9931196557 Enrollment ID: I20040427000590 |
| Provider Name | Benjamin P Rechner |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1215995428 PECOS PAC ID: 5890782080 Enrollment ID: I20040429000152 |
| Provider Name | Irene E Franowicz |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1508027830 PECOS PAC ID: 8820087638 Enrollment ID: I20040507000689 |
| Provider Name | Melinda E Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821088220 PECOS PAC ID: 9234110875 Enrollment ID: I20040528000258 |
| Provider Name | David E Scheeres |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1225102254 PECOS PAC ID: 3971587429 Enrollment ID: I20040616000280 |
| Provider Name | Matthew L Marvin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679514731 PECOS PAC ID: 3274503255 Enrollment ID: I20040728000035 |
| Provider Name | John Mogor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518932839 PECOS PAC ID: 7618944158 Enrollment ID: I20040914000419 |
| Provider Name | Stacie L Griemsman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417945288 PECOS PAC ID: 2860469368 Enrollment ID: I20040914000800 |
| Provider Name | Jeffrey Christopher Gawel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821039470 PECOS PAC ID: 3870560006 Enrollment ID: I20040915001179 |
| Provider Name | Jessica J Lalley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265488399 PECOS PAC ID: 5890762934 Enrollment ID: I20040916000782 |
| Provider Name | Stephen J Macedo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841294477 PECOS PAC ID: 6406824333 Enrollment ID: I20040920000305 |
| Provider Name | Rima Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841267804 PECOS PAC ID: 0840253886 Enrollment ID: I20041110000467 |
| Provider Name | Steven C Naum |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1326030255 PECOS PAC ID: 9830080001 Enrollment ID: I20041124000192 |
| Provider Name | Joel F Van De Riet |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255372306 PECOS PAC ID: 9830155951 Enrollment ID: I20041209000489 |
| Provider Name | Glenn M Vanotteren |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1700826880 PECOS PAC ID: 0446155071 Enrollment ID: I20041229000808 |
| Provider Name | Marguerite Aitken |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1982609095 PECOS PAC ID: 0840249710 Enrollment ID: I20050118000701 |
| Provider Name | Stacy L Mccarron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649213133 PECOS PAC ID: 6002866498 Enrollment ID: I20050124000769 |
| Provider Name | Neal D Hillman |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1073583126 PECOS PAC ID: 9436109493 Enrollment ID: I20050127000167 |
| Provider Name | Andrew John Livingston |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1689624017 PECOS PAC ID: 4688629587 Enrollment ID: I20050314000731 |
| Provider Name | Mathew Hwayup Chung |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1386685592 PECOS PAC ID: 6709828437 Enrollment ID: I20050524000266 |
| Provider Name | Kim G Lee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1861587602 PECOS PAC ID: 6305872631 Enrollment ID: I20050721000138 |
| Provider Name | Jeffrey R Schneider |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366537177 PECOS PAC ID: 1951337286 Enrollment ID: I20050721000379 |
| Provider Name | Michael Rf Jabara |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306833462 PECOS PAC ID: 4981663473 Enrollment ID: I20050803000680 |
| Provider Name | Kristin Suzanne Oldenberg |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346293362 PECOS PAC ID: 1658304084 Enrollment ID: I20050915000480 |
| Provider Name | Calvin E Leazenby |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588668248 PECOS PAC ID: 5799719100 Enrollment ID: I20050926000119 |
| Provider Name | Mithilesh J Mishra |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1710977723 PECOS PAC ID: 5496774259 Enrollment ID: I20051122000289 |
| Provider Name | John D Renucci |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1487659827 PECOS PAC ID: 2567481328 Enrollment ID: I20051122000305 |
| Provider Name | Dennis Clyde Hammond |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1508808536 PECOS PAC ID: 6002899101 Enrollment ID: I20060117000941 |
| Provider Name | James L Loker |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255311692 PECOS PAC ID: 6103832159 Enrollment ID: I20060228000405 |
| Provider Name | Leigh G Seamon |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1821147422 PECOS PAC ID: 8123035789 Enrollment ID: I20060307000773 |
| Provider Name | Anas Aljanadi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1790727360 PECOS PAC ID: 3577572171 Enrollment ID: I20060410000509 |
| Provider Name | Jeanne Evelyn Cheshier Alvarado |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942365069 PECOS PAC ID: 1052321833 Enrollment ID: I20060424000338 |
| Provider Name | Elizabeth A Pierson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972550952 PECOS PAC ID: 7012928229 Enrollment ID: I20060531000104 |
| Provider Name | Robert C Mackinder |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124022660 PECOS PAC ID: 2567466543 Enrollment ID: I20060905000545 |
| Provider Name | Sejal P Bennett |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508881616 PECOS PAC ID: 9931103736 Enrollment ID: I20060911000195 |
| Provider Name | Sohail Qadir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649247032 PECOS PAC ID: 4284638909 Enrollment ID: I20060911000458 |
| Provider Name | Duane C Berkompas |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1174521116 PECOS PAC ID: 0446162168 Enrollment ID: I20060926000338 |
| Provider Name | Allison A Bannick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821103441 PECOS PAC ID: 4688679699 Enrollment ID: I20060926000397 |
| Provider Name | Jennifer L Pals |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386699692 PECOS PAC ID: 2062410731 Enrollment ID: I20061114000193 |
| Provider Name | Heather L Sypien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730217407 PECOS PAC ID: 3779688056 Enrollment ID: I20070416000060 |
| Provider Name | Darcy Lynne Jaarsma |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1275654303 PECOS PAC ID: 5799882072 Enrollment ID: I20070522000059 |
| Provider Name | Kirsten Ann Kramer |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1568583508 PECOS PAC ID: 9335247113 Enrollment ID: I20070601000013 |
| Provider Name | Eric J Wielhouwer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790819449 PECOS PAC ID: 7517066392 Enrollment ID: I20070619000585 |
| Provider Name | Benjamin R Schipper |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750415238 PECOS PAC ID: 2668571134 Enrollment ID: I20070625000229 |
| Provider Name | Lara A Freeburger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821102013 PECOS PAC ID: 0345341244 Enrollment ID: I20070723000241 |
| Provider Name | William M Merhi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386786044 PECOS PAC ID: 7214038124 Enrollment ID: I20070723000287 |
| Provider Name | Rebecca Caldwell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396768032 PECOS PAC ID: 7416960893 Enrollment ID: I20070913000842 |
| Provider Name | Elizabeth A Leary |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437199411 PECOS PAC ID: 0648365999 Enrollment ID: I20071001000751 |
| Provider Name | Lana K Gagin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669693487 PECOS PAC ID: 6305931353 Enrollment ID: I20071005000024 |
| Provider Name | Daniel L Wallace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275525875 PECOS PAC ID: 5496841561 Enrollment ID: I20071019000640 |
| Provider Name | Mohamad A El Kurdi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851518682 PECOS PAC ID: 2264529817 Enrollment ID: I20071030000473 |
| Provider Name | Peter B Lundeen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467513234 PECOS PAC ID: 1850369927 Enrollment ID: I20071109000554 |
| Provider Name | Karl C Roberts |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508827049 PECOS PAC ID: 8123118098 Enrollment ID: I20071214000645 |
| Provider Name | Patrick Zietz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1750396412 PECOS PAC ID: 7113013616 Enrollment ID: I20071214000665 |
| Provider Name | Sarah K Depas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518020395 PECOS PAC ID: 9133116577 Enrollment ID: I20080116000589 |
| Provider Name | Linda J Morris Mccoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639354152 PECOS PAC ID: 5395822142 Enrollment ID: I20080404000136 |
| Provider Name | Renee M Bates |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1174547053 PECOS PAC ID: 8729166814 Enrollment ID: I20080415000187 |
| Provider Name | Mark W Armstrong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932104882 PECOS PAC ID: 1658336326 Enrollment ID: I20080529000791 |
| Provider Name | Kenneth D Minks |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235129875 PECOS PAC ID: 5890751556 Enrollment ID: I20080620000096 |
| Provider Name | Amy Lynn Manley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730296609 PECOS PAC ID: 4486726155 Enrollment ID: I20080712000148 |
| Provider Name | David R Alfonso |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1093930190 PECOS PAC ID: 1951402809 Enrollment ID: I20080728000358 |
| Provider Name | Gustavo A Moretta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750566709 PECOS PAC ID: 9931274586 Enrollment ID: I20080818000321 |
| Provider Name | Michael Thomas Stout |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447372750 PECOS PAC ID: 2062595903 Enrollment ID: I20080829000359 |
| Provider Name | Cara M Rasmussen |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1629142856 PECOS PAC ID: 9133297302 Enrollment ID: I20081001000703 |
| Provider Name | Richard M Wilcox |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578658365 PECOS PAC ID: 9537162508 Enrollment ID: I20081008000304 |
| Provider Name | Allison P Tran |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1952551178 PECOS PAC ID: 2062574254 Enrollment ID: I20081223000090 |
| Provider Name | Julie A Ondersma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538312889 PECOS PAC ID: 2365504594 Enrollment ID: I20081223000436 |
| Provider Name | Maryanne George |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1811972730 PECOS PAC ID: 8628127123 Enrollment ID: I20090512000336 |
| Provider Name | David M Stone |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770522245 PECOS PAC ID: 8123177953 Enrollment ID: I20090527000186 |
| Provider Name | John M Dysart |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265425177 PECOS PAC ID: 2466501200 Enrollment ID: I20090527000223 |
| Provider Name | Jeffry D Knibbe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700825296 PECOS PAC ID: 6901958529 Enrollment ID: I20090713000462 |
| Provider Name | Amy Bishop |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568681377 PECOS PAC ID: 1456405216 Enrollment ID: I20090813000747 |
| Provider Name | Ewa D Komorowska Timek |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1710996319 PECOS PAC ID: 2062416134 Enrollment ID: I20090826000428 |
| Provider Name | Michelle A Backus Walzer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124011531 PECOS PAC ID: 9234106642 Enrollment ID: I20090826000635 |
| Provider Name | Sharon H Smith |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1083659031 PECOS PAC ID: 6608875851 Enrollment ID: I20090924000285 |
| Provider Name | Kenneth C Hanson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295734135 PECOS PAC ID: 4284641259 Enrollment ID: I20091016000150 |
| Provider Name | Beth A Kurt |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700051679 PECOS PAC ID: 1658410121 Enrollment ID: I20091124000060 |
| Provider Name | Ulrich A Duffner |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1235342569 PECOS PAC ID: 8527107796 Enrollment ID: I20091201000221 |
| Provider Name | Lawrence G Foe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689678401 PECOS PAC ID: 6608917166 Enrollment ID: I20100105000736 |
| Provider Name | Richard Hodgson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932108354 PECOS PAC ID: 4587705041 Enrollment ID: I20100105000765 |
| Provider Name | Carlos E Tavera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942277348 PECOS PAC ID: 9032250592 Enrollment ID: I20100105000771 |
| Provider Name | Marcy L Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366770505 PECOS PAC ID: 5092857953 Enrollment ID: I20100115000404 |
| Provider Name | Josip Divic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770587305 PECOS PAC ID: 8527100304 Enrollment ID: I20100115000628 |
| Provider Name | Barbara F Bradley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912960493 PECOS PAC ID: 6608918495 Enrollment ID: I20100115000744 |
| Provider Name | Andrea E Van Pelt |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1285756148 PECOS PAC ID: 4082749965 Enrollment ID: I20100317000434 |
| Provider Name | Melanie A Burghgraef |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457398208 PECOS PAC ID: 4284769936 Enrollment ID: I20100319000084 |
| Provider Name | Kimberly A Texley-quigg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053552117 PECOS PAC ID: 1052448628 Enrollment ID: I20100430000106 |
| Provider Name | Sarah Roseanne Skavnak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548585367 PECOS PAC ID: 6608904537 Enrollment ID: I20100513000235 |
| Provider Name | Lee P Begrow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528062155 PECOS PAC ID: 1052440732 Enrollment ID: I20100519000498 |
| Provider Name | Natasha D Dehaan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295051209 PECOS PAC ID: 3375672579 Enrollment ID: I20100526000898 |
| Provider Name | Adam G Edlund |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073550216 PECOS PAC ID: 2961531025 Enrollment ID: I20100527000603 |
| Provider Name | Vidyulatha Talla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528005899 PECOS PAC ID: 4688703614 Enrollment ID: I20100528000601 |
| Provider Name | Mary M Dagen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831341130 PECOS PAC ID: 3274666201 Enrollment ID: I20100728000456 |
| Provider Name | John Charles Heiser |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1174596639 PECOS PAC ID: 3476538109 Enrollment ID: I20100813000440 |
| Provider Name | Julie J Sommerfield Ronek |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902955214 PECOS PAC ID: 5597899237 Enrollment ID: I20100817000152 |
| Provider Name | Kira R Sieplinga |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235346198 PECOS PAC ID: 0840366647 Enrollment ID: I20100817000311 |
| Provider Name | Deanna S Mitchell |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1649241548 PECOS PAC ID: 8820122146 Enrollment ID: I20100820001132 |
| Provider Name | Harland T Holman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922049022 PECOS PAC ID: 5799714952 Enrollment ID: I20100903000499 |
| Provider Name | Cheryl J Kuz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447230107 PECOS PAC ID: 1951426691 Enrollment ID: I20100917000460 |
| Provider Name | Richard A Axtell |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1932170065 PECOS PAC ID: 3072705193 Enrollment ID: I20101007001134 |
| Provider Name | Anacleto B Diaz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922241942 PECOS PAC ID: 4981896511 Enrollment ID: I20101014000180 |
| Provider Name | Karen S Vanderlaan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447230891 PECOS PAC ID: 2062605603 Enrollment ID: I20101015000183 |
| Provider Name | William B Stratbucker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003883281 PECOS PAC ID: 3678766144 Enrollment ID: I20101018000636 |
| Provider Name | Paul Mark |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831137629 PECOS PAC ID: 9931205762 Enrollment ID: I20101111001066 |
| Provider Name | Brenda J Hoffner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710299532 PECOS PAC ID: 7517155757 Enrollment ID: I20110103000669 |
| Provider Name | Phillip R Paras |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003016064 PECOS PAC ID: 7810186699 Enrollment ID: I20110110000344 |
| Provider Name | Jeri W Kessenich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386624633 PECOS PAC ID: 6406037241 Enrollment ID: I20110225000833 |
| Provider Name | Amy J Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336463785 PECOS PAC ID: 7416130554 Enrollment ID: I20110325000814 |
| Provider Name | Justin Fanning |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1700908522 PECOS PAC ID: 5092814798 Enrollment ID: I20110513000586 |
| Provider Name | Lisa L Hovingh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316248735 PECOS PAC ID: 3577749878 Enrollment ID: I20110523000334 |
| Provider Name | Giselle L Saulnier- Sholler |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1275640872 PECOS PAC ID: 3678503349 Enrollment ID: I20110623000636 |
| Provider Name | Julie Grech |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861798878 PECOS PAC ID: 9335327881 Enrollment ID: I20110701000361 |
| Provider Name | Kavitha Golipelly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740586999 PECOS PAC ID: 5496923906 Enrollment ID: I20110727000206 |
| Provider Name | Alejandro Quiroga Chand |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1508165630 PECOS PAC ID: 3577732205 Enrollment ID: I20110812000627 |
| Provider Name | Christopher B Willoughby |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1902007453 PECOS PAC ID: 9739238064 Enrollment ID: I20110829000226 |
| Provider Name | Drue M Orwig |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144497686 PECOS PAC ID: 5991976268 Enrollment ID: I20110916000101 |
| Provider Name | Aaron W Ziegler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194700963 PECOS PAC ID: 7012188980 Enrollment ID: I20110926000533 |
| Provider Name | Cara A Poland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184890642 PECOS PAC ID: 5294908612 Enrollment ID: I20111101000066 |
| Provider Name | Heather A Sowinski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700036274 PECOS PAC ID: 0648446302 Enrollment ID: I20111229000621 |
| Provider Name | Erin E Broene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134496342 PECOS PAC ID: 0840467874 Enrollment ID: I20120116000078 |
| Provider Name | Albert S Cornelius |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1417927781 PECOS PAC ID: 3476720004 Enrollment ID: I20120121000120 |
| Provider Name | Tate Gregaitis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881971216 PECOS PAC ID: 1153580998 Enrollment ID: I20120314000095 |
| Provider Name | Kelly A Conley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013294222 PECOS PAC ID: 8628238268 Enrollment ID: I20120320000156 |
| Provider Name | Catina E Painter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558638056 PECOS PAC ID: 0648430355 Enrollment ID: I20120404000214 |
| Provider Name | Carlos H Rodriguez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700971546 PECOS PAC ID: 3072516046 Enrollment ID: I20120410000405 |
| Provider Name | Jayne Elizabeth Paulson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144315920 PECOS PAC ID: 6507021540 Enrollment ID: I20120626000268 |
| Provider Name | Chad Matthew Coe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255595807 PECOS PAC ID: 4082879887 Enrollment ID: I20120628000605 |
| Provider Name | Kania G Mcghee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1801058912 PECOS PAC ID: 9931355237 Enrollment ID: I20120801000700 |
| Provider Name | Andrea M Wolf |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508078544 PECOS PAC ID: 5092961268 Enrollment ID: I20120804000083 |
| Provider Name | Viet H Do |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1023235884 PECOS PAC ID: 8820244817 Enrollment ID: I20120807000472 |
| Provider Name | Lora Z Silverman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023214822 PECOS PAC ID: 4587810403 Enrollment ID: I20120809000016 |
| Provider Name | Ericka L Vander Sys |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1295013571 PECOS PAC ID: 6608022439 Enrollment ID: I20120810000430 |
| Provider Name | Marcus P Haw |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1205197639 PECOS PAC ID: 7113173659 Enrollment ID: I20120815000793 |
| Provider Name | Vivian C Romero Romero |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245432368 PECOS PAC ID: 7719135011 Enrollment ID: I20120911000619 |
| Provider Name | Margaret Hermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497010615 PECOS PAC ID: 3678722030 Enrollment ID: I20121001000199 |
| Provider Name | Nancy Renn |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1275668774 PECOS PAC ID: 7214188044 Enrollment ID: I20121103000112 |
| Provider Name | Bradd G Hemker |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1366632408 PECOS PAC ID: 5799953865 Enrollment ID: I20121106000248 |
| Provider Name | Khushpal Kaur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386994234 PECOS PAC ID: 4385896125 Enrollment ID: I20121130000439 |
| Provider Name | Jessica M Guiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326392176 PECOS PAC ID: 6103079728 Enrollment ID: I20130110000315 |
| Provider Name | Melinda K Miller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437393535 PECOS PAC ID: 0941441794 Enrollment ID: I20130722000121 |
| Provider Name | Hanna C Jaworski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588878631 PECOS PAC ID: 3375739907 Enrollment ID: I20130724000047 |
| Provider Name | William P Mckeown |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962798835 PECOS PAC ID: 5597907535 Enrollment ID: I20130805000292 |
| Provider Name | Victor Fayad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164654604 PECOS PAC ID: 0749422368 Enrollment ID: I20130812000383 |
| Provider Name | Abeba M Berhane |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033436761 PECOS PAC ID: 8022251024 Enrollment ID: I20130823000226 |
| Provider Name | Katherine Ellen Kowalczyk |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295997633 PECOS PAC ID: 8224271994 Enrollment ID: I20130828000132 |
| Provider Name | Nisha S Bertucci |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215170766 PECOS PAC ID: 1658522123 Enrollment ID: I20131008001565 |
| Provider Name | Luke T Durling |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356544514 PECOS PAC ID: 5193974095 Enrollment ID: I20131028001803 |
| Provider Name | Amanda Yang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154576098 PECOS PAC ID: 2567615438 Enrollment ID: I20131029000829 |
| Provider Name | Matthew Pridgeon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255642732 PECOS PAC ID: 8224263108 Enrollment ID: I20131031000083 |
| Provider Name | Megan E Warner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376978700 PECOS PAC ID: 8921234105 Enrollment ID: I20131118000612 |
| Provider Name | David J Sterken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578997680 PECOS PAC ID: 0941436158 Enrollment ID: I20131118001147 |
| Provider Name | Timothy Allen Sparling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124451927 PECOS PAC ID: 9830325919 Enrollment ID: I20131119001653 |
| Provider Name | Steven G Moser |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831396449 PECOS PAC ID: 2860660214 Enrollment ID: I20131126000321 |
| Provider Name | Courtney A Lane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720410400 PECOS PAC ID: 8729215009 Enrollment ID: I20131211001542 |
| Provider Name | Judy Lynn Smith |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1154302172 PECOS PAC ID: 4789596255 Enrollment ID: I20131227001821 |
| Provider Name | Christopher Ratnasamy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043411721 PECOS PAC ID: 7315039302 Enrollment ID: I20140107001260 |
| Provider Name | Rebecca M Grabill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1942637715 PECOS PAC ID: 5597993873 Enrollment ID: I20140113000945 |
| Provider Name | Michael R Hojnacki |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1609062967 PECOS PAC ID: 3779660501 Enrollment ID: I20140121002051 |
| Provider Name | Amy R Spencer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043489842 PECOS PAC ID: 7113155953 Enrollment ID: I20140124000457 |
| Provider Name | Elizabeth A Steensma |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174681316 PECOS PAC ID: 5890925564 Enrollment ID: I20140224002015 |
| Provider Name | Sarah Nicole Vandermolen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720400898 PECOS PAC ID: 3072743608 Enrollment ID: I20140227001654 |
| Provider Name | Hayley M Bee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154743466 PECOS PAC ID: 6709017593 Enrollment ID: I20140319001829 |
| Provider Name | Caleb Bupp |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1841432713 PECOS PAC ID: 6103059647 Enrollment ID: I20140507001339 |
| Provider Name | Jessica M Foley |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1457554271 PECOS PAC ID: 6800019027 Enrollment ID: I20140515001369 |
| Provider Name | John A Girotto |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1417984162 PECOS PAC ID: 0143211102 Enrollment ID: I20140519000481 |
| Provider Name | Natasha Peoples |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356757173 PECOS PAC ID: 8022234988 Enrollment ID: I20140729002558 |
| Provider Name | Matthew D Martin |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1912169095 PECOS PAC ID: 9032335823 Enrollment ID: I20140731001493 |
| Provider Name | Lindsay Snyder |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528274099 PECOS PAC ID: 0941369813 Enrollment ID: I20140813002513 |
| Provider Name | Alison Margaret Mastin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821407750 PECOS PAC ID: 4284852948 Enrollment ID: I20140822000252 |
| Provider Name | Alexander Stoffan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558578823 PECOS PAC ID: 3375761745 Enrollment ID: I20140826002291 |
| Provider Name | Robin S O Meara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821021551 PECOS PAC ID: 9931160876 Enrollment ID: I20140828001785 |
| Provider Name | Cathryn L Chadwick |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003945908 PECOS PAC ID: 8123175148 Enrollment ID: I20140925000177 |
| Provider Name | Arida Siripong |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1386807782 PECOS PAC ID: 8628292471 Enrollment ID: I20141029002647 |
| Provider Name | Courtney Hilbert |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1033134846 PECOS PAC ID: 7315943107 Enrollment ID: I20141205001795 |
| Provider Name | Kimberly Vanwingen |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518029248 PECOS PAC ID: 6901129261 Enrollment ID: I20141218000917 |
| Provider Name | Patricia Mcgowan |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1124131859 PECOS PAC ID: 7315260460 Enrollment ID: I20141223000221 |
| Provider Name | Emily Quiney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245587906 PECOS PAC ID: 3678896222 Enrollment ID: I20150106002401 |
| Provider Name | Allison J Amidon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356749337 PECOS PAC ID: 8628392800 Enrollment ID: I20150116000517 |
| Provider Name | Yasser Al-khatib |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053311779 PECOS PAC ID: 3971580705 Enrollment ID: I20150129002304 |
| Provider Name | Sarah Elizabeth Kent |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1467850552 PECOS PAC ID: 1759605371 Enrollment ID: I20150130000294 |
| Provider Name | Gerald P Wright |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1700199809 PECOS PAC ID: 5395973101 Enrollment ID: I20150218001021 |
| Provider Name | Meagon Ann Oliver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992103667 PECOS PAC ID: 6800111592 Enrollment ID: I20150223000932 |
| Provider Name | Miranda Hillard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942597729 PECOS PAC ID: 1658698394 Enrollment ID: I20150318000512 |
| Provider Name | William Doanld Clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184987711 PECOS PAC ID: 8426290115 Enrollment ID: I20150609001557 |
| Provider Name | Ashley-ann Storms |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083812952 PECOS PAC ID: 1456663145 Enrollment ID: I20150709001005 |
| Provider Name | Amy Banks-venegoni |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235367715 PECOS PAC ID: 8628207149 Enrollment ID: I20150709001314 |
| Provider Name | Thomas Martin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114169570 PECOS PAC ID: 0941453807 Enrollment ID: I20150710001208 |
| Provider Name | Murwarid Assifi |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1548416563 PECOS PAC ID: 1658550934 Enrollment ID: I20150714000209 |
| Provider Name | Stephanie Downing |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174834055 PECOS PAC ID: 6002039708 Enrollment ID: I20150721000467 |
| Provider Name | Giedrius Baliulis |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1215311220 PECOS PAC ID: 4880908425 Enrollment ID: I20150727002772 |
| Provider Name | David Colombo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164487716 PECOS PAC ID: 0042111072 Enrollment ID: I20150729007057 |
| Provider Name | Christel M Keefe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669616462 PECOS PAC ID: 9638483696 Enrollment ID: I20150804004925 |
| Provider Name | Sandra M Sawicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588687818 PECOS PAC ID: 4688988306 Enrollment ID: I20150807014786 |
| Provider Name | Nicole Bedore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962694752 PECOS PAC ID: 5193960797 Enrollment ID: I20150811005588 |
| Provider Name | Patricia Anne Pentiak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083877120 PECOS PAC ID: 8820229313 Enrollment ID: I20150910002230 |
| Provider Name | Jennifer J Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528367687 PECOS PAC ID: 2466769039 Enrollment ID: I20150915000216 |
| Provider Name | Katrina M Vandebunte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871914952 PECOS PAC ID: 8224260476 Enrollment ID: I20150915001316 |
| Provider Name | Shamelle White |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073869590 PECOS PAC ID: 7416264643 Enrollment ID: I20150921000308 |
| Provider Name | Christina Limke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457720310 PECOS PAC ID: 2668780552 Enrollment ID: I20150925001128 |
| Provider Name | Patrick Joseph Grohar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225175201 PECOS PAC ID: 9032385588 Enrollment ID: I20151112000347 |
| Provider Name | Stephane Leung Wai Sang |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1366859985 PECOS PAC ID: 5698994911 Enrollment ID: I20151222000812 |
| Provider Name | Alicia A Vanderzanden |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1871960922 PECOS PAC ID: 0840593513 Enrollment ID: I20160129001860 |
| Provider Name | Quiana J Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477911865 PECOS PAC ID: 8921305160 Enrollment ID: I20160401001088 |
| Provider Name | Crystal Mae Ritsema |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093958548 PECOS PAC ID: 6002070414 Enrollment ID: I20160503002308 |
| Provider Name | Alistair Jon Chapman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1225266331 PECOS PAC ID: 1052540754 Enrollment ID: I20160606000569 |
| Provider Name | Charles Jerard Gibson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740596402 PECOS PAC ID: 8022247626 Enrollment ID: I20160606000860 |
| Provider Name | Laurie H Seaver |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477661908 PECOS PAC ID: 2860455227 Enrollment ID: I20160620000878 |
| Provider Name | Ryan Conway |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861787475 PECOS PAC ID: 5799927240 Enrollment ID: I20160707000601 |
| Provider Name | Anas Taqatqa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538471230 PECOS PAC ID: 9931491966 Enrollment ID: I20160712000428 |
| Provider Name | Randi Vanocker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396180337 PECOS PAC ID: 3274765490 Enrollment ID: I20160718000230 |
| Provider Name | Kathryn M Driza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740625672 PECOS PAC ID: 2466761309 Enrollment ID: I20160722000281 |
| Provider Name | Gabriel Gallardo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730409178 PECOS PAC ID: 5395038178 Enrollment ID: I20160802000081 |
| Provider Name | Amie Hop |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194014019 PECOS PAC ID: 3476781329 Enrollment ID: I20160808000314 |
| Provider Name | Heather Joy Mcgovern |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902246085 PECOS PAC ID: 3577863208 Enrollment ID: I20160810000367 |
| Provider Name | Kristen V Dib |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1144673070 PECOS PAC ID: 6507151313 Enrollment ID: I20160818000368 |
| Provider Name | Nicole Harpold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881047652 PECOS PAC ID: 4688969405 Enrollment ID: I20160818000769 |
| Provider Name | Casey Madura |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013172949 PECOS PAC ID: 6709009079 Enrollment ID: I20160823001755 |
| Provider Name | Lauren M Snyder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386082683 PECOS PAC ID: 0648567040 Enrollment ID: I20160929000177 |
| Provider Name | Shelley A Meyerholtz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992252795 PECOS PAC ID: 4587952981 Enrollment ID: I20161018002780 |
| Provider Name | Marcos Itamar Cordoba-munoz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003084286 PECOS PAC ID: 8820217003 Enrollment ID: I20161019000698 |
| Provider Name | Elizabeth Parker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720427412 PECOS PAC ID: 9830329531 Enrollment ID: I20161020000542 |
| Provider Name | Laura Neubecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952751778 PECOS PAC ID: 4486933496 Enrollment ID: I20161115002179 |
| Provider Name | Alexandra Bratschie |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669809711 PECOS PAC ID: 6002135514 Enrollment ID: I20161117000712 |
| Provider Name | Amanda R Ezekiel |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1437606670 PECOS PAC ID: 0547540569 Enrollment ID: I20161209000718 |
| Provider Name | Robyn Sackeyfio |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1073799946 PECOS PAC ID: 6002037256 Enrollment ID: I20161214002370 |
| Provider Name | Brian A Trethowan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386188761 PECOS PAC ID: 0345521670 Enrollment ID: I20161229000285 |
| Provider Name | Candie Ritsema |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659815207 PECOS PAC ID: 1153602495 Enrollment ID: I20161229000333 |
| Provider Name | Tami Lynn Pettenger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235676651 PECOS PAC ID: 7113201039 Enrollment ID: I20170221001450 |
| Provider Name | Jamie Albert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629516661 PECOS PAC ID: 3375827066 Enrollment ID: I20170223002317 |
| Provider Name | Aimee Wilson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457765257 PECOS PAC ID: 5890910103 Enrollment ID: I20170505000632 |
| Provider Name | Katheryn E Clark |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1417489931 PECOS PAC ID: 1557648995 Enrollment ID: I20170511002198 |
| Provider Name | Trisha M Bruns |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1568862654 PECOS PAC ID: 9133406416 Enrollment ID: I20170516000886 |
| Provider Name | Ruth E Mulder |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1720325194 PECOS PAC ID: 4688941263 Enrollment ID: I20170602000470 |
| Provider Name | Gayathri Sathiyamoorthy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1831405539 PECOS PAC ID: 0042588444 Enrollment ID: I20170607001395 |
| Provider Name | Michael Tsimis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174840185 PECOS PAC ID: 7315166055 Enrollment ID: I20170621000667 |
| Provider Name | Nicole Ellis Sherwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043747876 PECOS PAC ID: 5799054086 Enrollment ID: I20170629001527 |
| Provider Name | Lauren Elizabeth Rink Deleon |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740728617 PECOS PAC ID: 4688943996 Enrollment ID: I20170629002441 |
| Provider Name | Stanley Sedore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306163092 PECOS PAC ID: 5193011450 Enrollment ID: I20170706001597 |
| Provider Name | Benjamin Brand Davidson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215341458 PECOS PAC ID: 3678884244 Enrollment ID: I20170707000162 |
| Provider Name | Erin Fricke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1003128471 PECOS PAC ID: 6800025503 Enrollment ID: I20170707001772 |
| Provider Name | Justin Triemstra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588002661 PECOS PAC ID: 0648578674 Enrollment ID: I20170707003100 |
| Provider Name | Oliver E Aregullin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275882599 PECOS PAC ID: 4789953688 Enrollment ID: I20170710000752 |
| Provider Name | Leah Renae Vanenk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184036089 PECOS PAC ID: 6002186582 Enrollment ID: I20170717000248 |
| Provider Name | Sihong Huang |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174561484 PECOS PAC ID: 3678622412 Enrollment ID: I20170726001398 |
| Provider Name | Matthew Aaron Falkiewicz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447631411 PECOS PAC ID: 7810200631 Enrollment ID: I20170911001840 |
| Provider Name | Nicholas Blank |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275914244 PECOS PAC ID: 4789997511 Enrollment ID: I20170926002522 |
| Provider Name | Johanna Krebiehl |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1487967733 PECOS PAC ID: 0042449811 Enrollment ID: I20171005000619 |
| Provider Name | Kate Westrate |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528585676 PECOS PAC ID: 2961768247 Enrollment ID: I20171102003109 |
| Provider Name | Anupama R Allington |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164856357 PECOS PAC ID: 3779849328 Enrollment ID: I20171114003225 |
| Provider Name | Michele L Van Soelen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750419297 PECOS PAC ID: 0446517569 Enrollment ID: I20171128002392 |
| Provider Name | Sami Brake |
|---|---|
| Provider Type | Practitioner - Hematopoietic Cell Transplantation And Cellular Therapy |
| Provider Identifiers | NPI Number: 1043416811 PECOS PAC ID: 9830367085 Enrollment ID: I20171212001356 |
| Provider Name | Lisa Michele Thiel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699898940 PECOS PAC ID: 6901057280 Enrollment ID: I20180104000660 |
| Provider Name | Lori Sue Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982110367 PECOS PAC ID: 7517226004 Enrollment ID: I20180108002128 |
| Provider Name | Courtney Dotinga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275048431 PECOS PAC ID: 1254691363 Enrollment ID: I20180212000642 |
| Provider Name | Eryn Hart Dutta |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184808651 PECOS PAC ID: 3072557388 Enrollment ID: I20180222000528 |
| Provider Name | Allison Elizabeth Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912405234 PECOS PAC ID: 8628339934 Enrollment ID: I20180301001945 |
| Provider Name | Lisa Chieko Bishop |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356831903 PECOS PAC ID: 4284999517 Enrollment ID: I20180607000723 |
| Provider Name | Jessica Dempsey |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1629441324 PECOS PAC ID: 1355630419 Enrollment ID: I20180612002507 |
| Provider Name | Lindsey Cortez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578056784 PECOS PAC ID: 8426305715 Enrollment ID: I20180718000301 |
| Provider Name | Anna Kathleen Weller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285006700 PECOS PAC ID: 0840574844 Enrollment ID: I20180718003877 |
| Provider Name | Craig Michael Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568876290 PECOS PAC ID: 1951521897 Enrollment ID: I20180727000487 |
| Provider Name | Chelsea Rae Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174016521 PECOS PAC ID: 7911255633 Enrollment ID: I20180810003076 |
| Provider Name | Anna Marie Rykse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538654835 PECOS PAC ID: 4486902103 Enrollment ID: I20180813000114 |
| Provider Name | Benjamin Nabil Gayed |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205061942 PECOS PAC ID: 0547407496 Enrollment ID: I20180814000932 |
| Provider Name | Tricia Maria Vanderbilt Luke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609354489 PECOS PAC ID: 0042561896 Enrollment ID: I20180918003581 |
| Provider Name | Nafisah Mcclendon |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1548752835 PECOS PAC ID: 9830442821 Enrollment ID: I20181020000818 |
| Provider Name | Clayton Richard Perry |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083927396 PECOS PAC ID: 9830494715 Enrollment ID: I20181213001206 |
| Provider Name | Kelly Ann Levitt |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1750835005 PECOS PAC ID: 3971849571 Enrollment ID: I20190117002056 |
| Provider Name | Kaitlin Derks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649743766 PECOS PAC ID: 5092052563 Enrollment ID: I20190123001017 |
| Provider Name | Ryan K Doyle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164950481 PECOS PAC ID: 8224309174 Enrollment ID: I20190129002182 |
| Provider Name | Carey Sue Groendal |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1306310313 PECOS PAC ID: 1759622137 Enrollment ID: I20190411002642 |
| Provider Name | Laurel Patricia Jessup |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1164776423 PECOS PAC ID: 6800032038 Enrollment ID: I20190516000832 |
| Provider Name | Jess Alan Spradling |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114352309 PECOS PAC ID: 7618281312 Enrollment ID: I20190701000135 |
| Provider Name | Rebecca Marie Loret De Mola |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558515957 PECOS PAC ID: 1759521214 Enrollment ID: I20190701000154 |
| Provider Name | Ashley Marie Veenstra |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801451448 PECOS PAC ID: 2062747223 Enrollment ID: I20190710001027 |
| Provider Name | Daniel Isaac |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1326486416 PECOS PAC ID: 4688805146 Enrollment ID: I20190717000202 |
| Provider Name | Beena Philip |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366006942 PECOS PAC ID: 8123353935 Enrollment ID: I20190717000348 |
| Provider Name | Hope Ann Vivian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053976258 PECOS PAC ID: 8527395144 Enrollment ID: I20190806000118 |
| Provider Name | Allison Gill Close |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1649513672 PECOS PAC ID: 9931436508 Enrollment ID: I20190806002187 |
| Provider Name | Seema Mahdavi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427505890 PECOS PAC ID: 4688901523 Enrollment ID: I20190814003836 |
| Provider Name | Katherine Mills Duram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336700756 PECOS PAC ID: 9537496369 Enrollment ID: I20190815003499 |
| Provider Name | Terri A Zomerlei |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1861530438 PECOS PAC ID: 8022347806 Enrollment ID: I20190903002896 |
| Provider Name | Erica L Spalding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386205912 PECOS PAC ID: 1557690583 Enrollment ID: I20190917000339 |
| Provider Name | Amy Elizabeth Veltkamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144879875 PECOS PAC ID: 5890025183 Enrollment ID: I20190930002679 |
| Provider Name | Brian Wilder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275983835 PECOS PAC ID: 5698107753 Enrollment ID: I20191112002037 |
| Provider Name | Linda Barbara Pauliks |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013903947 PECOS PAC ID: 7618881160 Enrollment ID: I20191126000091 |
| Provider Name | Julie A Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144337882 PECOS PAC ID: 2567632193 Enrollment ID: I20191209000426 |
| Provider Name | Rachel Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285270736 PECOS PAC ID: 1456785633 Enrollment ID: I20191220001280 |
| Provider Name | Heather Ozinga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285270157 PECOS PAC ID: 1951735133 Enrollment ID: I20191220001473 |
| Provider Name | Jill N Boynton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104467083 PECOS PAC ID: 3870929185 Enrollment ID: I20200211002689 |
| Provider Name | Timothy Moss |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1568721850 PECOS PAC ID: 6608026760 Enrollment ID: I20200307000165 |
| Provider Name | Emily A Jandasek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093237356 PECOS PAC ID: 5294164398 Enrollment ID: I20200409003400 |
| Provider Name | Linda Zhong Rossetti |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1427411131 PECOS PAC ID: 5092137422 Enrollment ID: I20200612000201 |
| Provider Name | Adam Fredrick Sawyer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639605389 PECOS PAC ID: 4082943477 Enrollment ID: I20200624002395 |
| Provider Name | Troy Quigg |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1942403720 PECOS PAC ID: 3274798186 Enrollment ID: I20200629000732 |
| Provider Name | Allison Schnepp |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073924510 PECOS PAC ID: 4587088505 Enrollment ID: I20200723002269 |
| Provider Name | John Eric Sisson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548780596 PECOS PAC ID: 1052680808 Enrollment ID: I20200728001705 |
| Provider Name | Joshua Smith |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1184006124 PECOS PAC ID: 2668785643 Enrollment ID: I20200731000192 |
| Provider Name | Kailyn Kwong Hing |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528477387 PECOS PAC ID: 3476771676 Enrollment ID: I20200818000495 |
| Provider Name | Vanessa Sue Steen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295346682 PECOS PAC ID: 2062839475 Enrollment ID: I20200831003245 |
| Provider Name | Christine Jarocki |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1891164638 PECOS PAC ID: 1658627294 Enrollment ID: I20201014000976 |
| Provider Name | Margaret E Tol |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225637325 PECOS PAC ID: 6507286945 Enrollment ID: I20201023000671 |
| Provider Name | Pauline U Boy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952908279 PECOS PAC ID: 0648680876 Enrollment ID: I20201029001189 |
| Provider Name | Christina Marie Barton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134721814 PECOS PAC ID: 9335551373 Enrollment ID: I20201215002148 |
| Provider Name | Jaclyn Denenfeld |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194068197 PECOS PAC ID: 3476825803 Enrollment ID: I20201221000560 |
| Provider Name | Ellen M Manegold |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194376053 PECOS PAC ID: 3375955040 Enrollment ID: I20201222001807 |
| Provider Name | Clare Susan Deveau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285224386 PECOS PAC ID: 4385058247 Enrollment ID: I20210204001052 |
| Provider Name | Kristy Lynn Pilbeam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750651253 PECOS PAC ID: 2365713567 Enrollment ID: I20210210000765 |
| Provider Name | Matthew Brent Dull |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1346503455 PECOS PAC ID: 9133358914 Enrollment ID: I20210225001251 |
| Provider Name | Rupin Shah |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1073932695 PECOS PAC ID: 8820355886 Enrollment ID: I20210603001789 |
| Provider Name | Giuseppe Zambito |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598116956 PECOS PAC ID: 8628340775 Enrollment ID: I20210607002273 |
| Provider Name | Cynthia Piercefield |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1538761416 PECOS PAC ID: 0042611378 Enrollment ID: I20210624001164 |
| Provider Name | Samantha Marie-balaj Hyzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417528787 PECOS PAC ID: 5496158776 Enrollment ID: I20210723002060 |
| Provider Name | James Martin Hammel |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1063461317 PECOS PAC ID: 1759326911 Enrollment ID: I20210729002637 |
| Provider Name | Erica Wrubel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376925313 PECOS PAC ID: 7911210992 Enrollment ID: I20210809001836 |
| Provider Name | Jessica Thompson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982055349 PECOS PAC ID: 4082986138 Enrollment ID: I20210816000647 |
| Provider Name | Callie Grace Kilpatrick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649774118 PECOS PAC ID: 7113322991 Enrollment ID: I20210817001017 |
| Provider Name | Veronica Sarah Vandewege |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831761972 PECOS PAC ID: 9638574429 Enrollment ID: I20210817001205 |
| Provider Name | James M Regan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093061905 PECOS PAC ID: 9931348885 Enrollment ID: I20210817001208 |
| Provider Name | Ashley Feehan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548755507 PECOS PAC ID: 4183028566 Enrollment ID: I20210820000363 |
| Provider Name | Matthew Peter Fahrenkopf |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1083028161 PECOS PAC ID: 6901021021 Enrollment ID: I20211105001062 |
| Provider Name | Joel Tyler Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235791328 PECOS PAC ID: 3173854072 Enrollment ID: I20211213001516 |
| Provider Name | Roneidra Dionne Hill Lucky |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1790442168 PECOS PAC ID: 3476943044 Enrollment ID: I20211214002247 |
| Provider Name | Zachary Lee Wagar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033771191 PECOS PAC ID: 6002147931 Enrollment ID: I20220121001127 |
| Provider Name | Laura Ann Oddo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861153736 PECOS PAC ID: 2961894936 Enrollment ID: I20220125001519 |
| Provider Name | Sarah Badran |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114067469 PECOS PAC ID: 2062703820 Enrollment ID: I20220210000486 |
| Provider Name | Tammy Bectel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881119667 PECOS PAC ID: 1557637832 Enrollment ID: I20220323002250 |
| Provider Name | Jean A Ballweg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1043236730 PECOS PAC ID: 9032150644 Enrollment ID: I20220517002882 |
| Provider Name | David Hoogstra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093165144 PECOS PAC ID: 8527352921 Enrollment ID: I20220519000396 |
| Provider Name | Sarah Elizabeth Fahnhorst |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699112607 PECOS PAC ID: 5597086348 Enrollment ID: I20220718000283 |
| Provider Name | Thomas Carberry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487043907 PECOS PAC ID: 6800278664 Enrollment ID: I20220727000945 |
| Provider Name | Stephanie Grace Abinoja Raymundo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003294455 PECOS PAC ID: 1254603566 Enrollment ID: I20220805000239 |
| Provider Name | Mario Pasquale Zambito |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1083078844 PECOS PAC ID: 7517341456 Enrollment ID: I20220826001406 |
| Provider Name | Leah Blair Westjohn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013508340 PECOS PAC ID: 5698150753 Enrollment ID: I20220910000396 |
| Provider Name | Jamie Baum Governal |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1194971523 PECOS PAC ID: 6608924048 Enrollment ID: I20220926003547 |
| Provider Name | Isaac J Vandam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649809229 PECOS PAC ID: 9537583513 Enrollment ID: I20221109000732 |
| Provider Name | Cody Voss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376171439 PECOS PAC ID: 7517381551 Enrollment ID: I20230207000273 |
| Provider Name | Carissa Johanna Vanderwoude |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285349464 PECOS PAC ID: 5597138677 Enrollment ID: I20230310002400 |
| Provider Name | Bradley Sherman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801102439 PECOS PAC ID: 9133448541 Enrollment ID: I20230428002541 |
| Provider Name | Shontreal Monique Cooper |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235540154 PECOS PAC ID: 8921356437 Enrollment ID: I20230523001461 |
| Provider Name | Sophia Khalil |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417576604 PECOS PAC ID: 2466876628 Enrollment ID: I20230531000472 |
| Provider Name | Maeve Kathleen Bartiss |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700415890 PECOS PAC ID: 9032533609 Enrollment ID: I20230606000326 |
| Provider Name | Craig Matisoff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598384620 PECOS PAC ID: 2668896846 Enrollment ID: I20230627001413 |
| Provider Name | John James Mcglynn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508327529 PECOS PAC ID: 6709261902 Enrollment ID: I20230629001813 |
| Provider Name | Lauren Sall |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1457733131 PECOS PAC ID: 4981995958 Enrollment ID: I20230720000572 |
| Provider Name | Michael J Hubbard |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1588283048 PECOS PAC ID: 1658795935 Enrollment ID: I20230720003113 |
| Provider Name | Gregory Dane Fritz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437644655 PECOS PAC ID: 6305190737 Enrollment ID: I20230725001463 |
| Provider Name | Andrew Brett Sorah |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518239748 PECOS PAC ID: 4486922259 Enrollment ID: I20230816003455 |
| Provider Name | Dhaval D Patel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487181707 PECOS PAC ID: 0446523302 Enrollment ID: I20230905000891 |
| Provider Name | Jessica Ruth Collister Priestley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366935439 PECOS PAC ID: 0840654299 Enrollment ID: I20230918003977 |
| Provider Name | Zhanttal Castro |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194451757 PECOS PAC ID: 6709232820 Enrollment ID: I20231026000887 |
| Provider Name | Erica Lynn Meleca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467134767 PECOS PAC ID: 1951744671 Enrollment ID: I20240209002380 |
Gastroenterology Specialist Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1179 E Paris Ave Se Ste 200, Grand Rapids, MI 49546 Phone: 616-975-9100 Fax: 616-975-1161 | |
Mfb Professional Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1155 E. Paris, Ste 200, Grand Rapids, MI 49546 Phone: 616-233-3480 Fax: 616-233-3481 | |
American Current Care Of Michigan Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 933 Three Mile Road, Suite 110, Grand Rapids, MI 49544 Phone: 616-785-2619 Fax: 616-785-2623 | |
Patient One Care, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1740 28th St Se, Grand Rapids, MI 49508 Phone: 616-323-3999 Fax: 616-552-1618 | |
Elite Health, Plc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 Fulton St E, Suite A, Grand Rapids, MI 49503 Phone: 616-644-1423 Fax: 616-773-1291 | |
Cherry Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Cherry St Se, Grand Rapids, MI 49503 Phone: 616-965-8200 | |
Dr Asif Azeem Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1200 East Paris Ave Se, Ste 8, Grand Rapids, MI 49546 Phone: 616-942-6230 Fax: 616-942-6270 |