| Summit Medical Group Arizona Llc | |
|
5620 W Thunderbird Rd Ste F1 Glendale AZ 85306-4652 | |
| (844) 969-0686 | |
| (773) 832-7083 |
| Full Name | Summit Medical Group Arizona Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 5620 W Thunderbird Rd Ste F1, Glendale, Arizona |
| Authorized Official Name and Position | Rebecca Rager (DIRECTOR REVENUE CYCLE) |
| Authorized Official Contact | 8449690686 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Summit Medical Group Arizona Llc Po Box 360185 Pittsburgh PA 15251-6185 Ph: (844) 969-0686 | Summit Medical Group Arizona Llc 5620 W Thunderbird Rd Ste F1 Glendale AZ 85306-4652 Ph: (844) 969-0686 |
| NPI Number | 1053810622 |
|---|---|
| Provider Enumeration Date | 02/08/2018 |
| Last Update Date | 01/10/2025 |
| Medicare PECOS PAC ID | 3173872835 |
|---|---|
| Medicare Enrollment ID | O20180814003015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053810622 | NPI | - | NPPES |
| Provider Name | David B Foy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497747448 PECOS PAC ID: 8123922382 Enrollment ID: I20031120000599 |
| Provider Name | Jerry M Fioramonti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669465530 PECOS PAC ID: 5294639746 Enrollment ID: I20031125000696 |
| Provider Name | Jared L Dayton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508816331 PECOS PAC ID: 6901708163 Enrollment ID: I20040127000366 |
| Provider Name | Luis M Irizarry |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487658175 PECOS PAC ID: 1456247741 Enrollment ID: I20040224000817 |
| Provider Name | Anthony M Will |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629175104 PECOS PAC ID: 7113814351 Enrollment ID: I20040302000719 |
| Provider Name | Christopher J Labban |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134165848 PECOS PAC ID: 7618865791 Enrollment ID: I20040309001334 |
| Provider Name | Myriam E Rodriguez-padilla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073503850 PECOS PAC ID: 1951293364 Enrollment ID: I20040329000988 |
| Provider Name | Subhasis Maitra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487673760 PECOS PAC ID: 4486544244 Enrollment ID: I20040330000650 |
| Provider Name | Jennifer Maitra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619996535 PECOS PAC ID: 0840180600 Enrollment ID: I20040330000802 |
| Provider Name | Robert F West |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831145796 PECOS PAC ID: 7810989704 Enrollment ID: I20040331001344 |
| Provider Name | April L Estes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851356802 PECOS PAC ID: 8921096249 Enrollment ID: I20040505000437 |
| Provider Name | Kent M Johnson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1386699502 PECOS PAC ID: 6002805967 Enrollment ID: I20040508000066 |
| Provider Name | Scott B Hatfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093752032 PECOS PAC ID: 3678563392 Enrollment ID: I20040514000779 |
| Provider Name | Chia How H Liu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851382899 PECOS PAC ID: 7911997101 Enrollment ID: I20040518000861 |
| Provider Name | Philo A Rogers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841371572 PECOS PAC ID: 0345231098 Enrollment ID: I20040520001234 |
| Provider Name | Kamel M Sadek |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144384603 PECOS PAC ID: 1254312663 Enrollment ID: I20040601000042 |
| Provider Name | Sudeep Singh Punia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073696746 PECOS PAC ID: 0446245815 Enrollment ID: I20040615000437 |
| Provider Name | Jennifer L Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558362715 PECOS PAC ID: 9830174648 Enrollment ID: I20040623001566 |
| Provider Name | Darrin M Saikley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245245661 PECOS PAC ID: 2769468750 Enrollment ID: I20040629001005 |
| Provider Name | Grace A Haynes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215070792 PECOS PAC ID: 6406831692 Enrollment ID: I20040630000487 |
| Provider Name | Rachel Langland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164411849 PECOS PAC ID: 0345152492 Enrollment ID: I20040708000748 |
| Provider Name | Collin Udall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861495434 PECOS PAC ID: 2860487469 Enrollment ID: I20040729000041 |
| Provider Name | Donald L Griner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821091497 PECOS PAC ID: 1850386459 Enrollment ID: I20040729000068 |
| Provider Name | Graeme M Tolson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518966860 PECOS PAC ID: 4284612359 Enrollment ID: I20040802000275 |
| Provider Name | Lucille Lancaster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043295793 PECOS PAC ID: 0941271860 Enrollment ID: I20040804000702 |
| Provider Name | Sean K Sackett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972595940 PECOS PAC ID: 6800869678 Enrollment ID: I20040818001411 |
| Provider Name | Richard R Reilly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942289467 PECOS PAC ID: 2769457233 Enrollment ID: I20040827001124 |
| Provider Name | Kim M Lucas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285816777 PECOS PAC ID: 0042284846 Enrollment ID: I20040830000229 |
| Provider Name | Richard L Kelly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528068178 PECOS PAC ID: 1759273014 Enrollment ID: I20040903000924 |
| Provider Name | Mark J Lewis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710906128 PECOS PAC ID: 2365419116 Enrollment ID: I20040913000495 |
| Provider Name | Aspen I Ralph |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548264450 PECOS PAC ID: 3779542089 Enrollment ID: I20041004000415 |
| Provider Name | Vicky H Chen-yang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033159207 PECOS PAC ID: 7113976192 Enrollment ID: I20050117000485 |
| Provider Name | Deborah K Robertson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851394407 PECOS PAC ID: 8820043458 Enrollment ID: I20050316001066 |
| Provider Name | Jay V Swanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346265675 PECOS PAC ID: 1951357821 Enrollment ID: I20050323001046 |
| Provider Name | Rama J Devineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750312484 PECOS PAC ID: 3173562386 Enrollment ID: I20050427000889 |
| Provider Name | Rodolfo Jimenez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013910751 PECOS PAC ID: 1759321284 Enrollment ID: I20050504000666 |
| Provider Name | Michael R Keller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821062183 PECOS PAC ID: 1658320999 Enrollment ID: I20050512000577 |
| Provider Name | Dustin G Morris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396721403 PECOS PAC ID: 9335184282 Enrollment ID: I20050622000397 |
| Provider Name | Rise-ann Wohl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013993245 PECOS PAC ID: 8224073036 Enrollment ID: I20050622000973 |
| Provider Name | Cesar M Rodarte |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1134279375 PECOS PAC ID: 6608801667 Enrollment ID: I20050928001448 |
| Provider Name | Teresa L King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366444580 PECOS PAC ID: 7618902305 Enrollment ID: I20050930000668 |
| Provider Name | Megan Y Blackburn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457334450 PECOS PAC ID: 3072538222 Enrollment ID: I20051007000100 |
| Provider Name | Russell J Homewood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851573109 PECOS PAC ID: 7214977966 Enrollment ID: I20051110000115 |
| Provider Name | Stephen W Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902933823 PECOS PAC ID: 6103833702 Enrollment ID: I20060307000360 |
| Provider Name | Parwin S Sadaat |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487695243 PECOS PAC ID: 1759308935 Enrollment ID: I20060323000806 |
| Provider Name | Ethiopia Gebeyehu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609845908 PECOS PAC ID: 7012928195 Enrollment ID: I20060606000277 |
| Provider Name | Angela M Sturdivant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689622086 PECOS PAC ID: 1355231788 Enrollment ID: I20060809000452 |
| Provider Name | Afeworki Kidane |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1326018557 PECOS PAC ID: 0547157984 Enrollment ID: I20060822000627 |
| Provider Name | David C Izenberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104930122 PECOS PAC ID: 6103822531 Enrollment ID: I20061009000061 |
| Provider Name | Jeffrey T Dare |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679538839 PECOS PAC ID: 5395742027 Enrollment ID: I20061023000139 |
| Provider Name | Jennifer Mae Prescott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023039575 PECOS PAC ID: 3072512490 Enrollment ID: I20061213000295 |
| Provider Name | Mary Jo Colorafi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497793137 PECOS PAC ID: 6709982564 Enrollment ID: I20070511000074 |
| Provider Name | Aditi A Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730266289 PECOS PAC ID: 0547367831 Enrollment ID: I20070522000124 |
| Provider Name | Armando Rodriguez-asbun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679561203 PECOS PAC ID: 7416054531 Enrollment ID: I20070523000601 |
| Provider Name | Mehrnoosh Zarkoob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649343815 PECOS PAC ID: 8022116912 Enrollment ID: I20070530000414 |
| Provider Name | Joshua A Millstein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376749721 PECOS PAC ID: 5092816652 Enrollment ID: I20070726000170 |
| Provider Name | Stephen C Hammett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659593739 PECOS PAC ID: 2264523224 Enrollment ID: I20070806000069 |
| Provider Name | Sheryl Anne Niccum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457332199 PECOS PAC ID: 4385623099 Enrollment ID: I20070808000536 |
| Provider Name | Amy M Strocsher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174714349 PECOS PAC ID: 8729171277 Enrollment ID: I20070829000788 |
| Provider Name | Varuzhan Movsesyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326196809 PECOS PAC ID: 0244335362 Enrollment ID: I20070913000461 |
| Provider Name | Sanjay S Bommakanti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114111002 PECOS PAC ID: 9335233063 Enrollment ID: I20070925000628 |
| Provider Name | Nakisa Mohsen Sheini |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1376730234 PECOS PAC ID: 4688760580 Enrollment ID: I20071023000225 |
| Provider Name | Melanie A Sweeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740207448 PECOS PAC ID: 7719075407 Enrollment ID: I20071113000729 |
| Provider Name | Gregory S Allen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952380925 PECOS PAC ID: 4880614015 Enrollment ID: I20080108000922 |
| Provider Name | Thomas G Habiger |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447326038 PECOS PAC ID: 3678658572 Enrollment ID: I20080317000093 |
| Provider Name | Tracy L Stricker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760407589 PECOS PAC ID: 5294814455 Enrollment ID: I20080430000158 |
| Provider Name | Roanne M Parker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720274863 PECOS PAC ID: 9931273950 Enrollment ID: I20080808000203 |
| Provider Name | Michael A Herrera |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871610774 PECOS PAC ID: 5799850483 Enrollment ID: I20080814000358 |
| Provider Name | Robert A Swierupski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134143092 PECOS PAC ID: 6305873225 Enrollment ID: I20080827000137 |
| Provider Name | Paul E Gawelko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750597985 PECOS PAC ID: 9133295934 Enrollment ID: I20080902000308 |
| Provider Name | Patricia L Higgins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447416847 PECOS PAC ID: 3678633765 Enrollment ID: I20081119000468 |
| Provider Name | Terez J Getz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750589974 PECOS PAC ID: 3274695606 Enrollment ID: I20081219000035 |
| Provider Name | Marc L Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962498709 PECOS PAC ID: 9931263696 Enrollment ID: I20090126000439 |
| Provider Name | Francene A Warner |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932373693 PECOS PAC ID: 5294882593 Enrollment ID: I20090402000120 |
| Provider Name | Faith Cutrona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033358387 PECOS PAC ID: 1355492711 Enrollment ID: I20090624000395 |
| Provider Name | Jared J Berkowitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386865780 PECOS PAC ID: 0042362410 Enrollment ID: I20090715000590 |
| Provider Name | Elizabeth J Mcconnell |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1952393761 PECOS PAC ID: 9739176595 Enrollment ID: I20090831000106 |
| Provider Name | David J Hume |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912009291 PECOS PAC ID: 6204981616 Enrollment ID: I20090909000412 |
| Provider Name | Jeffrey W Gardner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1366775835 PECOS PAC ID: 0941349419 Enrollment ID: I20091124000035 |
| Provider Name | Susan S Eller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558699595 PECOS PAC ID: 4587705165 Enrollment ID: I20100105000010 |
| Provider Name | Michael J Demko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477561652 PECOS PAC ID: 5395888713 Enrollment ID: I20100208000560 |
| Provider Name | Mark D Goldberg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144238312 PECOS PAC ID: 2961575360 Enrollment ID: I20100216000292 |
| Provider Name | Peter S Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376543108 PECOS PAC ID: 2860384112 Enrollment ID: I20100217000402 |
| Provider Name | Richard F Fowler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316923584 PECOS PAC ID: 7315081130 Enrollment ID: I20100217000593 |
| Provider Name | Prineet K Tung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285849372 PECOS PAC ID: 6507998358 Enrollment ID: I20100714001017 |
| Provider Name | Rosanna R Nicoletti |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013927607 PECOS PAC ID: 7315079043 Enrollment ID: I20100715000935 |
| Provider Name | Kayvaan Mortazavi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124265285 PECOS PAC ID: 9032241765 Enrollment ID: I20100715000947 |
| Provider Name | David Warfield |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023018660 PECOS PAC ID: 0244356392 Enrollment ID: I20100925000232 |
| Provider Name | David E Hatfield |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093767824 PECOS PAC ID: 1557430758 Enrollment ID: I20100927001385 |
| Provider Name | Trinh Doan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518966878 PECOS PAC ID: 9234329186 Enrollment ID: I20101005001228 |
| Provider Name | Kent T Lewis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114970324 PECOS PAC ID: 7719179944 Enrollment ID: I20101006001131 |
| Provider Name | Narendra A Godbole |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396745956 PECOS PAC ID: 7416147368 Enrollment ID: I20101011001154 |
| Provider Name | James Carpenter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073513131 PECOS PAC ID: 3870783723 Enrollment ID: I20101012000588 |
| Provider Name | Frank A Agnone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891783411 PECOS PAC ID: 6002851581 Enrollment ID: I20101019001612 |
| Provider Name | Linda M Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558543678 PECOS PAC ID: 7517153422 Enrollment ID: I20101117001570 |
| Provider Name | Traci E Jensen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053595041 PECOS PAC ID: 8628264223 Enrollment ID: I20101122000799 |
| Provider Name | Kimberly H Herman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104157742 PECOS PAC ID: 2769678788 Enrollment ID: I20101201001359 |
| Provider Name | Karen P Gonsalves Wetherell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033118393 PECOS PAC ID: 0941498059 Enrollment ID: I20101215001222 |
| Provider Name | Katherine J Willett-goehring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174562359 PECOS PAC ID: 9032308986 Enrollment ID: I20110107000999 |
| Provider Name | Darlene M Mcmillon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225332216 PECOS PAC ID: 4587845052 Enrollment ID: I20110217000210 |
| Provider Name | Manisha S Nerkar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730130006 PECOS PAC ID: 5395777205 Enrollment ID: I20111201000596 |
| Provider Name | Joseph R Mawyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336301035 PECOS PAC ID: 6507031168 Enrollment ID: I20111208000800 |
| Provider Name | Jason P Heavens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063781797 PECOS PAC ID: 3375799810 Enrollment ID: I20120815000744 |
| Provider Name | Ann M Lacey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346509833 PECOS PAC ID: 0941457261 Enrollment ID: I20120821001067 |
| Provider Name | Nezar Dahdal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194977405 PECOS PAC ID: 7214093236 Enrollment ID: I20130121000063 |
| Provider Name | Kristi M Goyne |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255684676 PECOS PAC ID: 3274787205 Enrollment ID: I20130129000180 |
| Provider Name | Zuleikha Vellani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376897314 PECOS PAC ID: 5698920726 Enrollment ID: I20130221000275 |
| Provider Name | Sarah Locke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497091854 PECOS PAC ID: 0143465658 Enrollment ID: I20130403000256 |
| Provider Name | Susan M Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255671780 PECOS PAC ID: 1557507308 Enrollment ID: I20130423000288 |
| Provider Name | John S. Graham |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336137538 PECOS PAC ID: 3274432869 Enrollment ID: I20130514000579 |
| Provider Name | Rachel Np Prell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265596753 PECOS PAC ID: 6204075666 Enrollment ID: I20130614000175 |
| Provider Name | Kimberly Brandstetter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205134350 PECOS PAC ID: 6002057932 Enrollment ID: I20130718000590 |
| Provider Name | Maryann L Moyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932549961 PECOS PAC ID: 7214179761 Enrollment ID: I20130813000006 |
| Provider Name | Alina Doina Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336584739 PECOS PAC ID: 5991945073 Enrollment ID: I20130816000002 |
| Provider Name | Caren M Pfieffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124469085 PECOS PAC ID: 2567605967 Enrollment ID: I20130904000799 |
| Provider Name | John Modrzejewski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831439413 PECOS PAC ID: 2769617612 Enrollment ID: I20131030000955 |
| Provider Name | Pilar M Hoffsten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386074284 PECOS PAC ID: 9032347075 Enrollment ID: I20140120000738 |
| Provider Name | Robin Julianne Poedel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942637921 PECOS PAC ID: 3779706130 Enrollment ID: I20140603002272 |
| Provider Name | Eric Scott Koenig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194163865 PECOS PAC ID: 4284859620 Enrollment ID: I20140627000901 |
| Provider Name | Robert D Devine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699056101 PECOS PAC ID: 7911135892 Enrollment ID: I20140724000549 |
| Provider Name | Charlene F Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033546411 PECOS PAC ID: 2961628292 Enrollment ID: I20140730002884 |
| Provider Name | Uma Gopakumar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124367255 PECOS PAC ID: 5991921843 Enrollment ID: I20140805002384 |
| Provider Name | Jeremy Nebeker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013208545 PECOS PAC ID: 9739327743 Enrollment ID: I20140904002681 |
| Provider Name | Lokeswari Bucchireddigari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538575253 PECOS PAC ID: 1355561291 Enrollment ID: I20140929000203 |
| Provider Name | Weston G Young |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538456470 PECOS PAC ID: 5799916581 Enrollment ID: I20140930002110 |
| Provider Name | Christine T Minch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669881819 PECOS PAC ID: 1658327747 Enrollment ID: I20150618000489 |
| Provider Name | Satya D Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952571341 PECOS PAC ID: 7517008766 Enrollment ID: I20150618002537 |
| Provider Name | Jenny Ho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427315506 PECOS PAC ID: 8022327121 Enrollment ID: I20151012000590 |
| Provider Name | Heather A Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356720007 PECOS PAC ID: 5395054910 Enrollment ID: I20151022000990 |
| Provider Name | Jann M Ford Petersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710357355 PECOS PAC ID: 9436459831 Enrollment ID: I20151207001655 |
| Provider Name | Sheryl Spadone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902804669 PECOS PAC ID: 5799775128 Enrollment ID: I20151228002129 |
| Provider Name | Shraddha S Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447408778 PECOS PAC ID: 6305003260 Enrollment ID: I20160202000159 |
| Provider Name | Sandra Lee Brummett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255705851 PECOS PAC ID: 0042516825 Enrollment ID: I20160303001332 |
| Provider Name | Jess Henry Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760840581 PECOS PAC ID: 6406152933 Enrollment ID: I20160309002872 |
| Provider Name | Melinda Marie Ramsdell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174995807 PECOS PAC ID: 0547567042 Enrollment ID: I20160329000996 |
| Provider Name | Alane Marie Larison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851799258 PECOS PAC ID: 1254532203 Enrollment ID: I20160414001638 |
| Provider Name | Maria Kenneally |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205821493 PECOS PAC ID: 3971400763 Enrollment ID: I20160426001656 |
| Provider Name | Amy M Hanford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699152900 PECOS PAC ID: 3577854058 Enrollment ID: I20160614002290 |
| Provider Name | Elle Ross |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275976706 PECOS PAC ID: 4587958426 Enrollment ID: I20160816000415 |
| Provider Name | Bobby Rhudy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952854457 PECOS PAC ID: 1557658572 Enrollment ID: I20160919002737 |
| Provider Name | Christal Michelle Garza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457804932 PECOS PAC ID: 4486941366 Enrollment ID: I20160920002299 |
| Provider Name | Ekaphol Wooden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437386752 PECOS PAC ID: 1355650482 Enrollment ID: I20160921001259 |
| Provider Name | Mary S Rihani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447703913 PECOS PAC ID: 9830486570 Enrollment ID: I20160923002182 |
| Provider Name | John Spencer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548369937 PECOS PAC ID: 2668555830 Enrollment ID: I20161221001912 |
| Provider Name | Angela G Jarvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306218540 PECOS PAC ID: 9739460296 Enrollment ID: I20161221002184 |
| Provider Name | Nagma Sharma Lott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619155181 PECOS PAC ID: 0749353407 Enrollment ID: I20170519001154 |
| Provider Name | Carrie Church |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790231546 PECOS PAC ID: 9931476967 Enrollment ID: I20170523002387 |
| Provider Name | Nina A Zabalza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467999045 PECOS PAC ID: 2163790114 Enrollment ID: I20170614002649 |
| Provider Name | Denise Sample |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083919898 PECOS PAC ID: 5395909683 Enrollment ID: I20170615002500 |
| Provider Name | Matthew Dale Millett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881850907 PECOS PAC ID: 7113295635 Enrollment ID: I20170623002140 |
| Provider Name | Roxane Marie Jueckstock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780044842 PECOS PAC ID: 3870868227 Enrollment ID: I20171023002103 |
| Provider Name | Kelly Lapa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255856803 PECOS PAC ID: 6305103797 Enrollment ID: I20171120000626 |
| Provider Name | John Edgar Alan Hammonds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518494020 PECOS PAC ID: 3870850571 Enrollment ID: I20171205003503 |
| Provider Name | Shanna S Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154865350 PECOS PAC ID: 6507125903 Enrollment ID: I20180110001339 |
| Provider Name | Laura Cole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184159741 PECOS PAC ID: 8729348024 Enrollment ID: I20180206001507 |
| Provider Name | Erica Lynne Eggman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821536897 PECOS PAC ID: 3375805583 Enrollment ID: I20180328002754 |
| Provider Name | Leslee Hamadeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144728130 PECOS PAC ID: 3678835782 Enrollment ID: I20180328003071 |
| Provider Name | Jessica Majcherek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831594837 PECOS PAC ID: 7416270772 Enrollment ID: I20180502001435 |
| Provider Name | Krista Nicole Beasley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518262567 PECOS PAC ID: 9638433386 Enrollment ID: I20180503001991 |
| Provider Name | Jai S Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407892268 PECOS PAC ID: 2163495953 Enrollment ID: I20180515001767 |
| Provider Name | Alexandra Ebong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831680305 PECOS PAC ID: 0345596649 Enrollment ID: I20180628001666 |
| Provider Name | Evelyn G Heigh-rosen |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1073933826 PECOS PAC ID: 6901171792 Enrollment ID: I20180629002580 |
| Provider Name | Tonya Dominguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710492509 PECOS PAC ID: 4284981473 Enrollment ID: I20180718004026 |
| Provider Name | Alyssa P Vivas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720460819 PECOS PAC ID: 8426306606 Enrollment ID: I20180803001303 |
| Provider Name | Jacey Leclair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093213050 PECOS PAC ID: 3971851023 Enrollment ID: I20180806001520 |
| Provider Name | Rupa Krishna Low |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487915294 PECOS PAC ID: 6002112752 Enrollment ID: I20180815001605 |
| Provider Name | Shin Jung Yoon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801278981 PECOS PAC ID: 8426361759 Enrollment ID: I20180817001870 |
| Provider Name | Misty Pagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184119844 PECOS PAC ID: 4385996321 Enrollment ID: I20181002003611 |
| Provider Name | Melissa M Monson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255826806 PECOS PAC ID: 8820341027 Enrollment ID: I20181105000942 |
| Provider Name | Sharon Caburatan Caterial |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831606375 PECOS PAC ID: 4486998903 Enrollment ID: I20181210002126 |
| Provider Name | Maria Cristina De Souza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689602393 PECOS PAC ID: 8426365917 Enrollment ID: I20181214002036 |
| Provider Name | Angela V Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992296768 PECOS PAC ID: 4486990678 Enrollment ID: I20190109000728 |
| Provider Name | Emelita L Cabilatazan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891275657 PECOS PAC ID: 5991042319 Enrollment ID: I20190123002971 |
| Provider Name | Michael A Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548235773 PECOS PAC ID: 6002155108 Enrollment ID: I20190307002397 |
| Provider Name | Anna L Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427528686 PECOS PAC ID: 7315287182 Enrollment ID: I20190314002065 |
| Provider Name | Troy Lance Passmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528561016 PECOS PAC ID: 7012257488 Enrollment ID: I20190321000590 |
| Provider Name | Debra Sharene Corley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386129328 PECOS PAC ID: 3375883598 Enrollment ID: I20190325002089 |
| Provider Name | Sharnette Washington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427522556 PECOS PAC ID: 2264773266 Enrollment ID: I20190329002377 |
| Provider Name | Marivic Badilla Guanso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669951729 PECOS PAC ID: 1658612288 Enrollment ID: I20190409002193 |
| Provider Name | Maralee Wagner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902370711 PECOS PAC ID: 9739420878 Enrollment ID: I20190417002990 |
| Provider Name | Shannon Lynn Stark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730645763 PECOS PAC ID: 8123369212 Enrollment ID: I20190418001998 |
| Provider Name | Dana Michael Klein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386023760 PECOS PAC ID: 4486954625 Enrollment ID: I20190612002752 |
| Provider Name | Kristin Angeli Oarde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215491097 PECOS PAC ID: 5991039513 Enrollment ID: I20190701001781 |
| Provider Name | William Paul Hennon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295149896 PECOS PAC ID: 8729200530 Enrollment ID: I20190805002424 |
| Provider Name | Richard V Romero |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679032577 PECOS PAC ID: 4486983582 Enrollment ID: I20190916002451 |
| Provider Name | Traci Ann Doliente-cruz Vopalensky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942855705 PECOS PAC ID: 3274863253 Enrollment ID: I20190918002732 |
| Provider Name | Sammya Shahla |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407175284 PECOS PAC ID: 1951538347 Enrollment ID: I20190925002435 |
| Provider Name | Amanda Sue Andersen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033504410 PECOS PAC ID: 8628342854 Enrollment ID: I20191001001820 |
| Provider Name | Justin Jay Stenquist |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285096503 PECOS PAC ID: 5597095760 Enrollment ID: I20191001002937 |
| Provider Name | Abigail Lee Moreno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306491113 PECOS PAC ID: 0345571725 Enrollment ID: I20191016002004 |
| Provider Name | Brandy Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912298209 PECOS PAC ID: 8426380346 Enrollment ID: I20191025002626 |
| Provider Name | Michael Christopher Hawkes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780234369 PECOS PAC ID: 2567895766 Enrollment ID: I20191202001031 |
| Provider Name | Randy Savageau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548804735 PECOS PAC ID: 1658704234 Enrollment ID: I20191212001915 |
| Provider Name | Kelly A Ranahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316506561 PECOS PAC ID: 0446684450 Enrollment ID: I20191230000582 |
| Provider Name | Guen Cecilia Tawagon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609415744 PECOS PAC ID: 5294161550 Enrollment ID: I20200204002443 |
| Provider Name | Shana J Bean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538709761 PECOS PAC ID: 7214363290 Enrollment ID: I20200211001702 |
| Provider Name | Bright Alvaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477009413 PECOS PAC ID: 0143283879 Enrollment ID: I20200228001771 |
| Provider Name | Cristina Marie Lister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427698166 PECOS PAC ID: 7113355447 Enrollment ID: I20200319000729 |
| Provider Name | Bruce C Herman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801894951 PECOS PAC ID: 4981593787 Enrollment ID: I20200319002914 |
| Provider Name | Kyla Worrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932748456 PECOS PAC ID: 2365871936 Enrollment ID: I20200402000134 |
| Provider Name | Alfredo M Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750913810 PECOS PAC ID: 6002245537 Enrollment ID: I20200406000449 |
| Provider Name | Flor Marlene Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952601908 PECOS PAC ID: 8527247121 Enrollment ID: I20200605000546 |
| Provider Name | Dana Rae |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972138741 PECOS PAC ID: 6406278092 Enrollment ID: I20200629001266 |
| Provider Name | Marlaine Baldelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083265011 PECOS PAC ID: 3870916455 Enrollment ID: I20200715001765 |
| Provider Name | Raul I Medina Sicre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649685652 PECOS PAC ID: 0446525968 Enrollment ID: I20200728000253 |
| Provider Name | Devin Lee Hon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033640529 PECOS PAC ID: 5991120503 Enrollment ID: I20200729003762 |
| Provider Name | Shavith G Samson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578097374 PECOS PAC ID: 9133490212 Enrollment ID: I20200803003394 |
| Provider Name | Nathan K Hatfield |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053846105 PECOS PAC ID: 5193141802 Enrollment ID: I20200812001318 |
| Provider Name | Nelson Martin Flores |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669082970 PECOS PAC ID: 7719303080 Enrollment ID: I20200817003657 |
| Provider Name | Caitlin M Guinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265064539 PECOS PAC ID: 0244656155 Enrollment ID: I20200821001014 |
| Provider Name | Robyn L Fossey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053831172 PECOS PAC ID: 1759700404 Enrollment ID: I20200929002307 |
| Provider Name | Christine Marie Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023626785 PECOS PAC ID: 2062831597 Enrollment ID: I20201005000482 |
| Provider Name | Kimberly M Hoste |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285245969 PECOS PAC ID: 4789003849 Enrollment ID: I20201005001597 |
| Provider Name | Jamie Linnea Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487257093 PECOS PAC ID: 2264843069 Enrollment ID: I20201130003126 |
| Provider Name | Chelsey Mae Schiefelbein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114308632 PECOS PAC ID: 7012227382 Enrollment ID: I20210211001211 |
| Provider Name | Belinda Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730571993 PECOS PAC ID: 0042625568 Enrollment ID: I20210216000807 |
| Provider Name | Brijeshaben U Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538787072 PECOS PAC ID: 1759797053 Enrollment ID: I20210311001342 |
| Provider Name | Frank Macalma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235767328 PECOS PAC ID: 4183032519 Enrollment ID: I20210422002575 |
| Provider Name | Steven Gregory Gonos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932789989 PECOS PAC ID: 2466860770 Enrollment ID: I20210426000788 |
| Provider Name | Samantha Ashlee Wirth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932709656 PECOS PAC ID: 6204245343 Enrollment ID: I20210503000422 |
| Provider Name | Coddie Tatro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073119442 PECOS PAC ID: 5092114074 Enrollment ID: I20210524002268 |
| Provider Name | Ju Ry Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255911384 PECOS PAC ID: 1658770169 Enrollment ID: I20210602002582 |
| Provider Name | Sabrina Lynn Kibby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508351826 PECOS PAC ID: 7719388735 Enrollment ID: I20210629001116 |
| Provider Name | Amie Horst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073192878 PECOS PAC ID: 9234530056 Enrollment ID: I20210630000867 |
| Provider Name | Kristen Elizabeth Reiter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528638418 PECOS PAC ID: 4385046341 Enrollment ID: I20210713002562 |
| Provider Name | Theresa Krueger-junk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225400500 PECOS PAC ID: 4082918198 Enrollment ID: I20210804003301 |
| Provider Name | Joshua Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952893547 PECOS PAC ID: 2567719958 Enrollment ID: I20210804003745 |
| Provider Name | Madhavi Naidu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083813331 PECOS PAC ID: 8022100387 Enrollment ID: I20210810003791 |
| Provider Name | Maegan Drummond |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093387060 PECOS PAC ID: 7113321076 Enrollment ID: I20210813002983 |
| Provider Name | Christine Machele Leach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356924179 PECOS PAC ID: 3870998727 Enrollment ID: I20210816003716 |
| Provider Name | Sophia Madahar Roalkvam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861996290 PECOS PAC ID: 1355748922 Enrollment ID: I20210923003038 |
| Provider Name | Catherine M Aquino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417628025 PECOS PAC ID: 7214335512 Enrollment ID: I20211015002408 |
| Provider Name | Devin Rollender |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538665021 PECOS PAC ID: 3375975188 Enrollment ID: I20211020000686 |
| Provider Name | David Collins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902303340 PECOS PAC ID: 0941559306 Enrollment ID: I20211028003114 |
| Provider Name | Renee Martha Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417414483 PECOS PAC ID: 8729320122 Enrollment ID: I20211208001644 |
| Provider Name | Meaghan Patricia Payne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245738509 PECOS PAC ID: 3779973342 Enrollment ID: I20211214002134 |
| Provider Name | Limy Fernandus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972005189 PECOS PAC ID: 8820424070 Enrollment ID: I20211216002411 |
| Provider Name | Rusalina Muntean Mincu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295782431 PECOS PAC ID: 4486603610 Enrollment ID: I20211221001442 |
| Provider Name | Eduard Shnaydman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912942624 PECOS PAC ID: 1759284797 Enrollment ID: I20220408001648 |
| Provider Name | Diane Labban |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629390778 PECOS PAC ID: 5991182065 Enrollment ID: I20220510002018 |
| Provider Name | Kelly R Mcalister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073150496 PECOS PAC ID: 3274968292 Enrollment ID: I20220524000721 |
| Provider Name | Elizabeth A Romeo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245301977 PECOS PAC ID: 7315070141 Enrollment ID: I20220614001107 |
| Provider Name | Brittany Atkinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972120798 PECOS PAC ID: 4981097953 Enrollment ID: I20220622003128 |
| Provider Name | Chad Scott Parson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871151845 PECOS PAC ID: 4789063561 Enrollment ID: I20220624001730 |
| Provider Name | Urielle Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679976799 PECOS PAC ID: 1052633112 Enrollment ID: I20220706000361 |
| Provider Name | Dan Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639824642 PECOS PAC ID: 6507248184 Enrollment ID: I20220728002114 |
| Provider Name | Anda Neagoe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265093439 PECOS PAC ID: 3870975774 Enrollment ID: I20220808003550 |
| Provider Name | Kathy Derrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689082174 PECOS PAC ID: 2264651256 Enrollment ID: I20220816003849 |
| Provider Name | Veronica Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710357181 PECOS PAC ID: 2264731231 Enrollment ID: I20220819001861 |
| Provider Name | Kavitha Krishnamani |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629196282 PECOS PAC ID: 3072653401 Enrollment ID: I20220902001206 |
| Provider Name | Juvi T Lindsey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164939674 PECOS PAC ID: 8628339702 Enrollment ID: I20221018002588 |
| Provider Name | Trina L Bury |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871092569 PECOS PAC ID: 2466716345 Enrollment ID: I20221031000805 |
| Provider Name | Breanna Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760077093 PECOS PAC ID: 6305213679 Enrollment ID: I20221031001836 |
| Provider Name | Regina Marie Formentin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700470275 PECOS PAC ID: 2163890955 Enrollment ID: I20221129002151 |
| Provider Name | Aneta Arzumanova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073236360 PECOS PAC ID: 1153791579 Enrollment ID: I20221229002357 |
| Provider Name | Brenda S Witsaman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811492424 PECOS PAC ID: 9234493925 Enrollment ID: I20230126001777 |
| Provider Name | Jennifer C Savageau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902521321 PECOS PAC ID: 1254706484 Enrollment ID: I20230331000851 |
| Provider Name | Mary Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912178781 PECOS PAC ID: 8527125764 Enrollment ID: I20230626001154 |
| Provider Name | Katerina Shnaydman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841819596 PECOS PAC ID: 1153781158 Enrollment ID: I20230724000231 |
| Provider Name | Mary S Crowell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780927251 PECOS PAC ID: 1557685203 Enrollment ID: I20230823000716 |
| Provider Name | Shaheen Lakhani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639542491 PECOS PAC ID: 9739482019 Enrollment ID: I20231016002138 |
| Provider Name | Stacy Fine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669224879 PECOS PAC ID: 1052753167 Enrollment ID: I20240521002546 |
| Provider Name | Nubia Denise Ozuna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407698749 PECOS PAC ID: 6406393834 Enrollment ID: I20240802003455 |
| Provider Name | Emily Isabel Jordan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245067222 PECOS PAC ID: 1759812597 Enrollment ID: I20241003001134 |
| Provider Name | Thomas Allen Cornwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386679082 PECOS PAC ID: 0547157505 Enrollment ID: I20241003003859 |
| Provider Name | Sheryl Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760715965 PECOS PAC ID: 3375699689 Enrollment ID: I20241016001003 |
| Provider Name | Sarah Backof |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003413121 PECOS PAC ID: 4880001270 Enrollment ID: I20241023000396 |
| Provider Name | Amy Lhote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013940691 PECOS PAC ID: 5193918167 Enrollment ID: I20241102000372 |
| Provider Name | Haley Elizabeth Page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871313577 PECOS PAC ID: 4385178813 Enrollment ID: I20241106003264 |
| Provider Name | Tiffany Kaye Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497576847 PECOS PAC ID: 5193259380 Enrollment ID: I20241111002215 |
| Provider Name | Jeanie Menendez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558866939 PECOS PAC ID: 1557626389 Enrollment ID: I20241122003736 |
| Provider Name | Millicent G Kadner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174859409 PECOS PAC ID: 5294877007 Enrollment ID: I20250203003177 |
| Provider Name | Angela Marie Carney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518783539 PECOS PAC ID: 1355864877 Enrollment ID: I20250325003845 |
Endocrinology, Diabetes, And Thyroid Center Of Arizona Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 20100 N 51st Ave, Suite F-635, Glendale, AZ 85308 Phone: 623-266-7858 Fax: 623-444-9810 | |
A New Leaf Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8581 N 61st Ave Bldg A, Glendale, AZ 85302 Phone: 623-934-1991 Fax: 623-878-9335 | |
William E. Zachow D.o., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7802 N 43rd Ave, Suite # 5, Glendale, AZ 85301 Phone: 602-790-4221 | |
Arrowhead Health Center & Spa, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 17100 W 67th Ave, 300, Glendale, AZ 85308 Phone: 818-458-2587 | |
Sun Valley Geriatric Medicine, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6740 W Deer Valley Rd, Suite D 107, Glendale, AZ 85310 Phone: 623-734-7414 | |
Woods Family Practice Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20652 N 53rd Ave, Glendale, AZ 85308 Phone: 262-383-5517 Fax: 920-268-4285 | |
Malinka Care Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 18700 N 64th Dr Ste 201, Glendale, AZ 85308 Phone: 602-699-6272 Fax: 862-343-9530 |