| The Core Institute | |
|
18444 N 25th Ave Ste 210 Phoenix AZ 85023-1261 | |
| (623) 537-5600 | |
| (866) 939-2673 |
| Full Name | The Core Institute |
|---|---|
| Speciality | Orthopaedic Surgery |
| Location | 18444 N 25th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | David Joseph Jacofsky (MD -CEO) |
| Authorized Official Contact | 8669742673 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| The Core Institute 18444 N 25th Ave Ste 310 Phoenix AZ 85023-1266 Ph: (623) 537-5600 | The Core Institute 18444 N 25th Ave Ste 210 Phoenix AZ 85023-1261 Ph: (623) 537-5600 |
| NPI Number | 1427095801 |
|---|---|
| Provider Enumeration Date | 06/02/2006 |
| Last Update Date | 10/27/2026 |
| Certification Date | 10/27/2026 |
| Medicare PECOS PAC ID | 0345287322 |
|---|---|
| Medicare Enrollment ID | O20050412000087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427095801 | NPI | - | NPPES |
| Provider Name | Dorothy a Mcguinness |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699769992 PECOS PAC ID: 9032004247 Enrollment ID: I20040217000750 |
| Provider Name | Arash Araghi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1730183690 PECOS PAC ID: 9335039536 Enrollment ID: I20040402000052 |
| Provider Name | Mark D Mellinger |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922070366 PECOS PAC ID: 3779577614 Enrollment ID: I20040413000815 |
| Provider Name | Jennifer Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184651663 PECOS PAC ID: 3870580632 Enrollment ID: I20040426001314 |
| Provider Name | Tharesh Udupa |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1275537607 PECOS PAC ID: 1951398460 Enrollment ID: I20040427001400 |
| Provider Name | Kirk M Puttlitz |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1205807971 PECOS PAC ID: 8224017504 Enrollment ID: I20040719001524 |
| Provider Name | Michelle R Hitchcock |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467492637 PECOS PAC ID: 0244200673 Enrollment ID: I20040730001071 |
| Provider Name | Byron H Willis |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1316960842 PECOS PAC ID: 2062487457 Enrollment ID: I20040830000481 |
| Provider Name | Andre Hagevik |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528039625 PECOS PAC ID: 4486615010 Enrollment ID: I20041026000747 |
| Provider Name | Bourck D Cashmore |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1225009707 PECOS PAC ID: 8729043617 Enrollment ID: I20041119000518 |
| Provider Name | John Andrew Brown |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306887088 PECOS PAC ID: 0345239612 Enrollment ID: I20050413000011 |
| Provider Name | David J Jacofsky |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922040179 PECOS PAC ID: 8022055003 Enrollment ID: I20050413000028 |
| Provider Name | Mark Doran Campbell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619918745 PECOS PAC ID: 6204873144 Enrollment ID: I20050413000055 |
| Provider Name | Amber L Randall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1063496255 PECOS PAC ID: 4284606385 Enrollment ID: I20050705001027 |
| Provider Name | Eric Michael Feldman |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1477509693 PECOS PAC ID: 0446282131 Enrollment ID: I20050901000777 |
| Provider Name | Kristen L Green |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255511713 PECOS PAC ID: 3173549672 Enrollment ID: I20051024000090 |
| Provider Name | Vardges Vandian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093755274 PECOS PAC ID: 7911802921 Enrollment ID: I20051128000528 |
| Provider Name | Limor P Wall |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1619959970 PECOS PAC ID: 3870584642 Enrollment ID: I20051206000474 |
| Provider Name | Becky R Cooley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689627374 PECOS PAC ID: 4385665710 Enrollment ID: I20051214000041 |
| Provider Name | Yuri Lewicky |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467454702 PECOS PAC ID: 6800824525 Enrollment ID: I20060109000141 |
| Provider Name | Steven L Myerthall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487691739 PECOS PAC ID: 2365457710 Enrollment ID: I20060207000525 |
| Provider Name | Greg E Harris |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487684049 PECOS PAC ID: 0244245926 Enrollment ID: I20060216000393 |
| Provider Name | Joseph B Dobrusin |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1457391559 PECOS PAC ID: 4082629050 Enrollment ID: I20060310000024 |
| Provider Name | Sepein Chiang |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154491710 PECOS PAC ID: 1153307517 Enrollment ID: I20060421000560 |
| Provider Name | Katherine a Zwanziger |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1871515171 PECOS PAC ID: 1153325907 Enrollment ID: I20060908000335 |
| Provider Name | John Allen Kearney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578583928 PECOS PAC ID: 7113923541 Enrollment ID: I20061009000054 |
| Provider Name | Jennifer M Fergestad |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1043276777 PECOS PAC ID: 7618997909 Enrollment ID: I20061219000011 |
| Provider Name | John W Cory |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1760474845 PECOS PAC ID: 7810985892 Enrollment ID: I20070108000584 |
| Provider Name | Rene Angel Lucas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1821081902 PECOS PAC ID: 9133129430 Enrollment ID: I20070111000072 |
| Provider Name | Vikram a Kumar |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295758035 PECOS PAC ID: 9537164918 Enrollment ID: I20070130000412 |
| Provider Name | Jose a Menendez |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295744779 PECOS PAC ID: 6002817202 Enrollment ID: I20070130000437 |
| Provider Name | Bryan T Wall |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790712792 PECOS PAC ID: 5799727822 Enrollment ID: I20070213000033 |
| Provider Name | Tammy a Doering |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609800135 PECOS PAC ID: 0941239073 Enrollment ID: I20070214000089 |
| Provider Name | Sarah E Muller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285717124 PECOS PAC ID: 9739281692 Enrollment ID: I20070223000025 |
| Provider Name | Kyra R Barbosa |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1326253485 PECOS PAC ID: 6507965274 Enrollment ID: I20070620000587 |
| Provider Name | Frank J Raia |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1043411416 PECOS PAC ID: 6305945890 Enrollment ID: I20070625000306 |
| Provider Name | Jason Scalise |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073681367 PECOS PAC ID: 7214968585 Enrollment ID: I20070625000321 |
| Provider Name | Damon Adamany |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1770622771 PECOS PAC ID: 7618068826 Enrollment ID: I20070802000135 |
| Provider Name | Jennifer L Wright |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831278316 PECOS PAC ID: 4688767890 Enrollment ID: I20070904000735 |
| Provider Name | Manda L Chatelain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124049838 PECOS PAC ID: 5597853655 Enrollment ID: I20071127000047 |
| Provider Name | Matthew Weichbrodt |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1013123058 PECOS PAC ID: 4880643980 Enrollment ID: I20080602000568 |
| Provider Name | Scott William Siverhus |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336121102 PECOS PAC ID: 5193617801 Enrollment ID: I20080603000383 |
| Provider Name | Lawrence M Kutz |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1992825343 PECOS PAC ID: 9335212935 Enrollment ID: I20080715000537 |
| Provider Name | Jason R Sherman |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1689896060 PECOS PAC ID: 8426122698 Enrollment ID: I20080806000261 |
| Provider Name | Linda Tipton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770739187 PECOS PAC ID: 7214091974 Enrollment ID: I20090126000433 |
| Provider Name | David a Ben Aviv |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1639348436 PECOS PAC ID: 6305995697 Enrollment ID: I20090515000214 |
| Provider Name | Robert Cercek |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1962621292 PECOS PAC ID: 5294887329 Enrollment ID: I20090721000042 |
| Provider Name | David Terry |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1801916630 PECOS PAC ID: 0042398950 Enrollment ID: I20090722000608 |
| Provider Name | Chandrahas Patel |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1770799660 PECOS PAC ID: 2769557479 Enrollment ID: I20090805000187 |
| Provider Name | Lannery S Lauvao |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1124242029 PECOS PAC ID: 5395899264 Enrollment ID: I20090812000701 |
| Provider Name | Hilary a Delis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154656437 PECOS PAC ID: 5698814374 Enrollment ID: I20091209000661 |
| Provider Name | Melissa a Barrett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114257342 PECOS PAC ID: 4880721935 Enrollment ID: I20100421000202 |
| Provider Name | Amalia M Decomas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1063603843 PECOS PAC ID: 6608909890 Enrollment ID: I20100809001130 |
| Provider Name | Tony K Nguyen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598939175 PECOS PAC ID: 0042334419 Enrollment ID: I20100908000282 |
| Provider Name | Mona Vijay Mhatre |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1609993179 PECOS PAC ID: 5496948051 Enrollment ID: I20101015000386 |
| Provider Name | William Clyne Thompson |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1538394408 PECOS PAC ID: 0345434825 Enrollment ID: I20101028000706 |
| Provider Name | Krystle Uribe |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1013223890 PECOS PAC ID: 7012101132 Enrollment ID: I20101103000351 |
| Provider Name | Ali Araghi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1912969635 PECOS PAC ID: 4082656202 Enrollment ID: I20110113000174 |
| Provider Name | Christopher a Iannotti |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1124294913 PECOS PAC ID: 0648304709 Enrollment ID: I20110203000862 |
| Provider Name | Troy Matthew Merckle |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316140916 PECOS PAC ID: 8224123583 Enrollment ID: I20110302000872 |
| Provider Name | Mark a Triplett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1508192519 PECOS PAC ID: 3779623061 Enrollment ID: I20110726000903 |
| Provider Name | Carolyn C Janik |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144534595 PECOS PAC ID: 9436327889 Enrollment ID: I20110816000561 |
| Provider Name | Bradford Gibson Tenney |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043599814 PECOS PAC ID: 6204009525 Enrollment ID: I20111102000533 |
| Provider Name | Carolyn R Wagner Von Hoff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013290410 PECOS PAC ID: 0749456796 Enrollment ID: I20111222000303 |
| Provider Name | Carlos S Pence |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477839041 PECOS PAC ID: 8820264609 Enrollment ID: I20111228000354 |
| Provider Name | Lana L Duncan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255617049 PECOS PAC ID: 2062688492 Enrollment ID: I20120105000612 |
| Provider Name | Chaim Kaplan |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043593353 PECOS PAC ID: 3577730571 Enrollment ID: I20120113000727 |
| Provider Name | Christina L Wooldridge |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700054335 PECOS PAC ID: 1951462688 Enrollment ID: I20120116000136 |
| Provider Name | Jessica M Ryder |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649317470 PECOS PAC ID: 9830352012 Enrollment ID: I20120525000497 |
| Provider Name | Jessica R Hepburn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649505181 PECOS PAC ID: 9638335672 Enrollment ID: I20120719000453 |
| Provider Name | Jennifer M Almendarez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457589061 PECOS PAC ID: 2365594637 Enrollment ID: I20120820000716 |
| Provider Name | Nicholas Peter Bellinaso |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487911798 PECOS PAC ID: 1759538069 Enrollment ID: I20120821000954 |
| Provider Name | Ahmad Nizam |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427368885 PECOS PAC ID: 0749437754 Enrollment ID: I20120827000706 |
| Provider Name | Nicholas a Scott |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1588849517 PECOS PAC ID: 3971750910 Enrollment ID: I20120828000106 |
| Provider Name | Evan J Freedman |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1184835613 PECOS PAC ID: 1850548892 Enrollment ID: I20120828000141 |
| Provider Name | Todd C Herman |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1063788875 PECOS PAC ID: 9638326580 Enrollment ID: I20120828000316 |
| Provider Name | Ryan Thomas Scott |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1053554600 PECOS PAC ID: 2769650829 Enrollment ID: I20120926000296 |
| Provider Name | Cathleen Bickel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992058127 PECOS PAC ID: 2668624313 Enrollment ID: I20121204000413 |
| Provider Name | Megan L Mccarty |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114278611 PECOS PAC ID: 4284888082 Enrollment ID: I20130201000354 |
| Provider Name | Kareem Akinfefumwah Anderson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1346575420 PECOS PAC ID: 7214074111 Enrollment ID: I20130401000206 |
| Provider Name | Garret W Bruno |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942559547 PECOS PAC ID: 4880830405 Enrollment ID: I20130425000695 |
| Provider Name | Harvinder Kumar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881859460 PECOS PAC ID: 6800034232 Enrollment ID: I20130524000366 |
| Provider Name | Daniel F Spetrini |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1821325846 PECOS PAC ID: 1658410360 Enrollment ID: I20131014000456 |
| Provider Name | Melissa M Galli |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659509214 PECOS PAC ID: 9234394107 Enrollment ID: I20140218002111 |
| Provider Name | Anuj Prakash Daftari |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1043452196 PECOS PAC ID: 9739319526 Enrollment ID: I20140221001455 |
| Provider Name | Norman Barrington Chutkan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689682890 PECOS PAC ID: 2062577901 Enrollment ID: I20140701000802 |
| Provider Name | Nina Patel-hinkle |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1073515078 PECOS PAC ID: 9335364306 Enrollment ID: I20140707001652 |
| Provider Name | Justin Edward Statt |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1649590050 PECOS PAC ID: 2163649765 Enrollment ID: I20140805001732 |
| Provider Name | Jamie M Pearson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700960325 PECOS PAC ID: 0143350629 Enrollment ID: I20140818000449 |
| Provider Name | Robert N Steinmeyer |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1255732558 PECOS PAC ID: 8628298163 Enrollment ID: I20141003000517 |
| Provider Name | Kalynn Marie Burrows |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184049959 PECOS PAC ID: 1759504095 Enrollment ID: I20141112000391 |
| Provider Name | Jonathan D Halley-ibrahim |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841691755 PECOS PAC ID: 9830311349 Enrollment ID: I20141118002426 |
| Provider Name | David Maurice Jackson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1144364696 PECOS PAC ID: 6406044536 Enrollment ID: I20150106002621 |
| Provider Name | Stephanie Murphy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215331699 PECOS PAC ID: 2668791369 Enrollment ID: I20150430001727 |
| Provider Name | David Eschler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255770863 PECOS PAC ID: 6901047323 Enrollment ID: I20150721000587 |
| Provider Name | Brigitte Flanagan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1962600585 PECOS PAC ID: 4789998568 Enrollment ID: I20150806012873 |
| Provider Name | Raymond Finch |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639551617 PECOS PAC ID: 7113232349 Enrollment ID: I20150818004513 |
| Provider Name | Bernadette Connor |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760574503 PECOS PAC ID: 2961412069 Enrollment ID: I20150910001781 |
| Provider Name | Michael H Amini |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1528292166 PECOS PAC ID: 3678790433 Enrollment ID: I20150921002826 |
| Provider Name | Mark W Allen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1124339676 PECOS PAC ID: 6800104423 Enrollment ID: I20151001001267 |
| Provider Name | Chad Benninghoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912256256 PECOS PAC ID: 4385894203 Enrollment ID: I20151209001141 |
| Provider Name | Monica Janac |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1285061481 PECOS PAC ID: 6002042751 Enrollment ID: I20160315002904 |
| Provider Name | Morris B Hamburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104176627 PECOS PAC ID: 7911150511 Enrollment ID: I20160330001362 |
| Provider Name | Jaime M Rawson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508026469 PECOS PAC ID: 8224329461 Enrollment ID: I20160620001316 |
| Provider Name | Eamonn M Mahoney |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366626756 PECOS PAC ID: 6305962408 Enrollment ID: I20160819001959 |
| Provider Name | John Wallace |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1225292634 PECOS PAC ID: 4789834375 Enrollment ID: I20161003001633 |
| Provider Name | Grayson Halladay |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1225589021 PECOS PAC ID: 8820378730 Enrollment ID: I20161212002005 |
| Provider Name | Joshua Korson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316497308 PECOS PAC ID: 3971886730 Enrollment ID: I20170202000658 |
| Provider Name | Niloofar Dehghan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295272334 PECOS PAC ID: 9436432747 Enrollment ID: I20170213000658 |
| Provider Name | Amanda Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922550367 PECOS PAC ID: 7012290992 Enrollment ID: I20170220002562 |
| Provider Name | Kurt Lundberg |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1689930927 PECOS PAC ID: 4981836822 Enrollment ID: I20170707002072 |
| Provider Name | Kelly Krohn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942279948 PECOS PAC ID: 4587690391 Enrollment ID: I20170724000328 |
| Provider Name | Heather Ann Fett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811423262 PECOS PAC ID: 5193099802 Enrollment ID: I20170919003316 |
| Provider Name | Brooks T Tennyson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1497276299 PECOS PAC ID: 8325312465 Enrollment ID: I20170927004625 |
| Provider Name | Kristen Nicole Hogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932610862 PECOS PAC ID: 7618233081 Enrollment ID: I20171117002629 |
| Provider Name | Marshall M Hughes |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1457866147 PECOS PAC ID: 1355600016 Enrollment ID: I20180125002849 |
| Provider Name | Nally Oteng Ofosu Budu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1881192037 PECOS PAC ID: 9436419298 Enrollment ID: I20180216000768 |
| Provider Name | Benjamin C Damico |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609365188 PECOS PAC ID: 8123374063 Enrollment ID: I20180706000495 |
| Provider Name | Samuel L Ashby |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598150492 PECOS PAC ID: 5496002495 Enrollment ID: I20180723001233 |
| Provider Name | Jennifer Anne White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407157811 PECOS PAC ID: 3476729534 Enrollment ID: I20180830000602 |
| Provider Name | Nicholas Kurt Wischmeier |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700148731 PECOS PAC ID: 2860798964 Enrollment ID: I20180912000169 |
| Provider Name | Brandon Paul Hirsch |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447559216 PECOS PAC ID: 4789956517 Enrollment ID: I20180918001084 |
| Provider Name | Michael B Rose |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861758435 PECOS PAC ID: 3779737002 Enrollment ID: I20181001002373 |
| Provider Name | Kylie Malychewski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568942944 PECOS PAC ID: 3274886551 Enrollment ID: I20181102002402 |
| Provider Name | Jordan Alexandra Cave |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134626880 PECOS PAC ID: 6507110863 Enrollment ID: I20181126004004 |
| Provider Name | Jason J Koczman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376648782 PECOS PAC ID: 1254392053 Enrollment ID: I20181213002024 |
| Provider Name | Ryan G Zate |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1790110112 PECOS PAC ID: 0840418893 Enrollment ID: I20190123000892 |
| Provider Name | Zaccary George Ekdahl |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134631104 PECOS PAC ID: 3971859372 Enrollment ID: I20190125000987 |
| Provider Name | Ashley Marie Warner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639643612 PECOS PAC ID: 9133468879 Enrollment ID: I20190225001937 |
| Provider Name | Kristen Lynn Julius |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1912474149 PECOS PAC ID: 7517207665 Enrollment ID: I20190327002168 |
| Provider Name | Jonathan E Bolles |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1316183338 PECOS PAC ID: 9638232390 Enrollment ID: I20190328000597 |
| Provider Name | Justine Wang |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851863740 PECOS PAC ID: 4284975533 Enrollment ID: I20190415000489 |
| Provider Name | Joshua Loggins |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1295163699 PECOS PAC ID: 2769619196 Enrollment ID: I20190524002523 |
| Provider Name | Emmanuel Bonilla-segura |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518423532 PECOS PAC ID: 6204161383 Enrollment ID: I20190711001559 |
| Provider Name | Natanya Aron Mcdonough |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245500818 PECOS PAC ID: 5597901850 Enrollment ID: I20190802001642 |
| Provider Name | Thomas Acott |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1760826853 PECOS PAC ID: 1759520448 Enrollment ID: I20190827003632 |
| Provider Name | Joseph Jabrucki |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104337088 PECOS PAC ID: 0840566485 Enrollment ID: I20190923000826 |
| Provider Name | Rebecca Shoup |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124676689 PECOS PAC ID: 7012248024 Enrollment ID: I20191004002559 |
| Provider Name | Amanda Whiteside |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396210621 PECOS PAC ID: 8426380544 Enrollment ID: I20191022003907 |
| Provider Name | Cassie M Newport |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235691155 PECOS PAC ID: 3072945690 Enrollment ID: I20191119002158 |
| Provider Name | Kristian Angelo Dumelod Oarde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801399407 PECOS PAC ID: 6901238484 Enrollment ID: I20191121002527 |
| Provider Name | Shannon Costello |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1144865171 PECOS PAC ID: 5799111969 Enrollment ID: I20200206001279 |
| Provider Name | Charlotte Petin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962059865 PECOS PAC ID: 3375970932 Enrollment ID: I20200221000582 |
| Provider Name | Torrey a Parry |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1326459660 PECOS PAC ID: 0547690141 Enrollment ID: I20200422002865 |
| Provider Name | Kirsten Sumner |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1578981601 PECOS PAC ID: 0941503130 Enrollment ID: I20200501000140 |
| Provider Name | Kolby Hemmele |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962030734 PECOS PAC ID: 3678904273 Enrollment ID: I20200514003222 |
| Provider Name | Tanner Olsen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942840335 PECOS PAC ID: 9931520871 Enrollment ID: I20200602001757 |
| Provider Name | Hayden Poulson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1710444831 PECOS PAC ID: 7810324969 Enrollment ID: I20200619000443 |
| Provider Name | Blake Obrock |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770879843 PECOS PAC ID: 8729358544 Enrollment ID: I20200630003404 |
| Provider Name | Emily R Moore |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164937439 PECOS PAC ID: 6608299839 Enrollment ID: I20200707002439 |
| Provider Name | Rachael a Brovitz |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194342303 PECOS PAC ID: 2264855253 Enrollment ID: I20200709001320 |
| Provider Name | Timothy James Degan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447679840 PECOS PAC ID: 2961753405 Enrollment ID: I20200824002407 |
| Provider Name | Stephen Joseph Ros |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013320431 PECOS PAC ID: 8224336896 Enrollment ID: I20200901001718 |
| Provider Name | Jason Allan Genco |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1487023453 PECOS PAC ID: 3678882206 Enrollment ID: I20200911001849 |
| Provider Name | Jonathan T Marshall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952549644 PECOS PAC ID: 9830346006 Enrollment ID: I20200921000545 |
| Provider Name | Thomas Goodine |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1366931354 PECOS PAC ID: 0749531655 Enrollment ID: I20201012002158 |
| Provider Name | Chad Gleason |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578029336 PECOS PAC ID: 4284044710 Enrollment ID: I20201111002096 |
| Provider Name | Sarah Helen Briggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598377715 PECOS PAC ID: 5395156368 Enrollment ID: I20201123002498 |
| Provider Name | Taylor M Lonsdale |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477156917 PECOS PAC ID: 9739590746 Enrollment ID: I20201124000575 |
| Provider Name | Danielle M France |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1952956260 PECOS PAC ID: 7012339518 Enrollment ID: I20201221001700 |
| Provider Name | Rachel a Stephenson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1891394680 PECOS PAC ID: 6103238738 Enrollment ID: I20201223001152 |
| Provider Name | Kylee Ann Lattomus |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356957062 PECOS PAC ID: 9537571161 Enrollment ID: I20201223001229 |
| Provider Name | Bridgette Lynn Caquatto |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962026955 PECOS PAC ID: 8628481546 Enrollment ID: I20210113000953 |
| Provider Name | Megan M Youngstead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346840055 PECOS PAC ID: 6406269190 Enrollment ID: I20210121001575 |
| Provider Name | Jamie Yokley |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1992312474 PECOS PAC ID: 2860807922 Enrollment ID: I20210223001654 |
| Provider Name | Heather Miyashiro |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1922516483 PECOS PAC ID: 3072875863 Enrollment ID: I20210317001297 |
| Provider Name | Cassandra Cavallaro |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043729494 PECOS PAC ID: 2769757632 Enrollment ID: I20210324002064 |
| Provider Name | Drew Lichtblau |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578148391 PECOS PAC ID: 3971911843 Enrollment ID: I20210413001997 |
| Provider Name | Megan Harder |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205456464 PECOS PAC ID: 4183033376 Enrollment ID: I20210428002888 |
| Provider Name | Ashlyn Clarise Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467035931 PECOS PAC ID: 7113326224 Enrollment ID: I20210521001599 |
| Provider Name | Lana Elizabeth Formo |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1396364261 PECOS PAC ID: 5092114637 Enrollment ID: I20210601002186 |
| Provider Name | Donald Oliver Morgenson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1598216434 PECOS PAC ID: 2860893724 Enrollment ID: I20210629002730 |
| Provider Name | James P Moran |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609850585 PECOS PAC ID: 7012809957 Enrollment ID: I20210712000171 |
| Provider Name | Zachary Hahn |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891363420 PECOS PAC ID: 7113320102 Enrollment ID: I20210728002950 |
| Provider Name | Michael Duran |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659765568 PECOS PAC ID: 2062785942 Enrollment ID: I20210813002677 |
| Provider Name | Paul Sousa |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275915332 PECOS PAC ID: 4486969870 Enrollment ID: I20210818002474 |
| Provider Name | Jaharris Ahmed Collier |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679928436 PECOS PAC ID: 6800180589 Enrollment ID: I20210825002796 |
| Provider Name | Jason Erickson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942890843 PECOS PAC ID: 9739585571 Enrollment ID: I20210902002173 |
| Provider Name | Matthew Hall Mccorkle |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154993335 PECOS PAC ID: 1951708999 Enrollment ID: I20210917002376 |
| Provider Name | Kelly Klein |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407296882 PECOS PAC ID: 6406080662 Enrollment ID: I20210927003356 |
| Provider Name | Joseph Marian |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1093346926 PECOS PAC ID: 8022430859 Enrollment ID: I20210928001312 |
| Provider Name | Kyndal Schultz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528695608 PECOS PAC ID: 8820496821 Enrollment ID: I20211005003028 |
| Provider Name | James Christopher Linhoff |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1649259482 PECOS PAC ID: 8224161328 Enrollment ID: I20211221002861 |
| Provider Name | Gillian Marie Hyde |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1467119610 PECOS PAC ID: 3173914975 Enrollment ID: I20220106000044 |
| Provider Name | Christina Lillian Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396411765 PECOS PAC ID: 3678968849 Enrollment ID: I20220325000193 |
| Provider Name | Lyndon Knights |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1902175839 PECOS PAC ID: 3476720012 Enrollment ID: I20220325001312 |
| Provider Name | Alexandra M Perez Witzman |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700389988 PECOS PAC ID: 7012279334 Enrollment ID: I20220408002217 |
| Provider Name | Courtney Page |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1003439373 PECOS PAC ID: 8325434541 Enrollment ID: I20220414002093 |
| Provider Name | Jared R Grow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740934959 PECOS PAC ID: 4880081520 Enrollment ID: I20220427000363 |
| Provider Name | Matthew Repp |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1205570892 PECOS PAC ID: 5991192627 Enrollment ID: I20220428000790 |
| Provider Name | Michala Anne Scott |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1609516889 PECOS PAC ID: 9830576131 Enrollment ID: I20220505002625 |
| Provider Name | Kaitlyn E Post |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1154734176 PECOS PAC ID: 9830318815 Enrollment ID: I20220511000824 |
| Provider Name | Emily J Larsen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245821487 PECOS PAC ID: 3274910278 Enrollment ID: I20220512001873 |
| Provider Name | Sienna Klopp |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1124770284 PECOS PAC ID: 4880071729 Enrollment ID: I20220516002099 |
| Provider Name | Tasha Stark |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356850267 PECOS PAC ID: 8921342510 Enrollment ID: I20220519002364 |
| Provider Name | Megan Greener |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154999571 PECOS PAC ID: 7517361074 Enrollment ID: I20220614002833 |
| Provider Name | Chayla Bonelli |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932783750 PECOS PAC ID: 4486033628 Enrollment ID: I20220620000310 |
| Provider Name | Elizabeth M Henquinet |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376299362 PECOS PAC ID: 7810377934 Enrollment ID: I20220707001831 |
| Provider Name | Kimberly Marston |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1568191344 PECOS PAC ID: 8224419916 Enrollment ID: I20220712003319 |
| Provider Name | Karen Nicole Woods |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1033615091 PECOS PAC ID: 8921353087 Enrollment ID: I20220726001716 |
| Provider Name | Vikram Mayuran |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1568879773 PECOS PAC ID: 3375878366 Enrollment ID: I20220817003956 |
| Provider Name | Jeffrey Blaine Surina |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1750743191 PECOS PAC ID: 8224323720 Enrollment ID: I20220819001246 |
| Provider Name | Andrew V Chester |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154069128 PECOS PAC ID: 2062896244 Enrollment ID: I20220907003309 |
| Provider Name | Sara Lynn Grubor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447971999 PECOS PAC ID: 0042695256 Enrollment ID: I20220923000378 |
| Provider Name | Burak Altintas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831604552 PECOS PAC ID: 2163775966 Enrollment ID: I20220923001279 |
| Provider Name | Leah Chen Liu Williams |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366197121 PECOS PAC ID: 0749666873 Enrollment ID: I20220927003053 |
| Provider Name | Mira Rhae Luke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1841913456 PECOS PAC ID: 9133595507 Enrollment ID: I20221026002615 |
| Provider Name | Chase Thomas Pologa |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043939945 PECOS PAC ID: 9234506676 Enrollment ID: I20221027002826 |
| Provider Name | Mariana Kedzia |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1407575053 PECOS PAC ID: 6103293485 Enrollment ID: I20221028001489 |
| Provider Name | Alicia Lynn Murray |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780271270 PECOS PAC ID: 3274901632 Enrollment ID: I20221116002492 |
| Provider Name | Judy Cho |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1851064059 PECOS PAC ID: 0042688319 Enrollment ID: I20221116003235 |
| Provider Name | Katarzyna Mosio |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932841947 PECOS PAC ID: 7719355908 Enrollment ID: I20221118001687 |
| Provider Name | Sara Maldonado |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093160723 PECOS PAC ID: 1153799762 Enrollment ID: I20221201000797 |
| Provider Name | Claire Marie Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043971823 PECOS PAC ID: 0840660445 Enrollment ID: I20221222001742 |
| Provider Name | Amanda Rose Cheetham |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1164016820 PECOS PAC ID: 6507237062 Enrollment ID: I20230119001373 |
| Provider Name | Jasmine Dominique Kalili |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932639788 PECOS PAC ID: 0345611398 Enrollment ID: I20230130001912 |
| Provider Name | Brent Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1144420472 PECOS PAC ID: 7012054158 Enrollment ID: I20230208000915 |
| Provider Name | Esther Toronto |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588370860 PECOS PAC ID: 9638541618 Enrollment ID: I20230221002511 |
| Provider Name | Kari St. Hubert |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1891837902 PECOS PAC ID: 9335214774 Enrollment ID: I20230301000229 |
| Provider Name | Brittney Marie Petersen |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679160436 PECOS PAC ID: 2163896861 Enrollment ID: I20230321000361 |
| Provider Name | Nirain Dsouza |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1295736106 PECOS PAC ID: 5799888764 Enrollment ID: I20230501002809 |
| Provider Name | Ryan Paul Malburg |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104599265 PECOS PAC ID: 5991161267 Enrollment ID: I20230512000617 |
| Provider Name | Nancy Tiet Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093327421 PECOS PAC ID: 1355708470 Enrollment ID: I20230606000932 |
| Provider Name | Anthony M White |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386141521 PECOS PAC ID: 6002205143 Enrollment ID: I20230606002721 |
| Provider Name | Melissa Brummond |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1578750188 PECOS PAC ID: 4486734001 Enrollment ID: I20230609000929 |
| Provider Name | John Moeser |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902590706 PECOS PAC ID: 3274991765 Enrollment ID: I20230614003979 |
| Provider Name | Colleen E Karn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710210109 PECOS PAC ID: 7315083078 Enrollment ID: I20230629003208 |
| Provider Name | Michael Holmboe |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720596653 PECOS PAC ID: 2668831025 Enrollment ID: I20230703000113 |
| Provider Name | Katherine Xie |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134654858 PECOS PAC ID: 8123398914 Enrollment ID: I20230707001424 |
| Provider Name | Michael James Mckernan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1356873392 PECOS PAC ID: 1850784810 Enrollment ID: I20230717003070 |
| Provider Name | Corey Carver |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013417518 PECOS PAC ID: 9335404649 Enrollment ID: I20230719002323 |
| Provider Name | Kelly Marie Miller |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215631130 PECOS PAC ID: 2264893981 Enrollment ID: I20230727003330 |
| Provider Name | Victoria North |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1033807755 PECOS PAC ID: 1658732250 Enrollment ID: I20230728003021 |
| Provider Name | Justin Thomas Butler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396246583 PECOS PAC ID: 5496116733 Enrollment ID: I20230802002202 |
| Provider Name | Brenna L Canterbury |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699057091 PECOS PAC ID: 4688846660 Enrollment ID: I20230815002297 |
| Provider Name | Kassandra Michelle Hardtke |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790454775 PECOS PAC ID: 2567856396 Enrollment ID: I20230823000726 |
| Provider Name | Theresa Pak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1922536630 PECOS PAC ID: 4880073881 Enrollment ID: I20230908000232 |
| Provider Name | Cole Michael Luby |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740978352 PECOS PAC ID: 1557725066 Enrollment ID: I20230918002064 |
| Provider Name | Emily Paige Ducatte |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740991751 PECOS PAC ID: 5496109571 Enrollment ID: I20230922001763 |
| Provider Name | Nathan Cord Meyer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1679203319 PECOS PAC ID: 0345696753 Enrollment ID: I20231020002092 |
| Provider Name | Richard Michaelson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801310149 PECOS PAC ID: 1759653249 Enrollment ID: I20231025001970 |
| Provider Name | Christopher Russell Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164144077 PECOS PAC ID: 4880042027 Enrollment ID: I20231128002106 |
| Provider Name | Lysa Marie Busalacchi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629757224 PECOS PAC ID: 0244688034 Enrollment ID: I20231205001658 |
| Provider Name | Haley Brooks Everroad |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1578297891 PECOS PAC ID: 8729438502 Enrollment ID: I20231219003679 |
| Provider Name | Madeline Patricia Marotta |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154196756 PECOS PAC ID: 1254781479 Enrollment ID: I20231229000398 |
| Provider Name | Ryan D Johnson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104459353 PECOS PAC ID: 2163852179 Enrollment ID: I20240111002630 |
| Provider Name | Debra Brown |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1114274669 PECOS PAC ID: 1355623877 Enrollment ID: I20240124002597 |
| Provider Name | Mark Winchell |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265209027 PECOS PAC ID: 2466805270 Enrollment ID: I20240129001930 |
| Provider Name | Luke Chon |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1437928116 PECOS PAC ID: 2961855531 Enrollment ID: I20240131000001 |
| Provider Name | Kurt Barger |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417514902 PECOS PAC ID: 0244607729 Enrollment ID: I20240131001198 |
| Provider Name | Shannon Galish |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942061569 PECOS PAC ID: 0941643118 Enrollment ID: I20240206000001 |
| Provider Name | Armand Payne |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740058205 PECOS PAC ID: 0446693196 Enrollment ID: I20240209000044 |
| Provider Name | Kael Nahikian |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932559077 PECOS PAC ID: 6002259785 Enrollment ID: I20240209001034 |
| Provider Name | Jalonna Rose Ohr |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013628023 PECOS PAC ID: 8022452358 Enrollment ID: I20240214003809 |
| Provider Name | Jordan Daniel Willoughby |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1013790856 PECOS PAC ID: 9335583301 Enrollment ID: I20240217000118 |
| Provider Name | Madison Soles |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1942076062 PECOS PAC ID: 9931544889 Enrollment ID: I20240229004694 |
| Provider Name | Ann Sautter Daniel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1568238863 PECOS PAC ID: 5193161743 Enrollment ID: I20240306001746 |
| Provider Name | Garrett Lee Chartier |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1245096122 PECOS PAC ID: 6507202512 Enrollment ID: I20240313001413 |
| Provider Name | Daniel L Lara |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1861847915 PECOS PAC ID: 3375838535 Enrollment ID: I20240410003088 |
| Provider Name | Sina Vaitiere Gartner |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700402450 PECOS PAC ID: 4587063474 Enrollment ID: I20240502001967 |
| Provider Name | Adam Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508511015 PECOS PAC ID: 5698160653 Enrollment ID: I20240522002761 |
| Provider Name | Carlos Daniel Villalpando |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104485184 PECOS PAC ID: 9335681337 Enrollment ID: I20240605003339 |
| Provider Name | Albit Paoli Garrido |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508363912 PECOS PAC ID: 5799220802 Enrollment ID: I20240712003748 |
| Provider Name | Grant Schindler |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1326645706 PECOS PAC ID: 5193122786 Enrollment ID: I20240717001584 |
| Provider Name | William Clarence Geisert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1336415736 PECOS PAC ID: 0840417192 Enrollment ID: I20240724003478 |
| Provider Name | Jeremiah Bryan Ozuna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407696792 PECOS PAC ID: 7214474501 Enrollment ID: I20240805001313 |
| Provider Name | Hye Won Chang |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1780425967 PECOS PAC ID: 3577000637 Enrollment ID: I20240807000343 |
| Provider Name | Kristen Allissa Connelly |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972354652 PECOS PAC ID: 8426596339 Enrollment ID: I20240809002203 |
| Provider Name | Jennifer H Wood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679773386 PECOS PAC ID: 3678720141 Enrollment ID: I20240820004280 |
| Provider Name | Hayley Elizabeth O'connell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1184152795 PECOS PAC ID: 4183162134 Enrollment ID: I20240821002538 |
| Provider Name | Fady Hijji |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467985283 PECOS PAC ID: 5597033001 Enrollment ID: I20240822000900 |
| Provider Name | Patricia Melvin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467984526 PECOS PAC ID: 7012275514 Enrollment ID: I20240910001189 |
| Provider Name | Julia Myers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1700256799 PECOS PAC ID: 8527378777 Enrollment ID: I20241007001353 |
| Provider Name | Calysta Jayme Thurston |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639913734 PECOS PAC ID: 6507398856 Enrollment ID: I20241011002285 |
| Provider Name | Rebecca Lynn Varney |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1386224715 PECOS PAC ID: 0244762375 Enrollment ID: I20241015001092 |
| Provider Name | Zoey Glenn Goralski |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1861224750 PECOS PAC ID: 8426580424 Enrollment ID: I20241015004697 |
| Provider Name | Andrew Nelson |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1215621115 PECOS PAC ID: 5799218160 Enrollment ID: I20241024001781 |
| Provider Name | Chanah Marie Turis |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1245069012 PECOS PAC ID: 1850824095 Enrollment ID: I20241028000842 |
| Provider Name | Karina Katchko |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003347832 PECOS PAC ID: 1557631876 Enrollment ID: I20241126001728 |
| Provider Name | Royce Heffington |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1306014626 PECOS PAC ID: 4486727518 Enrollment ID: I20241210001182 |
| Provider Name | Amber Wiser |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689499196 PECOS PAC ID: 3476089657 Enrollment ID: I20241211002026 |
| Provider Name | Amy Dang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265250344 PECOS PAC ID: 5597292201 Enrollment ID: I20241219001154 |
| Provider Name | Salvador Kamanu Ruiz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356173439 PECOS PAC ID: 9931637162 Enrollment ID: I20250115001842 |
| Provider Name | Annalisa Wright |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1760153027 PECOS PAC ID: 3173998226 Enrollment ID: I20250124003010 |
| Provider Name | Kristine Gradisher |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942825492 PECOS PAC ID: 8224568191 Enrollment ID: I20250206002624 |
| Provider Name | Eric Curtis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033746474 PECOS PAC ID: 2365964814 Enrollment ID: I20250313003295 |
| Provider Name | Stacy Thornley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477379121 PECOS PAC ID: 2062934896 Enrollment ID: I20250320002610 |
| Provider Name | Elizabeth Hardy |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750180766 PECOS PAC ID: 7012430390 Enrollment ID: I20250327001079 |
| Provider Name | Carla J Strohhofer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1619592888 PECOS PAC ID: 8628496015 Enrollment ID: I20250328001544 |
| Provider Name | Rachel Lan Semus |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740818905 PECOS PAC ID: 0840714861 Enrollment ID: I20250410002618 |
| Provider Name | Molly Fenimore |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861047920 PECOS PAC ID: 8921330317 Enrollment ID: I20250411002778 |
| Provider Name | Matthew M Gibbs |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285263533 PECOS PAC ID: 6800218496 Enrollment ID: I20250507001010 |
| Provider Name | Sara Kubick |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1396468096 PECOS PAC ID: 1254785314 Enrollment ID: I20250729002600 |
| Provider Name | Matthew Kennedy |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1962077693 PECOS PAC ID: 5395253231 Enrollment ID: I20250801004026 |
| Provider Name | Jacob Kobernick |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942093695 PECOS PAC ID: 3870097710 Enrollment ID: I20250916000406 |
| Provider Name | Lucy Charlotte Bowers |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942092945 PECOS PAC ID: 1557866365 Enrollment ID: I20250923004158 |
| Provider Name | Sarah B Winward |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1629624143 PECOS PAC ID: 1153732755 Enrollment ID: I20250929003750 |
| Provider Name | Todd Phillips |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1073075446 PECOS PAC ID: 3577902659 Enrollment ID: I20251014003739 |
| Provider Name | Paula M Kasuboski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801035613 PECOS PAC ID: 2264581701 Enrollment ID: I20251021004760 |
| Provider Name | Madison Marie Collins |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831875590 PECOS PAC ID: 7810342425 Enrollment ID: I20251105003715 |
| Provider Name | Cole Patrick Bosler |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356219323 PECOS PAC ID: 6204328479 Enrollment ID: I20251125001212 |
| Provider Name | Nicholas P Ramirez |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1215441837 PECOS PAC ID: 7911492954 Enrollment ID: I20251217003931 |
| Provider Name | William Tanner Daniell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1255173019 PECOS PAC ID: 6507352358 Enrollment ID: I20251231000870 |
| Provider Name | Kristin Riggs Wyble-meza |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508729500 PECOS PAC ID: 6709363112 Enrollment ID: I20260115003959 |
| Provider Name | Noor Pawar |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972468742 PECOS PAC ID: 6204313513 Enrollment ID: I20260116002282 |
| Provider Name | Olga Margarita Elias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457827388 PECOS PAC ID: 5597242834 Enrollment ID: I20260116003185 |
| Provider Name | Jack Goforth |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1922957844 PECOS PAC ID: 1759861867 Enrollment ID: I20260217003006 |
| Provider Name | Thomas Claiborne |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1639038334 PECOS PAC ID: 5395227680 Enrollment ID: I20260305001756 |
| Provider Name | Kyla Marie Chavez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1154299014 PECOS PAC ID: 6800371089 Enrollment ID: I20260326002099 |
| Provider Name | Robert Powell |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1043840283 PECOS PAC ID: 7810391786 Enrollment ID: I20260508001937 |
| Provider Name | Alyssa Ann Klop |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1902792104 PECOS PAC ID: 9234608696 Enrollment ID: I20260514002245 |
Richard A. Snider, MD, PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12010 S Warner Elliot Loop, Phoenix, AZ 85044 Phone: 480-893-2644 |
Kelly H. Roy, MD, PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1008 E Mcdowell Rd, Phoenix, AZ 85006 Phone: 602-358-8588 Fax: 602-688-6991 |
My Family Doctor in the Valley PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd, Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 |
Deborah L Dykema DO PC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20045 N 19th Ave Bldg 9-151, Phoenix, AZ 85027 Phone: 602-978-1555 |
Scottsdale Housecall Physicians, LLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11030 N Tatum Blvd Ste 101, Phoenix, AZ 85028 Phone: 602-687-8265 |
Wings of Hope Medical Services, LLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11022 N 28th Dr Ste 270, Phoenix, AZ 85029 Phone: 623-404-8505 Fax: 602-429-8475 |