| UT Health Austin | |
|
1601 Trinity Street Austin TX 78712 | |
| (833) 882-2737 | |
| Not Available |
| Full Name | UT Health Austin |
|---|---|
| Speciality | General Practice |
| Location | 1601 Trinity Street, Austin, Texas |
| Authorized Official Name and Position | Lisa Zavala (REVENUE CYCLE DIRECTOR) |
| Authorized Official Contact | 5124955670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| UT Health Austin Po Box 739960 Dallas TX 75373-9960 Ph: (512) 495-5910 | UT Health Austin 1601 Trinity Street Austin TX 78712 Ph: (833) 882-2737 |
| NPI Number | 1073066239 |
|---|---|
| Provider Enumeration Date | 07/25/2016 |
| Last Update Date | 05/14/2026 |
| Certification Date | 05/14/2026 |
| Medicare PECOS PAC ID | 2668559436 |
|---|---|
| Medicare Enrollment ID | O20080408000293 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073066239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (NU) | Primary |
| Provider Name | John a Bertelson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215959697 PECOS PAC ID: 5799698460 Enrollment ID: I20031110000014 |
| Provider Name | Jeff E Hagen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710965488 PECOS PAC ID: 9931092327 Enrollment ID: I20040209000745 |
| Provider Name | John M Uecker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508889205 PECOS PAC ID: 6507753928 Enrollment ID: I20040301001246 |
| Provider Name | Heather E Cuevas |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1538266861 PECOS PAC ID: 2365331550 Enrollment ID: I20040315000618 |
| Provider Name | Jennifer Aranda |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1902875453 PECOS PAC ID: 6608767298 Enrollment ID: I20040323000913 |
| Provider Name | Robert Paul Dole |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538382452 PECOS PAC ID: 4880677426 Enrollment ID: I20040612000408 |
| Provider Name | Kimberly Carter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538193495 PECOS PAC ID: 2668421967 Enrollment ID: I20050113000495 |
| Provider Name | Vaishali M Vaidya |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1265594691 PECOS PAC ID: 1951350677 Enrollment ID: I20050119000892 |
| Provider Name | Richard B Briggs |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699740712 PECOS PAC ID: 6507816345 Enrollment ID: I20050128000508 |
| Provider Name | Lisa Doggett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982611026 PECOS PAC ID: 6608827563 Enrollment ID: I20050208000709 |
| Provider Name | Zachary Chipman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083776041 PECOS PAC ID: 2264478841 Enrollment ID: I20050705000969 |
| Provider Name | Michael Nix |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891857884 PECOS PAC ID: 0345286837 Enrollment ID: I20050706000953 |
| Provider Name | John G Harkins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629130513 PECOS PAC ID: 2668418161 Enrollment ID: I20050706001003 |
| Provider Name | Elizabeth Douglass |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1073675401 PECOS PAC ID: 7012949415 Enrollment ID: I20050907000352 |
| Provider Name | Leah Dawn Yturri |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1366435323 PECOS PAC ID: 0749213213 Enrollment ID: I20050914001411 |
| Provider Name | Isaac Lavie |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487716478 PECOS PAC ID: 1153340500 Enrollment ID: I20051115001046 |
| Provider Name | Whitney Condra Keller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093877078 PECOS PAC ID: 6608895537 Enrollment ID: I20051121000171 |
| Provider Name | Josephine Flees |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972617470 PECOS PAC ID: 1658393905 Enrollment ID: I20051229000589 |
| Provider Name | Michael Breen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225190259 PECOS PAC ID: 4385691864 Enrollment ID: I20060130000273 |
| Provider Name | Stephen Don Blair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962404244 PECOS PAC ID: 1658386081 Enrollment ID: I20060207000292 |
| Provider Name | Alejandro Moreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609891126 PECOS PAC ID: 9436153996 Enrollment ID: I20060914000421 |
| Provider Name | Ashlea Mica Lucas |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1962591024 PECOS PAC ID: 4082710199 Enrollment ID: I20070521000415 |
| Provider Name | Cassie Lynn Connerty |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1790820397 PECOS PAC ID: 0840399143 Enrollment ID: I20070627000620 |
| Provider Name | Amanda B White |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164642237 PECOS PAC ID: 9133213374 Enrollment ID: I20070919000696 |
| Provider Name | Jane C Edmond |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1023007432 PECOS PAC ID: 1759457153 Enrollment ID: I20080909000493 |
| Provider Name | Amy Young |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518047869 PECOS PAC ID: 1759376080 Enrollment ID: I20081003000679 |
| Provider Name | Jonathan Macclements |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760472625 PECOS PAC ID: 8921167263 Enrollment ID: I20081031000477 |
| Provider Name | Francis P Buckley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104816008 PECOS PAC ID: 5890854939 Enrollment ID: I20081105000155 |
| Provider Name | Alison J Brooks-heinzman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043412471 PECOS PAC ID: 3971663238 Enrollment ID: I20081118000417 |
| Provider Name | Roma B Patel |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538317128 PECOS PAC ID: 3476613258 Enrollment ID: I20081124000592 |
| Provider Name | Mrinalini N Kulkarni |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1568434694 PECOS PAC ID: 6204998909 Enrollment ID: I20081215000056 |
| Provider Name | Adnan a Khan |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1083861249 PECOS PAC ID: 1951463900 Enrollment ID: I20081229000467 |
| Provider Name | Kristin E Mondy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265459762 PECOS PAC ID: 9436181575 Enrollment ID: I20081230000347 |
| Provider Name | Sylvia Deily |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1861436933 PECOS PAC ID: 5698778892 Enrollment ID: I20090116000032 |
| Provider Name | Marian Y Williams-brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861696460 PECOS PAC ID: 9537212642 Enrollment ID: I20090806000127 |
| Provider Name | Wren a Deavers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356392682 PECOS PAC ID: 2860545944 Enrollment ID: I20090807000003 |
| Provider Name | Rita Tsai |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609085042 PECOS PAC ID: 2860547510 Enrollment ID: I20090901000304 |
| Provider Name | Deepak Agrawal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417174707 PECOS PAC ID: 7618023177 Enrollment ID: I20090924000388 |
| Provider Name | Dave F Clarke |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871550772 PECOS PAC ID: 9436186871 Enrollment ID: I20100104000092 |
| Provider Name | Elliot M Frohman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689630147 PECOS PAC ID: 9032253059 Enrollment ID: I20100215000395 |
| Provider Name | Gil Wolfe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215995535 PECOS PAC ID: 4688718612 Enrollment ID: I20100215000505 |
| Provider Name | Gurjeet S Shokar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467520957 PECOS PAC ID: 9931234127 Enrollment ID: I20100312000527 |
| Provider Name | Stephanie J Reich |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346234143 PECOS PAC ID: 6204962376 Enrollment ID: I20100327000529 |
| Provider Name | Mark V Queralt |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1437160934 PECOS PAC ID: 6002906682 Enrollment ID: I20100407000208 |
| Provider Name | John W. Shore |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1194716035 PECOS PAC ID: 2769415058 Enrollment ID: I20100429000216 |
| Provider Name | Kent T Ellington |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487752986 PECOS PAC ID: 5092611129 Enrollment ID: I20100517000851 |
| Provider Name | Jacki L Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700897550 PECOS PAC ID: 7618092552 Enrollment ID: I20100915000367 |
| Provider Name | Lloyd S Berg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548295785 PECOS PAC ID: 0345138756 Enrollment ID: I20101019001432 |
| Provider Name | Navkiran K. Shokar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588722151 PECOS PAC ID: 1052505047 Enrollment ID: I20101103001098 |
| Provider Name | Robert M Feldman |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1093796864 PECOS PAC ID: 8628162468 Enrollment ID: I20101203000382 |
| Provider Name | James G Baker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487650156 PECOS PAC ID: 4880690429 Enrollment ID: I20101215001049 |
| Provider Name | Vanessa J Yium |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598759300 PECOS PAC ID: 7810185691 Enrollment ID: I20101221000142 |
| Provider Name | Steven a Abrams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790782670 PECOS PAC ID: 5991993735 Enrollment ID: I20101221000886 |
| Provider Name | Richard Youatt Declan Fleming |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1881623114 PECOS PAC ID: 3072798008 Enrollment ID: I20110506000079 |
| Provider Name | Holly S Cross |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1811292212 PECOS PAC ID: 9032395322 Enrollment ID: I20110523000191 |
| Provider Name | Sangeeta C Kamdar |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1417247321 PECOS PAC ID: 8921285446 Enrollment ID: I20110610000216 |
| Provider Name | Alex B Haynes |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679609408 PECOS PAC ID: 9931387933 Enrollment ID: I20110622000162 |
| Provider Name | Vivian Pugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932307253 PECOS PAC ID: 4486843703 Enrollment ID: I20110804000087 |
| Provider Name | Samuel Collier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508064114 PECOS PAC ID: 9830229202 Enrollment ID: I20110926000410 |
| Provider Name | Kimberly Maureen Brown |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1326019571 PECOS PAC ID: 9638108772 Enrollment ID: I20110926000744 |
| Provider Name | Kerry M O'mahar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356639173 PECOS PAC ID: 7113193517 Enrollment ID: I20120106000380 |
| Provider Name | Clive Polon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962476762 PECOS PAC ID: 4183882194 Enrollment ID: I20120222000608 |
| Provider Name | Robin Colleen Hilsabeck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356432181 PECOS PAC ID: 0941268544 Enrollment ID: I20120619000288 |
| Provider Name | Brenda Chang |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497013635 PECOS PAC ID: 5890950992 Enrollment ID: I20120622000031 |
| Provider Name | Roshanak Zinn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659660991 PECOS PAC ID: 8729244777 Enrollment ID: I20120719000566 |
| Provider Name | Blair Walker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649404401 PECOS PAC ID: 8820244247 Enrollment ID: I20120816000927 |
| Provider Name | Marcos Sosa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912160763 PECOS PAC ID: 7416104716 Enrollment ID: I20120821000796 |
| Provider Name | Koonj a Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316193907 PECOS PAC ID: 6204084742 Enrollment ID: I20120907000228 |
| Provider Name | Shannon Kathleen O Neill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588960819 PECOS PAC ID: 6709035215 Enrollment ID: I20120927000030 |
| Provider Name | Gene Kim |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1639332372 PECOS PAC ID: 2062681521 Enrollment ID: I20121010000502 |
| Provider Name | Matthew Fox |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1740471929 PECOS PAC ID: 6406002518 Enrollment ID: I20121204000382 |
| Provider Name | Jared Benge |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629307228 PECOS PAC ID: 8820241375 Enrollment ID: I20130111000114 |
| Provider Name | Ashley H Choucroun |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376704544 PECOS PAC ID: 5698929529 Enrollment ID: I20130131000269 |
| Provider Name | Steven J Warach |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407925886 PECOS PAC ID: 7911151865 Enrollment ID: I20130131000390 |
| Provider Name | Amy E Papermaster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417200429 PECOS PAC ID: 3072759620 Enrollment ID: I20130426000277 |
| Provider Name | Jillian Y Bissar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144548470 PECOS PAC ID: 4789822917 Enrollment ID: I20130530000256 |
| Provider Name | Ting-yi Chen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1003059346 PECOS PAC ID: 4688814734 Enrollment ID: I20130712000505 |
| Provider Name | Paige D Frock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588908420 PECOS PAC ID: 0547403859 Enrollment ID: I20130905000089 |
| Provider Name | Emily Burns Mcleod |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1053745505 PECOS PAC ID: 2769618552 Enrollment ID: I20131127000618 |
| Provider Name | Valerie C Rosen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407883580 PECOS PAC ID: 4385871474 Enrollment ID: I20131217000908 |
| Provider Name | Vivian Del Carmen Aguilar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144286014 PECOS PAC ID: 2961490800 Enrollment ID: I20131218000987 |
| Provider Name | Sussann Kotara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588899041 PECOS PAC ID: 1658594189 Enrollment ID: I20140602000369 |
| Provider Name | Gayle Ayers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508182668 PECOS PAC ID: 6608099015 Enrollment ID: I20140603000585 |
| Provider Name | Jennifer S Summers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588894323 PECOS PAC ID: 9830315985 Enrollment ID: I20140725000163 |
| Provider Name | Kavitha Kumbum |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508079302 PECOS PAC ID: 9739071531 Enrollment ID: I20140826001233 |
| Provider Name | Kristin Vinueza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235548736 PECOS PAC ID: 7315269982 Enrollment ID: I20141210000865 |
| Provider Name | Gurpreet Singh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972896330 PECOS PAC ID: 9335462399 Enrollment ID: I20141223001074 |
| Provider Name | William Derrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477958049 PECOS PAC ID: 2961725585 Enrollment ID: I20150106000863 |
| Provider Name | Lauren Rebecca Dreyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043617905 PECOS PAC ID: 0042536583 Enrollment ID: I20150227001786 |
| Provider Name | Stephanie Doggett |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1104218676 PECOS PAC ID: 2466779848 Enrollment ID: I20150324000236 |
| Provider Name | Ashleigh Hayes Noble |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1497147078 PECOS PAC ID: 5597082586 Enrollment ID: I20150401001191 |
| Provider Name | Julie Farrington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427114545 PECOS PAC ID: 4789623588 Enrollment ID: I20150724010839 |
| Provider Name | Richard G Key |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750438644 PECOS PAC ID: 0547438384 Enrollment ID: I20151001000313 |
| Provider Name | Kevin J Bozic |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013960921 PECOS PAC ID: 9739262908 Enrollment ID: I20151014000788 |
| Provider Name | Ashley Westrum |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1477959542 PECOS PAC ID: 8224348677 Enrollment ID: I20151114000105 |
| Provider Name | Joanna Lopez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1801298773 PECOS PAC ID: 3274833660 Enrollment ID: I20151208002316 |
| Provider Name | Joseph Kugler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093026734 PECOS PAC ID: 7012218084 Enrollment ID: I20151216000971 |
| Provider Name | Jeffrey M Saniuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649655382 PECOS PAC ID: 7810299294 Enrollment ID: I20151230002697 |
| Provider Name | Erin M Logue |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619351806 PECOS PAC ID: 8123323789 Enrollment ID: I20160219001787 |
| Provider Name | Sigrid B Tristan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912199563 PECOS PAC ID: 4789870411 Enrollment ID: I20160229002990 |
| Provider Name | Carrie C Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396161725 PECOS PAC ID: 9234436023 Enrollment ID: I20160322001317 |
| Provider Name | James Stuart Ferriss |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1114129541 PECOS PAC ID: 6709078264 Enrollment ID: I20160331002334 |
| Provider Name | Anokhi Jambusaria-pahlajani |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1740442433 PECOS PAC ID: 5193974467 Enrollment ID: I20160427000119 |
| Provider Name | Elizabeth Whitten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114281631 PECOS PAC ID: 3779872668 Enrollment ID: I20160517000253 |
| Provider Name | Karl M Koenig |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659483865 PECOS PAC ID: 4789683236 Enrollment ID: I20160621000916 |
| Provider Name | Devin V Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154521086 PECOS PAC ID: 9032267455 Enrollment ID: I20160622002622 |
| Provider Name | David C Ring |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1568452746 PECOS PAC ID: 5193620888 Enrollment ID: I20160623000710 |
| Provider Name | Zhouwen Tang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619297223 PECOS PAC ID: 6507157302 Enrollment ID: I20160627000814 |
| Provider Name | Leorah a Freeman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023463114 PECOS PAC ID: 5799077293 Enrollment ID: I20160701000231 |
| Provider Name | Esther Melamed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144563669 PECOS PAC ID: 8921391327 Enrollment ID: I20160722000561 |
| Provider Name | Audrey Baum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295836393 PECOS PAC ID: 9537454640 Enrollment ID: I20160827000114 |
| Provider Name | Frank Parker Hudson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639331226 PECOS PAC ID: 7810150729 Enrollment ID: I20161025002778 |
| Provider Name | Maj Paulina Henriksson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033664016 PECOS PAC ID: 4082992409 Enrollment ID: I20161104001340 |
| Provider Name | Justin Frederick Rousseau |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770862971 PECOS PAC ID: 9032431200 Enrollment ID: I20161110000426 |
| Provider Name | William B Lawson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750499406 PECOS PAC ID: 6800057928 Enrollment ID: I20161112000198 |
| Provider Name | Michele Marie Pierson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841468667 PECOS PAC ID: 6901185941 Enrollment ID: I20161116001006 |
| Provider Name | Aaron Braverman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053863233 PECOS PAC ID: 3072893874 Enrollment ID: I20161214000854 |
| Provider Name | Long H Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619138468 PECOS PAC ID: 4587951439 Enrollment ID: I20170104002127 |
| Provider Name | James Stuart Wolf |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1023100492 PECOS PAC ID: 1355240953 Enrollment ID: I20170110000426 |
| Provider Name | Stephen M Strakowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720009541 PECOS PAC ID: 2062302946 Enrollment ID: I20170123001119 |
| Provider Name | Mary E Feeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790230324 PECOS PAC ID: 2062795503 Enrollment ID: I20170208000869 |
| Provider Name | Jonathan Geralds |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972938777 PECOS PAC ID: 4789812843 Enrollment ID: I20170213002173 |
| Provider Name | Sarah M Felderhoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699213702 PECOS PAC ID: 9032494182 Enrollment ID: I20170403000089 |
| Provider Name | Thomas R Vetter |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1225081656 PECOS PAC ID: 7416916671 Enrollment ID: I20170503001403 |
| Provider Name | Laura K Eastep |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457555013 PECOS PAC ID: 8628347770 Enrollment ID: I20170705000311 |
| Provider Name | Kobina D Ghartey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033438684 PECOS PAC ID: 5193969913 Enrollment ID: I20170721000259 |
| Provider Name | Christina a Salazar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083902068 PECOS PAC ID: 5193023315 Enrollment ID: I20170802003245 |
| Provider Name | Jamie Shanahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134644636 PECOS PAC ID: 9335412832 Enrollment ID: I20170905002986 |
| Provider Name | Rachel Bowman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851735591 PECOS PAC ID: 2466726559 Enrollment ID: I20170928002191 |
| Provider Name | Marcela C Castillo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841516192 PECOS PAC ID: 3375761315 Enrollment ID: I20171002002848 |
| Provider Name | Jorge Almeida |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558709170 PECOS PAC ID: 0143522821 Enrollment ID: I20171003004490 |
| Provider Name | Charley Rose Peterson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841715158 PECOS PAC ID: 4981979291 Enrollment ID: I20171011003077 |
| Provider Name | Susan Lea Sneed |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1215471438 PECOS PAC ID: 8527334143 Enrollment ID: I20171026002610 |
| Provider Name | Alyssa Beth Aguirre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306180989 PECOS PAC ID: 3779849534 Enrollment ID: I20171110000451 |
| Provider Name | David Paydarfar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134104797 PECOS PAC ID: 8527008101 Enrollment ID: I20171110001839 |
| Provider Name | Anthony E Johnson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700875176 PECOS PAC ID: 0941440093 Enrollment ID: I20171113001193 |
| Provider Name | Marissa Aileen Wagner Mery |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831363217 PECOS PAC ID: 0143586842 Enrollment ID: I20171114000420 |
| Provider Name | Mayra Elizabeth Robles-alvarado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881938983 PECOS PAC ID: 8325305766 Enrollment ID: I20171120003056 |
| Provider Name | Margaret Whitney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043576127 PECOS PAC ID: 0749424752 Enrollment ID: I20171121002957 |
| Provider Name | Jeny Ghartey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235306713 PECOS PAC ID: 7315012440 Enrollment ID: I20171204001816 |
| Provider Name | Rachel High |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245677582 PECOS PAC ID: 5496027351 Enrollment ID: I20171208002425 |
| Provider Name | Elizabeth a Kvale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245267616 PECOS PAC ID: 1052584455 Enrollment ID: I20171213000195 |
| Provider Name | Lindsey Lee Marie Wineholt |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1467963082 PECOS PAC ID: 6406114578 Enrollment ID: I20171219000270 |
| Provider Name | Vijay Rayalu Gorrepati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437413937 PECOS PAC ID: 8123321940 Enrollment ID: I20171227000301 |
| Provider Name | Christina L Moussette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780055202 PECOS PAC ID: 9537429667 Enrollment ID: I20180208002629 |
| Provider Name | Lauren D Thaxton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760772859 PECOS PAC ID: 5294042966 Enrollment ID: I20180213000265 |
| Provider Name | Nicole B Lovell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023525029 PECOS PAC ID: 1456613553 Enrollment ID: I20180402000267 |
| Provider Name | Jess P Ambiee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316454598 PECOS PAC ID: 3173887254 Enrollment ID: I20180426002231 |
| Provider Name | Christine D Craig |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679885909 PECOS PAC ID: 5092936708 Enrollment ID: I20180507000701 |
| Provider Name | Ewell Steve Roach |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922084011 PECOS PAC ID: 3476535790 Enrollment ID: I20180607001896 |
| Provider Name | David P Brigati |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578846002 PECOS PAC ID: 9537414610 Enrollment ID: I20180613000873 |
| Provider Name | Ethan Meltzer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467865790 PECOS PAC ID: 5597983429 Enrollment ID: I20180620000569 |
| Provider Name | Tammy Lynn Noel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942712815 PECOS PAC ID: 3173871761 Enrollment ID: I20180730000484 |
| Provider Name | Samantha Shapiro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518200930 PECOS PAC ID: 4981832540 Enrollment ID: I20180807001659 |
| Provider Name | Amisha J Amin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679065445 PECOS PAC ID: 1052660594 Enrollment ID: I20180816002624 |
| Provider Name | William Matsui |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1568411049 PECOS PAC ID: 6709918782 Enrollment ID: I20180824002389 |
| Provider Name | Adewole S Adamson |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1255630034 PECOS PAC ID: 3971819053 Enrollment ID: I20180904000391 |
| Provider Name | Diana Patricia Mendoza |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1538531249 PECOS PAC ID: 5991008013 Enrollment ID: I20180904002800 |
| Provider Name | Pamela a Lopez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922444611 PECOS PAC ID: 5890087910 Enrollment ID: I20180921001114 |
| Provider Name | Corinne a Jones |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1992019681 PECOS PAC ID: 7911182001 Enrollment ID: I20180924001920 |
| Provider Name | Winifred Mak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912160680 PECOS PAC ID: 9638341456 Enrollment ID: I20181002000334 |
| Provider Name | Eric L Crowell |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1831431006 PECOS PAC ID: 7810267283 Enrollment ID: I20181012001342 |
| Provider Name | Sarah Blair |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093296287 PECOS PAC ID: 8921350174 Enrollment ID: I20181016002851 |
| Provider Name | Paul E Tatum |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1821079559 PECOS PAC ID: 8224942263 Enrollment ID: I20181101001555 |
| Provider Name | Charles B Nemeroff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326228347 PECOS PAC ID: 6507937653 Enrollment ID: I20181113002022 |
| Provider Name | Steve L Steffensen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326028390 PECOS PAC ID: 6103164728 Enrollment ID: I20190206001894 |
| Provider Name | Laura Quan Man Chow |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1063745727 PECOS PAC ID: 8820130677 Enrollment ID: I20190214003083 |
| Provider Name | D. Jeffrey Newport |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275646291 PECOS PAC ID: 6406913268 Enrollment ID: I20190410002644 |
| Provider Name | David Spelber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447646898 PECOS PAC ID: 5991071169 Enrollment ID: I20190605000654 |
| Provider Name | Roberto Alejandro Cruz Saldana |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285016899 PECOS PAC ID: 3577866722 Enrollment ID: I20190612000438 |
| Provider Name | Karl Chiang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689928194 PECOS PAC ID: 0749433100 Enrollment ID: I20190716003409 |
| Provider Name | Carol Alter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083699870 PECOS PAC ID: 2163454125 Enrollment ID: I20190716003714 |
| Provider Name | Linda a Feagins |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376745158 PECOS PAC ID: 5092987719 Enrollment ID: I20190725000620 |
| Provider Name | Johanna I Busch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518320498 PECOS PAC ID: 6901132984 Enrollment ID: I20190729003229 |
| Provider Name | Nicholas F Ortiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164878914 PECOS PAC ID: 8628305612 Enrollment ID: I20190814001400 |
| Provider Name | Audrey Marian Addaquay-corey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710353651 PECOS PAC ID: 7618260951 Enrollment ID: I20190822001737 |
| Provider Name | Deepa Suneel |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1265087282 PECOS PAC ID: 7911235221 Enrollment ID: I20190824000617 |
| Provider Name | Samuel E Long |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235576356 PECOS PAC ID: 7416256706 Enrollment ID: I20190830001216 |
| Provider Name | Patrick Ryan Labrode |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790331551 PECOS PAC ID: 5698004695 Enrollment ID: I20190916002782 |
| Provider Name | George a Macones |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386647345 PECOS PAC ID: 1557305307 Enrollment ID: I20190916003529 |
| Provider Name | Cara C Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962537399 PECOS PAC ID: 8224198775 Enrollment ID: I20190918002615 |
| Provider Name | Alison Gale Cahill |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679788038 PECOS PAC ID: 3779682356 Enrollment ID: I20190920001871 |
| Provider Name | William Michael Brode |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619362217 PECOS PAC ID: 4486966264 Enrollment ID: I20191016000387 |
| Provider Name | Veena a Patel |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1033452255 PECOS PAC ID: 5193093318 Enrollment ID: I20191016001113 |
| Provider Name | Nicholas M. Barbaro |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1619925443 PECOS PAC ID: 9830273697 Enrollment ID: I20191017001834 |
| Provider Name | Rama V Thyagarajan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1003886151 PECOS PAC ID: 1658302831 Enrollment ID: I20191024002773 |
| Provider Name | Gregory Anthony Fonzo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174858070 PECOS PAC ID: 5890027106 Enrollment ID: I20191105002198 |
| Provider Name | Chelsey C Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205347952 PECOS PAC ID: 4082972351 Enrollment ID: I20191120000103 |
| Provider Name | Kevin Victor Hackshaw |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1255348785 PECOS PAC ID: 7416921192 Enrollment ID: I20191125002353 |
| Provider Name | Juan M Guzman |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1154715142 PECOS PAC ID: 2567766397 Enrollment ID: I20191127000893 |
| Provider Name | Cristal Latanza Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578730388 PECOS PAC ID: 1153637202 Enrollment ID: I20191216000306 |
| Provider Name | Kyaw Aung |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1780229047 PECOS PAC ID: 5294169629 Enrollment ID: I20191218000817 |
| Provider Name | Jason a Spees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033762828 PECOS PAC ID: 1052748712 Enrollment ID: I20200219001847 |
| Provider Name | Lindsay Kozicz |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1770736811 PECOS PAC ID: 8224176482 Enrollment ID: I20200330002141 |
| Provider Name | Scott J Selinger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629211016 PECOS PAC ID: 5799932174 Enrollment ID: I20200408000147 |
| Provider Name | Erin Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467935981 PECOS PAC ID: 3779837893 Enrollment ID: I20200521001655 |
| Provider Name | Lorie M Harper |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871613786 PECOS PAC ID: 3870749518 Enrollment ID: I20200602000375 |
| Provider Name | Tera F Howard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457647182 PECOS PAC ID: 9133432420 Enrollment ID: I20200706002274 |
| Provider Name | Eileen a Choudhury Bowden |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699153965 PECOS PAC ID: 8921344136 Enrollment ID: I20200713000515 |
| Provider Name | Denise Laura Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780047480 PECOS PAC ID: 9032534680 Enrollment ID: I20200730000988 |
| Provider Name | Christine Langner Bartow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346603735 PECOS PAC ID: 2567759038 Enrollment ID: I20200730001288 |
| Provider Name | Max S Holtz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447613963 PECOS PAC ID: 0749573327 Enrollment ID: I20200929001123 |
| Provider Name | Benjamin James Ehrenfeld |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003417668 PECOS PAC ID: 0446660062 Enrollment ID: I20201110000023 |
| Provider Name | Aliza Norwood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568752988 PECOS PAC ID: 4486978616 Enrollment ID: I20201123003240 |
| Provider Name | Valerie Bianca Galvan-turner |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1104060425 PECOS PAC ID: 2062651383 Enrollment ID: I20210127000773 |
| Provider Name | Karla Maguire |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750525333 PECOS PAC ID: 4082768403 Enrollment ID: I20210325001165 |
| Provider Name | Brian Kwun Kwok Lee |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1518056571 PECOS PAC ID: 2365501194 Enrollment ID: I20210426000117 |
| Provider Name | Duriel Isaih Hardy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659751527 PECOS PAC ID: 0749680031 Enrollment ID: I20210608001453 |
| Provider Name | Jennifer Lynne Travieso |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508247776 PECOS PAC ID: 5799099313 Enrollment ID: I20210628003035 |
| Provider Name | Molly Lisa Singer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629507702 PECOS PAC ID: 7012285992 Enrollment ID: I20210702000236 |
| Provider Name | Sowmya Boddhula |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1134569825 PECOS PAC ID: 9133352875 Enrollment ID: I20210723002981 |
| Provider Name | Justine Cynthia Reilly |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184144198 PECOS PAC ID: 3870903040 Enrollment ID: I20210806000632 |
| Provider Name | Jessica Batten |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235620402 PECOS PAC ID: 4981951522 Enrollment ID: I20210812002082 |
| Provider Name | Mary Micaela Rieger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134548399 PECOS PAC ID: 4587913462 Enrollment ID: I20210817004237 |
| Provider Name | Lisa Hadorn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164005807 PECOS PAC ID: 0143625608 Enrollment ID: I20210820001655 |
| Provider Name | Mikaela M Frissell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194490375 PECOS PAC ID: 6406251883 Enrollment ID: I20210824000060 |
| Provider Name | Moe Hein Aung |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1255794368 PECOS PAC ID: 1456757277 Enrollment ID: I20210902001401 |
| Provider Name | Sarah Wilson Poole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497425193 PECOS PAC ID: 5991103715 Enrollment ID: I20211008001946 |
| Provider Name | Branden W Daubel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265999593 PECOS PAC ID: 6608117437 Enrollment ID: I20211012003494 |
| Provider Name | Jacqueline Posada |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174918114 PECOS PAC ID: 2769743129 Enrollment ID: I20211101001228 |
| Provider Name | Elisa Furay |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245618180 PECOS PAC ID: 6608178124 Enrollment ID: I20211103002132 |
| Provider Name | Curry L Koening |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821158593 PECOS PAC ID: 6002902673 Enrollment ID: I20211120000032 |
| Provider Name | Maura Ruby Ronquillo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912433707 PECOS PAC ID: 3678828738 Enrollment ID: I20211202000693 |
| Provider Name | Barbara Suarez Chenoweth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366018525 PECOS PAC ID: 8527459114 Enrollment ID: I20211215000342 |
| Provider Name | Brianna Hurtado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144988304 PECOS PAC ID: 8123411402 Enrollment ID: I20220209001282 |
| Provider Name | Krystal Marie Duran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740933613 PECOS PAC ID: 1658764758 Enrollment ID: I20220214001957 |
| Provider Name | Kelsey Hatton |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1083003602 PECOS PAC ID: 0941558308 Enrollment ID: I20220215001814 |
| Provider Name | Lisa Boyars |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043659923 PECOS PAC ID: 4082903919 Enrollment ID: I20220215002081 |
| Provider Name | Lief Ericsson Fenno |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710349311 PECOS PAC ID: 0840612602 Enrollment ID: I20220414001931 |
| Provider Name | Rumi Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184676926 PECOS PAC ID: 7315967692 Enrollment ID: I20220520000406 |
| Provider Name | Mohammad Alsumrain |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1639327885 PECOS PAC ID: 2062675408 Enrollment ID: I20220524000849 |
| Provider Name | Trisha Manis Parekh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1568755916 PECOS PAC ID: 8224318076 Enrollment ID: I20220623000128 |
| Provider Name | Clarence Thomas Jayde Kee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275065682 PECOS PAC ID: 5395019400 Enrollment ID: I20220706000045 |
| Provider Name | Diana Nathalie Andino |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467957779 PECOS PAC ID: 5496004053 Enrollment ID: I20220718000088 |
| Provider Name | Emily Ann Biller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700376944 PECOS PAC ID: 8921497322 Enrollment ID: I20220816002990 |
| Provider Name | Alexandra Rossi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538892468 PECOS PAC ID: 5991188294 Enrollment ID: I20220819000627 |
| Provider Name | Arianna Magali Garcia |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1467185322 PECOS PAC ID: 2163805326 Enrollment ID: I20220821000098 |
| Provider Name | Lauren Caldwell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477948776 PECOS PAC ID: 3274917935 Enrollment ID: I20220829003479 |
| Provider Name | Amanda Balch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760775639 PECOS PAC ID: 4587893409 Enrollment ID: I20220907002743 |
| Provider Name | Megan Klein |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1356524201 PECOS PAC ID: 1254416738 Enrollment ID: I20220908003389 |
| Provider Name | Meagan MD Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811381080 PECOS PAC ID: 5496066532 Enrollment ID: I20220912002758 |
| Provider Name | Gregory Muller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962132902 PECOS PAC ID: 0345625174 Enrollment ID: I20220915001015 |
| Provider Name | Kristina Tzartzeva |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1760846802 PECOS PAC ID: 6709252661 Enrollment ID: I20221018000372 |
| Provider Name | Mark Townsend |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497778351 PECOS PAC ID: 0244423408 Enrollment ID: I20221121000069 |
| Provider Name | Brittany Rosales |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1508244583 PECOS PAC ID: 7911205232 Enrollment ID: I20221214002321 |
| Provider Name | Alexandra Weinberg |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528711785 PECOS PAC ID: 5496124158 Enrollment ID: I20221220000907 |
| Provider Name | Claire Fitzgerald Harrison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821610098 PECOS PAC ID: 1254797400 Enrollment ID: I20230515001889 |
| Provider Name | Aman Mittal |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699126425 PECOS PAC ID: 9931521093 Enrollment ID: I20230530003341 |
| Provider Name | Makayla Marie Mccoskey |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1215498340 PECOS PAC ID: 8325375744 Enrollment ID: I20230620000677 |
| Provider Name | Nerlyne Desravines |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1174917272 PECOS PAC ID: 5395054241 Enrollment ID: I20230706004158 |
| Provider Name | Navid Valizadeh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073933222 PECOS PAC ID: 1456603794 Enrollment ID: I20230717001202 |
| Provider Name | Bryanna Mantilla |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1437646569 PECOS PAC ID: 7113261272 Enrollment ID: I20230725000560 |
| Provider Name | Amanda Wood Hayes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083103717 PECOS PAC ID: 8426303157 Enrollment ID: I20230815000867 |
| Provider Name | Priya Elizabeth Kumar-kaparaboyna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578943411 PECOS PAC ID: 7810293669 Enrollment ID: I20230911002554 |
| Provider Name | Kari Rene Nations |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568145019 PECOS PAC ID: 0042674996 Enrollment ID: I20230912001401 |
| Provider Name | Stefanie Noelle Schutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609567197 PECOS PAC ID: 5698139228 Enrollment ID: I20230914001540 |
| Provider Name | Lena Liu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1730830662 PECOS PAC ID: 4789031303 Enrollment ID: I20231103000831 |
| Provider Name | Angelica Oscos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538840350 PECOS PAC ID: 6406205004 Enrollment ID: I20231207003119 |
| Provider Name | Amy Lan Tao-foster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952660839 PECOS PAC ID: 7719334127 Enrollment ID: I20231219002900 |
| Provider Name | James Jackson Burns |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427346717 PECOS PAC ID: 8123478351 Enrollment ID: I20231229000903 |
| Provider Name | Eboni S Lunsford Calbow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497304232 PECOS PAC ID: 2860845211 Enrollment ID: I20240201001536 |
| Provider Name | Parisa Khosravi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952924276 PECOS PAC ID: 1850730284 Enrollment ID: I20240418002303 |
| Provider Name | Kendall Lyn Goodyear |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1164043386 PECOS PAC ID: 6709228935 Enrollment ID: I20240520003087 |
| Provider Name | Saleema Kherani Ali |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1114487675 PECOS PAC ID: 0042635153 Enrollment ID: I20240530001858 |
| Provider Name | Paul Mueller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427021955 PECOS PAC ID: 5890838874 Enrollment ID: I20240604004142 |
| Provider Name | Christopher D Caldwell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1407346802 PECOS PAC ID: 1456680537 Enrollment ID: I20240614002036 |
| Provider Name | Nimmy Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922674076 PECOS PAC ID: 7911445861 Enrollment ID: I20240809003999 |
| Provider Name | John Wickman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609372499 PECOS PAC ID: 5890149884 Enrollment ID: I20240823002366 |
| Provider Name | David Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629746003 PECOS PAC ID: 6800284118 Enrollment ID: I20240828005101 |
| Provider Name | Thomas Grant Ratana |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275219891 PECOS PAC ID: 3678013166 Enrollment ID: I20240911001422 |
| Provider Name | Patrizia Perazzo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992583603 PECOS PAC ID: 4385184878 Enrollment ID: I20240911001515 |
| Provider Name | Elizabeth Nudd Racine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982469607 PECOS PAC ID: 2860924933 Enrollment ID: I20241014003419 |
| Provider Name | Jonathan Thomas Mason |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245887355 PECOS PAC ID: 4284088741 Enrollment ID: I20241017004392 |
| Provider Name | Sarah Coleman Vij |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982902581 PECOS PAC ID: 4981906435 Enrollment ID: I20241024002102 |
| Provider Name | Christina Alexander |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104581719 PECOS PAC ID: 3274066212 Enrollment ID: I20241029002095 |
| Provider Name | Joshua Shaffer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396366043 PECOS PAC ID: 4082147749 Enrollment ID: I20241101003088 |
| Provider Name | Amelia Frank |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1073381398 PECOS PAC ID: 6305371188 Enrollment ID: I20241203002663 |
| Provider Name | Corey Henley |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508498932 PECOS PAC ID: 9032524368 Enrollment ID: I20241209001873 |
| Provider Name | Hannah Powers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780273110 PECOS PAC ID: 1850820762 Enrollment ID: I20250122001939 |
| Provider Name | James R Korndorffer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346333655 PECOS PAC ID: 8123094612 Enrollment ID: I20250128004304 |
| Provider Name | Brian Edward Donley |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306469200 PECOS PAC ID: 8022550953 Enrollment ID: I20250219000210 |
| Provider Name | Jared Fridley |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1669703633 PECOS PAC ID: 3577859974 Enrollment ID: I20250407002282 |
| Provider Name | Sullivan Ayuso |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1194220921 PECOS PAC ID: 4385991025 Enrollment ID: I20250421002558 |
| Provider Name | Sofia N Silvestri |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1235925967 PECOS PAC ID: 1052837168 Enrollment ID: I20250430003655 |
| Provider Name | Elizabeth Rosenthal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265956262 PECOS PAC ID: 0446682355 Enrollment ID: I20250504000015 |
| Provider Name | David Dalton |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932606357 PECOS PAC ID: 0143686733 Enrollment ID: I20250513000905 |
| Provider Name | Amy E Durand |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1194345421 PECOS PAC ID: 7113446915 Enrollment ID: I20250523002666 |
| Provider Name | Irene Rose Nelson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982029617 PECOS PAC ID: 6305365966 Enrollment ID: I20250527003321 |
| Provider Name | Divya Rayapati |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649715483 PECOS PAC ID: 4789104639 Enrollment ID: I20250527003438 |
| Provider Name | Remigio Javier Flor |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1851773907 PECOS PAC ID: 1951812064 Enrollment ID: I20250616003144 |
| Provider Name | Geoffrey Azad Vasile |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649991597 PECOS PAC ID: 8325550981 Enrollment ID: I20250620001339 |
| Provider Name | Robert Seilheimer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922568591 PECOS PAC ID: 4587020193 Enrollment ID: I20250714001017 |
| Provider Name | Felipe De Jesus Flores |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376292037 PECOS PAC ID: 4486169869 Enrollment ID: I20250715001275 |
| Provider Name | Jordan Jacquez |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1073035044 PECOS PAC ID: 0840561734 Enrollment ID: I20250715002008 |
| Provider Name | Alan Guillermo Valdovino Gonzalez |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1245891183 PECOS PAC ID: 4688189848 Enrollment ID: I20250716000973 |
| Provider Name | Alisa Coker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477888212 PECOS PAC ID: 1759697071 Enrollment ID: I20250719000419 |
| Provider Name | Jon Willie |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1194934034 PECOS PAC ID: 7517145287 Enrollment ID: I20250901000346 |
| Provider Name | Alison Hanson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861887127 PECOS PAC ID: 6709122302 Enrollment ID: I20250923004328 |
| Provider Name | Shuyuan Li |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1205681418 PECOS PAC ID: 1557800745 Enrollment ID: I20250927000433 |
| Provider Name | Jacob Matthew Milling |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1326675463 PECOS PAC ID: 2961815196 Enrollment ID: I20250930003225 |
| Provider Name | Chelsae M Cornejo |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1386256477 PECOS PAC ID: 4183020712 Enrollment ID: I20251017004247 |
| Provider Name | Julia D Campbell |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1366137119 PECOS PAC ID: 6507354651 Enrollment ID: I20251021004821 |
| Provider Name | Phi Ryan Duong |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1093689788 PECOS PAC ID: 1759870033 Enrollment ID: I20251028000961 |
| Provider Name | David Bender |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336718881 PECOS PAC ID: 9234628892 Enrollment ID: I20251103001154 |
| Provider Name | Mahek Dhuka |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1972478865 PECOS PAC ID: 7719478494 Enrollment ID: I20251111002854 |
| Provider Name | Joaquin Camara |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1760778443 PECOS PAC ID: 3577897511 Enrollment ID: I20251112004348 |
| Provider Name | Sricharan Chalikonda |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568479145 PECOS PAC ID: 5496791808 Enrollment ID: I20251122000229 |
| Provider Name | Rachel Elizabeth Mis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1891571055 PECOS PAC ID: 1456844364 Enrollment ID: I20251130000059 |
| Provider Name | Mehdi Mirsaeidi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285961680 PECOS PAC ID: 9032339767 Enrollment ID: I20251201000974 |
| Provider Name | Michelle Duncan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467499400 PECOS PAC ID: 1153220314 Enrollment ID: I20260120000233 |
| Provider Name | Zakariah Mahmood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154530616 PECOS PAC ID: 8224208996 Enrollment ID: I20260210002411 |
| Provider Name | Mohamadsalim M Saiyed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932411725 PECOS PAC ID: 2466693759 Enrollment ID: I20260225001542 |
Harold D Lewis DO PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 West William Cannon Drive, Suite 123, Austin, TX 78745 Phone: 512-444-2661 Fax: 512-444-2720 |
Julie Graves Moy MD Mph PA Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8127 Mesa Dr, B206-54, Austin, TX 78759 Phone: 512-689-8001 |
Edie E. Shulman M.D., PLLC Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11673 Jollyville Rd., Suite B-101, Austin, TX 78759 Phone: 512-339-1535 Fax: 512-339-1526 |
El Buen Samaritano Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7000 Woodhue Dr, Austin, TX 78745 Phone: 512-439-0701 |
Concentra Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10001 S Ih 35 Ste 300, Austin, TX 78747 Phone: 512-440-0555 Fax: 214-775-4502 |
Doctx3 PLLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 709 E Slaughter Ln Ste 404, Austin, TX 78744 Phone: 469-277-8253 |