| Vantage Healthcare | |
|
C/o Workplace@45 45 Dan Rd Canton MA 02021 | |
| (781) 867-2050 | |
| Not Available |
| Full Name | Vantage Healthcare |
|---|---|
| Speciality | Internal Medicine |
| Location | C/o Workplace@45, Canton, Massachusetts |
| Authorized Official Name and Position | Jamie L Elliott (COO) |
| Authorized Official Contact | 7818672050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vantage Healthcare Po Box 411488 Boston MA 02241-1488 Ph: (781) 867-2050 | Vantage Healthcare C/o Workplace@45 45 Dan Rd Canton MA 02021 Ph: (781) 867-2050 |
| NPI Number | 1366903551 |
|---|---|
| Provider Enumeration Date | 03/29/2019 |
| Last Update Date | 08/21/2026 |
| Certification Date | 08/21/2026 |
| Medicare PECOS PAC ID | 8224361191 |
|---|---|
| Medicare Enrollment ID | O20190607000976 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366903551 | NPI | - | NPPES |
| 3118438 | Medicaid | NH | |
| 1366903551 | Medicaid | RI | |
| 110153150A | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | () | Secondary |
| Provider Name | Claes M Nilsson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912006065 PECOS PAC ID: 2365435351 Enrollment ID: I20040406000501 |
| Provider Name | Nancy Huggins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245307743 PECOS PAC ID: 9032109087 Enrollment ID: I20040513000365 |
| Provider Name | Anthony Gibran Eaton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831193101 PECOS PAC ID: 9931187101 Enrollment ID: I20040713000865 |
| Provider Name | Alison S Curcio |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689668568 PECOS PAC ID: 7012989403 Enrollment ID: I20040806000796 |
| Provider Name | Debra a Hussey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801855432 PECOS PAC ID: 6709847247 Enrollment ID: I20041019000932 |
| Provider Name | Brian C Fellows |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548211659 PECOS PAC ID: 6103874722 Enrollment ID: I20050110000912 |
| Provider Name | Paul a Bizinkauskas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578521415 PECOS PAC ID: 6406806322 Enrollment ID: I20050128000223 |
| Provider Name | Mark J Messenger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194726471 PECOS PAC ID: 0840261863 Enrollment ID: I20050405000302 |
| Provider Name | Jan P Urkevic |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1609983741 PECOS PAC ID: 3577503739 Enrollment ID: I20050506000189 |
| Provider Name | Karen Maney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881675528 PECOS PAC ID: 7517931322 Enrollment ID: I20050624000129 |
| Provider Name | Denise Ann Petrella |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669527354 PECOS PAC ID: 4284663592 Enrollment ID: I20050808000301 |
| Provider Name | Heather a Bryant Mckenney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912111733 PECOS PAC ID: 5193750016 Enrollment ID: I20050929000444 |
| Provider Name | Thomas B Percy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699709352 PECOS PAC ID: 2062436959 Enrollment ID: I20060118000713 |
| Provider Name | Joy L Osborne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952542607 PECOS PAC ID: 1557375920 Enrollment ID: I20060206000750 |
| Provider Name | Ramon Espinosa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245287838 PECOS PAC ID: 1456360189 Enrollment ID: I20060407000375 |
| Provider Name | Benjamin Cabral |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194756650 PECOS PAC ID: 9133122799 Enrollment ID: I20060821000407 |
| Provider Name | Michelle Laflamme |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073513834 PECOS PAC ID: 7315843547 Enrollment ID: I20061016000531 |
| Provider Name | Sandhya D Rao |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1801876073 PECOS PAC ID: 1951369909 Enrollment ID: I20061027000336 |
| Provider Name | Jennifer Patten |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1891720546 PECOS PAC ID: 3173561487 Enrollment ID: I20061108000379 |
| Provider Name | Paul J Spiegel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265414577 PECOS PAC ID: 4385613447 Enrollment ID: I20061129000305 |
| Provider Name | Alarick K Yung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780646372 PECOS PAC ID: 5395743330 Enrollment ID: I20061129000337 |
| Provider Name | Alfred Adegboyegun |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1205953957 PECOS PAC ID: 2668579863 Enrollment ID: I20070523000369 |
| Provider Name | Melady a Genereux |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437370913 PECOS PAC ID: 9537267661 Enrollment ID: I20070613000144 |
| Provider Name | Demetrius Rizos |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063491397 PECOS PAC ID: 0648379180 Enrollment ID: I20070623000067 |
| Provider Name | Irene I Tsirozidou |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912964610 PECOS PAC ID: 2466544119 Enrollment ID: I20070825000007 |
| Provider Name | Erica Mcisaac |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457530032 PECOS PAC ID: 6103915038 Enrollment ID: I20071130000080 |
| Provider Name | Jessica O Benedetto |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568495075 PECOS PAC ID: 3274507751 Enrollment ID: I20081016000350 |
| Provider Name | Alireza Toossi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780871970 PECOS PAC ID: 4688764541 Enrollment ID: I20081017000329 |
| Provider Name | Didie C Watsop |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215113279 PECOS PAC ID: 9436217866 Enrollment ID: I20081029000069 |
| Provider Name | Saira Nisar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114182680 PECOS PAC ID: 1850438714 Enrollment ID: I20091026000304 |
| Provider Name | Timothy Odonnell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346206091 PECOS PAC ID: 5395877625 Enrollment ID: I20100721000767 |
| Provider Name | Andrew J Martin |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1942511431 PECOS PAC ID: 7315062569 Enrollment ID: I20100913000311 |
| Provider Name | Julius Tanyi V Tabe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801093356 PECOS PAC ID: 8729104963 Enrollment ID: I20100925000052 |
| Provider Name | Shideh Amirifeli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083763890 PECOS PAC ID: 2062600877 Enrollment ID: I20101221000569 |
| Provider Name | Fabian Delgado |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629277454 PECOS PAC ID: 4082802368 Enrollment ID: I20101230000977 |
| Provider Name | Vishal Kuchaculla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386837342 PECOS PAC ID: 5799832853 Enrollment ID: I20110325000565 |
| Provider Name | Jasper I Ngomba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760620975 PECOS PAC ID: 2163548066 Enrollment ID: I20120924000657 |
| Provider Name | Jatinder Aujla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275700825 PECOS PAC ID: 7214000207 Enrollment ID: I20121226000197 |
| Provider Name | Willy Moy |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1558615906 PECOS PAC ID: 1153574827 Enrollment ID: I20130104000444 |
| Provider Name | Nelson K Aweh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891923199 PECOS PAC ID: 0749423507 Enrollment ID: I20130826000835 |
| Provider Name | Margarita Castro-zarraga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578705679 PECOS PAC ID: 5991948259 Enrollment ID: I20130905000642 |
| Provider Name | Amanda Hernandez |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1891062691 PECOS PAC ID: 4880847102 Enrollment ID: I20130910000234 |
| Provider Name | Sara N Breglio |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1639591829 PECOS PAC ID: 7012146913 Enrollment ID: I20140218000695 |
| Provider Name | Abila Benazea |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619305521 PECOS PAC ID: 5193955888 Enrollment ID: I20140225000473 |
| Provider Name | Virginia W Ndungu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1831528173 PECOS PAC ID: 5597995951 Enrollment ID: I20140304000741 |
| Provider Name | Alysia M Demartino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194151415 PECOS PAC ID: 4688805583 Enrollment ID: I20140318000445 |
| Provider Name | Marie-helene Almonor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972661064 PECOS PAC ID: 6103832365 Enrollment ID: I20140523000566 |
| Provider Name | Cheryl a Rothwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376777458 PECOS PAC ID: 0143440966 Enrollment ID: I20140930000833 |
| Provider Name | Scott B Mccarthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720488935 PECOS PAC ID: 3870715162 Enrollment ID: I20141121001153 |
| Provider Name | Daria M Hanson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992865901 PECOS PAC ID: 8123012291 Enrollment ID: I20141124001752 |
| Provider Name | David S Westrin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285035576 PECOS PAC ID: 6305168410 Enrollment ID: I20141201000241 |
| Provider Name | Corey Baechel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1003149972 PECOS PAC ID: 6800119843 Enrollment ID: I20141229000161 |
| Provider Name | Judith Bellevue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972908143 PECOS PAC ID: 5092030858 Enrollment ID: I20150219000887 |
| Provider Name | Tiffany Lynne Rhodes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083028716 PECOS PAC ID: 0941428742 Enrollment ID: I20150918000444 |
| Provider Name | Chirin Al Dalati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003166885 PECOS PAC ID: 9638489867 Enrollment ID: I20151030000651 |
| Provider Name | Karri a Crowley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780060426 PECOS PAC ID: 6305156027 Enrollment ID: I20151110000942 |
| Provider Name | Alexandra Miniati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013270446 PECOS PAC ID: 9537460795 Enrollment ID: I20151214001638 |
| Provider Name | Francis G Fluet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548638372 PECOS PAC ID: 2567500705 Enrollment ID: I20160105001925 |
| Provider Name | Benista Owusu Amo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710249834 PECOS PAC ID: 4789989815 Enrollment ID: I20160226000924 |
| Provider Name | Ashley Ko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821462045 PECOS PAC ID: 2668762667 Enrollment ID: I20160603000373 |
| Provider Name | Samila Francois |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134588106 PECOS PAC ID: 6305137779 Enrollment ID: I20160615002610 |
| Provider Name | Elizabeth D Johnston |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1699100347 PECOS PAC ID: 0941525422 Enrollment ID: I20160803001504 |
| Provider Name | Alicyn M Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245689652 PECOS PAC ID: 0345534715 Enrollment ID: I20160808001292 |
| Provider Name | Michael Joseph Mentakis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811988033 PECOS PAC ID: 7416987763 Enrollment ID: I20161017000292 |
| Provider Name | Fariyda Mulrain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831644129 PECOS PAC ID: 2466730114 Enrollment ID: I20161031001748 |
| Provider Name | Rebecca Donadio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871950733 PECOS PAC ID: 4385923010 Enrollment ID: I20161121000033 |
| Provider Name | Taylor L Andromidas |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093183501 PECOS PAC ID: 5890075782 Enrollment ID: I20161212001362 |
| Provider Name | Peterson Remy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972059665 PECOS PAC ID: 1052682515 Enrollment ID: I20170802002510 |
| Provider Name | Ngoc Anh Nguyen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861932691 PECOS PAC ID: 3577835107 Enrollment ID: I20170817000035 |
| Provider Name | Stella Uchendu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891232906 PECOS PAC ID: 9436416492 Enrollment ID: I20171129000733 |
| Provider Name | Cherie Wildrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083151260 PECOS PAC ID: 3476810300 Enrollment ID: I20171201001724 |
| Provider Name | Cornelius N Bela |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962912964 PECOS PAC ID: 2062771942 Enrollment ID: I20180123000903 |
| Provider Name | Jaleh Rasoli |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1740792530 PECOS PAC ID: 9335401967 Enrollment ID: I20180320001614 |
| Provider Name | Jamie a Folan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962954560 PECOS PAC ID: 0143503961 Enrollment ID: I20180328002627 |
| Provider Name | Luybang Trinh |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1932601887 PECOS PAC ID: 3274897871 Enrollment ID: I20180508000488 |
| Provider Name | Caroline Namuzinda Mawanda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154821114 PECOS PAC ID: 4082979000 Enrollment ID: I20180522002709 |
| Provider Name | Claude Lyne Valcin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144459876 PECOS PAC ID: 5294972238 Enrollment ID: I20180607000684 |
| Provider Name | Wael Barkoudah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932528924 PECOS PAC ID: 5597061903 Enrollment ID: I20180828001872 |
| Provider Name | Albert J Proia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134613185 PECOS PAC ID: 4082962717 Enrollment ID: I20190201001063 |
| Provider Name | Mussa Mohamed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770993172 PECOS PAC ID: 3173883774 Enrollment ID: I20190522000649 |
| Provider Name | Eghosa Idumwonyi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265894919 PECOS PAC ID: 1951698059 Enrollment ID: I20190925002175 |
| Provider Name | Jessica Dias |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033568233 PECOS PAC ID: 9739511445 Enrollment ID: I20191119001558 |
| Provider Name | Jamie Rodgers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730732199 PECOS PAC ID: 5597199737 Enrollment ID: I20191223000619 |
| Provider Name | Lianna Partee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750936126 PECOS PAC ID: 9234568718 Enrollment ID: I20200403002297 |
| Provider Name | Rosemonde Paulo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962059725 PECOS PAC ID: 3577992999 Enrollment ID: I20200407001220 |
| Provider Name | Taylor Pare Laramee |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1528603214 PECOS PAC ID: 2163844754 Enrollment ID: I20200629001562 |
| Provider Name | Jean-merimee N Kouagheu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689208050 PECOS PAC ID: 3577982198 Enrollment ID: I20201001001074 |
| Provider Name | Janet C Testoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568836765 PECOS PAC ID: 3072814565 Enrollment ID: I20201029001791 |
| Provider Name | Mehwash Naseem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528405677 PECOS PAC ID: 3678702958 Enrollment ID: I20201202002251 |
| Provider Name | Edwin Agbonavbare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386007631 PECOS PAC ID: 5496168080 Enrollment ID: I20201228000824 |
| Provider Name | Bharath Krishnamurthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326561390 PECOS PAC ID: 7012321540 Enrollment ID: I20210125002095 |
| Provider Name | Taylor Parks |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1689275455 PECOS PAC ID: 8921412065 Enrollment ID: I20210201000606 |
| Provider Name | Tatiana Andrade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336731819 PECOS PAC ID: 5698182350 Enrollment ID: I20210324001437 |
| Provider Name | Sai S Kaza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700310570 PECOS PAC ID: 0941572549 Enrollment ID: I20210419001476 |
| Provider Name | Bryan Mccullough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821662719 PECOS PAC ID: 2860891611 Enrollment ID: I20210527000176 |
| Provider Name | Donna J Remmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760082366 PECOS PAC ID: 0840688578 Enrollment ID: I20211028001648 |
| Provider Name | Shannon M Beck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114536463 PECOS PAC ID: 7214327733 Enrollment ID: I20211124000056 |
| Provider Name | Frew Fikru |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093341331 PECOS PAC ID: 0648688259 Enrollment ID: I20220329000601 |
| Provider Name | Deanna J Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689273054 PECOS PAC ID: 6305232943 Enrollment ID: I20220406002507 |
| Provider Name | Karen Magit |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083223630 PECOS PAC ID: 1759777360 Enrollment ID: I20220407002016 |
| Provider Name | Elizabeth Rita Barnes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962157537 PECOS PAC ID: 7719365097 Enrollment ID: I20220526002006 |
| Provider Name | Ashley Leddy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861095473 PECOS PAC ID: 5395158851 Enrollment ID: I20220804000201 |
| Provider Name | Allison Meyer |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1710638168 PECOS PAC ID: 5991181471 Enrollment ID: I20221006002237 |
| Provider Name | Kristine Nordstrom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285695668 PECOS PAC ID: 0446217764 Enrollment ID: I20221220000452 |
| Provider Name | Alec Beaulieu |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1376105049 PECOS PAC ID: 4981936713 Enrollment ID: I20230309002459 |
| Provider Name | Shana Annese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720794514 PECOS PAC ID: 8628442399 Enrollment ID: I20230320001655 |
| Provider Name | Yekaterina Kukharchuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285332270 PECOS PAC ID: 8921463704 Enrollment ID: I20230501000595 |
| Provider Name | Maybelle B Mbiatem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437888096 PECOS PAC ID: 5193181337 Enrollment ID: I20230515001193 |
| Provider Name | Betty Gyamfi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093098923 PECOS PAC ID: 1759686579 Enrollment ID: I20230727003250 |
| Provider Name | Victor Okwukaogu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578287546 PECOS PAC ID: 2466814587 Enrollment ID: I20230821003341 |
| Provider Name | Courtney Marquez |
|---|---|
| Provider Type | Practitioner - Physician Assistant |
| Provider Identifiers | NPI Number: 1194387555 PECOS PAC ID: 0446588297 Enrollment ID: I20231018002968 |
| Provider Name | Chinyere Vivian Nwanesidu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922887173 PECOS PAC ID: 2264888163 Enrollment ID: I20231030001435 |
| Provider Name | Uche Obu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548036387 PECOS PAC ID: 4981041290 Enrollment ID: I20240322000547 |
| Provider Name | Musa Mugenyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417722612 PECOS PAC ID: 7214224401 Enrollment ID: I20240424001372 |
| Provider Name | Kristen a Prophet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639926793 PECOS PAC ID: 5092156489 Enrollment ID: I20240516001598 |
| Provider Name | Mehrian Jafarizade |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235698465 PECOS PAC ID: 7214379353 Enrollment ID: I20240521003499 |
| Provider Name | Angel Nviiri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962252775 PECOS PAC ID: 0446793509 Enrollment ID: I20240617003124 |
| Provider Name | Kristin Mcavoy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245073386 PECOS PAC ID: 4880139906 Enrollment ID: I20240712003795 |
| Provider Name | Emily Ryan Mok |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568236446 PECOS PAC ID: 0042745069 Enrollment ID: I20241127000328 |
| Provider Name | Kirsten Joseph |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477375749 PECOS PAC ID: 1850826603 Enrollment ID: I20241203001466 |
| Provider Name | Darlene P Males |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821599101 PECOS PAC ID: 8022371343 Enrollment ID: I20250214000669 |
| Provider Name | Hetali Patel-fazzolari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609761642 PECOS PAC ID: 9638683006 Enrollment ID: I20250708003181 |
| Provider Name | Christine Lutfy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306454707 PECOS PAC ID: 4789113234 Enrollment ID: I20250718001390 |
| Provider Name | Sylvia Musoke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801769179 PECOS PAC ID: 9739675125 Enrollment ID: I20260106002164 |
| Provider Name | Mary Katherine Marcellus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700662004 PECOS PAC ID: 3577044601 Enrollment ID: I20260226000327 |
| Provider Name | Fielding Johnson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346336237 PECOS PAC ID: 0345140927 Enrollment ID: I20260402001396 |
| Provider Name | Elizabeth Ann Cronin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518765080 PECOS PAC ID: 4082189535 Enrollment ID: I20260413000535 |
| Provider Name | Neneh Jalloh Sammah |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336896257 PECOS PAC ID: 2961972724 Enrollment ID: I20260521004530 |
| Provider Name | Adedoyin Odumuyiwa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073472858 PECOS PAC ID: 4082185277 Enrollment ID: I20260609001370 |
| Provider Name | Rodnikka Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629938535 PECOS PAC ID: 2567934383 Enrollment ID: I20260612001143 |
First Class Primary Care PLLC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1017 Turnpike St Ste 33, Canton, MA 02021 Phone: 781-236-7343 |
Pappas Rehabilitation Hospital for Children Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3 Randolph St., Canton, MA 02021 Phone: 781-828-2440 Fax: 781-821-4086 |
Physicians Group Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 709 Washington St, Canton, MA 02021 Phone: 781-828-5351 |
Zinaida Levin MD PC Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 510 Chapman St, Canton, MA 02021 Phone: 781-575-1266 |
Point32health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1895 J W Foster Blvd, Canton, MA 02021 Phone: 617-972-1053 Fax: 617-972-1047 |
Family Medical Associates, P.C. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 709 Washington Street, Canton, MA 02021 Phone: 781-828-5351 Fax: 781-821-5471 |