| Vineyard Medical Care Llc | |
|
364 State Rd Vineyard Haven MA 02568-5624 | |
| (508) 693-4400 | |
| (508) 693-2098 |
| Full Name | Vineyard Medical Care Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 364 State Rd, Vineyard Haven, Massachusetts |
| Authorized Official Name and Position | Michael Loberg (PRESIDENT) |
| Authorized Official Contact | 5085488989 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vineyard Medical Care Llc Po Box 2557 Vineyard Haven MA 02568-0922 Ph: (508) 548-8989 | Vineyard Medical Care Llc 364 State Rd Vineyard Haven MA 02568-5624 Ph: (508) 693-4400 |
| NPI Number | 1346649886 |
|---|---|
| Provider Enumeration Date | 08/21/2014 |
| Last Update Date | 08/21/2014 |
| Medicare PECOS PAC ID | 7416279591 |
|---|---|
| Medicare Enrollment ID | O20141126000953 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346649886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Kathleen Koehler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013967140 PECOS PAC ID: 0446141832 Enrollment ID: I20040324000267 |
| Provider Name | Bill A Tsikitas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407827033 PECOS PAC ID: 8820036882 Enrollment ID: I20050420000592 |
| Provider Name | Karen Smith Rohrberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194815597 PECOS PAC ID: 3072511732 Enrollment ID: I20061114000166 |
| Provider Name | Gerald P Yukevich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992873566 PECOS PAC ID: 9133201668 Enrollment ID: I20080123000535 |
| Provider Name | Laura Rozsika Kelley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699336875 PECOS PAC ID: 7517296270 Enrollment ID: I20190906000286 |
Vineyard Medical Services Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 364 State Rd, Vineyard Haven, MA 02568 Phone: 508-693-4400 Fax: 508-693-2098 | |
Alliance Internal Medicine Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 455 State Rd Unit 11, Vineyard Haven, MA 02568 Phone: 508-627-3600 Fax: 508-627-3662 |