| Fort Healthcare Inc | |
|
611 Sherman Ave E Fort Atkinson WI 53538-1960 | |
| (920) 568-6580 | |
| (920) 568-4004 |
| Full Name | Fort Healthcare Inc |
|---|---|
| Speciality | Counselor |
| Location | 611 Sherman Ave E, Fort Atkinson, Wisconsin |
| Authorized Official Name and Position | Shelby Walling (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 9205634466 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fort Healthcare Inc Po Box 249 Fort Atkinson WI 53538-0249 Ph: (920) 563-4402 | Fort Healthcare Inc 611 Sherman Ave E Fort Atkinson WI 53538-1960 Ph: (920) 568-6580 |
| NPI Number | 1417993361 |
|---|---|
| Provider Enumeration Date | 06/21/2006 |
| Last Update Date | 10/07/2022 |
| Certification Date | 10/07/2022 |
| Medicare PECOS PAC ID | 0840189718 |
|---|---|
| Medicare Enrollment ID | O20040319001411 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417993361 | NPI | - | NPPES |
| 21273900 | Medicaid | WI | |
| 21274000 | Medicaid | WI | |
| 000000491 | Other | MEDICARE PTAN | |
| 21273800 | Medicaid | WI | |
| 21274200 | Medicaid | WI | |
| 21274600 | Medicaid | WI | |
| 21274500 | Medicaid | WI | |
| 21279400 | Medicaid | WI | |
| 11011900 | Medicaid | WI | |
| 21274300 | Medicaid | WI | |
| 21274900 | Medicaid | WI | |
| 21275700 | Medicaid | WI | |
| 21274100 | Medicaid | WI | |
| 21274800 | Medicaid | WI | |
| 52D0392916 | Other | WI | CLIA |
| 42237700 | Medicaid | WI | |
| 21274700 | Medicaid | WI |
| Provider Name | John A Jerisha |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053389288 PECOS PAC ID: 5991602369 Enrollment ID: I20031215000386 |
| Provider Name | Perry J Pickhardt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962464123 PECOS PAC ID: 3779484068 Enrollment ID: I20040120000016 |
| Provider Name | Raaid Museitif |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1992974174 PECOS PAC ID: 3072414150 Enrollment ID: I20040120001037 |
| Provider Name | Joseph A Bellissimo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477526515 PECOS PAC ID: 2264334689 Enrollment ID: I20040124000261 |
| Provider Name | Thomas M Mcgorey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770518540 PECOS PAC ID: 4385538586 Enrollment ID: I20040210000129 |
| Provider Name | Mohamed H Yafai |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730156431 PECOS PAC ID: 6901790088 Enrollment ID: I20040210000669 |
| Provider Name | Jennifer M Philbin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528084209 PECOS PAC ID: 7416847280 Enrollment ID: I20040316001192 |
| Provider Name | Thomas R Wallhaus |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215900022 PECOS PAC ID: 9335030006 Enrollment ID: I20040323000661 |
| Provider Name | Ranganatha R Sriram |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1972512895 PECOS PAC ID: 5698666204 Enrollment ID: I20040323001010 |
| Provider Name | Jonathan G Mclaughlin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427074509 PECOS PAC ID: 9133010630 Enrollment ID: I20040323001671 |
| Provider Name | Julie M Mokhtar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942221437 PECOS PAC ID: 3173414596 Enrollment ID: I20040323001846 |
| Provider Name | Billie G Kontny |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043236128 PECOS PAC ID: 4284525577 Enrollment ID: I20040324000938 |
| Provider Name | Marc H Erickson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730105826 PECOS PAC ID: 3779474978 Enrollment ID: I20040324001074 |
| Provider Name | Michael R Anderson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1588685077 PECOS PAC ID: 1658262803 Enrollment ID: I20040324001383 |
| Provider Name | Joyce M Dedrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972520625 PECOS PAC ID: 9133010317 Enrollment ID: I20040324001580 |
| Provider Name | Laurel J Runte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689607004 PECOS PAC ID: 0345132452 Enrollment ID: I20040325000557 |
| Provider Name | Christine A Chuppa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245257997 PECOS PAC ID: 7618869470 Enrollment ID: I20040326000394 |
| Provider Name | Cheryl A Kinney |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1184715989 PECOS PAC ID: 2961394523 Enrollment ID: I20040327000354 |
| Provider Name | Charles G Stepherson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508835596 PECOS PAC ID: 3375539125 Enrollment ID: I20040426000444 |
| Provider Name | Elizabeth L Teigen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285603282 PECOS PAC ID: 5799771556 Enrollment ID: I20040426000569 |
| Provider Name | Kathleen M Baus |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1063480291 PECOS PAC ID: 8729074596 Enrollment ID: I20040426000621 |
| Provider Name | Carolyn A Haerr |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033188032 PECOS PAC ID: 7517954316 Enrollment ID: I20040426000917 |
| Provider Name | Susan K Ipsen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205049582 PECOS PAC ID: 4587652920 Enrollment ID: I20040504000801 |
| Provider Name | Greg T Graglia |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1841244555 PECOS PAC ID: 3971586025 Enrollment ID: I20040609001390 |
| Provider Name | Lisa M Schmaltz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366410243 PECOS PAC ID: 7012991607 Enrollment ID: I20040614000113 |
| Provider Name | Stanley J Fudala |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356317184 PECOS PAC ID: 5991789075 Enrollment ID: I20040616000411 |
| Provider Name | Mouhammed Rihawi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1972542348 PECOS PAC ID: 4587559273 Enrollment ID: I20040723000538 |
| Provider Name | James L Hinshaw |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437123031 PECOS PAC ID: 3173595527 Enrollment ID: I20040806001194 |
| Provider Name | Nathaniel J Fullerton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366417461 PECOS PAC ID: 8729054226 Enrollment ID: I20040907000694 |
| Provider Name | William J Gurske |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245385848 PECOS PAC ID: 2365419363 Enrollment ID: I20040910000181 |
| Provider Name | Raed A Hamed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740241793 PECOS PAC ID: 9133197122 Enrollment ID: I20040917000668 |
| Provider Name | Orell R Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972559755 PECOS PAC ID: 3375511934 Enrollment ID: I20040921000930 |
| Provider Name | Mary Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487662060 PECOS PAC ID: 1052210762 Enrollment ID: I20040927000962 |
| Provider Name | John K Park |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1487623773 PECOS PAC ID: 0941269534 Enrollment ID: I20041008000406 |
| Provider Name | Lynn S Broderick |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083683031 PECOS PAC ID: 6608838347 Enrollment ID: I20041103001087 |
| Provider Name | Michael J Tuite |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467420950 PECOS PAC ID: 8224091913 Enrollment ID: I20041104000133 |
| Provider Name | Pamela A Propeck |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417911041 PECOS PAC ID: 1254394695 Enrollment ID: I20041108000398 |
| Provider Name | Emily H Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285602367 PECOS PAC ID: 6507821782 Enrollment ID: I20041130000371 |
| Provider Name | Renee K Remington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295843266 PECOS PAC ID: 5698733962 Enrollment ID: I20050201000039 |
| Provider Name | David H Kim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861469058 PECOS PAC ID: 5597703462 Enrollment ID: I20050420001402 |
| Provider Name | Douglas S Keehn |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1942277751 PECOS PAC ID: 1951349745 Enrollment ID: I20050421001023 |
| Provider Name | Martin M Okun |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1598144867 PECOS PAC ID: 4486696622 Enrollment ID: I20050526000899 |
| Provider Name | Isidoro V Zambrano |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1598712663 PECOS PAC ID: 4284661083 Enrollment ID: I20050723000120 |
| Provider Name | Stephanie L Nottestad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457360760 PECOS PAC ID: 5799716338 Enrollment ID: I20050824000275 |
| Provider Name | Lonie R Salkowski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669431102 PECOS PAC ID: 0345272274 Enrollment ID: I20050831000484 |
| Provider Name | Sandhya V Shah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114921046 PECOS PAC ID: 2264459635 Enrollment ID: I20051026000298 |
| Provider Name | Newrhee Kim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952370256 PECOS PAC ID: 9537177241 Enrollment ID: I20060322000294 |
| Provider Name | Samuel S Charles |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225089253 PECOS PAC ID: 9335150713 Enrollment ID: I20060523000167 |
| Provider Name | Tyler Marshall Prout |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003864125 PECOS PAC ID: 2961413372 Enrollment ID: I20060524000161 |
| Provider Name | Peter Joseph Chase |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295792158 PECOS PAC ID: 2769493170 Enrollment ID: I20060524000174 |
| Provider Name | Ailleen R Alquinto Anonuevo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417900143 PECOS PAC ID: 1951307503 Enrollment ID: I20061004000686 |
| Provider Name | James P Wishau |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962414938 PECOS PAC ID: 1951364637 Enrollment ID: I20061006000443 |
| Provider Name | Haydar K Saleh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225145592 PECOS PAC ID: 9638178213 Enrollment ID: I20061208000093 |
| Provider Name | Mai A Elezaby |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366525990 PECOS PAC ID: 2466452867 Enrollment ID: I20070109000442 |
| Provider Name | Bradley A Maxfield |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1760431555 PECOS PAC ID: 9436181856 Enrollment ID: I20070111000294 |
| Provider Name | Bora Ozel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1316998917 PECOS PAC ID: 6406959261 Enrollment ID: I20070315000187 |
| Provider Name | Robert J Glinert |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1144271404 PECOS PAC ID: 5294632956 Enrollment ID: I20070411000131 |
| Provider Name | Yaw D Berko |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003952995 PECOS PAC ID: 6608974050 Enrollment ID: I20070607000528 |
| Provider Name | Elizabeth A Hunkins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1417167586 PECOS PAC ID: 8426158973 Enrollment ID: I20070712000416 |
| Provider Name | Laura M Koenig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700881869 PECOS PAC ID: 6901907963 Enrollment ID: I20070720000846 |
| Provider Name | Thomas J Tackman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902802416 PECOS PAC ID: 9537260591 Enrollment ID: I20070720000859 |
| Provider Name | Donald L Williams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326043266 PECOS PAC ID: 3375644545 Enrollment ID: I20070727000748 |
| Provider Name | Thomas A Freichels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457394991 PECOS PAC ID: 6305938838 Enrollment ID: I20070828000821 |
| Provider Name | Prasad S Dalvie |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477757797 PECOS PAC ID: 2961597893 Enrollment ID: I20071005000814 |
| Provider Name | Deborah L Roe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053590851 PECOS PAC ID: 7012005184 Enrollment ID: I20071127000197 |
| Provider Name | Cheryl J Roets |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1609878453 PECOS PAC ID: 4082702162 Enrollment ID: I20071127000318 |
| Provider Name | Conrad D Pun |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1720297112 PECOS PAC ID: 0840360459 Enrollment ID: I20080609000064 |
| Provider Name | Jessica B Robbins |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407971336 PECOS PAC ID: 9739259367 Enrollment ID: I20080609000175 |
| Provider Name | Heidi J Jennrich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548223746 PECOS PAC ID: 9032289590 Enrollment ID: I20080610000449 |
| Provider Name | Meghan G Lubner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184845133 PECOS PAC ID: 5294809299 Enrollment ID: I20080809000088 |
| Provider Name | Brian K Markhardt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154335420 PECOS PAC ID: 8729152665 Enrollment ID: I20080811000394 |
| Provider Name | Kofi A Asiamah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427221621 PECOS PAC ID: 2466528567 Enrollment ID: I20080912000470 |
| Provider Name | Gislaine E Tsemo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851351068 PECOS PAC ID: 1456388750 Enrollment ID: I20081017000195 |
| Provider Name | Syed I Ali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952519142 PECOS PAC ID: 7810056538 Enrollment ID: I20081110000290 |
| Provider Name | Anne V Hoeft |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316184203 PECOS PAC ID: 5193881886 Enrollment ID: I20090304000592 |
| Provider Name | Michael C Kreager |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609850791 PECOS PAC ID: 2567516099 Enrollment ID: I20090819000179 |
| Provider Name | Katherine M Abbo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1962488965 PECOS PAC ID: 0042364481 Enrollment ID: I20090819000318 |
| Provider Name | William C Hofmann |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1306844949 PECOS PAC ID: 7214093368 Enrollment ID: I20090909000751 |
| Provider Name | Orhan S Ozkan |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1043394398 PECOS PAC ID: 8224130687 Enrollment ID: I20091006000698 |
| Provider Name | Jennifer A Winter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174726038 PECOS PAC ID: 8224176631 Enrollment ID: I20091105000008 |
| Provider Name | David D Schmitt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346237906 PECOS PAC ID: 6204817208 Enrollment ID: I20100109000129 |
| Provider Name | Brent Paul Yaeggi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1427001676 PECOS PAC ID: 7315035565 Enrollment ID: I20100125000821 |
| Provider Name | Robert J Goldman |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1790808509 PECOS PAC ID: 7113935610 Enrollment ID: I20100309000785 |
| Provider Name | Matthew S Bliss |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255378014 PECOS PAC ID: 5193854016 Enrollment ID: I20100602000254 |
| Provider Name | Edward J Borman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851340657 PECOS PAC ID: 3779612668 Enrollment ID: I20100602000936 |
| Provider Name | Jennifer L Klenske |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841350022 PECOS PAC ID: 2365489440 Enrollment ID: I20100603000906 |
| Provider Name | Jason W Pinchot |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1639339971 PECOS PAC ID: 3971633223 Enrollment ID: I20100611000658 |
| Provider Name | John-michael N Khalil |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588848923 PECOS PAC ID: 4587714407 Enrollment ID: I20100626000261 |
| Provider Name | Kimberly S Knudsen |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1619990769 PECOS PAC ID: 0840314795 Enrollment ID: I20100828000148 |
| Provider Name | Roberta Marie Strigel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710078746 PECOS PAC ID: 7113071879 Enrollment ID: I20100920000709 |
| Provider Name | Timothy J Ziemlewicz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184885683 PECOS PAC ID: 6800946773 Enrollment ID: I20100927001390 |
| Provider Name | Christopher G Guglielmo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770750432 PECOS PAC ID: 9638361504 Enrollment ID: I20101011000450 |
| Provider Name | Kamaljit Puri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780622787 PECOS PAC ID: 2163571183 Enrollment ID: I20101014000722 |
| Provider Name | Leonardo Montemurro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689620072 PECOS PAC ID: 9830382795 Enrollment ID: I20101022001353 |
| Provider Name | Julia R Dewey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760686729 PECOS PAC ID: 0941497739 Enrollment ID: I20101206000816 |
| Provider Name | David A Misorski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780791285 PECOS PAC ID: 1759563828 Enrollment ID: I20110310000497 |
| Provider Name | Kara Gill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477634624 PECOS PAC ID: 2163608175 Enrollment ID: I20110509000431 |
| Provider Name | Jolie A Nottelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750675781 PECOS PAC ID: 1951570498 Enrollment ID: I20110817000882 |
| Provider Name | Katie A Calabresa |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1871899377 PECOS PAC ID: 7315118627 Enrollment ID: I20110919000144 |
| Provider Name | Allen B Jetmore |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1093725111 PECOS PAC ID: 3971505041 Enrollment ID: I20110919000148 |
| Provider Name | Colleen M Drosdeck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1801027826 PECOS PAC ID: 6103098215 Enrollment ID: I20111014000450 |
| Provider Name | Veronica Rejon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497069231 PECOS PAC ID: 9032385026 Enrollment ID: I20111221000496 |
| Provider Name | Molly E Raske |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093820730 PECOS PAC ID: 9436220142 Enrollment ID: I20120328000963 |
| Provider Name | Venkata N Meduri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437424835 PECOS PAC ID: 7315103405 Enrollment ID: I20120717000577 |
| Provider Name | Amy M Fowler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992960975 PECOS PAC ID: 9234393182 Enrollment ID: I20130608000151 |
| Provider Name | Robert K Bour |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285892844 PECOS PAC ID: 7113168741 Enrollment ID: I20130724000811 |
| Provider Name | Michael A Woods |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1518096817 PECOS PAC ID: 5991946543 Enrollment ID: I20130725000102 |
| Provider Name | Paul William Schuppner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1215145206 PECOS PAC ID: 5496902777 Enrollment ID: I20131001000284 |
| Provider Name | Krishna Kottapalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952678286 PECOS PAC ID: 4486888484 Enrollment ID: I20131007000296 |
| Provider Name | Monica B Musete |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275897019 PECOS PAC ID: 7113173832 Enrollment ID: I20140130000608 |
| Provider Name | Ryan Woods |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598995748 PECOS PAC ID: 2466601653 Enrollment ID: I20140602001884 |
| Provider Name | Richard Amankwah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164712741 PECOS PAC ID: 6901022540 Enrollment ID: I20140717000527 |
| Provider Name | Mark G Kleedehn |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1508187964 PECOS PAC ID: 5395968069 Enrollment ID: I20140911001955 |
| Provider Name | Laura K Cichocki |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952409575 PECOS PAC ID: 3072558402 Enrollment ID: I20140927000175 |
| Provider Name | Lauren Mayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205232626 PECOS PAC ID: 7911220090 Enrollment ID: I20141222000270 |
| Provider Name | Bridget A Halbersma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568868537 PECOS PAC ID: 1052634680 Enrollment ID: I20150106001302 |
| Provider Name | Stefanie S Ruffolo |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1548572696 PECOS PAC ID: 4981920899 Enrollment ID: I20150311000847 |
| Provider Name | Anthony David Kuner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700115789 PECOS PAC ID: 1951543701 Enrollment ID: I20150518001146 |
| Provider Name | Lori Mankowski-gettle |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1376869594 PECOS PAC ID: 2062723893 Enrollment ID: I20150622000553 |
| Provider Name | Jessica L Holland |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225417488 PECOS PAC ID: 2961714845 Enrollment ID: I20150707000942 |
| Provider Name | Alicia K Leslie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437387958 PECOS PAC ID: 3375858863 Enrollment ID: I20150812008190 |
| Provider Name | Richmond Gyamfi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700089414 PECOS PAC ID: 1951426386 Enrollment ID: I20150916001161 |
| Provider Name | Lindsay L Vanselow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437523669 PECOS PAC ID: 7719282284 Enrollment ID: I20160222000007 |
| Provider Name | Bradley T Wagner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043581770 PECOS PAC ID: 7214233295 Enrollment ID: I20160317001103 |
| Provider Name | Zachary Borden |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750677290 PECOS PAC ID: 1951524743 Enrollment ID: I20160510002111 |
| Provider Name | Michael P Hartung |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750660692 PECOS PAC ID: 9133419369 Enrollment ID: I20160531002456 |
| Provider Name | Bryan Dustin Pooler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851650030 PECOS PAC ID: 2365746831 Enrollment ID: I20160804002674 |
| Provider Name | Elizabeth H Lynk |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124383690 PECOS PAC ID: 3577787027 Enrollment ID: I20161003000170 |
| Provider Name | Jonathan M Beck |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831648989 PECOS PAC ID: 7810277290 Enrollment ID: I20161130001328 |
| Provider Name | Angela N Monzon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689668287 PECOS PAC ID: 4789617226 Enrollment ID: I20161230001425 |
| Provider Name | John Stephen Symanski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073812236 PECOS PAC ID: 3870722408 Enrollment ID: I20170517001579 |
| Provider Name | Mark E Sharafinski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952612194 PECOS PAC ID: 4486932951 Enrollment ID: I20170525001641 |
| Provider Name | Kristian V Lozev |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326465519 PECOS PAC ID: 5092019877 Enrollment ID: I20170829001690 |
| Provider Name | Catherine L Sweeney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649699067 PECOS PAC ID: 7719279587 Enrollment ID: I20171002003184 |
| Provider Name | Jane Beth Lyon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750470647 PECOS PAC ID: 5193722700 Enrollment ID: I20171113003348 |
| Provider Name | Rachel L Guenther |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346751120 PECOS PAC ID: 5698032563 Enrollment ID: I20171130002495 |
| Provider Name | Fawn L Bingham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467960955 PECOS PAC ID: 3173885217 Enrollment ID: I20180329001036 |
| Provider Name | Kelly W Capel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356768220 PECOS PAC ID: 2365762895 Enrollment ID: I20180731003833 |
| Provider Name | Jennifer Gruber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134515703 PECOS PAC ID: 1951647858 Enrollment ID: I20190115000273 |
| Provider Name | Matthew William Shore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669814737 PECOS PAC ID: 8729202049 Enrollment ID: I20190529001459 |
| Provider Name | Minnie W Kieler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942659883 PECOS PAC ID: 6406136282 Enrollment ID: I20190701000877 |
| Provider Name | Girma Tesfaye Beyene |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467816561 PECOS PAC ID: 4789986597 Enrollment ID: I20190709001016 |
| Provider Name | Andrew Kanarek |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497137327 PECOS PAC ID: 6800176611 Enrollment ID: I20190710001675 |
| Provider Name | Joseph Lang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225422504 PECOS PAC ID: 4981904703 Enrollment ID: I20190812001760 |
| Provider Name | Natalie Elise Brunk |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730586496 PECOS PAC ID: 8729394747 Enrollment ID: I20190823000471 |
| Provider Name | Jason M Goodman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669013702 PECOS PAC ID: 4688905383 Enrollment ID: I20191010002246 |
| Provider Name | Georgia J Schiller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1306230818 PECOS PAC ID: 3870892987 Enrollment ID: I20191111000461 |
| Provider Name | Jacqueline Sue Wolff-ellifson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023653847 PECOS PAC ID: 4789018763 Enrollment ID: I20191227002028 |
| Provider Name | Eileen T Reilly |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700865573 PECOS PAC ID: 4587665484 Enrollment ID: I20200214000494 |
| Provider Name | John F Swietlik |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1285029314 PECOS PAC ID: 4880974666 Enrollment ID: I20200331002012 |
| Provider Name | David Somsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891112264 PECOS PAC ID: 6709181019 Enrollment ID: I20200408001756 |
| Provider Name | Abdelrahman Abdelazim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346622982 PECOS PAC ID: 3173954351 Enrollment ID: I20200505000255 |
| Provider Name | Ernesto A Bogarin-miranda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376951046 PECOS PAC ID: 2567733488 Enrollment ID: I20200513000403 |
| Provider Name | Alison R Gegios |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669867990 PECOS PAC ID: 9830420090 Enrollment ID: I20200521000095 |
| Provider Name | Ruthanne Reichert Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538278171 PECOS PAC ID: 6103977764 Enrollment ID: I20200528002489 |
| Provider Name | Mitchell K Daun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265827943 PECOS PAC ID: 2961776356 Enrollment ID: I20200603003079 |
| Provider Name | Samuel Hund |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205221108 PECOS PAC ID: 2163728858 Enrollment ID: I20200605000621 |
| Provider Name | Andrew Louis Wentland |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295121986 PECOS PAC ID: 6406151158 Enrollment ID: I20200609001538 |
| Provider Name | Marcin Ignaciuk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790167872 PECOS PAC ID: 0345528634 Enrollment ID: I20200616001650 |
| Provider Name | Janice Thai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568691392 PECOS PAC ID: 1759626294 Enrollment ID: I20200616003066 |
| Provider Name | James Flannery |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477948396 PECOS PAC ID: 8628370434 Enrollment ID: I20200618000194 |
| Provider Name | Teresa Martin-carreras |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922495399 PECOS PAC ID: 2860815388 Enrollment ID: I20200630003339 |
| Provider Name | Casey Mcroy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184019986 PECOS PAC ID: 1254659659 Enrollment ID: I20200709003633 |
| Provider Name | Edward M Lawrence |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912393703 PECOS PAC ID: 2860700879 Enrollment ID: I20200715003398 |
| Provider Name | Melissa B Carroll |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659766509 PECOS PAC ID: 6709181688 Enrollment ID: I20200831002401 |
| Provider Name | Indraneel I Gowdar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881030260 PECOS PAC ID: 1850679994 Enrollment ID: I20200901001892 |
| Provider Name | Felix Ofori-gyebi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366675480 PECOS PAC ID: 1052567641 Enrollment ID: I20200909000704 |
| Provider Name | Agnieszka J Silbert |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871543447 PECOS PAC ID: 0042201600 Enrollment ID: I20201001001367 |
| Provider Name | Joellyn Christine Krause |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124633920 PECOS PAC ID: 3274952403 Enrollment ID: I20201007001507 |
| Provider Name | Latisha Antoinette Smith-chase |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1154349900 PECOS PAC ID: 3274714431 Enrollment ID: I20201013002513 |
| Provider Name | Matthew Patrick Mallin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841884277 PECOS PAC ID: 6204244742 Enrollment ID: I20210421001598 |
| Provider Name | Molly M Larson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972898096 PECOS PAC ID: 5496979932 Enrollment ID: I20210505000569 |
| Provider Name | Daniel April |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851748057 PECOS PAC ID: 3870888969 Enrollment ID: I20210527002853 |
| Provider Name | Matthew H Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447538566 PECOS PAC ID: 8820394729 Enrollment ID: I20210528000528 |
| Provider Name | Barry Rush |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669835351 PECOS PAC ID: 6800188020 Enrollment ID: I20210603001287 |
| Provider Name | Douglas Lorenzo Handley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831552157 PECOS PAC ID: 0244630416 Enrollment ID: I20210609000973 |
| Provider Name | Giuseppe V Toia |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710364187 PECOS PAC ID: 1951605815 Enrollment ID: I20210610000163 |
| Provider Name | Addison Elston |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649625385 PECOS PAC ID: 0042502239 Enrollment ID: I20210610002962 |
| Provider Name | Michael Joseph Accavitti |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679952642 PECOS PAC ID: 4082905955 Enrollment ID: I20210610003033 |
| Provider Name | Cameron Adler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205298411 PECOS PAC ID: 8921376039 Enrollment ID: I20210623000941 |
| Provider Name | Zachary Stewart |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1457713166 PECOS PAC ID: 1658665625 Enrollment ID: I20210629001222 |
| Provider Name | Laura Elaine Bryant-piatkowski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699139469 PECOS PAC ID: 9638570419 Enrollment ID: I20210630002918 |
| Provider Name | Anand Kumar Narayan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124304217 PECOS PAC ID: 3971752270 Enrollment ID: I20210723000932 |
| Provider Name | Scott Mauch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598290272 PECOS PAC ID: 3173893104 Enrollment ID: I20210726001312 |
| Provider Name | Todd Cason |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689152068 PECOS PAC ID: 8123424744 Enrollment ID: I20210908000499 |
| Provider Name | Bethann Nowak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548931009 PECOS PAC ID: 5991194458 Enrollment ID: I20211123000614 |
| Provider Name | Dane R Schultz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649933748 PECOS PAC ID: 6901296227 Enrollment ID: I20211201000083 |
| Provider Name | Thomas Choorapokayil George |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922448018 PECOS PAC ID: 5294029666 Enrollment ID: I20220209002359 |
| Provider Name | Mckenna M Meihak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699344747 PECOS PAC ID: 0749675411 Enrollment ID: I20220315002475 |
| Provider Name | Kenneth A Lahrman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750822953 PECOS PAC ID: 4688051048 Enrollment ID: I20220524002745 |
| Provider Name | Taylor Morris |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003342676 PECOS PAC ID: 7012281041 Enrollment ID: I20220525002361 |
| Provider Name | Brad A Evans |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679005888 PECOS PAC ID: 8628456316 Enrollment ID: I20220608003062 |
| Provider Name | Nicholas Charles Laucis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255782116 PECOS PAC ID: 6901190891 Enrollment ID: I20220609002973 |
| Provider Name | Molly S Peterson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346774726 PECOS PAC ID: 0941571152 Enrollment ID: I20220610000996 |
| Provider Name | Matthew Mader |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578096566 PECOS PAC ID: 3971861725 Enrollment ID: I20220610001554 |
| Provider Name | Anthony Jiang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770014334 PECOS PAC ID: 3476822008 Enrollment ID: I20220613002849 |
| Provider Name | Tyler A Dailey |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700150406 PECOS PAC ID: 4587925862 Enrollment ID: I20220614001155 |
| Provider Name | Thymur Chaudhry |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043660285 PECOS PAC ID: 6305134503 Enrollment ID: I20220621002451 |
| Provider Name | Nicole Christine Sztuk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932631504 PECOS PAC ID: 7618240144 Enrollment ID: I20220624000599 |
| Provider Name | Joshua Arnold |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720511033 PECOS PAC ID: 2264703180 Enrollment ID: I20220628002620 |
| Provider Name | Jade A Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871941252 PECOS PAC ID: 7517246366 Enrollment ID: I20220629000233 |
| Provider Name | Kaitlin M Peterson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669903191 PECOS PAC ID: 6002248564 Enrollment ID: I20220706002821 |
| Provider Name | Mary Buchanan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831621507 PECOS PAC ID: 0547518904 Enrollment ID: I20220711001950 |
| Provider Name | Mario Juliano |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902334758 PECOS PAC ID: 1759762743 Enrollment ID: I20220721003912 |
| Provider Name | Anupama Joseph |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063861706 PECOS PAC ID: 7416249065 Enrollment ID: I20220730000400 |
| Provider Name | Mila V Quinn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033646971 PECOS PAC ID: 8426327131 Enrollment ID: I20220808003041 |
| Provider Name | Peter S Assaad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538324660 PECOS PAC ID: 0547586901 Enrollment ID: I20220816000240 |
| Provider Name | Andrew T Scrima |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508361932 PECOS PAC ID: 4981020773 Enrollment ID: I20220817003680 |
| Provider Name | Daniel Feldman Elmes |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1316500994 PECOS PAC ID: 7315271707 Enrollment ID: I20220930000510 |
| Provider Name | Angela D Schuldies |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538882782 PECOS PAC ID: 4385012269 Enrollment ID: I20221128000429 |
| Provider Name | Leslie Nelson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770088387 PECOS PAC ID: 7012373095 Enrollment ID: I20230517001035 |
| Provider Name | Evan Charles Benner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225532716 PECOS PAC ID: 8820454762 Enrollment ID: I20230518000827 |
| Provider Name | Robert R Brenteson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972090363 PECOS PAC ID: 4284022898 Enrollment ID: I20230522002796 |
| Provider Name | Jacob B Fleecs |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043716954 PECOS PAC ID: 2860859170 Enrollment ID: I20230601000559 |
| Provider Name | Thomas P Lo Duca |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497247159 PECOS PAC ID: 5698022085 Enrollment ID: I20230614003043 |
| Provider Name | Monica Cooley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568968840 PECOS PAC ID: 0446509897 Enrollment ID: I20230711004268 |
| Provider Name | Katharine H Molinarolo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689169898 PECOS PAC ID: 3577817824 Enrollment ID: I20230712001960 |
| Provider Name | Jacob T Mccallum |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194210492 PECOS PAC ID: 8527302702 Enrollment ID: I20230714002946 |
| Provider Name | Kathleen Fink |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902917909 PECOS PAC ID: 1951452994 Enrollment ID: I20230720002549 |
| Provider Name | Amanda Ruth Gatzke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629756705 PECOS PAC ID: 8820450950 Enrollment ID: I20230821003817 |
| Provider Name | Akm Abuhiya |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164043097 PECOS PAC ID: 8123482148 Enrollment ID: I20230908003639 |
| Provider Name | Stephen P Polanski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942732136 PECOS PAC ID: 5799139861 Enrollment ID: I20230922001101 |
| Provider Name | Joshua D Warner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922452366 PECOS PAC ID: 7113219841 Enrollment ID: I20230927002633 |
| Provider Name | Nathan Spangler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336727452 PECOS PAC ID: 6608279690 Enrollment ID: I20240313003671 |
Thomas R. Perry, M.d.,s.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 611 Sherman Ave E, Fort Atkinson, WI 53538 Phone: 920-568-5334 | |
Colleen A. Mitchell Psychological Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 S. Main Street Suite 104, Fort Atkinson, WI 53538 Phone: 773-387-0790 | |
Im Fine Counseling Services Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 20 Sherman Ave E, Fort Atkinson, WI 53538 Phone: 920-728-1810 | |
Healing Your Mind Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 S Main St, Fort Atkinson, WI 53538 Phone: 262-472-9591 | |
Hidden Path Counseling, Llc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 10 S Water St E, Fort Atkinson, WI 53538 Phone: 608-322-8552 | |
Insight Counseling Services Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 615 Frederick Ave., Fort Atkinson, WI 53538 Phone: 920-723-2517 |