| Holyoke Medical Center, Inc. | |
|
575 Beech St Holyoke MA 01040-2223 | |
| (413) 534-2567 | |
| (413) 534-2664 |
| Full Name | Holyoke Medical Center, Inc. |
|---|---|
| Speciality | General Acute Care Hospital |
| Location | 575 Beech St, Holyoke, Massachusetts |
| Authorized Official Name and Position | Paul M. Silva (VICE PRESIDENT OF FINANCE) |
| Authorized Official Contact | 4135342567 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Holyoke Medical Center, Inc. 575 Beech St Holyoke MA 01040-2223 Ph: (413) 534-2567 | Holyoke Medical Center, Inc. 575 Beech St Holyoke MA 01040-2223 Ph: (413) 534-2567 |
| NPI Number | 1750395737 |
|---|---|
| Provider Enumeration Date | 07/28/2006 |
| Last Update Date | 08/31/2015 |
| Medicare PECOS PAC ID | 2163419383 |
|---|---|
| Medicare Enrollment ID | O20040429000312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750395737 | NPI | - | NPPES |
| 110026773D | Other | MA | MMIS ID # OUTPATIENT MENTAL HEALTH |
| 1001647 | Medicaid | MA | |
| 110026773B | Other | MA | MMIS ID # OUTPATIENT |
| 1200798 | Medicaid | MA | |
| 110026773A | Other | MA | MMIS ID# INPATIENT |
| 110026773C | Other | MA | MMIS ID # INPATIENT MENTAL HEALTH |
| 22S024 | Other | MA | MEDICARE UPIN - PSYCH/BEHAVIORAL HEALTH |
| Provider Name | Margo Magdalena Moskos |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427095462 PECOS PAC ID: 6709798424 Enrollment ID: I20031105000056 |
| Provider Name | Risa Aronson-fox |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255426136 PECOS PAC ID: 7214841824 Enrollment ID: I20031118000428 |
| Provider Name | Mohammad A Hazratji |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578551966 PECOS PAC ID: 2961395538 Enrollment ID: I20040206000191 |
| Provider Name | Muhammad Z Kareem |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235126061 PECOS PAC ID: 0143113720 Enrollment ID: I20040206000248 |
| Provider Name | Robert J Cooper |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1992739726 PECOS PAC ID: 2961393723 Enrollment ID: I20040322001187 |
| Provider Name | Cecilia Anson Wonkka |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1881636520 PECOS PAC ID: 7315930849 Enrollment ID: I20040408000300 |
| Provider Name | Brenda I Maloney |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1811916174 PECOS PAC ID: 0840284295 Enrollment ID: I20040409000315 |
| Provider Name | Russell D Donnelly |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780672105 PECOS PAC ID: 5193713840 Enrollment ID: I20040503001067 |
| Provider Name | Mrinal S. Mali |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023055720 PECOS PAC ID: 7911997325 Enrollment ID: I20040517001204 |
| Provider Name | David J Pierangelo |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1861467748 PECOS PAC ID: 5890684039 Enrollment ID: I20040603000931 |
| Provider Name | Daryle A Ruark |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831174846 PECOS PAC ID: 0446237606 Enrollment ID: I20040706000746 |
| Provider Name | Kevin M Snow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447342183 PECOS PAC ID: 7113904392 Enrollment ID: I20040706000841 |
| Provider Name | Patricia Krebs |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1912975541 PECOS PAC ID: 2961475322 Enrollment ID: I20040816000142 |
| Provider Name | Susan Jordan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801844048 PECOS PAC ID: 5991792467 Enrollment ID: I20040816000736 |
| Provider Name | Miguel A Rodriguez |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1952370249 PECOS PAC ID: 6608849757 Enrollment ID: I20040817000368 |
| Provider Name | Ali Moshiri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679525786 PECOS PAC ID: 5799752317 Enrollment ID: I20040914000309 |
| Provider Name | Jennifer Lesperance |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982649729 PECOS PAC ID: 3779549043 Enrollment ID: I20041208000534 |
| Provider Name | Leo Stemp |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1528020278 PECOS PAC ID: 4688622251 Enrollment ID: I20050111000049 |
| Provider Name | Stephen V Klein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154355212 PECOS PAC ID: 1254384209 Enrollment ID: I20050302000185 |
| Provider Name | Lois C Albury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972580306 PECOS PAC ID: 5698729515 Enrollment ID: I20050303000556 |
| Provider Name | Philip J. Dombrowski |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679672794 PECOS PAC ID: 5799731139 Enrollment ID: I20050329000408 |
| Provider Name | Thomas S Gould |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1386671261 PECOS PAC ID: 6305893470 Enrollment ID: I20050401000067 |
| Provider Name | Thomas V Rossi |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558331892 PECOS PAC ID: 7911947239 Enrollment ID: I20050505001071 |
| Provider Name | Mohammad S Bajwa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235135336 PECOS PAC ID: 0840230173 Enrollment ID: I20050505001147 |
| Provider Name | Zoraida C Rodriguez |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1033244710 PECOS PAC ID: 8426098401 Enrollment ID: I20050510000141 |
| Provider Name | Nora Ethel Schwartz-martin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093821092 PECOS PAC ID: 0648210518 Enrollment ID: I20050510000758 |
| Provider Name | Garry M Bombardier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154471191 PECOS PAC ID: 0840272043 Enrollment ID: I20050519000202 |
| Provider Name | Stanley Swierzewski |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548230717 PECOS PAC ID: 5991747313 Enrollment ID: I20050525001229 |
| Provider Name | Catherine J Durie |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356368716 PECOS PAC ID: 0840233789 Enrollment ID: I20050602000314 |
| Provider Name | Nayyer Ghias |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275566622 PECOS PAC ID: 2961446547 Enrollment ID: I20050614001341 |
| Provider Name | Tedd H. Ackerman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649369133 PECOS PAC ID: 5890739197 Enrollment ID: I20050617000166 |
| Provider Name | Ignatius P Oyula |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619938958 PECOS PAC ID: 2860425600 Enrollment ID: I20050913000824 |
| Provider Name | Jane A Laskey |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1750454039 PECOS PAC ID: 3476586710 Enrollment ID: I20050916000116 |
| Provider Name | Beth L Brown |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750342705 PECOS PAC ID: 6709810849 Enrollment ID: I20050919000965 |
| Provider Name | Rani U Athreya |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114000734 PECOS PAC ID: 6608800115 Enrollment ID: I20050923000702 |
| Provider Name | James R Schumacher |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1770541195 PECOS PAC ID: 6103851951 Enrollment ID: I20050929000803 |
| Provider Name | Mary T Obrien |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1083614994 PECOS PAC ID: 5698790319 Enrollment ID: I20051012000301 |
| Provider Name | Amelia M Jaworek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518984947 PECOS PAC ID: 8628073509 Enrollment ID: I20060927000507 |
| Provider Name | Halbert J Feinberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689670770 PECOS PAC ID: 7214999382 Enrollment ID: I20061002000382 |
| Provider Name | Arthur Weinstock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487629234 PECOS PAC ID: 2365448404 Enrollment ID: I20061012000128 |
| Provider Name | Theodore K Mlapah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811929342 PECOS PAC ID: 5597765966 Enrollment ID: I20070109000202 |
| Provider Name | Nirav R Sheth |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770579369 PECOS PAC ID: 8123125325 Enrollment ID: I20070523000355 |
| Provider Name | Kathryn D Girardin |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1619186947 PECOS PAC ID: 3971409715 Enrollment ID: I20070822000389 |
| Provider Name | Shadi Zaghloul |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336157007 PECOS PAC ID: 8820034564 Enrollment ID: I20070831000095 |
| Provider Name | Alex B. Altamirano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356551071 PECOS PAC ID: 7719071679 Enrollment ID: I20070922000054 |
| Provider Name | April E Bowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710178348 PECOS PAC ID: 1355437740 Enrollment ID: I20071017000104 |
| Provider Name | Balaji P Athreya |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1598745010 PECOS PAC ID: 8224946983 Enrollment ID: I20071221000108 |
| Provider Name | Munir Ahmad |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1124126602 PECOS PAC ID: 5698769214 Enrollment ID: I20080208000199 |
| Provider Name | Frederik A Pennings |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1215126479 PECOS PAC ID: 4789769043 Enrollment ID: I20080311000298 |
| Provider Name | Francis Martinez |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154328490 PECOS PAC ID: 3678530573 Enrollment ID: I20080421000183 |
| Provider Name | Zubeena M Mateen |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1568409662 PECOS PAC ID: 4385714989 Enrollment ID: I20080609000814 |
| Provider Name | Alexander M Berry |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013019439 PECOS PAC ID: 4082785084 Enrollment ID: I20080619000055 |
| Provider Name | Mohammad Mujibur Rahman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992994438 PECOS PAC ID: 4880767623 Enrollment ID: I20080726000086 |
| Provider Name | Rose S Bernal-larioza |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1053529453 PECOS PAC ID: 3072680560 Enrollment ID: I20080925000271 |
| Provider Name | Shaji P Daniel |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1639384548 PECOS PAC ID: 0244399475 Enrollment ID: I20081103000725 |
| Provider Name | Aleksandr Kurbanov |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033100565 PECOS PAC ID: 8628061165 Enrollment ID: I20081217000105 |
| Provider Name | Mary E Norris |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881694362 PECOS PAC ID: 1951201680 Enrollment ID: I20090129000154 |
| Provider Name | Ryan W Crawford |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154509339 PECOS PAC ID: 6608927272 Enrollment ID: I20090623000185 |
| Provider Name | Juan P Lirio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124282025 PECOS PAC ID: 4688729981 Enrollment ID: I20090910000480 |
| Provider Name | Patricia Webber |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1386781722 PECOS PAC ID: 3476690603 Enrollment ID: I20091021000199 |
| Provider Name | Diana A Israeli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245541929 PECOS PAC ID: 1052505856 Enrollment ID: I20101104001229 |
| Provider Name | Khaled A Instrum |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1891774097 PECOS PAC ID: 7214116953 Enrollment ID: I20110126000901 |
| Provider Name | Dawn Chartier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285827758 PECOS PAC ID: 9032390448 Enrollment ID: I20110217000852 |
| Provider Name | Scott Stylos |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1427005115 PECOS PAC ID: 9032395900 Enrollment ID: I20110511000374 |
| Provider Name | Neeraj Vasishtha |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1982689048 PECOS PAC ID: 1850357724 Enrollment ID: I20110511000481 |
| Provider Name | Sidney L Kahn Iv |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750599700 PECOS PAC ID: 6002960473 Enrollment ID: I20110620000256 |
| Provider Name | Noah J Epstein |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1245427285 PECOS PAC ID: 8325222599 Enrollment ID: I20110830000120 |
| Provider Name | Marc Jean Zerbe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659323814 PECOS PAC ID: 5890702963 Enrollment ID: I20120104000524 |
| Provider Name | Julia T Bonacum |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1568403871 PECOS PAC ID: 0547362709 Enrollment ID: I20120405000083 |
| Provider Name | Omar D Santoyo Pacheco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467695387 PECOS PAC ID: 0244496610 Enrollment ID: I20120730000733 |
| Provider Name | Khawar Maqsood |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1205069010 PECOS PAC ID: 3274789573 Enrollment ID: I20120801000631 |
| Provider Name | Ursula Denise Mcmillian |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497812911 PECOS PAC ID: 0042474504 Enrollment ID: I20130709000410 |
| Provider Name | Sandip T Maru |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1437314325 PECOS PAC ID: 9335214949 Enrollment ID: I20140415000884 |
| Provider Name | Dawn C Quinn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609298413 PECOS PAC ID: 2668695339 Enrollment ID: I20140527001367 |
| Provider Name | Renuka Dulala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861652240 PECOS PAC ID: 4486664281 Enrollment ID: I20140917001985 |
| Provider Name | Hariharan Subramanian |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801080080 PECOS PAC ID: 4789770264 Enrollment ID: I20141020002249 |
| Provider Name | Savitri Rambissoon |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1144264961 PECOS PAC ID: 6103833579 Enrollment ID: I20150317002507 |
| Provider Name | Sukhchain Singh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255779146 PECOS PAC ID: 5890006266 Enrollment ID: I20150625002706 |
| Provider Name | Joseph T Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780860023 PECOS PAC ID: 2466519475 Enrollment ID: I20150708002378 |
| Provider Name | Charlene L Patenaude |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891085908 PECOS PAC ID: 1951537182 Enrollment ID: I20150716001538 |
| Provider Name | John J Mazzucco |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275515322 PECOS PAC ID: 7214837905 Enrollment ID: I20150807015080 |
| Provider Name | Tuyyab A Hassan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215160072 PECOS PAC ID: 8224290788 Enrollment ID: I20150810000653 |
| Provider Name | Sarah O'shea |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912269622 PECOS PAC ID: 4981924503 Enrollment ID: I20151029000141 |
| Provider Name | Jackie Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982071205 PECOS PAC ID: 5991015687 Enrollment ID: I20151109002294 |
| Provider Name | Adam C Lau |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649415530 PECOS PAC ID: 0143408914 Enrollment ID: I20151119001762 |
| Provider Name | Praveen Devineni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245586346 PECOS PAC ID: 3971803503 Enrollment ID: I20151203000312 |
| Provider Name | Tamela Rodrigues |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801264924 PECOS PAC ID: 5991005431 Enrollment ID: I20151204001717 |
| Provider Name | Ella S Sussman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235559428 PECOS PAC ID: 1759684475 Enrollment ID: I20160129000432 |
| Provider Name | Ioannis Raftopoulos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578538047 PECOS PAC ID: 5294821153 Enrollment ID: I20160331001545 |
| Provider Name | Rupal Patel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1699901496 PECOS PAC ID: 3274842349 Enrollment ID: I20160509000258 |
| Provider Name | Bela A Horvath |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1053687814 PECOS PAC ID: 8729379789 Enrollment ID: I20160622000500 |
| Provider Name | Laquita King |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1316180508 PECOS PAC ID: 3971656133 Enrollment ID: I20160809002494 |
| Provider Name | Aneta B Rafalowski |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1902118144 PECOS PAC ID: 9638482540 Enrollment ID: I20160816002898 |
| Provider Name | Joseph S Strebel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487896551 PECOS PAC ID: 9436379278 Enrollment ID: I20160822002345 |
| Provider Name | Jaehyun Byun |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881824225 PECOS PAC ID: 5698912640 Enrollment ID: I20160908001654 |
| Provider Name | Elizabeth M Rinehart |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1659715423 PECOS PAC ID: 7012159072 Enrollment ID: I20170216000650 |
| Provider Name | Kristie M Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962956649 PECOS PAC ID: 8729362785 Enrollment ID: I20170313000263 |
| Provider Name | Raphael C Jesin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154677243 PECOS PAC ID: 3779891460 Enrollment ID: I20170405000271 |
| Provider Name | Andrey Pavlov |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174818520 PECOS PAC ID: 7214200328 Enrollment ID: I20170919003043 |
| Provider Name | Dhaval Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164838868 PECOS PAC ID: 8022374040 Enrollment ID: I20171108000699 |
| Provider Name | Carly Siano Berneche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265941025 PECOS PAC ID: 2769749365 Enrollment ID: I20171207001154 |
| Provider Name | Maria A Quinn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245484641 PECOS PAC ID: 5395003701 Enrollment ID: I20171212002844 |
| Provider Name | Ana M Ronderos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821236308 PECOS PAC ID: 8729346754 Enrollment ID: I20171221001713 |
| Provider Name | Erika Hajati |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194050187 PECOS PAC ID: 9537424429 Enrollment ID: I20180523003230 |
| Provider Name | Rubeela Malik |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962575928 PECOS PAC ID: 9537358270 Enrollment ID: I20180625000118 |
| Provider Name | Thomas Parker Buck |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1356591788 PECOS PAC ID: 1052575263 Enrollment ID: I20180723000360 |
| Provider Name | Ghousia Mariam Alikhan |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1801275383 PECOS PAC ID: 3476802778 Enrollment ID: I20180820003184 |
| Provider Name | Eric Lederman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679918411 PECOS PAC ID: 6507092673 Enrollment ID: I20180927002657 |
| Provider Name | Pamela Ohri Zizzamia |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1568809416 PECOS PAC ID: 8325368913 Enrollment ID: I20181019001524 |
| Provider Name | Khaled Abuhashmeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952785982 PECOS PAC ID: 3971856527 Enrollment ID: I20181029000700 |
| Provider Name | Ronald Rice |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1518191162 PECOS PAC ID: 4486894177 Enrollment ID: I20181210001542 |
| Provider Name | Daniel G Collins |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1588003818 PECOS PAC ID: 7719234970 Enrollment ID: I20190503002291 |
| Provider Name | Syed M. Khurram Owais |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083096358 PECOS PAC ID: 1052645306 Enrollment ID: I20190620002011 |
| Provider Name | Michael Chill |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689013906 PECOS PAC ID: 5991045296 Enrollment ID: I20190712002621 |
| Provider Name | Dalal Mazraeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588015564 PECOS PAC ID: 6507195146 Enrollment ID: I20190909000157 |
| Provider Name | Yuri Khibkin |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1023177664 PECOS PAC ID: 1759449218 Enrollment ID: I20190926002509 |
| Provider Name | Pallavi Nadendla |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033553508 PECOS PAC ID: 0042540254 Enrollment ID: I20191001002212 |
| Provider Name | Johanna M Kolodziej |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326464165 PECOS PAC ID: 7810228095 Enrollment ID: I20191021000772 |
| Provider Name | Jessica Lynne Sanky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609420801 PECOS PAC ID: 6002148038 Enrollment ID: I20191024001563 |
| Provider Name | Carleny Henriquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518364579 PECOS PAC ID: 5496188260 Enrollment ID: I20191209002445 |
| Provider Name | Lucyna Nigro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609429166 PECOS PAC ID: 1456786250 Enrollment ID: I20200125000176 |
| Provider Name | Kelly J Hayward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275186041 PECOS PAC ID: 7810328028 Enrollment ID: I20200501002629 |
| Provider Name | Christina Ly |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831517648 PECOS PAC ID: 2365660842 Enrollment ID: I20200714003749 |
| Provider Name | Samantha Mcvay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891158689 PECOS PAC ID: 1456645480 Enrollment ID: I20200824002698 |
| Provider Name | Allison Alexander Richards |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1891700365 PECOS PAC ID: 2769577188 Enrollment ID: I20201107000087 |
| Provider Name | Natalie Stucenski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144834557 PECOS PAC ID: 0547671828 Enrollment ID: I20201117001432 |
| Provider Name | Jeisa Gomez Torres |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902814148 PECOS PAC ID: 2163459355 Enrollment ID: I20210427000867 |
| Provider Name | Alison Mary Smith Wynter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962016345 PECOS PAC ID: 0345641395 Enrollment ID: I20210628002272 |
| Provider Name | Christina I Luffman |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1457747206 PECOS PAC ID: 8820418213 Enrollment ID: I20210714001423 |
| Provider Name | Olga K Buchachiy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952076127 PECOS PAC ID: 1456759810 Enrollment ID: I20211015000209 |
| Provider Name | Grant J Yanagi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851615405 PECOS PAC ID: 7315078839 Enrollment ID: I20211028001278 |
| Provider Name | Sarah Moquin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871165977 PECOS PAC ID: 4082003124 Enrollment ID: I20211111001862 |
| Provider Name | Jooyun Shin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376214098 PECOS PAC ID: 7012308232 Enrollment ID: I20211223001407 |
| Provider Name | Marie Jane Carrier-manley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831230234 PECOS PAC ID: 3870988322 Enrollment ID: I20220318001198 |
| Provider Name | Martin Stephen Walko |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104837178 PECOS PAC ID: 4183661333 Enrollment ID: I20220325002102 |
| Provider Name | Bushra Zia |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922552181 PECOS PAC ID: 8628364361 Enrollment ID: I20220602002298 |
| Provider Name | Mohamed Talaat |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1730665340 PECOS PAC ID: 8527449214 Enrollment ID: I20220712003193 |
| Provider Name | Pratik Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821356122 PECOS PAC ID: 9436409182 Enrollment ID: I20220714001520 |
| Provider Name | Abdul Hussain Vali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942863410 PECOS PAC ID: 4284962465 Enrollment ID: I20220726002669 |
| Provider Name | Corlis Archer Goode |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437152360 PECOS PAC ID: 3173610219 Enrollment ID: I20220929002677 |
| Provider Name | Leslie Marshall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336873967 PECOS PAC ID: 7416323613 Enrollment ID: I20221012003580 |
| Provider Name | Sheila Whelan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336570126 PECOS PAC ID: 4183090863 Enrollment ID: I20221020002400 |
| Provider Name | Amie Marie Matos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508592783 PECOS PAC ID: 2860860293 Enrollment ID: I20221116001489 |
| Provider Name | Timothy C Huber |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689917866 PECOS PAC ID: 3870722663 Enrollment ID: I20221123001954 |
| Provider Name | Pasquale Marc Rocco |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578520060 PECOS PAC ID: 7214828755 Enrollment ID: I20221213001951 |
| Provider Name | Karen Marie Rafferty |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154446078 PECOS PAC ID: 4981705878 Enrollment ID: I20221221002850 |
| Provider Name | Jodi Ripka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013907179 PECOS PAC ID: 5799746277 Enrollment ID: I20230113001110 |
| Provider Name | Matthew James Tsianco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821786633 PECOS PAC ID: 2466819818 Enrollment ID: I20230531001246 |
| Provider Name | Daiana Khabir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477052363 PECOS PAC ID: 1658730122 Enrollment ID: I20230630000575 |
| Provider Name | Rachel Le |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1649774969 PECOS PAC ID: 4981949922 Enrollment ID: I20230718003402 |
| Provider Name | Pauline Wilks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861969966 PECOS PAC ID: 5496088379 Enrollment ID: I20230901000161 |
| Provider Name | Arielle Jordan Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386348167 PECOS PAC ID: 5597129874 Enrollment ID: I20230920000339 |
| Provider Name | Christina Ann Reardon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1467008227 PECOS PAC ID: 9537517859 Enrollment ID: I20231128001146 |
| Provider Name | Aysha Khan |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1669034187 PECOS PAC ID: 4284960881 Enrollment ID: I20240222002395 |
| Provider Name | Avinash Adiga |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1447667795 PECOS PAC ID: 5597064519 Enrollment ID: I20240502000132 |
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