| St Jude Children's Research Hospital, Inc. | |
|
262 Danny Thomas Pl Memphis TN 38105-3678 | |
| (901) 595-3300 | |
| Not Available |
| Full Name | St Jude Children's Research Hospital, Inc. |
|---|---|
| Speciality | Pediatrics |
| Location | 262 Danny Thomas Pl, Memphis, Tennessee |
| Authorized Official Name and Position | Patricia A Keel (CFO) |
| Authorized Official Contact | 9015951018 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| St Jude Children's Research Hospital, Inc. 262 Danny Thomas Place Ms 0515 Memphis TN 38105-3678 Ph: (901) 595-6863 | St Jude Children's Research Hospital, Inc. 262 Danny Thomas Pl Memphis TN 38105-3678 Ph: (901) 595-3300 |
| NPI Number | 1306335088 |
|---|---|
| Provider Enumeration Date | 05/08/2018 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Medicare PECOS PAC ID | 7315133444 |
|---|---|
| Medicare Enrollment ID | O20180821000139 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306335088 | NPI | - | NPPES |
| Provider Name | Ulrike M Reiss |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841293545 PECOS PAC ID: 8729989413 Enrollment ID: I20040115001029 |
| Provider Name | James C Fleming |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1477510857 PECOS PAC ID: 5799674628 Enrollment ID: I20040310001485 |
| Provider Name | Kimberly B Holden |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902864929 PECOS PAC ID: 7911990551 Enrollment ID: I20040412001635 |
| Provider Name | Fred Hagen Laningham |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962405753 PECOS PAC ID: 4082699095 Enrollment ID: I20040623000727 |
| Provider Name | Margaret C Hastings |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174544811 PECOS PAC ID: 7517943905 Enrollment ID: I20040626000117 |
| Provider Name | Wendy B Thomas |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962498626 PECOS PAC ID: 0941267967 Enrollment ID: I20041211000026 |
| Provider Name | Kathryn M Brown |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457350407 PECOS PAC ID: 3274585195 Enrollment ID: I20050218000152 |
| Provider Name | Sidney D Selvidge |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538162946 PECOS PAC ID: 9133172653 Enrollment ID: I20050224000639 |
| Provider Name | Natalie C Kerr |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1093772816 PECOS PAC ID: 7113971656 Enrollment ID: I20050308001051 |
| Provider Name | Matthew W Wilson |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1104883701 PECOS PAC ID: 1456305994 Enrollment ID: I20050308001068 |
| Provider Name | Eric B Hutchins |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659374544 PECOS PAC ID: 5991750366 Enrollment ID: I20050318000027 |
| Provider Name | Matthew J Krasin |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1972506046 PECOS PAC ID: 0648227025 Enrollment ID: I20050407000508 |
| Provider Name | Renee Madden |
|---|---|
| Provider Type | Practitioner - Hematopoietic Cell Transplantation And Cellular Therapy |
| Provider Identifiers | NPI Number: 1902883754 PECOS PAC ID: 7719901644 Enrollment ID: I20060118001041 |
| Provider Name | Deborah D Flettrich |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265446884 PECOS PAC ID: 7618981978 Enrollment ID: I20060126000282 |
| Provider Name | Raja B Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366445454 PECOS PAC ID: 9830101542 Enrollment ID: I20060621000195 |
| Provider Name | Thomas J O Donnell |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1457302465 PECOS PAC ID: 5294766564 Enrollment ID: I20060626000171 |
| Provider Name | Christopher Somogyi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851317309 PECOS PAC ID: 9638177025 Enrollment ID: I20070810000369 |
| Provider Name | Farees T Farooq |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376663583 PECOS PAC ID: 3375634793 Enrollment ID: I20070814000259 |
| Provider Name | Angela Buckalew |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386865046 PECOS PAC ID: 9335232636 Enrollment ID: I20070831000432 |
| Provider Name | Hiroto Inaba |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356533046 PECOS PAC ID: 6406944032 Enrollment ID: I20071115000495 |
| Provider Name | Brian Cain |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679794341 PECOS PAC ID: 6406946466 Enrollment ID: I20071214000457 |
| Provider Name | Ibrahim A Qaddoumi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1902087232 PECOS PAC ID: 1759451230 Enrollment ID: I20080610000669 |
| Provider Name | Daniel T Fletcher |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1063638104 PECOS PAC ID: 4082787676 Enrollment ID: I20080715000409 |
| Provider Name | Timothy Folse |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669585063 PECOS PAC ID: 5799858197 Enrollment ID: I20080717000726 |
| Provider Name | Roland Kaddoum |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841205382 PECOS PAC ID: 3577631225 Enrollment ID: I20081007000831 |
| Provider Name | Kimberly D Woody |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376710889 PECOS PAC ID: 9830258946 Enrollment ID: I20081104000651 |
| Provider Name | Rachel A Turner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427202209 PECOS PAC ID: 6608938642 Enrollment ID: I20081229000330 |
| Provider Name | Dale A Viox |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1033363742 PECOS PAC ID: 8820151962 Enrollment ID: I20090115000156 |
| Provider Name | Noah D Sabin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124120571 PECOS PAC ID: 0749267896 Enrollment ID: I20090115000206 |
| Provider Name | Yaser Alsaek |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316155914 PECOS PAC ID: 7416057039 Enrollment ID: I20090219000555 |
| Provider Name | John M Davidson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235337833 PECOS PAC ID: 5991862385 Enrollment ID: I20090331000027 |
| Provider Name | Alyssa Cotton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013145440 PECOS PAC ID: 3779634621 Enrollment ID: I20090706000525 |
| Provider Name | Edward M Sanders |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629219720 PECOS PAC ID: 2769533595 Enrollment ID: I20090707000687 |
| Provider Name | Stephanie H Shive |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700010055 PECOS PAC ID: 8123170628 Enrollment ID: I20090714000680 |
| Provider Name | Sandra W Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689844714 PECOS PAC ID: 8325190358 Enrollment ID: I20090722000182 |
| Provider Name | Brandon M Triplett |
|---|---|
| Provider Type | Practitioner - Hematopoietic Cell Transplantation And Cellular Therapy |
| Provider Identifiers | NPI Number: 1811922545 PECOS PAC ID: 9335141316 Enrollment ID: I20090803000285 |
| Provider Name | Amanda M Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285875559 PECOS PAC ID: 5496808693 Enrollment ID: I20090805000784 |
| Provider Name | Luis A Trujillo Huaccho |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619120532 PECOS PAC ID: 7719031483 Enrollment ID: I20090813000853 |
| Provider Name | Yvette Humphrey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598841710 PECOS PAC ID: 7012063829 Enrollment ID: I20090921000257 |
| Provider Name | Shelley R Ost |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588862445 PECOS PAC ID: 8729127436 Enrollment ID: I20091209000037 |
| Provider Name | James S Hausmann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1083617971 PECOS PAC ID: 2668562851 Enrollment ID: I20100506000646 |
| Provider Name | Michael D Neel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1720081847 PECOS PAC ID: 2961580055 Enrollment ID: I20100517000040 |
| Provider Name | Kenneth S. Weiss |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700889730 PECOS PAC ID: 7315025400 Enrollment ID: I20100517000070 |
| Provider Name | Paul Klimo |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1336127968 PECOS PAC ID: 0941246383 Enrollment ID: I20100706000331 |
| Provider Name | Leeann E Carmichael |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972820769 PECOS PAC ID: 7517091937 Enrollment ID: I20100819001007 |
| Provider Name | Kevin M Garrett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689897563 PECOS PAC ID: 7416072293 Enrollment ID: I20100916000964 |
| Provider Name | James M Christian |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1356305569 PECOS PAC ID: 9537110648 Enrollment ID: I20101012000224 |
| Provider Name | Blakely J Weatherford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730406562 PECOS PAC ID: 1557553260 Enrollment ID: I20101012001308 |
| Provider Name | Robert D Wallace |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1023075637 PECOS PAC ID: 6608068234 Enrollment ID: I20101014000191 |
| Provider Name | Jeremy S Slone |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598990194 PECOS PAC ID: 8022201524 Enrollment ID: I20101015001099 |
| Provider Name | Julie H Harreld |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356545446 PECOS PAC ID: 9234325978 Enrollment ID: I20101120000186 |
| Provider Name | Katherine M Knapp |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841293925 PECOS PAC ID: 5890974968 Enrollment ID: I20110120001013 |
| Provider Name | Dean D Barger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841493749 PECOS PAC ID: 1456439678 Enrollment ID: I20110411000302 |
| Provider Name | Chun K Chan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083815112 PECOS PAC ID: 6204004583 Enrollment ID: I20110713000407 |
| Provider Name | William A Graves |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124021365 PECOS PAC ID: 1153411343 Enrollment ID: I20111019000388 |
| Provider Name | Randall A Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174526339 PECOS PAC ID: 2961592159 Enrollment ID: I20111019000713 |
| Provider Name | Anant Shah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235155599 PECOS PAC ID: 2466625736 Enrollment ID: I20111101000719 |
| Provider Name | David H Reid |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053397935 PECOS PAC ID: 3577736438 Enrollment ID: I20111109000622 |
| Provider Name | Michael Rossi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356377352 PECOS PAC ID: 5092719542 Enrollment ID: I20120316000200 |
| Provider Name | Arthura D Moore |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1538388863 PECOS PAC ID: 7214080266 Enrollment ID: I20120515000384 |
| Provider Name | Terri Alvardo Ramirez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750647566 PECOS PAC ID: 8820251432 Enrollment ID: I20120518000027 |
| Provider Name | Laura F Rikard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376811745 PECOS PAC ID: 6608039755 Enrollment ID: I20120530000053 |
| Provider Name | Lisa A Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538499090 PECOS PAC ID: 3971767112 Enrollment ID: I20120619000488 |
| Provider Name | Shiva A Bohn |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1235335118 PECOS PAC ID: 0749436293 Enrollment ID: I20120815000823 |
| Provider Name | Brent A Orr |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1790983542 PECOS PAC ID: 6406006758 Enrollment ID: I20121022000514 |
| Provider Name | Ronak J Naik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467688044 PECOS PAC ID: 8527211549 Enrollment ID: I20121226000238 |
| Provider Name | Danielle Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417215492 PECOS PAC ID: 4981857745 Enrollment ID: I20130104000187 |
| Provider Name | Lauren Claire Ditta |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1417190877 PECOS PAC ID: 2961648845 Enrollment ID: I20130624000684 |
| Provider Name | Elisabeth E Adderson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023011236 PECOS PAC ID: 0143460451 Enrollment ID: I20130710000474 |
| Provider Name | Catherine E Easterwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902249394 PECOS PAC ID: 1557502523 Enrollment ID: I20130802000608 |
| Provider Name | Lee K Hover |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629416268 PECOS PAC ID: 1850533480 Enrollment ID: I20130812000502 |
| Provider Name | Penny Beckham |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1457357162 PECOS PAC ID: 6800030693 Enrollment ID: I20130917000707 |
| Provider Name | James Jones |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1538365804 PECOS PAC ID: 8921255779 Enrollment ID: I20131018000772 |
| Provider Name | Carol Akin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679647754 PECOS PAC ID: 9032212725 Enrollment ID: I20131108000688 |
| Provider Name | Ranjit Raju Philip |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1194905000 PECOS PAC ID: 6103064928 Enrollment ID: I20131115000367 |
| Provider Name | Amanda Tompkins |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1053743534 PECOS PAC ID: 5193953669 Enrollment ID: I20140107000884 |
| Provider Name | Alejandro Natera |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326213919 PECOS PAC ID: 4183849755 Enrollment ID: I20140716000291 |
| Provider Name | Joseph M Gleason |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1760669808 PECOS PAC ID: 0941366587 Enrollment ID: I20140825000837 |
| Provider Name | Matthew S Fields |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1225340151 PECOS PAC ID: 6103043591 Enrollment ID: I20140927000409 |
| Provider Name | Tonia Elizabeth Gardner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063614659 PECOS PAC ID: 2860637261 Enrollment ID: I20141017000805 |
| Provider Name | Teresa Cb Santiago |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205070075 PECOS PAC ID: 2163660044 Enrollment ID: I20141024000624 |
| Provider Name | Jeffery M Klco |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1760680631 PECOS PAC ID: 6507088960 Enrollment ID: I20141119001964 |
| Provider Name | Nerma B Scharr |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1114158938 PECOS PAC ID: 0840433819 Enrollment ID: I20141121001386 |
| Provider Name | Justin Robert Newman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295901221 PECOS PAC ID: 5092953232 Enrollment ID: I20150529000178 |
| Provider Name | Tracy J Tidwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619977964 PECOS PAC ID: 4284700246 Enrollment ID: I20150617001665 |
| Provider Name | Teresa S Wright |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508995390 PECOS PAC ID: 8628144268 Enrollment ID: I20150801017365 |
| Provider Name | Darrell Andrew Elliott |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598082992 PECOS PAC ID: 3072759760 Enrollment ID: I20150804004894 |
| Provider Name | John T Lucas |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1902127269 PECOS PAC ID: 7214244375 Enrollment ID: I20150922001933 |
| Provider Name | Rhonda K Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285021337 PECOS PAC ID: 8729398797 Enrollment ID: I20151103001137 |
| Provider Name | Christopher L Tinkle |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366769069 PECOS PAC ID: 0143530162 Enrollment ID: I20151103003041 |
| Provider Name | Heather M Artiles |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427354091 PECOS PAC ID: 9234312760 Enrollment ID: I20151104001769 |
| Provider Name | Steven Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154790111 PECOS PAC ID: 9638479751 Enrollment ID: I20151123000004 |
| Provider Name | Michael A Rebolledo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1891893020 PECOS PAC ID: 1759325475 Enrollment ID: I20160707002331 |
| Provider Name | Jason Cheng-hsuan Chiang |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1871933135 PECOS PAC ID: 8921393398 Enrollment ID: I20160824001035 |
| Provider Name | Lauren David |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851751200 PECOS PAC ID: 5193011039 Enrollment ID: I20160901001441 |
| Provider Name | Catherine Sanders |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457672313 PECOS PAC ID: 2668697947 Enrollment ID: I20160922000964 |
| Provider Name | Paul M Mccaghren |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316390610 PECOS PAC ID: 6608164777 Enrollment ID: I20161005003155 |
| Provider Name | Asya Agulnik |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1639494040 PECOS PAC ID: 7214225838 Enrollment ID: I20161014001344 |
| Provider Name | Christina Aguero |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508103144 PECOS PAC ID: 4082869136 Enrollment ID: I20161114001269 |
| Provider Name | Alexandra Schaller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710220231 PECOS PAC ID: 9931339603 Enrollment ID: I20170510000482 |
| Provider Name | Vinod Govindaraj Maller |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1972882207 PECOS PAC ID: 0941446496 Enrollment ID: I20170613001642 |
| Provider Name | Anthony C Merlocco |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134469935 PECOS PAC ID: 8527338714 Enrollment ID: I20170720002022 |
| Provider Name | Marina Santa Cruz Terrazas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457790610 PECOS PAC ID: 3577835057 Enrollment ID: I20170817002821 |
| Provider Name | Melissa Petty |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891236972 PECOS PAC ID: 9739453556 Enrollment ID: I20170918002433 |
| Provider Name | Amy Patterson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629369475 PECOS PAC ID: 6103062914 Enrollment ID: I20170922001725 |
| Provider Name | Sanjeet V Rangarajan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1649568395 PECOS PAC ID: 9537396890 Enrollment ID: I20171009002732 |
| Provider Name | Emily L Coursey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649313669 PECOS PAC ID: 4880761212 Enrollment ID: I20171011001818 |
| Provider Name | Kavitha C Raghavan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053836197 PECOS PAC ID: 1254698046 Enrollment ID: I20171204001500 |
| Provider Name | Angela S Camfield |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356384887 PECOS PAC ID: 8729001326 Enrollment ID: I20171204001753 |
| Provider Name | Jeffrey A Bennett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1851362396 PECOS PAC ID: 9234103110 Enrollment ID: I20180124000142 |
| Provider Name | Kaitlin A Ryan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598022675 PECOS PAC ID: 4880943182 Enrollment ID: I20180820003417 |
| Provider Name | Grace Newman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396002796 PECOS PAC ID: 0345488581 Enrollment ID: I20180910001028 |
| Provider Name | Patricia O'sullivan Allmon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275025561 PECOS PAC ID: 6608127089 Enrollment ID: I20180924003712 |
| Provider Name | Amber Leigh Thacker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770903882 PECOS PAC ID: 5991056319 Enrollment ID: I20180925001780 |
| Provider Name | Asim Kumar Bag |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548422918 PECOS PAC ID: 9436322542 Enrollment ID: I20181006000160 |
| Provider Name | Andrew John Wodowski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518226398 PECOS PAC ID: 0941446611 Enrollment ID: I20181019002653 |
| Provider Name | Meagan Elizabeth Dulaney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205316072 PECOS PAC ID: 5799029617 Enrollment ID: I20181204002649 |
| Provider Name | Kelsey Lavelle Chance |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497241947 PECOS PAC ID: 2365786886 Enrollment ID: I20181210001857 |
| Provider Name | Elizabeth Danielle Eisenman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881173896 PECOS PAC ID: 7315284320 Enrollment ID: I20190129003715 |
| Provider Name | Erica Carmen Kaye |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1972827756 PECOS PAC ID: 2163761974 Enrollment ID: I20190221002544 |
| Provider Name | Thomas E Merchant |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1518960392 PECOS PAC ID: 6305185737 Enrollment ID: I20190302000078 |
| Provider Name | Patience Whitten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508321621 PECOS PAC ID: 7719228741 Enrollment ID: I20190401001130 |
| Provider Name | Scott N Hwang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801091434 PECOS PAC ID: 5193896298 Enrollment ID: I20190416003177 |
| Provider Name | Katharine Carruthers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699230037 PECOS PAC ID: 3173865862 Enrollment ID: I20190429002526 |
| Provider Name | Andrew M. Davidoff |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508869793 PECOS PAC ID: 9436492089 Enrollment ID: I20190522001112 |
| Provider Name | Sue C Kaste |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639172026 PECOS PAC ID: 7315270154 Enrollment ID: I20190610001452 |
| Provider Name | Jacqueline Angel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700220050 PECOS PAC ID: 3173762226 Enrollment ID: I20190618003514 |
| Provider Name | Priyadarshini Kumar |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1770988297 PECOS PAC ID: 3072842574 Enrollment ID: I20190909003196 |
| Provider Name | Isaac B Rhea |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568782811 PECOS PAC ID: 1557501350 Enrollment ID: I20191021002617 |
| Provider Name | Brittany Bius Raines |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750856811 PECOS PAC ID: 9537491451 Enrollment ID: I20191025002548 |
| Provider Name | Lorig Sildiryan |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1376062729 PECOS PAC ID: 8527325810 Enrollment ID: I20191112003629 |
| Provider Name | Michael Frett |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174765747 PECOS PAC ID: 7416263264 Enrollment ID: I20191223001581 |
| Provider Name | Barry Shulkin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043213614 PECOS PAC ID: 1951541614 Enrollment ID: I20200224000972 |
| Provider Name | Caitlyn Sharp |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780054106 PECOS PAC ID: 1153742978 Enrollment ID: I20200603002491 |
| Provider Name | Richard Finkel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073547741 PECOS PAC ID: 4880762889 Enrollment ID: I20200608000472 |
| Provider Name | Kirsten A Menn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558509166 PECOS PAC ID: 5395922702 Enrollment ID: I20200609001051 |
| Provider Name | Zachary R Abramson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396066577 PECOS PAC ID: 5395076012 Enrollment ID: I20200618002852 |
| Provider Name | Christopher Charles Derenzo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871755447 PECOS PAC ID: 5991127953 Enrollment ID: I20200619000925 |
| Provider Name | William A Hester |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1457770588 PECOS PAC ID: 5698065571 Enrollment ID: I20200619001200 |
| Provider Name | Cassandra Smithey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669098273 PECOS PAC ID: 8628492378 Enrollment ID: I20200728001453 |
| Provider Name | Marquita Nelson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1174866891 PECOS PAC ID: 7012200512 Enrollment ID: I20200810002950 |
| Provider Name | Gabriela Gheorghe |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1457407066 PECOS PAC ID: 9436297975 Enrollment ID: I20200811003650 |
| Provider Name | Claire Wright |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184010308 PECOS PAC ID: 6608170972 Enrollment ID: I20200813003839 |
| Provider Name | Katherine Farabee Bailey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275152589 PECOS PAC ID: 6002232188 Enrollment ID: I20200819003773 |
| Provider Name | Kerri Bosfield |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1861897241 PECOS PAC ID: 2062830946 Enrollment ID: I20200909000665 |
| Provider Name | Swapna Thota |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1821301052 PECOS PAC ID: 3577836576 Enrollment ID: I20201009000529 |
| Provider Name | Christopher K. Cheng |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700175312 PECOS PAC ID: 8426320755 Enrollment ID: I20201207001838 |
| Provider Name | Jason Degani |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922235167 PECOS PAC ID: 2567699457 Enrollment ID: I20201218001468 |
| Provider Name | Yen-chun Liu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1467744664 PECOS PAC ID: 3971737040 Enrollment ID: I20201228000871 |
| Provider Name | Yan Zheng |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1184984619 PECOS PAC ID: 1951695733 Enrollment ID: I20210106002882 |
| Provider Name | Anita M Max |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215251764 PECOS PAC ID: 3274776620 Enrollment ID: I20210111002856 |
| Provider Name | Ashley Harrison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982912614 PECOS PAC ID: 4082854773 Enrollment ID: I20210111002932 |
| Provider Name | John D Grattan-smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1548234933 PECOS PAC ID: 8820175987 Enrollment ID: I20210112000347 |
| Provider Name | Mary E Mccarville |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114920907 PECOS PAC ID: 5799198768 Enrollment ID: I20210112001645 |
| Provider Name | Amy Kimble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851384374 PECOS PAC ID: 4486602711 Enrollment ID: I20210113001443 |
| Provider Name | Robert Ruiz |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205918182 PECOS PAC ID: 3971795808 Enrollment ID: I20210127003020 |
| Provider Name | Erma Louise Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164062071 PECOS PAC ID: 3173937331 Enrollment ID: I20210128002840 |
| Provider Name | Jessica Michelle Morgan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083064364 PECOS PAC ID: 5799199600 Enrollment ID: I20210203002112 |
| Provider Name | Monique Kyles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629683453 PECOS PAC ID: 6608282264 Enrollment ID: I20210304002424 |
| Provider Name | William Jerkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184889610 PECOS PAC ID: 5395800908 Enrollment ID: I20210423000696 |
| Provider Name | Manal Moustafa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467780684 PECOS PAC ID: 7618278011 Enrollment ID: I20210504001407 |
| Provider Name | Selene Koo |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1205122967 PECOS PAC ID: 8325341464 Enrollment ID: I20210514001475 |
| Provider Name | Evelyn Kay Mcdivitt |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356317457 PECOS PAC ID: 6305811878 Enrollment ID: I20210527001507 |
| Provider Name | Nehali D Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780687426 PECOS PAC ID: 5395985170 Enrollment ID: I20210721000403 |
| Provider Name | Carey Burton Wood |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1386030666 PECOS PAC ID: 8729380878 Enrollment ID: I20210723001111 |
| Provider Name | Ann D Schechter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1982677571 PECOS PAC ID: 7618054701 Enrollment ID: I20210728001303 |
| Provider Name | Mahsa Khanlari |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073981197 PECOS PAC ID: 1557766359 Enrollment ID: I20210817001682 |
| Provider Name | Martha Harden Wells |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1699861708 PECOS PAC ID: 6709281488 Enrollment ID: I20210818001355 |
| Provider Name | Price Trapp Edwards |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144617044 PECOS PAC ID: 6002212800 Enrollment ID: I20210902000411 |
| Provider Name | Julieann Christine Lee |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1235524224 PECOS PAC ID: 4082943212 Enrollment ID: I20210923002211 |
| Provider Name | Neil Chandrakant Tailor |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1083033757 PECOS PAC ID: 4688095623 Enrollment ID: I20210927001848 |
| Provider Name | Wade Glazner Mcclain |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1386873677 PECOS PAC ID: 6901049550 Enrollment ID: I20210927002536 |
| Provider Name | Anita Valeria Arias Prado |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033538400 PECOS PAC ID: 0749688661 Enrollment ID: I20211007001050 |
| Provider Name | Anna Quantrille Allen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497288138 PECOS PAC ID: 6305123902 Enrollment ID: I20211008000977 |
| Provider Name | Mireya Paulina Velasquez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235438698 PECOS PAC ID: 8022416569 Enrollment ID: I20211013002102 |
| Provider Name | Griffin Sinclair Collins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518348523 PECOS PAC ID: 1658635263 Enrollment ID: I20211019001806 |
| Provider Name | Shannon Dean |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417910647 PECOS PAC ID: 0143311571 Enrollment ID: I20211019001988 |
| Provider Name | Xiangxia Liu |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1427403278 PECOS PAC ID: 2466841788 Enrollment ID: I20211108001317 |
| Provider Name | Anas Eid |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1285908509 PECOS PAC ID: 5799174801 Enrollment ID: I20211111000679 |
| Provider Name | Esther A Obeng |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417114174 PECOS PAC ID: 1759560758 Enrollment ID: I20211113000067 |
| Provider Name | Mohammed H Absi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396951687 PECOS PAC ID: 4789718776 Enrollment ID: I20211124001576 |
| Provider Name | Lindsay Talbot |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659531861 PECOS PAC ID: 7012218209 Enrollment ID: I20211221002037 |
| Provider Name | Oneka E Poindexter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972119527 PECOS PAC ID: 6204227523 Enrollment ID: I20211221002382 |
| Provider Name | Gia Nguyen Hoang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477227916 PECOS PAC ID: 9335530666 Enrollment ID: I20211222000168 |
| Provider Name | Marcin Wojciech Wlodarski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801552955 PECOS PAC ID: 8224420864 Enrollment ID: I20220111002852 |
| Provider Name | Yogindra Persaud |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982087771 PECOS PAC ID: 1951657501 Enrollment ID: I20220124002018 |
| Provider Name | Ali Suliman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275828063 PECOS PAC ID: 2163662602 Enrollment ID: I20220201001224 |
| Provider Name | Tzipa Leah Zweig |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851754436 PECOS PAC ID: 4486068855 Enrollment ID: I20220208002168 |
| Provider Name | Melissa Perrino |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447664917 PECOS PAC ID: 3173939626 Enrollment ID: I20220208002215 |
| Provider Name | Mahmoud Hassouba |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1437534682 PECOS PAC ID: 6204229412 Enrollment ID: I20220211000665 |
| Provider Name | Christine Yu |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1538109582 PECOS PAC ID: 8921005711 Enrollment ID: I20220222001604 |
| Provider Name | Swati Naik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235565409 PECOS PAC ID: 9830583129 Enrollment ID: I20220302002477 |
| Provider Name | Cassidy Mcrorie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518636760 PECOS PAC ID: 0042605651 Enrollment ID: I20220317001923 |
| Provider Name | Matthew Rees |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376993899 PECOS PAC ID: 3577855675 Enrollment ID: I20220322001377 |
| Provider Name | Michael Mcneil |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811382369 PECOS PAC ID: 7911228762 Enrollment ID: I20220329000001 |
| Provider Name | Ruth Wang'ondu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164802740 PECOS PAC ID: 9739491721 Enrollment ID: I20220401001002 |
| Provider Name | Charlyn A Wilson |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1972638922 PECOS PAC ID: 1557649464 Enrollment ID: I20220502001181 |
| Provider Name | Alia Zaidi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447591912 PECOS PAC ID: 2567602345 Enrollment ID: I20220504001723 |
| Provider Name | Trisha Paul |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316441256 PECOS PAC ID: 9234477860 Enrollment ID: I20220504002140 |
| Provider Name | Dong Xi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508284068 PECOS PAC ID: 9032477641 Enrollment ID: I20220512000773 |
| Provider Name | Natalie Francis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831576560 PECOS PAC ID: 5294046058 Enrollment ID: I20220512001404 |
| Provider Name | Stephen Moore |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104280478 PECOS PAC ID: 1658759964 Enrollment ID: I20220601000257 |
| Provider Name | Devra Beyer Becker |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1831254127 PECOS PAC ID: 3274608989 Enrollment ID: I20220603000617 |
| Provider Name | Nidhi Bhatt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811252752 PECOS PAC ID: 2567601511 Enrollment ID: I20220606000682 |
| Provider Name | Daniel Mulrooney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316023328 PECOS PAC ID: 3779544820 Enrollment ID: I20220608001350 |
| Provider Name | Nir Shimony |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1730625450 PECOS PAC ID: 1658629704 Enrollment ID: I20220615002378 |
| Provider Name | Miguela Caniza |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790788990 PECOS PAC ID: 9537309158 Enrollment ID: I20220628002662 |
| Provider Name | Caitlin Zebley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538426333 PECOS PAC ID: 0840670238 Enrollment ID: I20220701000412 |
| Provider Name | Gabriela Maron |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528283819 PECOS PAC ID: 3476793258 Enrollment ID: I20220706000732 |
| Provider Name | Ashok Srinivasan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1306090725 PECOS PAC ID: 5395987226 Enrollment ID: I20220707001239 |
| Provider Name | Akshay Sharma |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558630624 PECOS PAC ID: 1254711187 Enrollment ID: I20220708001888 |
| Provider Name | Elisa Margolis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477877454 PECOS PAC ID: 0648598508 Enrollment ID: I20220713003298 |
| Provider Name | Martha C Ballesteros |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508897216 PECOS PAC ID: 9537583067 Enrollment ID: I20220727002678 |
| Provider Name | Soniya Naomi Pinto |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306264429 PECOS PAC ID: 3173954492 Enrollment ID: I20220801003070 |
| Provider Name | Jessica Morgan Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114666807 PECOS PAC ID: 9032592738 Enrollment ID: I20220812001820 |
| Provider Name | Priscilla Lao |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1033571088 PECOS PAC ID: 5991076739 Enrollment ID: I20220812001961 |
| Provider Name | Lillian Guenther |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740579739 PECOS PAC ID: 6103043575 Enrollment ID: I20220818002332 |
| Provider Name | Joseph Fong |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1386177574 PECOS PAC ID: 6800165119 Enrollment ID: I20220821000149 |
| Provider Name | Angela Snyder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114904893 PECOS PAC ID: 2860632502 Enrollment ID: I20220825000639 |
| Provider Name | Emily Hanzlik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477949089 PECOS PAC ID: 5799084331 Enrollment ID: I20220901002895 |
| Provider Name | Tarachandra Narumanchi |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1538253570 PECOS PAC ID: 3779512215 Enrollment ID: I20220902000519 |
| Provider Name | Angela Marie Pratt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720436710 PECOS PAC ID: 1759765852 Enrollment ID: I20220908000490 |
| Provider Name | Tekesha Henry |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407932031 PECOS PAC ID: 5698816494 Enrollment ID: I20220921004061 |
| Provider Name | Tarun Aurora |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578927356 PECOS PAC ID: 6901198670 Enrollment ID: I20220922001844 |
| Provider Name | Brett Allen Wilson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1386025963 PECOS PAC ID: 5092028589 Enrollment ID: I20220925000070 |
| Provider Name | Margaret Cupit-link |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851885826 PECOS PAC ID: 6406231695 Enrollment ID: I20220926000095 |
| Provider Name | Ellen Donohue |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700456910 PECOS PAC ID: 0941686547 Enrollment ID: I20221005002293 |
| Provider Name | Celine C Richard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750909404 PECOS PAC ID: 8628454030 Enrollment ID: I20221007000188 |
| Provider Name | Stephanie Dixon |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619237005 PECOS PAC ID: 7911136528 Enrollment ID: I20221007002447 |
| Provider Name | Kim E Nichols |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831106038 PECOS PAC ID: 7214112523 Enrollment ID: I20221011002811 |
| Provider Name | Selina L Broadaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124765714 PECOS PAC ID: 9739555814 Enrollment ID: I20221013003440 |
| Provider Name | Parul Rai |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174836209 PECOS PAC ID: 5799151551 Enrollment ID: I20221019000866 |
| Provider Name | Elyshia Geldenhuys |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588391395 PECOS PAC ID: 7517334691 Enrollment ID: I20221102000953 |
| Provider Name | Nicholas Mechas |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1164886362 PECOS PAC ID: 5597052498 Enrollment ID: I20221108000630 |
| Provider Name | Dana Audrey Zimmerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124751094 PECOS PAC ID: 4082081682 Enrollment ID: I20221111000926 |
| Provider Name | Martha A Salek |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1104201086 PECOS PAC ID: 4486964608 Enrollment ID: I20221208002463 |
| Provider Name | Robert M Tuliszewski |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1417302274 PECOS PAC ID: 9830484351 Enrollment ID: I20221219001964 |
| Provider Name | Michael John Temple |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1811612393 PECOS PAC ID: 2567832009 Enrollment ID: I20221228001130 |
| Provider Name | Billy W. Mccann |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1629155197 PECOS PAC ID: 4789054156 Enrollment ID: I20221228003124 |
| Provider Name | Salima A Bhimani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700269768 PECOS PAC ID: 7719293877 Enrollment ID: I20221229002053 |
| Provider Name | Rachel Landisch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1982961058 PECOS PAC ID: 2062731433 Enrollment ID: I20230103000202 |
| Provider Name | Martha May |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679550347 PECOS PAC ID: 6901046788 Enrollment ID: I20230125000447 |
| Provider Name | Anna C Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235525593 PECOS PAC ID: 8224400361 Enrollment ID: I20230217001894 |
| Provider Name | Amy E Johnson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073578456 PECOS PAC ID: 8820140429 Enrollment ID: I20230228001606 |
| Provider Name | Clifford Takemoto |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1033140777 PECOS PAC ID: 1850488735 Enrollment ID: I20230302000009 |
| Provider Name | Alberto S. Pappo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003821752 PECOS PAC ID: 8820092539 Enrollment ID: I20230324000098 |
| Provider Name | Anand Govind Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457791022 PECOS PAC ID: 8325412695 Enrollment ID: I20230328002497 |
| Provider Name | Kendra Parris |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275862922 PECOS PAC ID: 2466827407 Enrollment ID: I20230405001666 |
| Provider Name | Heather C Mefford |
|---|---|
| Provider Type | Practitioner - Medical Genetics And Genomics |
| Provider Identifiers | NPI Number: 1114081999 PECOS PAC ID: 0446326789 Enrollment ID: I20230405002154 |
| Provider Name | Charles Roberts |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649239849 PECOS PAC ID: 8527240357 Enrollment ID: I20230405002553 |
| Provider Name | Sheena Teresa Mukkada |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255680625 PECOS PAC ID: 3779958418 Enrollment ID: I20230411000332 |
| Provider Name | Ashley Garrett Mctyre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023655461 PECOS PAC ID: 8921473646 Enrollment ID: I20230412000364 |
| Provider Name | Robin Evans |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1649740424 PECOS PAC ID: 3375972128 Enrollment ID: I20230419003192 |
| Provider Name | Supriya Sarvode |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720579451 PECOS PAC ID: 3678938743 Enrollment ID: I20230424002483 |
| Provider Name | Christina Trehlet Rosenthal |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1134291149 PECOS PAC ID: 0547625386 Enrollment ID: I20230428002792 |
| Provider Name | Alexis Kristine Leonard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821356478 PECOS PAC ID: 0446593255 Enrollment ID: I20230503001041 |
| Provider Name | Jasmine Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942790928 PECOS PAC ID: 7113278912 Enrollment ID: I20230509000294 |
| Provider Name | Shelton A Viola |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598811788 PECOS PAC ID: 5890940738 Enrollment ID: I20230509001060 |
| Provider Name | Devendra A Sawant |
|---|---|
| Provider Type | Practitioner - Nuclear Medicine |
| Provider Identifiers | NPI Number: 1215433578 PECOS PAC ID: 1456717719 Enrollment ID: I20230512000206 |
| Provider Name | Bradley Muller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861998932 PECOS PAC ID: 1658629803 Enrollment ID: I20230606002598 |
| Provider Name | Faizan Malik |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1922529429 PECOS PAC ID: 5092173997 Enrollment ID: I20230626001802 |
| Provider Name | Maggie M Vickers |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457887945 PECOS PAC ID: 8224305107 Enrollment ID: I20230718000274 |
| Provider Name | Hedieh Khalatbari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326184813 PECOS PAC ID: 9335331883 Enrollment ID: I20230720000853 |
| Provider Name | Georgios Christakopoulos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245763721 PECOS PAC ID: 3971963992 Enrollment ID: I20230721000824 |
| Provider Name | Ellen Grishman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1720035785 PECOS PAC ID: 6507862760 Enrollment ID: I20230724001056 |
| Provider Name | Callie Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639865769 PECOS PAC ID: 2466813233 Enrollment ID: I20230727000804 |
| Provider Name | Jennifer Roemer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003148974 PECOS PAC ID: 0749317451 Enrollment ID: I20230727000933 |
| Provider Name | Alexandra Kathleen Superdock |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1831687441 PECOS PAC ID: 2860853272 Enrollment ID: I20230802000333 |
| Provider Name | Dana Tlais |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710339643 PECOS PAC ID: 3971964917 Enrollment ID: I20230807002638 |
| Provider Name | Ewelina Mamcarz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497949218 PECOS PAC ID: 9335407063 Enrollment ID: I20230815002309 |
| Provider Name | Ronald Morrison |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750376737 PECOS PAC ID: 5597905356 Enrollment ID: I20230818002444 |
| Provider Name | Julie Park |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356422612 PECOS PAC ID: 9537209283 Enrollment ID: I20230821002201 |
| Provider Name | Mary Austin Mays Smith |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1497140636 PECOS PAC ID: 1456713536 Enrollment ID: I20230822002007 |
| Provider Name | Constance Fry |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1306804273 PECOS PAC ID: 1456359694 Enrollment ID: I20230824001063 |
| Provider Name | Alexandra Cheerva |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609857416 PECOS PAC ID: 1456328038 Enrollment ID: I20230825001612 |
| Provider Name | Ryan Keith Dagen |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1295098226 PECOS PAC ID: 1850745597 Enrollment ID: I20230928001517 |
| Provider Name | Richard Parmley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1073586707 PECOS PAC ID: 6305742578 Enrollment ID: I20231002000450 |
| Provider Name | Evan Harvey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619322765 PECOS PAC ID: 7315237203 Enrollment ID: I20231003003608 |
| Provider Name | Scott A Weiskopf |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1144456427 PECOS PAC ID: 9436445517 Enrollment ID: I20231023002640 |
| Provider Name | Aaron T Walsh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346773116 PECOS PAC ID: 0840577763 Enrollment ID: I20231026000069 |
| Provider Name | Carmen Perez |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1255563128 PECOS PAC ID: 1052539582 Enrollment ID: I20231026002581 |
| Provider Name | Elyse Kerner Miller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295180248 PECOS PAC ID: 9133413602 Enrollment ID: I20231026003457 |
| Provider Name | Salah Almohammed |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1992859573 PECOS PAC ID: 2163588393 Enrollment ID: I20231027000991 |
| Provider Name | Dani Kruchevsky |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1063123016 PECOS PAC ID: 9234585076 Enrollment ID: I20231030003573 |
| Provider Name | Margit Mikkelsen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1922567064 PECOS PAC ID: 7315289881 Enrollment ID: I20231103001371 |
| Provider Name | Maria Mejias |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1255586202 PECOS PAC ID: 9436275666 Enrollment ID: I20231106002441 |
| Provider Name | Brittany Ann Cowfer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649633009 PECOS PAC ID: 0345533782 Enrollment ID: I20231130001103 |
| Provider Name | Devin Murphy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1417510660 PECOS PAC ID: 8325497431 Enrollment ID: I20231214003200 |
| Provider Name | Denis Chamberlain Noubouossie Fondjie |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1902460223 PECOS PAC ID: 7618327875 Enrollment ID: I20231229001934 |
| Provider Name | Alyssa Kennedy |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912266156 PECOS PAC ID: 3072868751 Enrollment ID: I20240111002954 |
| Provider Name | Andrew Hardee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255089926 PECOS PAC ID: 1254783277 Enrollment ID: I20240116000999 |
| Provider Name | Jacob Vargo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376746305 PECOS PAC ID: 5799137238 Enrollment ID: I20240119001933 |
| Provider Name | Andrea N Jurbergs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1497959480 PECOS PAC ID: 3779723556 Enrollment ID: I20240122000411 |
| Provider Name | Allison S Aguado |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1750595138 PECOS PAC ID: 6002063682 Enrollment ID: I20240122000473 |
| Provider Name | Melissa M Hudson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861495889 PECOS PAC ID: 2163875394 Enrollment ID: I20240124002206 |
| Provider Name | Arun Solanki |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821331000 PECOS PAC ID: 3173827391 Enrollment ID: I20240124003137 |
| Provider Name | Carissa Danielle Crawford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376211664 PECOS PAC ID: 4981057924 Enrollment ID: I20240126000446 |
| Provider Name | Aleha Saleh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063041564 PECOS PAC ID: 6507285681 Enrollment ID: I20240130000888 |
| Provider Name | Jennifer Longoria |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1154977577 PECOS PAC ID: 7911350434 Enrollment ID: I20240131001877 |
| Provider Name | James Ball |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003864893 PECOS PAC ID: 8820030299 Enrollment ID: I20240208001886 |
| Provider Name | Stephen Gottschalk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134209489 PECOS PAC ID: 4981781671 Enrollment ID: I20240212001310 |
| Provider Name | Jeffrey Yuskevich |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427139450 PECOS PAC ID: 7214967546 Enrollment ID: I20240311002446 |
| Provider Name | Amy Berkman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699237636 PECOS PAC ID: 5799122495 Enrollment ID: I20240318000617 |
| Provider Name | Jennifer Cox |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669560827 PECOS PAC ID: 6204865397 Enrollment ID: I20240319002759 |
| Provider Name | Mark Lanzerotte |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013993872 PECOS PAC ID: 1951205863 Enrollment ID: I20240320001825 |
| Provider Name | Clark R. Gwaltney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922771195 PECOS PAC ID: 7517306723 Enrollment ID: I20240422000843 |
| Provider Name | Andrew Smith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356301972 PECOS PAC ID: 4183640741 Enrollment ID: I20240424002277 |
| Provider Name | Kristi Sheridan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669141669 PECOS PAC ID: 1355782087 Enrollment ID: I20240513003348 |
| Provider Name | Sira Duson |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1467686428 PECOS PAC ID: 0446545404 Enrollment ID: I20240530004208 |
| Provider Name | Daniel Vo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639326507 PECOS PAC ID: 3870729924 Enrollment ID: I20240612002304 |
| Provider Name | Maria Gabela Sanchez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659866382 PECOS PAC ID: 6608104211 Enrollment ID: I20240626000664 |
| Provider Name | Brittany Nicole Simpson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700248069 PECOS PAC ID: 7517385776 Enrollment ID: I20240702000990 |
| Provider Name | David Waisel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104888684 PECOS PAC ID: 9537209937 Enrollment ID: I20240709003274 |
| Provider Name | Maria Evelyn Lopez Garcia |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1619461951 PECOS PAC ID: 8123564259 Enrollment ID: I20240724003375 |
| Provider Name | Andrea Heifner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356703177 PECOS PAC ID: 2668779703 Enrollment ID: I20240725003975 |
| Provider Name | Bradley K Hyman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558892042 PECOS PAC ID: 7113283003 Enrollment ID: I20240802000156 |
| Provider Name | Sharan Mirchandani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598373615 PECOS PAC ID: 6002356151 Enrollment ID: I20240904003270 |
| Provider Name | Mary Granger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558473017 PECOS PAC ID: 6507906179 Enrollment ID: I20241007003428 |
| Provider Name | Sarah Mumanachit |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760046197 PECOS PAC ID: 6507191731 Enrollment ID: I20241018000456 |
| Provider Name | Kelly C Goclik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386420966 PECOS PAC ID: 9830621457 Enrollment ID: I20241021000833 |
| Provider Name | Aimee Talleur |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336383728 PECOS PAC ID: 1355581034 Enrollment ID: I20241021001588 |
| Provider Name | Megan Lilley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932769346 PECOS PAC ID: 7618309535 Enrollment ID: I20241022002357 |
| Provider Name | Aysenur Esen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174054613 PECOS PAC ID: 5395015978 Enrollment ID: I20241023004815 |
| Provider Name | Katelyn Nichole Purvis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114556941 PECOS PAC ID: 2062842164 Enrollment ID: I20241025000397 |
| Provider Name | Deena Rachel Levine |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124218482 PECOS PAC ID: 4981799871 Enrollment ID: I20241029004676 |
| Provider Name | Ryan Lion |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245791409 PECOS PAC ID: 6901286673 Enrollment ID: I20241030000289 |
| Provider Name | Erica Bone |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720822620 PECOS PAC ID: 8123552437 Enrollment ID: I20241108002720 |
| Provider Name | Mark E Hatley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710199229 PECOS PAC ID: 4688814973 Enrollment ID: I20241125001448 |
| Provider Name | Stephanie Crawford Gehle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235759986 PECOS PAC ID: 8325479900 Enrollment ID: I20241203003923 |
| Provider Name | Andrea Gropman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407848005 PECOS PAC ID: 3072511690 Enrollment ID: I20241210001052 |
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