| Wakemed Professional Physicians Staff | |
|
3000 New Bern Ave Raleigh NC 27610-1231 | |
| (919) 350-8000 | |
| (919) 350-0559 |
| Full Name | Wakemed Professional Physicians Staff |
|---|---|
| Speciality | Internal Medicine |
| Location | 3000 New Bern Ave, Raleigh, North Carolina |
| Authorized Official Name and Position | Rebecca E. Andrews (VP, FINANCE) |
| Authorized Official Contact | 9193508344 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wakemed Professional Physicians Staff 3000 New Bern Ave Managed Care Contracting Dept. Raleigh NC 27610-1231 Ph: (919) 350-0558 | Wakemed Professional Physicians Staff 3000 New Bern Ave Raleigh NC 27610-1231 Ph: (919) 350-8000 |
| NPI Number | 1194907717 |
|---|---|
| Provider Enumeration Date | 12/05/2007 |
| Last Update Date | 01/23/2017 |
| Medicare PECOS PAC ID | 7315937612 |
|---|---|
| Medicare Enrollment ID | O20040722000418 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194907717 | NPI | - | NPPES |
| 890770G | Medicaid | NC | |
| 1194907717 | Medicaid | NC |
| Provider Name | Pankaj N Parikh |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427008366 PECOS PAC ID: 1052300977 Enrollment ID: I20040506001746 |
| Provider Name | Susan Elizabeth Leonard |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093871188 PECOS PAC ID: 4082692850 Enrollment ID: I20040708001076 |
| Provider Name | Jeffrey R Daw |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174521694 PECOS PAC ID: 3375521891 Enrollment ID: I20040712000403 |
| Provider Name | Sunil J Desai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588652267 PECOS PAC ID: 3779562780 Enrollment ID: I20040714001062 |
| Provider Name | Scott C Bilbro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033258157 PECOS PAC ID: 8628057213 Enrollment ID: I20040716000858 |
| Provider Name | Dhiren N Shah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699763391 PECOS PAC ID: 6901886886 Enrollment ID: I20040721001392 |
| Provider Name | Pratik V Desai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588652283 PECOS PAC ID: 6305826249 Enrollment ID: I20040722000109 |
| Provider Name | Priyavadan M Shah |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679561369 PECOS PAC ID: 8729068499 Enrollment ID: I20040722001109 |
| Provider Name | Rama G Garimella |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1740278415 PECOS PAC ID: 1153391404 Enrollment ID: I20040726001486 |
| Provider Name | Diana Lynn Koenning |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1487789434 PECOS PAC ID: 4688648330 Enrollment ID: I20040819001382 |
| Provider Name | Kelly Jo Maria Bennett Vancelette |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1689622706 PECOS PAC ID: 0547209074 Enrollment ID: I20050425001209 |
| Provider Name | Mehar Srivani Ambati |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295764355 PECOS PAC ID: 5991713810 Enrollment ID: I20060404000709 |
| Provider Name | Alexia Sandra Maneschi |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1417000381 PECOS PAC ID: 6406865609 Enrollment ID: I20060417000632 |
| Provider Name | Kevin F Smythe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235223116 PECOS PAC ID: 5799876090 Enrollment ID: I20070731000671 |
| Provider Name | Joshua C Macomber |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780661033 PECOS PAC ID: 2163408857 Enrollment ID: I20070808000371 |
| Provider Name | Sagir Ahmed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245235506 PECOS PAC ID: 3971606823 Enrollment ID: I20070814000746 |
| Provider Name | Kathleen Marie Wiese |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790987923 PECOS PAC ID: 7214020809 Enrollment ID: I20070912000886 |
| Provider Name | Laurie R Leach |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659481075 PECOS PAC ID: 2567542012 Enrollment ID: I20080109000538 |
| Provider Name | Karen L Wilhelm |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851474969 PECOS PAC ID: 6507941200 Enrollment ID: I20080305000278 |
| Provider Name | Tonya R Gable |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003085713 PECOS PAC ID: 7214015460 Enrollment ID: I20080429000215 |
| Provider Name | Bhavani Balaravi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982681417 PECOS PAC ID: 2567428295 Enrollment ID: I20090407000105 |
| Provider Name | Pavlo I Netrebko |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1629240395 PECOS PAC ID: 2264504661 Enrollment ID: I20090901000563 |
| Provider Name | Jennifer Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588998363 PECOS PAC ID: 6204973167 Enrollment ID: I20091026000312 |
| Provider Name | Catherine L Stanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477889723 PECOS PAC ID: 6002954229 Enrollment ID: I20091109000614 |
| Provider Name | Jennifer W Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275641664 PECOS PAC ID: 1850431040 Enrollment ID: I20091218000465 |
| Provider Name | John Lawrence Cotton |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760593388 PECOS PAC ID: 0840335980 Enrollment ID: I20100301000785 |
| Provider Name | Scott Harding Buck |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164510376 PECOS PAC ID: 6002951159 Enrollment ID: I20100301000897 |
| Provider Name | Elman Grady Frantz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245320019 PECOS PAC ID: 7719016088 Enrollment ID: I20100525000366 |
| Provider Name | Glenndale Moore |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164485033 PECOS PAC ID: 1052441581 Enrollment ID: I20100610000252 |
| Provider Name | George L Vergolias |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1851478143 PECOS PAC ID: 4587788997 Enrollment ID: I20100907000772 |
| Provider Name | Justin A Ayre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821160433 PECOS PAC ID: 4486843505 Enrollment ID: I20110105000569 |
| Provider Name | Parul Kharod |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1720384233 PECOS PAC ID: 6709050230 Enrollment ID: I20111121000016 |
| Provider Name | Allison H Williams |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1760583090 PECOS PAC ID: 6002070307 Enrollment ID: I20120618000717 |
| Provider Name | Patrick J Mahaney |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1467712679 PECOS PAC ID: 7719133487 Enrollment ID: I20120813000155 |
| Provider Name | Eric D Tucker |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457521932 PECOS PAC ID: 7719135128 Enrollment ID: I20120910000389 |
| Provider Name | Sunita Juliana Ferns |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255591707 PECOS PAC ID: 6305093683 Enrollment ID: I20131025001499 |
| Provider Name | Ximena Morales |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477537256 PECOS PAC ID: 9739159039 Enrollment ID: I20140429000546 |
| Provider Name | Marlo Reyleen Watson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285982124 PECOS PAC ID: 0143449207 Enrollment ID: I20140923000323 |
| Provider Name | Melissa L Cirillo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952564015 PECOS PAC ID: 0648311308 Enrollment ID: I20141125001575 |
| Provider Name | Mateo Calderon Arnulphi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811159957 PECOS PAC ID: 0143454496 Enrollment ID: I20141218001784 |
| Provider Name | Sam Saha |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629394390 PECOS PAC ID: 3870733181 Enrollment ID: I20150107000141 |
| Provider Name | Timothy Michael Hoffman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295729697 PECOS PAC ID: 4486779246 Enrollment ID: I20150522001903 |
| Provider Name | Melissa E Pellegrino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164748331 PECOS PAC ID: 9133432966 Enrollment ID: I20150722004287 |
| Provider Name | Joanna Schechner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518357383 PECOS PAC ID: 0749596195 Enrollment ID: I20150831000877 |
| Provider Name | Zehra Husain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922276625 PECOS PAC ID: 8820307044 Enrollment ID: I20151028002310 |
| Provider Name | Lynn Suzanne Kakos |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1316322076 PECOS PAC ID: 6800106899 Enrollment ID: I20151103001710 |
| Provider Name | Richard J Boruta |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1043444722 PECOS PAC ID: 7517101223 Enrollment ID: I20151109000148 |
| Provider Name | Courtney Lee Brown |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1447635396 PECOS PAC ID: 2365743812 Enrollment ID: I20151229000837 |
| Provider Name | Sarah A Patterson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164845764 PECOS PAC ID: 5092018143 Enrollment ID: I20160122001058 |
| Provider Name | Amanda Huber Serrano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114366069 PECOS PAC ID: 6103121793 Enrollment ID: I20160218002298 |
| Provider Name | Kimberly Jones Dekan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902238108 PECOS PAC ID: 0244536233 Enrollment ID: I20160317001374 |
| Provider Name | Douglas Christopher Lonneman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487013835 PECOS PAC ID: 5092012096 Enrollment ID: I20160317001933 |
| Provider Name | Jesse B Creech |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588947501 PECOS PAC ID: 6507146404 Enrollment ID: I20161212001462 |
| Provider Name | Madeeha Saeed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1851554265 PECOS PAC ID: 4789966011 Enrollment ID: I20170123001034 |
| Provider Name | Margaret Elizabeth Anderson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154675148 PECOS PAC ID: 3678848116 Enrollment ID: I20171009002458 |
| Provider Name | Rochelle Lynn O'neil |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1487180394 PECOS PAC ID: 1759657547 Enrollment ID: I20171023001928 |
| Provider Name | Anna-marieta Moise |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083972046 PECOS PAC ID: 4385933589 Enrollment ID: I20171204000872 |
| Provider Name | Beverly H Savinsky |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1033620620 PECOS PAC ID: 6305107871 Enrollment ID: I20180223002038 |
| Provider Name | Meredith Lynne Hinson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013443670 PECOS PAC ID: 6608113840 Enrollment ID: I20190128000141 |
| Provider Name | Tiarney Dannone Ritchwood |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093115354 PECOS PAC ID: 8921331166 Enrollment ID: I20190604000011 |
| Provider Name | Andrew Todd Freeman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356745590 PECOS PAC ID: 1557698107 Enrollment ID: I20190806001411 |
| Provider Name | Kara Rochon Holden |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1285196980 PECOS PAC ID: 6204163348 Enrollment ID: I20190812002621 |
| Provider Name | Maria Kristina Butler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1275052565 PECOS PAC ID: 7416285135 Enrollment ID: I20190820000719 |
| Provider Name | Peyton Jessie Thompson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164867842 PECOS PAC ID: 8022027192 Enrollment ID: I20190909001332 |
| Provider Name | Elizabeth Marie Howell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1891087037 PECOS PAC ID: 9133434723 Enrollment ID: I20191218002714 |
| Provider Name | Jennifer Zurosky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245556745 PECOS PAC ID: 8921397936 Enrollment ID: I20200122001605 |
| Provider Name | Lindsay Marie Allotey |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619501202 PECOS PAC ID: 0749618825 Enrollment ID: I20200324001891 |
| Provider Name | Lori Lolita Harrison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174075683 PECOS PAC ID: 2365873999 Enrollment ID: I20200514000482 |
| Provider Name | Kathleen Tompkins |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1962896159 PECOS PAC ID: 0547589996 Enrollment ID: I20200723003855 |
| Provider Name | Latangela Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790162493 PECOS PAC ID: 4587979232 Enrollment ID: I20200827003504 |
| Provider Name | Ruchir Shah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396033437 PECOS PAC ID: 1557656501 Enrollment ID: I20200831000380 |
| Provider Name | Neeraj Singh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194160457 PECOS PAC ID: 6709136443 Enrollment ID: I20200901001675 |
| Provider Name | Rajiv Narula |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982959979 PECOS PAC ID: 6709147689 Enrollment ID: I20200910002778 |
| Provider Name | Mark Borsody |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215179767 PECOS PAC ID: 5890844575 Enrollment ID: I20201007002045 |
| Provider Name | Alok M Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457627465 PECOS PAC ID: 5092061788 Enrollment ID: I20201007003211 |
| Provider Name | Tapan Ravindra Kavi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780008748 PECOS PAC ID: 9931413804 Enrollment ID: I20201021002581 |
| Provider Name | Clover Cassidy Mckinney |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336660489 PECOS PAC ID: 9436569209 Enrollment ID: I20201105001993 |
| Provider Name | Evan David Allen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821101742 PECOS PAC ID: 8426945643 Enrollment ID: I20210120001197 |
| Provider Name | April Powers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376139717 PECOS PAC ID: 4082028717 Enrollment ID: I20210120002832 |
| Provider Name | Crystal Sherelle Jones |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508143637 PECOS PAC ID: 7315353117 Enrollment ID: I20210302002317 |
| Provider Name | Hannah M Masoud |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073047528 PECOS PAC ID: 7315215852 Enrollment ID: I20210305000300 |
| Provider Name | Jaclyn Frances Marcacci |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1770944753 PECOS PAC ID: 5193131191 Enrollment ID: I20210316002168 |
| Provider Name | Bashar A Mohsen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1114953650 PECOS PAC ID: 0648275917 Enrollment ID: I20210407001451 |
| Provider Name | Erin Michelle Piper |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023492048 PECOS PAC ID: 7416265517 Enrollment ID: I20210416000459 |
| Provider Name | Margaret Yueyang Yu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932590965 PECOS PAC ID: 2961747449 Enrollment ID: I20210503001810 |
| Provider Name | Kyle Yuichi Ogami |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801276571 PECOS PAC ID: 9638471626 Enrollment ID: I20210617000762 |
| Provider Name | Wendy Funes Pineda |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972091411 PECOS PAC ID: 2567864408 Enrollment ID: I20210714002190 |
| Provider Name | Nicole C White |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1972897387 PECOS PAC ID: 7911122619 Enrollment ID: I20210923002624 |
| Provider Name | Christian O Perez |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881985695 PECOS PAC ID: 5193027704 Enrollment ID: I20210928001864 |
| Provider Name | Sui Kwong Li |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1689011504 PECOS PAC ID: 1557657871 Enrollment ID: I20211018001341 |
| Provider Name | Sowmya Nanjappa |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1942565403 PECOS PAC ID: 4981825379 Enrollment ID: I20211027002152 |
| Provider Name | Neel B Shah |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1912162819 PECOS PAC ID: 6103971379 Enrollment ID: I20211028001244 |
| Provider Name | Natalie Jane Warta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457846909 PECOS PAC ID: 8426446188 Enrollment ID: I20211028002834 |
| Provider Name | Nupur Gupta |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417375940 PECOS PAC ID: 8729379938 Enrollment ID: I20211118000540 |
| Provider Name | Peter Joseph Salvatore Volpe |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1477970309 PECOS PAC ID: 5092083964 Enrollment ID: I20211118000720 |
| Provider Name | Michael Meng Chen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558757757 PECOS PAC ID: 9335424449 Enrollment ID: I20211124000476 |
| Provider Name | Alex Marshal Trzebucki |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1114269594 PECOS PAC ID: 9739471533 Enrollment ID: I20211208001827 |
| Provider Name | Lidia Yamada |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932461233 PECOS PAC ID: 8820312887 Enrollment ID: I20211229001973 |
| Provider Name | Shelby Louise Sawyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932728318 PECOS PAC ID: 1850782673 Enrollment ID: I20220104003014 |
| Provider Name | Thomas Mark Banas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508863051 PECOS PAC ID: 9537069299 Enrollment ID: I20220106001454 |
| Provider Name | Katherine Elizabeth Freiman-fox |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1821674847 PECOS PAC ID: 5294128773 Enrollment ID: I20220215002279 |
| Provider Name | Colleen Barbara Wentworth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568675320 PECOS PAC ID: 4082713862 Enrollment ID: I20220228000675 |
| Provider Name | Shavonne Nicole Harrell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821441460 PECOS PAC ID: 3173900818 Enrollment ID: I20220518000596 |
| Provider Name | Swati Laroia Coon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306284765 PECOS PAC ID: 8224255492 Enrollment ID: I20220601002282 |
| Provider Name | Jeremiah Bell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639533870 PECOS PAC ID: 0244524338 Enrollment ID: I20220705000427 |
| Provider Name | Breegan Loreal Elizabeth Ladd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538806567 PECOS PAC ID: 9830571868 Enrollment ID: I20220808000559 |
| Provider Name | Alvin Parker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184151151 PECOS PAC ID: 0547530966 Enrollment ID: I20220825002633 |
| Provider Name | Sabina Zawadzka |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1396109021 PECOS PAC ID: 8820382864 Enrollment ID: I20220915001604 |
| Provider Name | Bradley Mark Avery |
|---|---|
| Provider Type | Practitioner - Psychologist Billing Independently |
| Provider Identifiers | NPI Number: 1063948727 PECOS PAC ID: 1355718412 Enrollment ID: I20221101003372 |
| Provider Name | Christina Hope Lee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063148336 PECOS PAC ID: 5698143683 Enrollment ID: I20221123000335 |
| Provider Name | Breonna Delois Lane |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1477189546 PECOS PAC ID: 1052782331 Enrollment ID: I20230124002917 |
| Provider Name | Seema Arun Mehta Steinke |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1346493053 PECOS PAC ID: 3870815020 Enrollment ID: I20230503002378 |
| Provider Name | Melanie Winningham |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588954788 PECOS PAC ID: 9335434752 Enrollment ID: I20230726000831 |
| Provider Name | Alejandra Maria Stewart |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588897664 PECOS PAC ID: 6305223991 Enrollment ID: I20230814002580 |
| Provider Name | Amy Lynne Macurdy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447932314 PECOS PAC ID: 4981058310 Enrollment ID: I20231003003213 |
| Provider Name | Maria Leigh Codispoti |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053185389 PECOS PAC ID: 3678921764 Enrollment ID: I20231130000434 |
| Provider Name | Alyssa D Pensirikul |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912133539 PECOS PAC ID: 4981844032 Enrollment ID: I20231207001036 |
| Provider Name | Jyes Annemarie Querubin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154688604 PECOS PAC ID: 6901179662 Enrollment ID: I20231207001570 |
| Provider Name | Norianne Martinez Pimentel-piatt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841646981 PECOS PAC ID: 6901149061 Enrollment ID: I20231214001333 |
| Provider Name | Margot R Nagan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528367281 PECOS PAC ID: 1254563265 Enrollment ID: I20231229000044 |
| Provider Name | Stephen Parker Fulton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548209257 PECOS PAC ID: 5698773943 Enrollment ID: I20240108004362 |
| Provider Name | Steven Tversky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356683874 PECOS PAC ID: 1658633664 Enrollment ID: I20240113000514 |
| Provider Name | Kussay Nassr |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316942022 PECOS PAC ID: 8820079684 Enrollment ID: I20240125004282 |
| Provider Name | Aravind Reddy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548756588 PECOS PAC ID: 9436527447 Enrollment ID: I20240126002746 |
| Provider Name | Joel Radhames Nunez Gonzalez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497066997 PECOS PAC ID: 3577862622 Enrollment ID: I20240126003461 |
| Provider Name | William A Vaughn |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649296369 PECOS PAC ID: 1456794353 Enrollment ID: I20240207003756 |
| Provider Name | Katharine Elizabeth Engler |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1720353402 PECOS PAC ID: 1557704475 Enrollment ID: I20240208000131 |
| Provider Name | Mary Ellen Worthy |
|---|---|
| Provider Type | Practitioner - Marriage And Family Therapist |
| Provider Identifiers | NPI Number: 1902008634 PECOS PAC ID: 2567806409 Enrollment ID: I20240219001914 |
| Provider Name | Karl Hamilton |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295375251 PECOS PAC ID: 4688019078 Enrollment ID: I20240226000549 |
| Provider Name | Onterio Tremayne Mcallister |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1063848802 PECOS PAC ID: 7517302144 Enrollment ID: I20240305001669 |
| Provider Name | Elizabeth Ashleigh Stalford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1619732849 PECOS PAC ID: 4587000757 Enrollment ID: I20240311000641 |
| Provider Name | Yi-jou Tsai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053674903 PECOS PAC ID: 5890018568 Enrollment ID: I20240326003401 |
| Provider Name | Kathryn Ann Fitzgerald |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902394729 PECOS PAC ID: 4284074154 Enrollment ID: I20240426000134 |
| Provider Name | Lacresha Marsha Davis |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740308782 PECOS PAC ID: 6507206760 Enrollment ID: I20240505000012 |
| Provider Name | Mercedes Nicole Barrett Ijames |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1437807849 PECOS PAC ID: 1254772734 Enrollment ID: I20240515001511 |
| Provider Name | Jessica Wood Fleishman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679288260 PECOS PAC ID: 8123460169 Enrollment ID: I20240522003323 |
| Provider Name | Kirsten Loren Bubak |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053174508 PECOS PAC ID: 1759823818 Enrollment ID: I20240605001240 |
| Provider Name | Clifford William Meyers |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699090217 PECOS PAC ID: 4688988256 Enrollment ID: I20240605001486 |
Care One Nursing Services, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 331 Tryon Rd Suite 103 A, Raleigh, NC 27603 Phone: 919-771-2310 | |
Reaching Your Goals, Inc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 211 E Six Forks Rd Ste 201, Raleigh, NC 27609 Phone: 919-832-6150 Fax: 919-832-6151 | |
Triumph Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3210 Fairhill Dr, Raleigh, NC 27612 Phone: 919-256-0824 | |
Cheltenham Clinical Services, Pc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 2435 Lynn Rd, Suite 200, Raleigh, NC 27612 Phone: 919-438-7396 | |
Pamela J Rosenberg Lcsw Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 867 Washington St, Raleigh, NC 27605 Phone: 919-833-5867 Fax: 919-833-5859 | |
Thriveworks Clinical - North Carolina Pc Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 8406 Six Forks Rd Ste 104, Raleigh, NC 27615 Phone: 919-424-6045 Fax: 617-379-0496 | |
Downtown Raleigh Counseling, Pllc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 5109 Carter St, Raleigh, NC 27612 Phone: 910-257-7530 |