| Asante Physician Partners | |
|
2620 E Barnett Rd Suite H Medford OR 97504-8344 | |
| (541) 789-4728 | |
| (541) 789-4765 |
| Full Name | Asante Physician Partners |
|---|---|
| Speciality | Family Medicine |
| Location | 2620 E Barnett Rd, Medford, Oregon |
| Authorized Official Name and Position | Angie Simonson (ASANTE SENIOR VP OF OPERATIONS) |
| Authorized Official Contact | 5417894133 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Asante Physician Partners 2620 E Barnett Rd Suite H Medford OR 97504-8344 Ph: (541) 789-2559 | Asante Physician Partners 2620 E Barnett Rd Suite H Medford OR 97504-8344 Ph: (541) 789-4728 |
| NPI Number | 1922381326 |
|---|---|
| Provider Enumeration Date | 09/21/2011 |
| Last Update Date | 02/10/2024 |
| Medicare PECOS PAC ID | 8325206246 |
|---|---|
| Medicare Enrollment ID | O20120223000671 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922381326 | NPI | - | NPPES |
| Provider Name | David D Candelaria |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033112271 PECOS PAC ID: 0547165292 Enrollment ID: I20031204001109 |
| Provider Name | Juan M Castillo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609957877 PECOS PAC ID: 6901704469 Enrollment ID: I20031222000787 |
| Provider Name | Christina M Ford |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528057593 PECOS PAC ID: 0547169971 Enrollment ID: I20040107000435 |
| Provider Name | Timothy L Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982794293 PECOS PAC ID: 0547156838 Enrollment ID: I20040226000063 |
| Provider Name | Bobbie J Smith-ede |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285631648 PECOS PAC ID: 5193718229 Enrollment ID: I20040406000006 |
| Provider Name | Elizabeth B Hirni |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598754129 PECOS PAC ID: 2365435344 Enrollment ID: I20040406000434 |
| Provider Name | Steven L Hersch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174512149 PECOS PAC ID: 3274526264 Enrollment ID: I20040406000499 |
| Provider Name | Elizabeth Allen North |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336111616 PECOS PAC ID: 1254329808 Enrollment ID: I20040504000006 |
| Provider Name | Randall E Currier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942203260 PECOS PAC ID: 2668461773 Enrollment ID: I20040512000246 |
| Provider Name | John T Gallen |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1114993656 PECOS PAC ID: 3173513413 Enrollment ID: I20040517001435 |
| Provider Name | John M Terhes |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114906443 PECOS PAC ID: 9436135159 Enrollment ID: I20040624001413 |
| Provider Name | John B Reid |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689664385 PECOS PAC ID: 2264419340 Enrollment ID: I20040707000208 |
| Provider Name | Martha M Cavazos |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1639197742 PECOS PAC ID: 2163484387 Enrollment ID: I20041101000084 |
| Provider Name | Gary D Marks |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861569212 PECOS PAC ID: 8325003916 Enrollment ID: I20041123000410 |
| Provider Name | Oscar A Sanchez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063412427 PECOS PAC ID: 2769430503 Enrollment ID: I20050107000518 |
| Provider Name | Jill T Steinsiek |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1336115872 PECOS PAC ID: 9133166556 Enrollment ID: I20050415000852 |
| Provider Name | Beth A Leone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134232515 PECOS PAC ID: 7214976372 Enrollment ID: I20050427001389 |
| Provider Name | Kenneth L Millsap |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750305066 PECOS PAC ID: 4082655162 Enrollment ID: I20050519000959 |
| Provider Name | Donna M Bradshaw |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952390593 PECOS PAC ID: 0042238404 Enrollment ID: I20051104000257 |
| Provider Name | Tamara S Simpson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003935388 PECOS PAC ID: 3577469238 Enrollment ID: I20051116000728 |
| Provider Name | Thomas J Trubenbach |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396759916 PECOS PAC ID: 1850312422 Enrollment ID: I20051209000756 |
| Provider Name | Lynn C Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487600276 PECOS PAC ID: 8022022615 Enrollment ID: I20060202000911 |
| Provider Name | Marcelin Charles |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598726838 PECOS PAC ID: 6901888122 Enrollment ID: I20060816000063 |
| Provider Name | Jason Mauer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124086368 PECOS PAC ID: 2062304785 Enrollment ID: I20060829000238 |
| Provider Name | Michael J Marvinny |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164468534 PECOS PAC ID: 8820092331 Enrollment ID: I20060914000019 |
| Provider Name | Amanda B Alford |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992787808 PECOS PAC ID: 3779589650 Enrollment ID: I20061017000284 |
| Provider Name | Sarah Ann Lamanuzzi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235243049 PECOS PAC ID: 9931114857 Enrollment ID: I20061204000523 |
| Provider Name | Gabriel R Mayland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669586467 PECOS PAC ID: 6406864263 Enrollment ID: I20070102000116 |
| Provider Name | Leah S Bernard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487737573 PECOS PAC ID: 5799786851 Enrollment ID: I20070117000088 |
| Provider Name | James C Loos |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1801991476 PECOS PAC ID: 5193820777 Enrollment ID: I20070411000140 |
| Provider Name | Charles Carmeci |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1730237082 PECOS PAC ID: 5092811794 Enrollment ID: I20070425000641 |
| Provider Name | Sherry J Castillo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689799405 PECOS PAC ID: 4284732959 Enrollment ID: I20070604000272 |
| Provider Name | Erin B Brender |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588709521 PECOS PAC ID: 5193823243 Enrollment ID: I20070613000320 |
| Provider Name | Patricia M Reddy |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1134242167 PECOS PAC ID: 2264531904 Enrollment ID: I20070621000356 |
| Provider Name | Susan M Hansen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730129909 PECOS PAC ID: 5698734952 Enrollment ID: I20070622000546 |
| Provider Name | Tim F Johnston |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518002427 PECOS PAC ID: 9032203302 Enrollment ID: I20070917000720 |
| Provider Name | John L Sager |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306808043 PECOS PAC ID: 6305945726 Enrollment ID: I20070926000044 |
| Provider Name | Carl Jeffrey Berg |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1396876314 PECOS PAC ID: 9739286311 Enrollment ID: I20071127000519 |
| Provider Name | Ahsan Jaffar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235323619 PECOS PAC ID: 3274620653 Enrollment ID: I20071220000281 |
| Provider Name | Donald W Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730256926 PECOS PAC ID: 7315048402 Enrollment ID: I20080314000085 |
| Provider Name | Thu Han Aung |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659553162 PECOS PAC ID: 1759461593 Enrollment ID: I20080723000321 |
| Provider Name | Jose M Mondesi Garrido |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053589648 PECOS PAC ID: 1557436367 Enrollment ID: I20080813000488 |
| Provider Name | Suzin M Hagar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447260666 PECOS PAC ID: 5193790905 Enrollment ID: I20081126000095 |
| Provider Name | Brent Alexander Burket |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720048168 PECOS PAC ID: 6103883319 Enrollment ID: I20081230000331 |
| Provider Name | Brett M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053561241 PECOS PAC ID: 3375603061 Enrollment ID: I20090702000653 |
| Provider Name | Leonard Wilk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326180688 PECOS PAC ID: 2365534054 Enrollment ID: I20090707000738 |
| Provider Name | Anna K Westmoreland |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1821171570 PECOS PAC ID: 8729130299 Enrollment ID: I20090714000342 |
| Provider Name | Agnieszka L Dobiecka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659557148 PECOS PAC ID: 9537234109 Enrollment ID: I20090923000350 |
| Provider Name | Richard S Nelson |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1649499443 PECOS PAC ID: 8729186705 Enrollment ID: I20090928000652 |
| Provider Name | Jennifer Wabin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598979171 PECOS PAC ID: 7618037243 Enrollment ID: I20091104000355 |
| Provider Name | Adrian G Sue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588724611 PECOS PAC ID: 5799828539 Enrollment ID: I20100202000872 |
| Provider Name | George E Schultz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235225129 PECOS PAC ID: 1052454568 Enrollment ID: I20100205000503 |
| Provider Name | Lorie J Morgan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164436309 PECOS PAC ID: 6103952858 Enrollment ID: I20100405000015 |
| Provider Name | Christopher R Morgan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619981883 PECOS PAC ID: 2466588116 Enrollment ID: I20100405000050 |
| Provider Name | Byron B Telford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568598860 PECOS PAC ID: 1658409438 Enrollment ID: I20100514000881 |
| Provider Name | Douglas Morrison |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376618959 PECOS PAC ID: 8628968823 Enrollment ID: I20100628000607 |
| Provider Name | Michele C Rushton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699943845 PECOS PAC ID: 2062544323 Enrollment ID: I20100722000070 |
| Provider Name | Margaret M Bismarck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427093301 PECOS PAC ID: 7911031091 Enrollment ID: I20100811000213 |
| Provider Name | Leslie Stone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396896114 PECOS PAC ID: 3971401969 Enrollment ID: I20100819001035 |
| Provider Name | Glen S O Sullivan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1972504652 PECOS PAC ID: 1153425087 Enrollment ID: I20100928000657 |
| Provider Name | Minette C Lukban |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518287739 PECOS PAC ID: 7315139029 Enrollment ID: I20101012001259 |
| Provider Name | Daniel R Fear |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1407848948 PECOS PAC ID: 4688769391 Enrollment ID: I20101014000726 |
| Provider Name | Douglas B Mcmahon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568555001 PECOS PAC ID: 4183817380 Enrollment ID: I20101020001461 |
| Provider Name | Mohamed Siyad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780862391 PECOS PAC ID: 1254525066 Enrollment ID: I20101104001356 |
| Provider Name | Aaron D Martin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1932374808 PECOS PAC ID: 7517152531 Enrollment ID: I20101116000272 |
| Provider Name | William H Palm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134168560 PECOS PAC ID: 3375730682 Enrollment ID: I20101213001120 |
| Provider Name | Somnath B Ghosh |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1962698712 PECOS PAC ID: 8123215449 Enrollment ID: I20110720000479 |
| Provider Name | Radek Dutkiewicz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841376423 PECOS PAC ID: 0446331524 Enrollment ID: I20110831000439 |
| Provider Name | Laura A Smiricky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245205582 PECOS PAC ID: 1052362969 Enrollment ID: I20111005000576 |
| Provider Name | Shaik I Basha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578712378 PECOS PAC ID: 0244403723 Enrollment ID: I20111027000862 |
| Provider Name | Patrick K Honsinger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922111392 PECOS PAC ID: 5799959375 Enrollment ID: I20111116000493 |
| Provider Name | Carl Russell Griesser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316214281 PECOS PAC ID: 9234305012 Enrollment ID: I20111228000412 |
| Provider Name | Heidi A Loganbill |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649233362 PECOS PAC ID: 9739349671 Enrollment ID: I20120329000583 |
| Provider Name | Puneet Bandi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801030382 PECOS PAC ID: 2466608062 Enrollment ID: I20120815000194 |
| Provider Name | Richard K Huffaker |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841498300 PECOS PAC ID: 4688730203 Enrollment ID: I20120906000555 |
| Provider Name | Victor O Macias |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093095929 PECOS PAC ID: 3274781737 Enrollment ID: I20120907000501 |
| Provider Name | Milton W Kim |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871740787 PECOS PAC ID: 3072789213 Enrollment ID: I20120919000107 |
| Provider Name | Ellen S Plummer |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699965053 PECOS PAC ID: 5294985875 Enrollment ID: I20121016000547 |
| Provider Name | Estin K Yang |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1386887628 PECOS PAC ID: 7618128430 Enrollment ID: I20121102000550 |
| Provider Name | Mackenzie E Loughland |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366603045 PECOS PAC ID: 7618148883 Enrollment ID: I20130123000290 |
| Provider Name | Joseph Tristan N Oconer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942400858 PECOS PAC ID: 9234377300 Enrollment ID: I20130531000053 |
| Provider Name | Hilary R Redden |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1649476847 PECOS PAC ID: 2062667603 Enrollment ID: I20130618000489 |
| Provider Name | Megan M Frost |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255533550 PECOS PAC ID: 5496990897 Enrollment ID: I20130627000025 |
| Provider Name | Minal B Jaju |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427491620 PECOS PAC ID: 1052551421 Enrollment ID: I20130708000402 |
| Provider Name | Dani J Thomas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1104056092 PECOS PAC ID: 6507025111 Enrollment ID: I20130715000676 |
| Provider Name | Daniel R Oreskovich |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578875654 PECOS PAC ID: 4789826504 Enrollment ID: I20130807000729 |
| Provider Name | Rosemary O Chiedozi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902122690 PECOS PAC ID: 9739323379 Enrollment ID: I20130920000237 |
| Provider Name | Kelly A Dale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245420074 PECOS PAC ID: 5799871968 Enrollment ID: I20131031001699 |
| Provider Name | David E Sanchez Vasquez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619285798 PECOS PAC ID: 5991930786 Enrollment ID: I20131104000209 |
| Provider Name | Daniel C Wieking |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093976045 PECOS PAC ID: 6507011319 Enrollment ID: I20140325000750 |
| Provider Name | Mirela Cvijanovic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811314974 PECOS PAC ID: 6800010836 Enrollment ID: I20140613001696 |
| Provider Name | Patrick A Dawson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831233139 PECOS PAC ID: 2264476043 Enrollment ID: I20140627002141 |
| Provider Name | Anuj Mittal |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1336317775 PECOS PAC ID: 0446475693 Enrollment ID: I20140702002083 |
| Provider Name | Nandita Suresh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417242173 PECOS PAC ID: 7214154566 Enrollment ID: I20140808001822 |
| Provider Name | Ronald C Ruppert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174510234 PECOS PAC ID: 4183646078 Enrollment ID: I20140912001946 |
| Provider Name | Andrew T Young |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013273804 PECOS PAC ID: 4385899038 Enrollment ID: I20141111000001 |
| Provider Name | Lora J.m. Bergert |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881790426 PECOS PAC ID: 2860453693 Enrollment ID: I20150114001708 |
| Provider Name | Eileen W Stiles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114997244 PECOS PAC ID: 3476445685 Enrollment ID: I20150214000049 |
| Provider Name | Dorian E Fowler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588815138 PECOS PAC ID: 2961561006 Enrollment ID: I20150330000640 |
| Provider Name | Daniel A Kahn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144265463 PECOS PAC ID: 9234142126 Enrollment ID: I20150512002801 |
| Provider Name | Marla Samuel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831468370 PECOS PAC ID: 4880914217 Enrollment ID: I20150526001403 |
| Provider Name | Laurel L Bell |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760470207 PECOS PAC ID: 9436219367 Enrollment ID: I20150602002682 |
| Provider Name | Daniel G Mcallister |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629079504 PECOS PAC ID: 7012907918 Enrollment ID: I20150619002247 |
| Provider Name | Jamey L Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306065552 PECOS PAC ID: 3476650540 Enrollment ID: I20150623001738 |
| Provider Name | Rebecca A Leggett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841410198 PECOS PAC ID: 7618057795 Enrollment ID: I20150729010431 |
| Provider Name | Mirela Titianu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043575244 PECOS PAC ID: 1355655630 Enrollment ID: I20150730011997 |
| Provider Name | Diya Mohammad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427339738 PECOS PAC ID: 8123332871 Enrollment ID: I20150807015661 |
| Provider Name | Anna S Antonopulos |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1689831927 PECOS PAC ID: 1951433812 Enrollment ID: I20150811003869 |
| Provider Name | Arun Thekkekarott Kuruvila |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649534389 PECOS PAC ID: 6204069685 Enrollment ID: I20150827002327 |
| Provider Name | Michael R Blumhardt |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1952462798 PECOS PAC ID: 0345228607 Enrollment ID: I20150923001828 |
| Provider Name | Matthew E Hiesterman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154642387 PECOS PAC ID: 2860701372 Enrollment ID: I20151023001780 |
| Provider Name | Craig A Berg |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1659763639 PECOS PAC ID: 6709186000 Enrollment ID: I20151118000458 |
| Provider Name | Victoria Rose Smet |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740653393 PECOS PAC ID: 0244531515 Enrollment ID: I20151211000402 |
| Provider Name | Nancy M Obispo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871983353 PECOS PAC ID: 6901123140 Enrollment ID: I20160509000851 |
| Provider Name | Stephen D Hubbard |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1679911432 PECOS PAC ID: 1658696794 Enrollment ID: I20160614002688 |
| Provider Name | Ki Benjamin Kurtz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194088591 PECOS PAC ID: 8022309038 Enrollment ID: I20160622002033 |
| Provider Name | David H Delman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669764924 PECOS PAC ID: 4082833926 Enrollment ID: I20160831000741 |
| Provider Name | Angela Douglas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265571285 PECOS PAC ID: 5698080075 Enrollment ID: I20160831002677 |
| Provider Name | Gabrielle M Fey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578918546 PECOS PAC ID: 5294021721 Enrollment ID: I20160909001851 |
| Provider Name | Sarah K Kahn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1851681928 PECOS PAC ID: 0345495784 Enrollment ID: I20161013001783 |
| Provider Name | Scott E Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346624459 PECOS PAC ID: 5092022830 Enrollment ID: I20161018002097 |
| Provider Name | Kayla B Weber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780037945 PECOS PAC ID: 6204114481 Enrollment ID: I20161021001292 |
| Provider Name | Ernesto Jimenez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487092045 PECOS PAC ID: 0446553911 Enrollment ID: I20161021001616 |
| Provider Name | Beatrice U Song |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457420150 PECOS PAC ID: 5799966115 Enrollment ID: I20161028001232 |
| Provider Name | Sharon P Krische |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457701930 PECOS PAC ID: 9739468042 Enrollment ID: I20161109000703 |
| Provider Name | Elisabeth Anacius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003109828 PECOS PAC ID: 7810155090 Enrollment ID: I20161109001708 |
| Provider Name | Jacqueline C Wilk |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528251840 PECOS PAC ID: 3870872997 Enrollment ID: I20161114001147 |
| Provider Name | Katie L Townes-mcmann |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366687998 PECOS PAC ID: 2365688454 Enrollment ID: I20161130002528 |
| Provider Name | Mehul U Daulat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508270745 PECOS PAC ID: 2466671276 Enrollment ID: I20170112002022 |
| Provider Name | Peter G Teichman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023325362 PECOS PAC ID: 0446223127 Enrollment ID: I20170118001260 |
| Provider Name | Ramesh Mishra |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487967212 PECOS PAC ID: 5991946303 Enrollment ID: I20170201002668 |
| Provider Name | Nicole M Cowley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225321391 PECOS PAC ID: 9638391956 Enrollment ID: I20170612001955 |
| Provider Name | Nicole Shirvani |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295175347 PECOS PAC ID: 7315215522 Enrollment ID: I20170612002686 |
| Provider Name | Robyn Borghese |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1669688560 PECOS PAC ID: 1456483403 Enrollment ID: I20170718003472 |
| Provider Name | Julie G Ohlschwager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831636067 PECOS PAC ID: 9133499429 Enrollment ID: I20170719002102 |
| Provider Name | Gurjeet Singh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780947937 PECOS PAC ID: 8224261763 Enrollment ID: I20170731001640 |
| Provider Name | Rishiinder S Harry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639587454 PECOS PAC ID: 0345512828 Enrollment ID: I20170817002554 |
| Provider Name | Pratibha Seshadri |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1801143615 PECOS PAC ID: 4789957564 Enrollment ID: I20170829003969 |
| Provider Name | Philip F Michael |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285965657 PECOS PAC ID: 2668520446 Enrollment ID: I20171114002890 |
| Provider Name | Lisa Braun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770925265 PECOS PAC ID: 4486898988 Enrollment ID: I20171117002741 |
| Provider Name | Bradley M Dekorte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699185256 PECOS PAC ID: 0244453348 Enrollment ID: I20171201001523 |
| Provider Name | Kellene A Fisler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760982474 PECOS PAC ID: 2365704368 Enrollment ID: I20180402000739 |
| Provider Name | Jared D Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952631103 PECOS PAC ID: 3870737463 Enrollment ID: I20180413001513 |
| Provider Name | Alexander E Bonato |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083137251 PECOS PAC ID: 0840548749 Enrollment ID: I20180809001174 |
| Provider Name | Amy Lynne Card |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003162959 PECOS PAC ID: 8325273733 Enrollment ID: I20180831000773 |
| Provider Name | Lindsay M Wenger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679916480 PECOS PAC ID: 2264651470 Enrollment ID: I20181010002290 |
| Provider Name | Alyse K Power |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578941373 PECOS PAC ID: 7315259884 Enrollment ID: I20181102002638 |
| Provider Name | Melissa M Greive |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134567027 PECOS PAC ID: 9830433358 Enrollment ID: I20181210002168 |
| Provider Name | John C Byers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013405729 PECOS PAC ID: 8820332315 Enrollment ID: I20181211001392 |
| Provider Name | Ayodeji A Oduola |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942530266 PECOS PAC ID: 6305009077 Enrollment ID: I20190110000750 |
| Provider Name | Priscilla Kim Codiga |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629009402 PECOS PAC ID: 7315926979 Enrollment ID: I20190301002403 |
| Provider Name | Candy Burkenbine-yamaguchi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154567857 PECOS PAC ID: 2668520206 Enrollment ID: I20190320001671 |
| Provider Name | Amber N Spivey |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1306401179 PECOS PAC ID: 6103151253 Enrollment ID: I20190711000636 |
| Provider Name | Kathryn Sm Hardaway |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073079430 PECOS PAC ID: 4688909773 Enrollment ID: I20190711001851 |
| Provider Name | Liam C Macleod |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1306135488 PECOS PAC ID: 8123334299 Enrollment ID: I20190731000010 |
| Provider Name | Jennifer K Hartsock-vandine |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1528386604 PECOS PAC ID: 7012152556 Enrollment ID: I20190910003807 |
| Provider Name | Grant C Lightfoot |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952754111 PECOS PAC ID: 0648500546 Enrollment ID: I20190918003665 |
| Provider Name | Derek Flack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679923098 PECOS PAC ID: 9032403589 Enrollment ID: I20190923000519 |
| Provider Name | Rajpreet Singh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316391956 PECOS PAC ID: 8022305473 Enrollment ID: I20191001001964 |
| Provider Name | Christina R Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528532108 PECOS PAC ID: 7416289962 Enrollment ID: I20191101001360 |
| Provider Name | Carla A Cochran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003284068 PECOS PAC ID: 0345544573 Enrollment ID: I20191101001415 |
| Provider Name | Amanda Rae Maitland |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891295176 PECOS PAC ID: 9032474317 Enrollment ID: I20191113001555 |
| Provider Name | Brianna M Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790334019 PECOS PAC ID: 2466886544 Enrollment ID: I20191224000125 |
| Provider Name | Ekaterina Evguenievna Alchits |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922449081 PECOS PAC ID: 7113227513 Enrollment ID: I20191228000306 |
| Provider Name | Laura M Ulloa |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326474800 PECOS PAC ID: 0244665586 Enrollment ID: I20200115001243 |
| Provider Name | Colin Dennis Fee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679833925 PECOS PAC ID: 5890915292 Enrollment ID: I20200130002243 |
| Provider Name | Jessie I Hibner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255853909 PECOS PAC ID: 3971939406 Enrollment ID: I20200131002662 |
| Provider Name | Rachel M Dunn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497218614 PECOS PAC ID: 5698101483 Enrollment ID: I20200226001920 |
| Provider Name | William B Haynal |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1114218120 PECOS PAC ID: 5597063271 Enrollment ID: I20200304001962 |
| Provider Name | Karen L Gibbons-berry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861448227 PECOS PAC ID: 8820077498 Enrollment ID: I20200326003433 |
| Provider Name | Consuelo V Bartyzal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336781863 PECOS PAC ID: 0345679247 Enrollment ID: I20200327001801 |
| Provider Name | Murtaza Khan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356780514 PECOS PAC ID: 1658514534 Enrollment ID: I20200416000551 |
| Provider Name | Christian J. W. Burrell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033476817 PECOS PAC ID: 9133366636 Enrollment ID: I20200416000585 |
| Provider Name | Alicia Bennett |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1023317633 PECOS PAC ID: 6002033370 Enrollment ID: I20200416001888 |
| Provider Name | Christopher Fanale |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598776452 PECOS PAC ID: 6103803465 Enrollment ID: I20200417003385 |
| Provider Name | Byron R Spencer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518941343 PECOS PAC ID: 4789721978 Enrollment ID: I20200423002308 |
| Provider Name | Rishi Shravan Arora |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912314279 PECOS PAC ID: 5395044598 Enrollment ID: I20200506001075 |
| Provider Name | Baha M Obaidat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437563772 PECOS PAC ID: 0749579613 Enrollment ID: I20200515000878 |
| Provider Name | Amir M Anabtawi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689105116 PECOS PAC ID: 1759652415 Enrollment ID: I20200526002912 |
| Provider Name | David J Downey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508205972 PECOS PAC ID: 5496997579 Enrollment ID: I20200604001119 |
| Provider Name | Adam Kristopher Graham |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427252725 PECOS PAC ID: 2860653334 Enrollment ID: I20200617003367 |
| Provider Name | Kristin C Gannett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679197982 PECOS PAC ID: 9133543663 Enrollment ID: I20200623002662 |
| Provider Name | Jennifer G Henderson |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1902123888 PECOS PAC ID: 4587888268 Enrollment ID: I20200630002485 |
| Provider Name | Gemma C Bornick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386961415 PECOS PAC ID: 1052566270 Enrollment ID: I20200707001921 |
| Provider Name | Ian Stuart Hallows |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528482650 PECOS PAC ID: 8022342203 Enrollment ID: I20200721000763 |
| Provider Name | Mirza Faris Ali Baig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639692304 PECOS PAC ID: 6608299375 Enrollment ID: I20200721000943 |
| Provider Name | Shannon E Henderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740532480 PECOS PAC ID: 0547410045 Enrollment ID: I20200721002867 |
| Provider Name | Zia A Choudhury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700316544 PECOS PAC ID: 6709202377 Enrollment ID: I20200805003306 |
| Provider Name | Qurat Ul Ain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730605296 PECOS PAC ID: 7517383961 Enrollment ID: I20200814001940 |
| Provider Name | Denise Driscoll |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699138917 PECOS PAC ID: 3577858885 Enrollment ID: I20200814002594 |
| Provider Name | Bryan Y Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275671414 PECOS PAC ID: 2163679473 Enrollment ID: I20200824001956 |
| Provider Name | Jenna E Diggs |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184087207 PECOS PAC ID: 1658600044 Enrollment ID: I20200903000537 |
| Provider Name | Amy Lim |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1639514979 PECOS PAC ID: 1557584232 Enrollment ID: I20200907000034 |
| Provider Name | Jeffrey Wagner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033321914 PECOS PAC ID: 2769580075 Enrollment ID: I20200914002936 |
| Provider Name | Nicole Y Roth |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689029852 PECOS PAC ID: 2062741499 Enrollment ID: I20200917002816 |
| Provider Name | Shelly Haug |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1710277215 PECOS PAC ID: 0648526392 Enrollment ID: I20200920000039 |
| Provider Name | Baxter Allen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710253737 PECOS PAC ID: 0547530743 Enrollment ID: I20200923000947 |
| Provider Name | Rachel Jessica Vanderwall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316560865 PECOS PAC ID: 3779902663 Enrollment ID: I20200925001523 |
| Provider Name | Theodore A Crum |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881918811 PECOS PAC ID: 8628214541 Enrollment ID: I20201001000331 |
| Provider Name | Ira Chang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285645440 PECOS PAC ID: 3678556727 Enrollment ID: I20201008001480 |
| Provider Name | Michael Fusaro |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194109785 PECOS PAC ID: 0345546511 Enrollment ID: I20201027003142 |
| Provider Name | Virginia L Vanwart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649873530 PECOS PAC ID: 2264846179 Enrollment ID: I20210203002021 |
| Provider Name | Chalita Charles Atallah |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265731418 PECOS PAC ID: 9638478589 Enrollment ID: I20210421001784 |
| Provider Name | Mark L Siefring |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245729870 PECOS PAC ID: 0941633465 Enrollment ID: I20210422002601 |
| Provider Name | Kianne R Smith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558922088 PECOS PAC ID: 5698004984 Enrollment ID: I20210513002554 |
| Provider Name | Jose I Rodriguez Moreno |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891148854 PECOS PAC ID: 3476819434 Enrollment ID: I20210517002677 |
| Provider Name | Tala Salem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245760586 PECOS PAC ID: 8022417351 Enrollment ID: I20210518003104 |
| Provider Name | Christina A Godwin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1932494630 PECOS PAC ID: 6709033848 Enrollment ID: I20210609002746 |
| Provider Name | Alok L Shrestha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558509034 PECOS PAC ID: 7012186570 Enrollment ID: I20210610003620 |
| Provider Name | Jennifer Perry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1548640006 PECOS PAC ID: 5395145148 Enrollment ID: I20210615003477 |
| Provider Name | Summaya A Latif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356737118 PECOS PAC ID: 6709199748 Enrollment ID: I20210624001617 |
| Provider Name | Jessie Magnani |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487041455 PECOS PAC ID: 8325449168 Enrollment ID: I20210630001572 |
| Provider Name | Shaan Wadhawan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376037556 PECOS PAC ID: 6204183460 Enrollment ID: I20210830001293 |
| Provider Name | Minh Nguyen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881954469 PECOS PAC ID: 5092023846 Enrollment ID: I20210830001617 |
| Provider Name | Madison Knox |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1598338956 PECOS PAC ID: 8527465061 Enrollment ID: I20210924002669 |
| Provider Name | Donald E Stowell |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1467420711 PECOS PAC ID: 5496747867 Enrollment ID: I20210928003746 |
| Provider Name | Zhi Cheng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083076954 PECOS PAC ID: 0648565390 Enrollment ID: I20211001002293 |
| Provider Name | Elena Higuchi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316435019 PECOS PAC ID: 6305244963 Enrollment ID: I20211012002098 |
| Provider Name | Richard Beach |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558858092 PECOS PAC ID: 8921402405 Enrollment ID: I20211019002012 |
| Provider Name | Lucien T Megna |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699775924 PECOS PAC ID: 5092602235 Enrollment ID: I20211210001336 |
| Provider Name | David Kashmer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275748386 PECOS PAC ID: 9638243173 Enrollment ID: I20211223001394 |
| Provider Name | Shannon Bates |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275007601 PECOS PAC ID: 1850783549 Enrollment ID: I20220107001642 |
| Provider Name | Andrew Seth Rosenzweig |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942203690 PECOS PAC ID: 9234043134 Enrollment ID: I20220126001525 |
| Provider Name | Rebecca Werner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881739332 PECOS PAC ID: 6901902857 Enrollment ID: I20220204000602 |
| Provider Name | Michelle Benoit |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831224369 PECOS PAC ID: 9537058250 Enrollment ID: I20220221002206 |
| Provider Name | Carolyn Kor |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972952471 PECOS PAC ID: 7113215047 Enrollment ID: I20220303001520 |
| Provider Name | Dikshya Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639581226 PECOS PAC ID: 4688090418 Enrollment ID: I20220321001754 |
| Provider Name | Dimitris Gerothanassis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1124134069 PECOS PAC ID: 2163525478 Enrollment ID: I20220408002255 |
| Provider Name | Liza Rodriguez Jimenez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346222049 PECOS PAC ID: 1456315563 Enrollment ID: I20220428000446 |
| Provider Name | Ross Harrison |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1841610920 PECOS PAC ID: 4981911864 Enrollment ID: I20220511002278 |
| Provider Name | Viorel V Angheloiu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063687234 PECOS PAC ID: 9931271616 Enrollment ID: I20220513002238 |
| Provider Name | Bilal Samhouri |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1013460500 PECOS PAC ID: 0244526838 Enrollment ID: I20220523002013 |
| Provider Name | Emily E Giesen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174986590 PECOS PAC ID: 5698064681 Enrollment ID: I20220627002367 |
| Provider Name | Kim H Thai |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1962839399 PECOS PAC ID: 8426344938 Enrollment ID: I20220629001922 |
| Provider Name | Saad A Mir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356603161 PECOS PAC ID: 2466606926 Enrollment ID: I20220721002799 |
| Provider Name | Kyle J Rutledge |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265828446 PECOS PAC ID: 9133499460 Enrollment ID: I20220727001045 |
| Provider Name | Charles M Dungan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275278996 PECOS PAC ID: 3971986548 Enrollment ID: I20220815000708 |
| Provider Name | Palak Dwarkesh Parikh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295909331 PECOS PAC ID: 2668629205 Enrollment ID: I20220815000887 |
| Provider Name | Tenishia Kim Santiago |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497254932 PECOS PAC ID: 7113277369 Enrollment ID: I20220831003614 |
| Provider Name | Edewor B Osevwe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386939429 PECOS PAC ID: 8426436155 Enrollment ID: I20220906001052 |
| Provider Name | Christina Kalemkeris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376093054 PECOS PAC ID: 7012292832 Enrollment ID: I20220915001836 |
| Provider Name | Roxanne L Alsbury |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629481064 PECOS PAC ID: 3274838800 Enrollment ID: I20220921000945 |
| Provider Name | Tyler T Leigh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952523482 PECOS PAC ID: 2365621083 Enrollment ID: I20220930000899 |
| Provider Name | Zachary I Norman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427439801 PECOS PAC ID: 8224386164 Enrollment ID: I20220930001210 |
| Provider Name | Nathaniel Kelly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548823552 PECOS PAC ID: 6204212053 Enrollment ID: I20220930001389 |
| Provider Name | Danielle Hammons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598319246 PECOS PAC ID: 9436588951 Enrollment ID: I20221003000230 |
| Provider Name | Nicolette A Cortez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194356006 PECOS PAC ID: 6507293784 Enrollment ID: I20221010000847 |
| Provider Name | Kevin Schmitt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952780108 PECOS PAC ID: 2567709959 Enrollment ID: I20221020002631 |
| Provider Name | Derek Palmer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407290372 PECOS PAC ID: 2769788736 Enrollment ID: I20221110002375 |
| Provider Name | Brenton R Mccoy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821388901 PECOS PAC ID: 7214255082 Enrollment ID: I20221128002022 |
| Provider Name | Sushanta K Goswami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366548547 PECOS PAC ID: 1254229065 Enrollment ID: I20221205003115 |
| Provider Name | Katharine A Walz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1487048377 PECOS PAC ID: 2769795285 Enrollment ID: I20221207002066 |
| Provider Name | Maria Khristina A Vibal-poaster |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376046680 PECOS PAC ID: 8224386800 Enrollment ID: I20221207002325 |
| Provider Name | Dominic A Hovsepian |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154749588 PECOS PAC ID: 5991136160 Enrollment ID: I20221207002807 |
| Provider Name | Neelanjan Ray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942445861 PECOS PAC ID: 2961681309 Enrollment ID: I20221219000876 |
| Provider Name | Karen Lea Skjei |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710995220 PECOS PAC ID: 7719982115 Enrollment ID: I20221222000992 |
| Provider Name | Fuad-al Ali |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932581428 PECOS PAC ID: 7012224744 Enrollment ID: I20221222002621 |
| Provider Name | Steven J Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306160031 PECOS PAC ID: 1254649353 Enrollment ID: I20221228000781 |
| Provider Name | Rut Dinkar Dholakia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164633913 PECOS PAC ID: 3870789415 Enrollment ID: I20230106001201 |
| Provider Name | Michelle E Trowbridge |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548284359 PECOS PAC ID: 3678473493 Enrollment ID: I20230111000914 |
| Provider Name | Jingxin Wang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336501741 PECOS PAC ID: 7416336979 Enrollment ID: I20230111001327 |
| Provider Name | Lynsee Hudson Lang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699821371 PECOS PAC ID: 2062505639 Enrollment ID: I20230227000951 |
| Provider Name | Monika Mehrens |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205176617 PECOS PAC ID: 6406079110 Enrollment ID: I20230227001563 |
| Provider Name | Scott D Caganap |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962845073 PECOS PAC ID: 7315239548 Enrollment ID: I20230301001376 |
| Provider Name | Usha Aryal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073712287 PECOS PAC ID: 2163657362 Enrollment ID: I20230324001990 |
| Provider Name | Amy Nieberlein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982078549 PECOS PAC ID: 4587958707 Enrollment ID: I20230327001453 |
| Provider Name | Arifa Ali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1225598899 PECOS PAC ID: 8123359783 Enrollment ID: I20230417001943 |
| Provider Name | Rachael A Montgomery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912614868 PECOS PAC ID: 4486019262 Enrollment ID: I20230501000562 |
| Provider Name | Sonal O Bhatia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356605844 PECOS PAC ID: 3476862087 Enrollment ID: I20230508001314 |
| Provider Name | Amir Laktineh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407204027 PECOS PAC ID: 2062704265 Enrollment ID: I20230508002023 |
| Provider Name | Asil Naim Al-abed Daoud |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629424395 PECOS PAC ID: 2163849589 Enrollment ID: I20230511001493 |
| Provider Name | Saviour Kelechi Achilike |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033506688 PECOS PAC ID: 9032440433 Enrollment ID: I20230517003443 |
| Provider Name | Hamza N Salam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1104278605 PECOS PAC ID: 0446543706 Enrollment ID: I20230518000889 |
| Provider Name | Neelambuj Regmi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1033648365 PECOS PAC ID: 4789002106 Enrollment ID: I20230518000913 |
| Provider Name | Armina Omole |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275944316 PECOS PAC ID: 9537495684 Enrollment ID: I20230523000821 |
| Provider Name | Jessica Lynn Danison |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477874618 PECOS PAC ID: 2163640590 Enrollment ID: I20230523003343 |
| Provider Name | Laila Lobo |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1598108219 PECOS PAC ID: 0345611026 Enrollment ID: I20230612001306 |
| Provider Name | Raya M.f. Al Ghalayini |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255990735 PECOS PAC ID: 1951636950 Enrollment ID: I20230619001131 |
| Provider Name | Mason T Hinchcliff |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1548765407 PECOS PAC ID: 2769739077 Enrollment ID: I20230622003012 |
| Provider Name | Chris Arca |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275987216 PECOS PAC ID: 0840658845 Enrollment ID: I20230707002147 |
| Provider Name | Nathaniel L Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477174076 PECOS PAC ID: 7012339765 Enrollment ID: I20230714002269 |
| Provider Name | Shahzana Shahzad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053932194 PECOS PAC ID: 6406277698 Enrollment ID: I20230726000555 |
| Provider Name | Karen Schaaf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295704484 PECOS PAC ID: 8628099561 Enrollment ID: I20230804000435 |
| Provider Name | Danielle M Jacks |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1730597147 PECOS PAC ID: 4587951827 Enrollment ID: I20230811001814 |
| Provider Name | John Carlos Brockington |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548200777 PECOS PAC ID: 8022104272 Enrollment ID: I20230914003281 |
| Provider Name | Mark A Lynch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770938003 PECOS PAC ID: 7618268533 Enrollment ID: I20231003001632 |
| Provider Name | Jamal Farooq Khattak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144648429 PECOS PAC ID: 7214242643 Enrollment ID: I20231017001715 |
| Provider Name | Sanjib D Shrestha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285715938 PECOS PAC ID: 6709989494 Enrollment ID: I20231017003250 |
| Provider Name | Meyeon Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649566316 PECOS PAC ID: 0547493603 Enrollment ID: I20231026003948 |
| Provider Name | Vanessa Sui |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558821975 PECOS PAC ID: 1052653391 Enrollment ID: I20231030003591 |
| Provider Name | Mohammed Adegbite |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265127864 PECOS PAC ID: 8123474723 Enrollment ID: I20231101003033 |
| Provider Name | Thomas C Pitts |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750624656 PECOS PAC ID: 9133357775 Enrollment ID: I20231106003127 |
| Provider Name | Jennifer A Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942081054 PECOS PAC ID: 0143677971 Enrollment ID: I20231115002599 |
| Provider Name | Rylee C Stahla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447030234 PECOS PAC ID: 3072962570 Enrollment ID: I20231208002906 |
| Provider Name | Nicole D Parrotta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407231590 PECOS PAC ID: 1850635145 Enrollment ID: I20240102001400 |
| Provider Name | Benjamin Ray Merbler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134748114 PECOS PAC ID: 9133511611 Enrollment ID: I20240105003863 |
| Provider Name | Veronica D Burke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699550244 PECOS PAC ID: 2961854088 Enrollment ID: I20240113000832 |
| Provider Name | Saher Suleman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851747935 PECOS PAC ID: 6507235629 Enrollment ID: I20240118003905 |
| Provider Name | Robert P Boyle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346557550 PECOS PAC ID: 4789086513 Enrollment ID: I20240426003059 |
| Provider Name | Julia K Kostka |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1295398782 PECOS PAC ID: 0042650483 Enrollment ID: I20240501003817 |
| Provider Name | Brittany Leigh Tabler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679830566 PECOS PAC ID: 8628343043 Enrollment ID: I20240510003011 |
| Provider Name | Jorge Aldo A Barajas Ochoa |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1619463601 PECOS PAC ID: 6002290285 Enrollment ID: I20240514001816 |
| Provider Name | Tyler Richard Scott |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366897365 PECOS PAC ID: 4082902697 Enrollment ID: I20240524003479 |
Ups Medford (cdrc - Expansion) Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2825 E Barnett Rd, Medford, OR 97504 Phone: 503-494-9000 | |
Rogue Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 E Main St, Medford, OR 97504 Phone: 541-842-7705 Fax: 541-842-7640 | |
Columbiacare Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3200 Juanipero Way, Medford, OR 97504 Phone: 541-858-8170 Fax: 541-858-8167 | |
Pmg Medford Physiatry Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 920 Royal Ave, Medford, OR 97504 Phone: 541-732-8400 Fax: 541-732-8401 | |
Pmg South Heart Rhythm Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504 Phone: 541-732-7850 Fax: 541-732-7851 | |
Complete Integrative Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3156 State St, Medford, OR 97504 Phone: 541-773-5772 Fax: 541-773-1113 | |
La Clinica Acute Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 638 Market St, Medford, OR 97504 Phone: 541-494-3840 Fax: 541-494-1789 |