| Aspirus Gilman Clinic | |
|
320 East Main Gilman WI 54433 | |
| (715) 447-8293 | |
| (715) 447-8270 |
| Full Name | Aspirus Gilman Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 320 East Main, Gilman, Wisconsin |
| Authorized Official Name and Position | Jerry M Yang (SVP & CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 7158472526 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspirus Gilman Clinic 135 S Gibson St Medford WI 54451-1622 Ph: (715) 748-8100 | Aspirus Gilman Clinic 320 East Main Gilman WI 54433 Ph: (715) 447-8293 |
| NPI Number | 1285703173 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 06/10/2024 |
| Medicare PECOS PAC ID | 5799688602 |
|---|---|
| Medicare Enrollment ID | O20040129000007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285703173 | NPI | - | NPPES |
| 21303800 | Medicaid | WI |
| Provider Name | Diane M Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801875364 PECOS PAC ID: 9739087024 Enrollment ID: I20031223000559 |
| Provider Name | Michelle M Roiger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295762896 PECOS PAC ID: 4486555869 Enrollment ID: I20040119000188 |
| Provider Name | Janice H Alexander |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851363592 PECOS PAC ID: 8224931951 Enrollment ID: I20040130000019 |
| Provider Name | Steven B Mccann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1932165636 PECOS PAC ID: 9537153382 Enrollment ID: I20040417000245 |
| Provider Name | Susan J Frazier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184606469 PECOS PAC ID: 9032106232 Enrollment ID: I20040518000864 |
| Provider Name | Christopher L Younker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528001716 PECOS PAC ID: 5092706168 Enrollment ID: I20040519000620 |
| Provider Name | Scott J Rotar |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376586099 PECOS PAC ID: 2365433364 Enrollment ID: I20040519000877 |
| Provider Name | Gene E Walker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1740207349 PECOS PAC ID: 9234121120 Enrollment ID: I20040525000556 |
| Provider Name | Kevin R Krueger |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568403806 PECOS PAC ID: 6507847035 Enrollment ID: I20040528000946 |
| Provider Name | Richard J Mayrer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023047859 PECOS PAC ID: 7810977717 Enrollment ID: I20040721001565 |
| Provider Name | Pavel Guigauri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801874094 PECOS PAC ID: 5496729683 Enrollment ID: I20040824000133 |
| Provider Name | Cary G Tauchman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891800389 PECOS PAC ID: 7719954197 Enrollment ID: I20040915000028 |
| Provider Name | Mary Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487662060 PECOS PAC ID: 1052210762 Enrollment ID: I20040927000962 |
| Provider Name | Ellyn M Meshel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205875242 PECOS PAC ID: 9335114024 Enrollment ID: I20041008000009 |
| Provider Name | David D Vanderkin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962407197 PECOS PAC ID: 3779486030 Enrollment ID: I20050106000937 |
| Provider Name | Renee M Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750310900 PECOS PAC ID: 9537117296 Enrollment ID: I20050110000337 |
| Provider Name | German Larrain |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1508845090 PECOS PAC ID: 9638129588 Enrollment ID: I20050127000832 |
| Provider Name | Steven A Hadlock |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497842157 PECOS PAC ID: 8325098056 Enrollment ID: I20050131000092 |
| Provider Name | David J Sell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902833700 PECOS PAC ID: 9931154515 Enrollment ID: I20050316000709 |
| Provider Name | Thomas R Silbernagel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922097351 PECOS PAC ID: 8426098997 Enrollment ID: I20050504000992 |
| Provider Name | Rebecca Reim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043211766 PECOS PAC ID: 2668416744 Enrollment ID: I20050620000605 |
| Provider Name | Mark T Hoffmann |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1356342034 PECOS PAC ID: 8527966803 Enrollment ID: I20050706000135 |
| Provider Name | Timothy N Logemann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184626053 PECOS PAC ID: 2163320441 Enrollment ID: I20050706000159 |
| Provider Name | Paul A Luetmer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689675332 PECOS PAC ID: 9133027410 Enrollment ID: I20050706000179 |
| Provider Name | David K Murdock |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942200910 PECOS PAC ID: 5991603276 Enrollment ID: I20050706000195 |
| Provider Name | Christopher Gary Peterson |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1700897535 PECOS PAC ID: 8820024474 Enrollment ID: I20050714000500 |
| Provider Name | Troy D Sennholz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861410110 PECOS PAC ID: 5395773030 Enrollment ID: I20050803000054 |
| Provider Name | Odessa M Gallett |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1245241272 PECOS PAC ID: 3870522253 Enrollment ID: I20050805000443 |
| Provider Name | Susan O Messerly |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447261706 PECOS PAC ID: 9931139771 Enrollment ID: I20050822000214 |
| Provider Name | Jessica M Engel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114037793 PECOS PAC ID: 6204868086 Enrollment ID: I20050831000858 |
| Provider Name | Eunice Corujo Incha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255371837 PECOS PAC ID: 9931125994 Enrollment ID: I20051019000215 |
| Provider Name | Heidi J Pendleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376584847 PECOS PAC ID: 6507882362 Enrollment ID: I20051020000672 |
| Provider Name | David E Lange |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255449567 PECOS PAC ID: 6608895909 Enrollment ID: I20051116000340 |
| Provider Name | Marjorie S Miller |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1487687604 PECOS PAC ID: 3577583418 Enrollment ID: I20051207000376 |
| Provider Name | Haresh B Modi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780699660 PECOS PAC ID: 3870497480 Enrollment ID: I20060111000418 |
| Provider Name | Bradley J Schwager |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265497598 PECOS PAC ID: 1951315761 Enrollment ID: I20060201000194 |
| Provider Name | Ronald J Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396799615 PECOS PAC ID: 8022026392 Enrollment ID: I20060328000534 |
| Provider Name | Michelle L Douglas |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730113424 PECOS PAC ID: 5193720845 Enrollment ID: I20061002000300 |
| Provider Name | Sarah Ann Sewall |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1447215736 PECOS PAC ID: 1153328166 Enrollment ID: I20061106000338 |
| Provider Name | Linda R Frahm |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104881317 PECOS PAC ID: 3779582986 Enrollment ID: I20061218000243 |
| Provider Name | John A Culp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497792139 PECOS PAC ID: 9931108081 Enrollment ID: I20061219000068 |
| Provider Name | Rebecca L England |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457360869 PECOS PAC ID: 7214035500 Enrollment ID: I20070611000307 |
| Provider Name | Gregory C Tyler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871695452 PECOS PAC ID: 3971603176 Enrollment ID: I20070717000010 |
| Provider Name | Joshua L Luce |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1780600668 PECOS PAC ID: 8022063346 Enrollment ID: I20070807000353 |
| Provider Name | Robyn A Schertz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043410673 PECOS PAC ID: 4688767023 Enrollment ID: I20070830000630 |
| Provider Name | Peter Scott Dahlberg |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1750318218 PECOS PAC ID: 4880789205 Enrollment ID: I20071001000383 |
| Provider Name | Peter M Mccool |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306044847 PECOS PAC ID: 3274620133 Enrollment ID: I20071025000076 |
| Provider Name | Jeffrey M Vanbendegom |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477544427 PECOS PAC ID: 9436248002 Enrollment ID: I20071204000806 |
| Provider Name | Michael A Umland |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518920578 PECOS PAC ID: 2062593023 Enrollment ID: I20080115000827 |
| Provider Name | Mitchell L Lewis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912956137 PECOS PAC ID: 3870686462 Enrollment ID: I20080222000358 |
| Provider Name | Linda I Murphy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346394640 PECOS PAC ID: 3971688060 Enrollment ID: I20080313000472 |
| Provider Name | Sean M Cashin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558564203 PECOS PAC ID: 2961588595 Enrollment ID: I20080324000607 |
| Provider Name | Bradley J Boettcher |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295906675 PECOS PAC ID: 9830269588 Enrollment ID: I20080606000187 |
| Provider Name | Steven John Gasper |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043238405 PECOS PAC ID: 3870667785 Enrollment ID: I20080811000108 |
| Provider Name | Ludmil Lazarov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285826404 PECOS PAC ID: 1254407729 Enrollment ID: I20080906000160 |
| Provider Name | Thomas W Tully |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851369664 PECOS PAC ID: 6709847874 Enrollment ID: I20080919000462 |
| Provider Name | Reed J Davis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720259112 PECOS PAC ID: 5193892446 Enrollment ID: I20080929000204 |
| Provider Name | Vickie J Woelfel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144337999 PECOS PAC ID: 6103985460 Enrollment ID: I20081101000119 |
| Provider Name | James E Dunn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962446351 PECOS PAC ID: 4284653965 Enrollment ID: I20081202000561 |
| Provider Name | Angelene K Timmerman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265475966 PECOS PAC ID: 9032275151 Enrollment ID: I20090225000489 |
| Provider Name | Robert K Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437119781 PECOS PAC ID: 8022192178 Enrollment ID: I20090306000344 |
| Provider Name | Michael P Bellino |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780670950 PECOS PAC ID: 1153224431 Enrollment ID: I20090602000566 |
| Provider Name | Christian Zuver |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194843367 PECOS PAC ID: 5890887830 Enrollment ID: I20090624000126 |
| Provider Name | Brad Robert Rogowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932365947 PECOS PAC ID: 9032272141 Enrollment ID: I20090707000681 |
| Provider Name | Sandip Ghuge |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770727083 PECOS PAC ID: 9537211362 Enrollment ID: I20090709000030 |
| Provider Name | Philip M Bovet |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912118308 PECOS PAC ID: 7810040532 Enrollment ID: I20090728000814 |
| Provider Name | Clint Grant Semrau |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346465739 PECOS PAC ID: 1254484835 Enrollment ID: I20090729000504 |
| Provider Name | Jennifer A Mikulich |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1831128669 PECOS PAC ID: 2163575283 Enrollment ID: I20090806000244 |
| Provider Name | Andrew J Weddle |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1831395888 PECOS PAC ID: 8921159708 Enrollment ID: I20090921000599 |
| Provider Name | Pamela S Rahmer |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1134350754 PECOS PAC ID: 3375689839 Enrollment ID: I20091014000213 |
| Provider Name | Michael D Repplinger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154521425 PECOS PAC ID: 5294872693 Enrollment ID: I20091016000136 |
| Provider Name | Michael D Polka |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1144242223 PECOS PAC ID: 3072654425 Enrollment ID: I20100106000782 |
| Provider Name | Thomas A Koepke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912068982 PECOS PAC ID: 6901794817 Enrollment ID: I20100202000500 |
| Provider Name | Sarah L Walder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912234881 PECOS PAC ID: 5799828505 Enrollment ID: I20100202000557 |
| Provider Name | Steven D Nichols |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518991199 PECOS PAC ID: 9830234897 Enrollment ID: I20100303000081 |
| Provider Name | Katharine D Van Fossen |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1356316483 PECOS PAC ID: 5698854180 Enrollment ID: I20100421000892 |
| Provider Name | Jonathan T Ketzler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275509754 PECOS PAC ID: 3375672397 Enrollment ID: I20100528000524 |
| Provider Name | James E Svenson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700847183 PECOS PAC ID: 5698805455 Enrollment ID: I20100604001133 |
| Provider Name | Matthew P Doering |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255439543 PECOS PAC ID: 9234269481 Enrollment ID: I20100614000875 |
| Provider Name | Susan M Schneider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447264098 PECOS PAC ID: 3577644970 Enrollment ID: I20100618000833 |
| Provider Name | Michael C Walters |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1063473973 PECOS PAC ID: 1456482017 Enrollment ID: I20100625000120 |
| Provider Name | Mary M Schultz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265414676 PECOS PAC ID: 6305977430 Enrollment ID: I20100706000347 |
| Provider Name | Ngozi Jacqueline Ekwueme |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548271984 PECOS PAC ID: 6800928201 Enrollment ID: I20100721000282 |
| Provider Name | Kevin E Rist |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1497734750 PECOS PAC ID: 7618864075 Enrollment ID: I20100724000181 |
| Provider Name | Fushen Xu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1376513036 PECOS PAC ID: 6608873617 Enrollment ID: I20100914001138 |
| Provider Name | Tracy L Cousins |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1679543383 PECOS PAC ID: 7517964521 Enrollment ID: I20100916000531 |
| Provider Name | Laura M Sova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891707881 PECOS PAC ID: 2860517331 Enrollment ID: I20100921000804 |
| Provider Name | Dennis Mcfadden |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184758237 PECOS PAC ID: 2961580717 Enrollment ID: I20101004000991 |
| Provider Name | Andrew Mykytsey |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1750547378 PECOS PAC ID: 0648465310 Enrollment ID: I20101109000220 |
| Provider Name | Jonathan Parisi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659455970 PECOS PAC ID: 3971790981 Enrollment ID: I20101202001153 |
| Provider Name | Scott L Gradberg |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528152287 PECOS PAC ID: 0345439410 Enrollment ID: I20110105001189 |
| Provider Name | Sammy U Rehman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558372706 PECOS PAC ID: 7315904661 Enrollment ID: I20110112000028 |
| Provider Name | James Kraatz |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336186071 PECOS PAC ID: 1052215795 Enrollment ID: I20110513000377 |
| Provider Name | John P Jarocki |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972525368 PECOS PAC ID: 7315078623 Enrollment ID: I20110526000790 |
| Provider Name | Ganesh L Pawar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568623999 PECOS PAC ID: 0042406753 Enrollment ID: I20110623000696 |
| Provider Name | Debra J Zenner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891081113 PECOS PAC ID: 4284803966 Enrollment ID: I20110815000473 |
| Provider Name | Steven P Phillipson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023034105 PECOS PAC ID: 0345141313 Enrollment ID: I20110923000055 |
| Provider Name | Michael E Traktman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1356325740 PECOS PAC ID: 6406820513 Enrollment ID: I20111004000296 |
| Provider Name | Nikki A Bonitz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396026266 PECOS PAC ID: 2567634199 Enrollment ID: I20111004000353 |
| Provider Name | Jean E Erdman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922388925 PECOS PAC ID: 3173795515 Enrollment ID: I20111007000460 |
| Provider Name | Amber N Petersen-kuemmel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598042285 PECOS PAC ID: 8729247861 Enrollment ID: I20120309000372 |
| Provider Name | Vimarsh Raina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508177841 PECOS PAC ID: 9537315064 Enrollment ID: I20120815000587 |
| Provider Name | Niaz M Haque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871783407 PECOS PAC ID: 9234271107 Enrollment ID: I20120917000455 |
| Provider Name | Glenda K Way |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437404811 PECOS PAC ID: 7012165780 Enrollment ID: I20120921000404 |
| Provider Name | Michael T Landis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558624908 PECOS PAC ID: 2668621731 Enrollment ID: I20121004000573 |
| Provider Name | Premraj Makkuni |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730395740 PECOS PAC ID: 5092857532 Enrollment ID: I20121004000837 |
| Provider Name | Timothy E Wasano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982959391 PECOS PAC ID: 1658356175 Enrollment ID: I20121012000317 |
| Provider Name | Thomas D Boostrom |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164773685 PECOS PAC ID: 7810147931 Enrollment ID: I20121026000450 |
| Provider Name | Sarah J Staff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881944858 PECOS PAC ID: 0345492724 Enrollment ID: I20121228000191 |
| Provider Name | Jodi L Space |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518217280 PECOS PAC ID: 3971758962 Enrollment ID: I20130222000413 |
| Provider Name | Rebecca A Mielke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588900609 PECOS PAC ID: 3678719945 Enrollment ID: I20130412000063 |
| Provider Name | Michael J Olson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891062592 PECOS PAC ID: 0941466585 Enrollment ID: I20130806000324 |
| Provider Name | Kelly J Witt-erickson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801106265 PECOS PAC ID: 5496999526 Enrollment ID: I20130911000554 |
| Provider Name | Stacie M Valukas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477995876 PECOS PAC ID: 6103060595 Enrollment ID: I20130925000696 |
| Provider Name | Douglas R Brown |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1992784904 PECOS PAC ID: 5597866863 Enrollment ID: I20131009000266 |
| Provider Name | Liova E Rivera-garcia |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790712610 PECOS PAC ID: 2062420318 Enrollment ID: I20131009000994 |
| Provider Name | Adam G Clements |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033477997 PECOS PAC ID: 0749419778 Enrollment ID: I20140214000951 |
| Provider Name | Tahnee R Siewert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013265966 PECOS PAC ID: 2264670124 Enrollment ID: I20140507001308 |
| Provider Name | Samantha J Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225457526 PECOS PAC ID: 3173746047 Enrollment ID: I20140521001749 |
| Provider Name | Erin C Harrington |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194129353 PECOS PAC ID: 4486876349 Enrollment ID: I20141107001369 |
| Provider Name | Kaitlin A Eichman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174878631 PECOS PAC ID: 6103142419 Enrollment ID: I20150304001406 |
| Provider Name | Kelly M Orysen |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1497937957 PECOS PAC ID: 1456679794 Enrollment ID: I20150416000547 |
| Provider Name | Nicole K Rice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831582436 PECOS PAC ID: 3476872896 Enrollment ID: I20150507000572 |
| Provider Name | Kyle Dembowiak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235499815 PECOS PAC ID: 7517271539 Enrollment ID: I20150805006698 |
| Provider Name | Keith J Bratulich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750646295 PECOS PAC ID: 9133372436 Enrollment ID: I20150807014727 |
| Provider Name | Sharon M Kaplon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639555311 PECOS PAC ID: 6103132147 Enrollment ID: I20150904001521 |
| Provider Name | Craig D Destree |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154732063 PECOS PAC ID: 2062722895 Enrollment ID: I20151106002246 |
| Provider Name | Henry K Bong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831213438 PECOS PAC ID: 7517140353 Enrollment ID: I20160114001157 |
| Provider Name | Herbert C Hoover |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1386683613 PECOS PAC ID: 0648262790 Enrollment ID: I20160203002363 |
| Provider Name | Stacie R Leahy |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1750748646 PECOS PAC ID: 2365746427 Enrollment ID: I20160210000713 |
| Provider Name | Jason D Randall |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235550955 PECOS PAC ID: 2466760095 Enrollment ID: I20160211000035 |
| Provider Name | Derek Hoyme |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245469808 PECOS PAC ID: 2062657372 Enrollment ID: I20160808002817 |
| Provider Name | Margaret Mary Greco |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1760686414 PECOS PAC ID: 9739251703 Enrollment ID: I20160817003183 |
| Provider Name | Catherine Cooch Allen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1265673164 PECOS PAC ID: 5991090110 Enrollment ID: I20160825002781 |
| Provider Name | Michael A Ward |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316279433 PECOS PAC ID: 5294901526 Enrollment ID: I20170706000889 |
| Provider Name | Michael J Kuklinski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821383407 PECOS PAC ID: 1850520289 Enrollment ID: I20170706001162 |
| Provider Name | Efe M Akpoigbe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1023365152 PECOS PAC ID: 9032334891 Enrollment ID: I20170719003840 |
| Provider Name | Chikako Ono |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1699903526 PECOS PAC ID: 9335389188 Enrollment ID: I20170725002777 |
| Provider Name | Jappan J Bhatt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669594115 PECOS PAC ID: 2567562952 Enrollment ID: I20171026001437 |
| Provider Name | Pamela Lowry Burr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639227978 PECOS PAC ID: 0648369173 Enrollment ID: I20171120002450 |
| Provider Name | Amanada J Gaccetta |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417219197 PECOS PAC ID: 8426311721 Enrollment ID: I20180419002269 |
| Provider Name | Dawne D Suehring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255399291 PECOS PAC ID: 1456523885 Enrollment ID: I20180613000149 |
| Provider Name | Benjamin J Graboyes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720424807 PECOS PAC ID: 2264723519 Enrollment ID: I20180615000361 |
| Provider Name | Bret K Stysly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104188416 PECOS PAC ID: 8224344544 Enrollment ID: I20180702002370 |
| Provider Name | Kimberly Hatch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619484532 PECOS PAC ID: 3870840754 Enrollment ID: I20180724001367 |
| Provider Name | Ronnie Orlando Ortiz |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1245474410 PECOS PAC ID: 8426195900 Enrollment ID: I20180724003178 |
| Provider Name | Ahmed Mohammed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407231178 PECOS PAC ID: 1557619913 Enrollment ID: I20180801004049 |
| Provider Name | Carli M Winter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114418662 PECOS PAC ID: 2163770017 Enrollment ID: I20180808003424 |
| Provider Name | Katie E Vangoethem |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760962393 PECOS PAC ID: 7012267958 Enrollment ID: I20180913002198 |
| Provider Name | Mary B Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356824098 PECOS PAC ID: 2163774910 Enrollment ID: I20181008000074 |
| Provider Name | Tammy G Buchanan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487627022 PECOS PAC ID: 9335108463 Enrollment ID: I20190104000721 |
| Provider Name | Kay Johnson-keys |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043247190 PECOS PAC ID: 4587621271 Enrollment ID: I20190312000165 |
| Provider Name | Richard C Prokesch |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1427064583 PECOS PAC ID: 2668411570 Enrollment ID: I20190319000054 |
| Provider Name | Lisa M Werner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609340561 PECOS PAC ID: 6709127335 Enrollment ID: I20190409002427 |
| Provider Name | Shirin Sultana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053610691 PECOS PAC ID: 7416266846 Enrollment ID: I20190423001599 |
| Provider Name | Kerry A Lingen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942766407 PECOS PAC ID: 3971845645 Enrollment ID: I20190429001686 |
| Provider Name | Francis Kwarteng |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851551923 PECOS PAC ID: 1052470705 Enrollment ID: I20190510000143 |
| Provider Name | Christine M Baker |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508350521 PECOS PAC ID: 4688907710 Enrollment ID: I20190605000740 |
| Provider Name | Choua Thao |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053653576 PECOS PAC ID: 6901128081 Enrollment ID: I20190607000155 |
| Provider Name | David A Kloss |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1003842915 PECOS PAC ID: 6002009065 Enrollment ID: I20190617001015 |
| Provider Name | Lynnette M. Valentijn |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275524175 PECOS PAC ID: 6406088954 Enrollment ID: I20190626000532 |
| Provider Name | Jamie Lynn Schneider |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801240858 PECOS PAC ID: 3072877364 Enrollment ID: I20190711002059 |
| Provider Name | Hilary E Faust |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1669764817 PECOS PAC ID: 5698044816 Enrollment ID: I20190723001486 |
| Provider Name | Elizabeth Wood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396128930 PECOS PAC ID: 2769799881 Enrollment ID: I20190801001953 |
| Provider Name | Bryan Austin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316997943 PECOS PAC ID: 3678511326 Enrollment ID: I20190819002635 |
| Provider Name | Dorene Zerfas |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427299973 PECOS PAC ID: 1759519549 Enrollment ID: I20190909002185 |
| Provider Name | Grethe June Mortenson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205183415 PECOS PAC ID: 7315196920 Enrollment ID: I20190920000072 |
| Provider Name | Kayla J Palmeter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841841244 PECOS PAC ID: 0547592305 Enrollment ID: I20191028001376 |
| Provider Name | Heidi L Hodgins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497092225 PECOS PAC ID: 6507001963 Enrollment ID: I20191105000833 |
| Provider Name | Ricardo De Leon |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639402795 PECOS PAC ID: 3779734934 Enrollment ID: I20191212001041 |
| Provider Name | Nathan D Mcparlan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1073656955 PECOS PAC ID: 3173680089 Enrollment ID: I20200207000002 |
| Provider Name | James Matthew Tracey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1598102527 PECOS PAC ID: 9638487804 Enrollment ID: I20200213000878 |
| Provider Name | Hilary K Eggen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790291300 PECOS PAC ID: 1153680863 Enrollment ID: I20200218001016 |
| Provider Name | Thomas C Howard |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1932369584 PECOS PAC ID: 0749583706 Enrollment ID: I20200610001054 |
| Provider Name | Justin Teresinski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134615131 PECOS PAC ID: 1153679048 Enrollment ID: I20200618000908 |
| Provider Name | Amy Jeanne Defranco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962045393 PECOS PAC ID: 2466697842 Enrollment ID: I20200713000588 |
| Provider Name | Johonna Asquith |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1730447400 PECOS PAC ID: 5395986848 Enrollment ID: I20200720000195 |
| Provider Name | Colleen E Lane |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1659717312 PECOS PAC ID: 3779722251 Enrollment ID: I20200814002130 |
| Provider Name | Thomas E Mckenzie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629050448 PECOS PAC ID: 5597756841 Enrollment ID: I20200817002245 |
| Provider Name | Lukman Lawal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1669824074 PECOS PAC ID: 7810225414 Enrollment ID: I20200818003433 |
| Provider Name | Syed M Imam |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699202408 PECOS PAC ID: 8527339514 Enrollment ID: I20200917001379 |
| Provider Name | Justin Asquith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699031138 PECOS PAC ID: 1052603636 Enrollment ID: I20200925001250 |
| Provider Name | Myrna Mitchell |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1477938884 PECOS PAC ID: 2264851906 Enrollment ID: I20200930001986 |
| Provider Name | Jahoon Koo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629554209 PECOS PAC ID: 1355692922 Enrollment ID: I20201028000989 |
| Provider Name | Jeffrey A Morgan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1043436132 PECOS PAC ID: 8921108366 Enrollment ID: I20201111001127 |
| Provider Name | Angela E Colby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174139869 PECOS PAC ID: 1759791247 Enrollment ID: I20201112001581 |
| Provider Name | Waleed Mansour |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043628589 PECOS PAC ID: 1557661980 Enrollment ID: I20201210002640 |
| Provider Name | Bradley Richard Brossard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457968687 PECOS PAC ID: 3577977057 Enrollment ID: I20210125000293 |
| Provider Name | Leah Becicka |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1396790390 PECOS PAC ID: 2466519715 Enrollment ID: I20210126001513 |
| Provider Name | Nancy A Rihana |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1982835237 PECOS PAC ID: 5294954699 Enrollment ID: I20210201000594 |
| Provider Name | Carl H Zondlo |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215549852 PECOS PAC ID: 1052725066 Enrollment ID: I20210203001663 |
| Provider Name | Deanna Lynn Strama |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174617765 PECOS PAC ID: 3072912831 Enrollment ID: I20210527000433 |
| Provider Name | Srikar Karanam |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588034227 PECOS PAC ID: 5092074302 Enrollment ID: I20210615003299 |
| Provider Name | Heidi Warmbold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285886531 PECOS PAC ID: 8921167214 Enrollment ID: I20210618001932 |
| Provider Name | Ryan Check |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366947269 PECOS PAC ID: 2264783216 Enrollment ID: I20210810002979 |
| Provider Name | Angelica T Hon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144892464 PECOS PAC ID: 5799189742 Enrollment ID: I20210812001983 |
| Provider Name | Tom T Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922389048 PECOS PAC ID: 0941578736 Enrollment ID: I20210813001496 |
| Provider Name | Emmanuel Trigenis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225011844 PECOS PAC ID: 7719074319 Enrollment ID: I20210831002964 |
| Provider Name | Nathan John Walters |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730281312 PECOS PAC ID: 1254366933 Enrollment ID: I20211007003223 |
| Provider Name | Maxwell Henricks |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1578927547 PECOS PAC ID: 0941547301 Enrollment ID: I20211109003207 |
| Provider Name | Jennifer Gayle Polacek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508535360 PECOS PAC ID: 0941699938 Enrollment ID: I20211112001264 |
| Provider Name | Fernando Escobar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548265994 PECOS PAC ID: 0648294884 Enrollment ID: I20220119001339 |
| Provider Name | Aarti Attreya-latuso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538514799 PECOS PAC ID: 9234422361 Enrollment ID: I20220406000856 |
| Provider Name | Karim Robert Saleeby |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710322110 PECOS PAC ID: 7517264732 Enrollment ID: I20220407000495 |
| Provider Name | Ashley Kleutsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932860244 PECOS PAC ID: 6103203450 Enrollment ID: I20220506001780 |
| Provider Name | Elizabeth G Mathews |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124084306 PECOS PAC ID: 6800849258 Enrollment ID: I20220512000939 |
| Provider Name | Stuart Babcock |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366463689 PECOS PAC ID: 4880756790 Enrollment ID: I20220519002656 |
| Provider Name | Sonny Park |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720071277 PECOS PAC ID: 2264443233 Enrollment ID: I20220621001207 |
| Provider Name | Korby J Wipf |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1225128010 PECOS PAC ID: 5991185233 Enrollment ID: I20220705002568 |
| Provider Name | Kimberly L Anderson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053549873 PECOS PAC ID: 5294889853 Enrollment ID: I20220711003221 |
| Provider Name | Edward Mckenna |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164884433 PECOS PAC ID: 6406111764 Enrollment ID: I20220809003475 |
| Provider Name | Chimkama Ibe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366606337 PECOS PAC ID: 1456525914 Enrollment ID: I20220909002742 |
| Provider Name | Haley Erl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770067357 PECOS PAC ID: 9234514829 Enrollment ID: I20220919000636 |
| Provider Name | Kehinde Idowu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063806982 PECOS PAC ID: 1153695887 Enrollment ID: I20221005001133 |
| Provider Name | Monica Cespedes Santana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114204161 PECOS PAC ID: 7214212653 Enrollment ID: I20221008000304 |
| Provider Name | Kelsey E Gelhaus |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235559659 PECOS PAC ID: 3476858804 Enrollment ID: I20221011001027 |
| Provider Name | Elias G Issa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053305888 PECOS PAC ID: 6002840584 Enrollment ID: I20221019001722 |
| Provider Name | Amy Jo Schmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912621822 PECOS PAC ID: 9931576337 Enrollment ID: I20221027001194 |
| Provider Name | Sherif Latif |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518167188 PECOS PAC ID: 9830221233 Enrollment ID: I20221031003119 |
| Provider Name | Carole Vincent |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497731038 PECOS PAC ID: 9830131994 Enrollment ID: I20221103000709 |
| Provider Name | Omar M El-sheikh |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760681225 PECOS PAC ID: 6901030097 Enrollment ID: I20221104002088 |
| Provider Name | Erin Meyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922265305 PECOS PAC ID: 0143396184 Enrollment ID: I20221108001327 |
| Provider Name | Jordan Abel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1417273301 PECOS PAC ID: 4789806522 Enrollment ID: I20221111000425 |
| Provider Name | Katie Seybold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629793948 PECOS PAC ID: 5698143345 Enrollment ID: I20221130001676 |
| Provider Name | Mitchell T Meagher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932621307 PECOS PAC ID: 2668842014 Enrollment ID: I20221230000838 |
| Provider Name | David Slobodkin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194795591 PECOS PAC ID: 3678545928 Enrollment ID: I20230104003063 |
| Provider Name | Robert Shafor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1528042702 PECOS PAC ID: 2264330117 Enrollment ID: I20230105001844 |
| Provider Name | Sridevi Manginani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609156975 PECOS PAC ID: 0648444646 Enrollment ID: I20230130001608 |
| Provider Name | Nicole Marie Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487363594 PECOS PAC ID: 3072985241 Enrollment ID: I20230216001304 |
| Provider Name | Ravindran Arcot Padmanabhan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730114943 PECOS PAC ID: 5799727616 Enrollment ID: I20230302001458 |
| Provider Name | Parth Bhavsar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104323203 PECOS PAC ID: 4789932518 Enrollment ID: I20230308001567 |
| Provider Name | Sarah Siekert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831802958 PECOS PAC ID: 0648643809 Enrollment ID: I20230309000095 |
| Provider Name | Makayla Lisa Meyer-moser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023727278 PECOS PAC ID: 3678947538 Enrollment ID: I20230316002079 |
| Provider Name | Katherine Vosburg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326332040 PECOS PAC ID: 1850517269 Enrollment ID: I20230322001154 |
| Provider Name | Taylor Jean Ewert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265141378 PECOS PAC ID: 0941674352 Enrollment ID: I20230327002348 |
| Provider Name | Andrea Caballero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003173824 PECOS PAC ID: 3274841770 Enrollment ID: I20230428001880 |
| Provider Name | Elizabeth O Wendt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821784067 PECOS PAC ID: 3870959513 Enrollment ID: I20230522003253 |
| Provider Name | Christopher L Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629028782 PECOS PAC ID: 6901790252 Enrollment ID: I20230524003086 |
| Provider Name | Patrick H Archie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982895835 PECOS PAC ID: 0749355543 Enrollment ID: I20230602000332 |
| Provider Name | Tian Xia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437357423 PECOS PAC ID: 2961681713 Enrollment ID: I20230602002603 |
| Provider Name | Thomas Oliver |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083069470 PECOS PAC ID: 9739477324 Enrollment ID: I20230711001880 |
| Provider Name | Richard Belt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275064263 PECOS PAC ID: 1850643115 Enrollment ID: I20230731000081 |
| Provider Name | Sophia Kim Marie Pernsteiner |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1184301129 PECOS PAC ID: 7911369277 Enrollment ID: I20230817003290 |
| Provider Name | Tatyana Bombard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255629861 PECOS PAC ID: 0941595748 Enrollment ID: I20230911001645 |
| Provider Name | Katy Lynn Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295412815 PECOS PAC ID: 8527412295 Enrollment ID: I20230928002772 |
| Provider Name | Joshua C Dilday |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033591185 PECOS PAC ID: 6709230477 Enrollment ID: I20230928002810 |
| Provider Name | Meghan C Hughes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346869476 PECOS PAC ID: 7214354968 Enrollment ID: I20231102002230 |
| Provider Name | Rachel L Rindt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912680588 PECOS PAC ID: 8426405556 Enrollment ID: I20231113000191 |
| Provider Name | Thomas Anthony Licata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427638659 PECOS PAC ID: 8123475258 Enrollment ID: I20231113000321 |
| Provider Name | Ayden D Zarkhah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487159091 PECOS PAC ID: 8022492982 Enrollment ID: I20231113001576 |
| Provider Name | Madeline Jean Oestreich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508489170 PECOS PAC ID: 2961850839 Enrollment ID: I20231204000709 |
| Provider Name | Richard Satterthwaite |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1346616901 PECOS PAC ID: 2062863665 Enrollment ID: I20240108005990 |
| Provider Name | Brooke Elizabeth Kottke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104695246 PECOS PAC ID: 8820440365 Enrollment ID: I20240119002110 |
| Provider Name | Alison A Cowan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386955417 PECOS PAC ID: 5395963623 Enrollment ID: I20240125000277 |
| Provider Name | Elizabeth A Edinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548034408 PECOS PAC ID: 1254776925 Enrollment ID: I20240304003456 |
| Provider Name | Prunetta O Brunson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538662556 PECOS PAC ID: 8820353071 Enrollment ID: I20240314000164 |
| Provider Name | Michael Borgen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659039238 PECOS PAC ID: 8921487778 Enrollment ID: I20240315002759 |
| Provider Name | Juan Huang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003351495 PECOS PAC ID: 3476837212 Enrollment ID: I20240319002766 |
| Provider Name | Angela L Arnold-ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548713191 PECOS PAC ID: 0941588693 Enrollment ID: I20240321000816 |
| Provider Name | Brett J. Guinn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083683783 PECOS PAC ID: 3375541568 Enrollment ID: I20240409003521 |