| Benefis Medical Group | |
|
1401 25th St S Great Falls MT 59405-5183 | |
| (406) 731-8888 | |
| (406) 731-8318 |
| Full Name | Benefis Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 1401 25th St S, Great Falls, Montana |
| Authorized Official Name and Position | Forrest G Ehlinger (CFO FOR BENEFIS HEALTH SYSTEMS) |
| Authorized Official Contact | 4064555000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Benefis Medical Group Po Box 6010 Great Falls MT 59406-6010 Ph: (406) 455-5000 | Benefis Medical Group 1401 25th St S Great Falls MT 59405-5183 Ph: (406) 731-8888 |
| NPI Number | 1780968974 |
|---|---|
| Provider Enumeration Date | 10/06/2011 |
| Last Update Date | 04/29/2024 |
| Medicare PECOS PAC ID | 1153235296 |
|---|---|
| Medicare Enrollment ID | O20100629000044 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780968974 | NPI | - | NPPES |
| 011003889 | Other | MT | MEDICARE PTAN # FOR PART B PHYSICIAN SERVICES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | William E Henning |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053495432 PECOS PAC ID: 1557275468 Enrollment ID: I20031114000624 |
| Provider Name | Randy R Sibbitt |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1679682413 PECOS PAC ID: 2365346129 Enrollment ID: I20031122000110 |
| Provider Name | Holly C Strong |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1548310998 PECOS PAC ID: 8426954892 Enrollment ID: I20031208001078 |
| Provider Name | Sarah R Kenney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1609090174 PECOS PAC ID: 9234036005 Enrollment ID: I20031218000635 |
| Provider Name | Marcella L Barker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265433148 PECOS PAC ID: 4981502929 Enrollment ID: I20031229000553 |
| Provider Name | Mark P Peterson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841391000 PECOS PAC ID: 3971417189 Enrollment ID: I20031230000693 |
| Provider Name | Julie L Kuykendall |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316982044 PECOS PAC ID: 6305746041 Enrollment ID: I20040119000543 |
| Provider Name | Mark R Miles |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598792384 PECOS PAC ID: 6204737570 Enrollment ID: I20040119000672 |
| Provider Name | Elizabeth A O'connor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740207224 PECOS PAC ID: 5294637161 Enrollment ID: I20040121001189 |
| Provider Name | Dale M Schaefer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1609951631 PECOS PAC ID: 2769385244 Enrollment ID: I20040130000992 |
| Provider Name | Shawn T Nesbo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457340457 PECOS PAC ID: 1153314216 Enrollment ID: I20040405001395 |
| Provider Name | Patricia A Calkin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1417922485 PECOS PAC ID: 9133114754 Enrollment ID: I20040414001812 |
| Provider Name | Mark K Buck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801887815 PECOS PAC ID: 2769374065 Enrollment ID: I20040415001173 |
| Provider Name | Michael Theisen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1134167943 PECOS PAC ID: 7012906563 Enrollment ID: I20040510000818 |
| Provider Name | Craig L Treptow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871695320 PECOS PAC ID: 3375524564 Enrollment ID: I20040525000756 |
| Provider Name | Patrick E Galvas |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1063595825 PECOS PAC ID: 6800873639 Enrollment ID: I20040630000618 |
| Provider Name | Bryan E Martin |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1689786519 PECOS PAC ID: 9335126663 Enrollment ID: I20040702001105 |
| Provider Name | Varghese Parambi |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1386645257 PECOS PAC ID: 2961498704 Enrollment ID: I20040707001317 |
| Provider Name | Kraig A Ward |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1285670521 PECOS PAC ID: 5496733859 Enrollment ID: I20040712000819 |
| Provider Name | George Ro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902990559 PECOS PAC ID: 7911971056 Enrollment ID: I20040824000627 |
| Provider Name | Mark A Mozer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508940941 PECOS PAC ID: 0648248898 Enrollment ID: I20040924000267 |
| Provider Name | Jeffrey R Kessler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518968478 PECOS PAC ID: 8022077304 Enrollment ID: I20041004000932 |
| Provider Name | Daniel K Gordon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821020686 PECOS PAC ID: 5698735199 Enrollment ID: I20041018001076 |
| Provider Name | Jeffrey A Stephenson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1053312900 PECOS PAC ID: 4688623226 Enrollment ID: I20050120000718 |
| Provider Name | Nafaa H Dawad |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457451932 PECOS PAC ID: 0648212068 Enrollment ID: I20050525001216 |
| Provider Name | Cory D Hessel |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619073327 PECOS PAC ID: 0840234456 Enrollment ID: I20050615000044 |
| Provider Name | Eric J Anderson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851498810 PECOS PAC ID: 4880639996 Enrollment ID: I20050620000949 |
| Provider Name | Jason B Tingey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154421634 PECOS PAC ID: 7315982428 Enrollment ID: I20050620000970 |
| Provider Name | Tamela J Vanderaarde-scholten |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780783332 PECOS PAC ID: 5799699906 Enrollment ID: I20050620000984 |
| Provider Name | Brian G Bertha |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801993860 PECOS PAC ID: 8921043860 Enrollment ID: I20050622000346 |
| Provider Name | Philip M Vercio |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275630246 PECOS PAC ID: 3577508126 Enrollment ID: I20050623000534 |
| Provider Name | Lyle J Onstad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639105968 PECOS PAC ID: 0345286274 Enrollment ID: I20050630000991 |
| Provider Name | Timothy P Roux |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780685644 PECOS PAC ID: 8820022411 Enrollment ID: I20050923000196 |
| Provider Name | Eliad T Culcea |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831172816 PECOS PAC ID: 4385633122 Enrollment ID: I20051013001033 |
| Provider Name | Jeffrey L Allen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245256916 PECOS PAC ID: 8820020589 Enrollment ID: I20051207000814 |
| Provider Name | James E Boatman |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1285615724 PECOS PAC ID: 1153313275 Enrollment ID: I20060109000211 |
| Provider Name | Ronald G Ray |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1104807411 PECOS PAC ID: 9436101128 Enrollment ID: I20060110000234 |
| Provider Name | Mark Reilly |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1699799981 PECOS PAC ID: 3678529302 Enrollment ID: I20060112001035 |
| Provider Name | Donald H Berdeaux |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1114934221 PECOS PAC ID: 1759305105 Enrollment ID: I20060124000775 |
| Provider Name | Michael T Gallagher |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497835771 PECOS PAC ID: 6305853979 Enrollment ID: I20060307000878 |
| Provider Name | Heidi L Fritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770538407 PECOS PAC ID: 5092725226 Enrollment ID: I20060502000452 |
| Provider Name | Robert M Grasseschi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1548261274 PECOS PAC ID: 4880604909 Enrollment ID: I20060503000334 |
| Provider Name | Darrin Lee Dixon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477597359 PECOS PAC ID: 2062495344 Enrollment ID: I20060705000254 |
| Provider Name | Michele C Marler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396736047 PECOS PAC ID: 7517909377 Enrollment ID: I20061220000182 |
| Provider Name | Charles G Marler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407847155 PECOS PAC ID: 6305888173 Enrollment ID: I20070129000371 |
| Provider Name | Jill D Bolstad |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932272077 PECOS PAC ID: 9537261334 Enrollment ID: I20070226000380 |
| Provider Name | Teresa Smith-keil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467475079 PECOS PAC ID: 7911971197 Enrollment ID: I20070301000565 |
| Provider Name | Kathleen S Blair |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346335189 PECOS PAC ID: 8729016936 Enrollment ID: I20070525000220 |
| Provider Name | Heath Rulin Diel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1629020045 PECOS PAC ID: 1456351170 Enrollment ID: I20070628000400 |
| Provider Name | Stacy M Kingsland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528160173 PECOS PAC ID: 5193826188 Enrollment ID: I20070720000227 |
| Provider Name | Cindy J Simpkins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457357980 PECOS PAC ID: 4981634359 Enrollment ID: I20070731000433 |
| Provider Name | Benny E Brandvold |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1760520084 PECOS PAC ID: 6204937592 Enrollment ID: I20070731000482 |
| Provider Name | Robert D Pfeffer |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1679563639 PECOS PAC ID: 2264424761 Enrollment ID: I20071018000245 |
| Provider Name | Andrew Carter |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700859659 PECOS PAC ID: 2668454067 Enrollment ID: I20071022000054 |
| Provider Name | Mark K Dodson |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1275570467 PECOS PAC ID: 6901701432 Enrollment ID: I20071024000208 |
| Provider Name | Nicholas K Ford |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366646887 PECOS PAC ID: 8325131246 Enrollment ID: I20071217000843 |
| Provider Name | Tyler L Will |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629163076 PECOS PAC ID: 0547347528 Enrollment ID: I20080402000299 |
| Provider Name | Richard J Teff |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982675104 PECOS PAC ID: 6305917543 Enrollment ID: I20080617000047 |
| Provider Name | Harnek Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811917917 PECOS PAC ID: 1951296961 Enrollment ID: I20080909000394 |
| Provider Name | Emilia A Ploplys |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1558475921 PECOS PAC ID: 2466529821 Enrollment ID: I20080926000231 |
| Provider Name | Thomas B Addison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871594754 PECOS PAC ID: 5991852147 Enrollment ID: I20090406000318 |
| Provider Name | Lacey Bond Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306089214 PECOS PAC ID: 7618025529 Enrollment ID: I20090504000336 |
| Provider Name | Kristy K Spaulding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346410701 PECOS PAC ID: 2668368275 Enrollment ID: I20090602000313 |
| Provider Name | Todd E Cameron |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1669520607 PECOS PAC ID: 3173684263 Enrollment ID: I20090825000693 |
| Provider Name | Angela M Casmier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1568670818 PECOS PAC ID: 6901951912 Enrollment ID: I20090827000017 |
| Provider Name | John Joseph Mazur |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659364651 PECOS PAC ID: 2668458373 Enrollment ID: I20090917000037 |
| Provider Name | Brian J Malloy |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1902807860 PECOS PAC ID: 2961558812 Enrollment ID: I20090918000235 |
| Provider Name | Kurt E Hecox |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164473997 PECOS PAC ID: 5991723694 Enrollment ID: I20091204000339 |
| Provider Name | James E Harkness |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376502658 PECOS PAC ID: 8527107267 Enrollment ID: I20091209000337 |
| Provider Name | Steven M Chrzanowski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568454692 PECOS PAC ID: 8123168887 Enrollment ID: I20091210000761 |
| Provider Name | Mark H Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1932100518 PECOS PAC ID: 0941340558 Enrollment ID: I20091211000586 |
| Provider Name | Thomas J Krajacich |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518968486 PECOS PAC ID: 3779623038 Enrollment ID: I20091216000644 |
| Provider Name | Gina M Painter |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1205837762 PECOS PAC ID: 9830239755 Enrollment ID: I20091228000026 |
| Provider Name | Mary E Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184625055 PECOS PAC ID: 0840331815 Enrollment ID: I20100113000228 |
| Provider Name | Kelly J Timmer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669473526 PECOS PAC ID: 8921140393 Enrollment ID: I20100122000484 |
| Provider Name | Dale R Mortenson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1801949722 PECOS PAC ID: 9739132762 Enrollment ID: I20100126000187 |
| Provider Name | James B Legan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871605790 PECOS PAC ID: 3779625835 Enrollment ID: I20100127000852 |
| Provider Name | Melchisedek Margaris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265544183 PECOS PAC ID: 0042353930 Enrollment ID: I20100201000203 |
| Provider Name | Bradford A Bergman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235130113 PECOS PAC ID: 1658414354 Enrollment ID: I20100203000394 |
| Provider Name | Anthony J Quebedeaux |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1659392983 PECOS PAC ID: 2365585817 Enrollment ID: I20100208000694 |
| Provider Name | Dennis P Ruggerie |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336140276 PECOS PAC ID: 8426193533 Enrollment ID: I20100301000488 |
| Provider Name | Glenn Allen Winslow |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255332102 PECOS PAC ID: 4082629324 Enrollment ID: I20100301000737 |
| Provider Name | Rennae I Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1841291705 PECOS PAC ID: 8527103910 Enrollment ID: I20100310000486 |
| Provider Name | Robin L Boland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528398492 PECOS PAC ID: 2961537253 Enrollment ID: I20100311000569 |
| Provider Name | Peter L Stivers |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669534814 PECOS PAC ID: 0941335608 Enrollment ID: I20100319000289 |
| Provider Name | Alexander N Chung |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275577249 PECOS PAC ID: 3971645730 Enrollment ID: I20100422001077 |
| Provider Name | W Lea Gorsuch |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1649211566 PECOS PAC ID: 1557498284 Enrollment ID: I20100428000551 |
| Provider Name | Keith D Bortnem |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1255372959 PECOS PAC ID: 4880751551 Enrollment ID: I20100428000594 |
| Provider Name | Anne Katherine Eby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396077632 PECOS PAC ID: 8224166871 Enrollment ID: I20100503000422 |
| Provider Name | Steven J Ayres |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265488464 PECOS PAC ID: 9335133420 Enrollment ID: I20100503000556 |
| Provider Name | Jeffrey E Smith |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427009570 PECOS PAC ID: 7517978885 Enrollment ID: I20100505001059 |
| Provider Name | Michael A Dube |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1285677237 PECOS PAC ID: 4880736644 Enrollment ID: I20100507000655 |
| Provider Name | Gregory S Tierney |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679519870 PECOS PAC ID: 8022159433 Enrollment ID: I20100507000667 |
| Provider Name | Thomas R Hoffman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427197466 PECOS PAC ID: 0840322574 Enrollment ID: I20100715000965 |
| Provider Name | Denise A Helin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831207802 PECOS PAC ID: 9638203979 Enrollment ID: I20100823000270 |
| Provider Name | Joshua A Newsted |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619139888 PECOS PAC ID: 7113041807 Enrollment ID: I20100901000992 |
| Provider Name | Christopher R Johnson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639389745 PECOS PAC ID: 1658495346 Enrollment ID: I20100901001000 |
| Provider Name | Jonathan C Anderson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174634745 PECOS PAC ID: 2860521994 Enrollment ID: I20101027001364 |
| Provider Name | Tracy Jo Lords |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649438524 PECOS PAC ID: 5799979118 Enrollment ID: I20101029001092 |
| Provider Name | Sonya M Gilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295981801 PECOS PAC ID: 4284701590 Enrollment ID: I20101029001154 |
| Provider Name | Milissa A Priebe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073820783 PECOS PAC ID: 2961698899 Enrollment ID: I20101118000197 |
| Provider Name | Patrick Thomas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538103502 PECOS PAC ID: 7315088101 Enrollment ID: I20101119000835 |
| Provider Name | Debra G Jones |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023085677 PECOS PAC ID: 8729060462 Enrollment ID: I20101206001239 |
| Provider Name | Kevin G Mccrea |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326081860 PECOS PAC ID: 4284821638 Enrollment ID: I20101210000201 |
| Provider Name | Justin J Madill |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578534715 PECOS PAC ID: 2264512540 Enrollment ID: I20110103000246 |
| Provider Name | Alyson E Hinderager |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275864373 PECOS PAC ID: 7012196124 Enrollment ID: I20110121000178 |
| Provider Name | Brian F Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407067903 PECOS PAC ID: 8123211679 Enrollment ID: I20110331000057 |
| Provider Name | Todd C Koch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518289982 PECOS PAC ID: 0547441677 Enrollment ID: I20110503000462 |
| Provider Name | Antonio Santin |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1073500336 PECOS PAC ID: 8729022231 Enrollment ID: I20110714000533 |
| Provider Name | Robinette L Jankiewicz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275515660 PECOS PAC ID: 9638354640 Enrollment ID: I20110719000798 |
| Provider Name | Rebecca L Lozano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447337852 PECOS PAC ID: 2860408192 Enrollment ID: I20111022000091 |
| Provider Name | Tanya R Mccullough |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912287152 PECOS PAC ID: 9436323466 Enrollment ID: I20111130000861 |
| Provider Name | Sara G Goroski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578841912 PECOS PAC ID: 9739354598 Enrollment ID: I20111207000373 |
| Provider Name | Kimberly W Floyd |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265609531 PECOS PAC ID: 4385811744 Enrollment ID: I20120125000780 |
| Provider Name | Michael J Walters |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285728949 PECOS PAC ID: 9335306281 Enrollment ID: I20120203000199 |
| Provider Name | Richard C Carson |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1255310017 PECOS PAC ID: 8729097902 Enrollment ID: I20120313000644 |
| Provider Name | Jeffrey C Baker |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1902003502 PECOS PAC ID: 7012106834 Enrollment ID: I20120803000482 |
| Provider Name | Nicole Leigh Wellman-donester |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1689909566 PECOS PAC ID: 6608023551 Enrollment ID: I20120828000366 |
| Provider Name | Colin Blair Van Orman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225117898 PECOS PAC ID: 3375586886 Enrollment ID: I20121023000244 |
| Provider Name | Andrew C Baugh |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1144459009 PECOS PAC ID: 6204098619 Enrollment ID: I20121031000333 |
| Provider Name | Nicole J White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720367840 PECOS PAC ID: 7618127432 Enrollment ID: I20121031000693 |
| Provider Name | Kally M Hasenkrug |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306192646 PECOS PAC ID: 4587814371 Enrollment ID: I20121102000125 |
| Provider Name | Emily A Cote |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013264175 PECOS PAC ID: 8426209909 Enrollment ID: I20121109000143 |
| Provider Name | Michael A Mahler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205870326 PECOS PAC ID: 3971588310 Enrollment ID: I20121116000206 |
| Provider Name | Mark P Vantighem |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093959280 PECOS PAC ID: 6406007392 Enrollment ID: I20121128000042 |
| Provider Name | Lisa J Edmister |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669722518 PECOS PAC ID: 3173775087 Enrollment ID: I20121128000351 |
| Provider Name | Brad A Nieset |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386631141 PECOS PAC ID: 7012909179 Enrollment ID: I20121231000104 |
| Provider Name | Jonathan L Bingham |
|---|---|
| Provider Type | Practitioner - Micrographic Dermatologic Surgery (mds) |
| Provider Identifiers | NPI Number: 1821074295 PECOS PAC ID: 4385719855 Enrollment ID: I20130430000513 |
| Provider Name | Joseph C Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326029851 PECOS PAC ID: 2769474816 Enrollment ID: I20130508000426 |
| Provider Name | John W Mahan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346241296 PECOS PAC ID: 0244336261 Enrollment ID: I20130513000427 |
| Provider Name | Anastasia M Balius |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1184802647 PECOS PAC ID: 4981778297 Enrollment ID: I20130531000080 |
| Provider Name | James H Daniel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770705329 PECOS PAC ID: 7618126871 Enrollment ID: I20130711000077 |
| Provider Name | Ashton S Hofstad |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285079913 PECOS PAC ID: 9436390382 Enrollment ID: I20130719000062 |
| Provider Name | Danae M. Aplas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144236498 PECOS PAC ID: 4385601301 Enrollment ID: I20130726000625 |
| Provider Name | Matthew M Newsted |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548586142 PECOS PAC ID: 9638310758 Enrollment ID: I20130731000773 |
| Provider Name | Renee G Vincent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336151612 PECOS PAC ID: 8921249913 Enrollment ID: I20130802000776 |
| Provider Name | Carrie A Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093812265 PECOS PAC ID: 0345482360 Enrollment ID: I20130805000013 |
| Provider Name | Vijay P Agarwal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609964154 PECOS PAC ID: 9638328974 Enrollment ID: I20130809000425 |
| Provider Name | Carol Ann Kerr |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225354400 PECOS PAC ID: 0042446478 Enrollment ID: I20131113001510 |
| Provider Name | Lisa D Cadwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750609343 PECOS PAC ID: 4082843594 Enrollment ID: I20140203001708 |
| Provider Name | Justin Lee Mitchell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790970697 PECOS PAC ID: 1254501570 Enrollment ID: I20140226002165 |
| Provider Name | Lynne Marie Nash |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427471424 PECOS PAC ID: 5799908315 Enrollment ID: I20140528001392 |
| Provider Name | Matthew Wetzel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245496900 PECOS PAC ID: 0941437511 Enrollment ID: I20140604001016 |
| Provider Name | Holly H Omar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104912120 PECOS PAC ID: 4082649934 Enrollment ID: I20140805001323 |
| Provider Name | Nicholas R Burnham |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1962795559 PECOS PAC ID: 6507009198 Enrollment ID: I20140805001624 |
| Provider Name | Patrick Tang |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1316109739 PECOS PAC ID: 4789801580 Enrollment ID: I20140818001686 |
| Provider Name | Matthew C Taecker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942527890 PECOS PAC ID: 1658599915 Enrollment ID: I20140827003000 |
| Provider Name | Amy M Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386058345 PECOS PAC ID: 5496973620 Enrollment ID: I20140828002543 |
| Provider Name | Khi V Soldano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639582968 PECOS PAC ID: 1355562224 Enrollment ID: I20141016002717 |
| Provider Name | Sarah A Topel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205244878 PECOS PAC ID: 3678795812 Enrollment ID: I20141104000546 |
| Provider Name | Bridget A Brennan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528020468 PECOS PAC ID: 0749325751 Enrollment ID: I20141118000037 |
| Provider Name | Courtney L Forde |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497162333 PECOS PAC ID: 0446572556 Enrollment ID: I20141128000089 |
| Provider Name | Jon William Taveau |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1083897086 PECOS PAC ID: 3072535772 Enrollment ID: I20150126002313 |
| Provider Name | Ryan Boer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598162075 PECOS PAC ID: 5395060172 Enrollment ID: I20150225002523 |
| Provider Name | Charlene A Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831442367 PECOS PAC ID: 6709103930 Enrollment ID: I20150326001051 |
| Provider Name | Erin E Flaherty |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1376788125 PECOS PAC ID: 4082847868 Enrollment ID: I20150331000857 |
| Provider Name | Bjorn Sauerwein |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1457443251 PECOS PAC ID: 6608877733 Enrollment ID: I20150512001103 |
| Provider Name | Michael A Jasumback |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114947843 PECOS PAC ID: 6204838147 Enrollment ID: I20150522000324 |
| Provider Name | Urmila Chaudhry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1427083278 PECOS PAC ID: 0345258729 Enrollment ID: I20150618002728 |
| Provider Name | Sarah E Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992057624 PECOS PAC ID: 3779734470 Enrollment ID: I20150710000840 |
| Provider Name | Andrew B Curtis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992021034 PECOS PAC ID: 0648490813 Enrollment ID: I20150728005571 |
| Provider Name | Rebecca Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790165082 PECOS PAC ID: 5799099040 Enrollment ID: I20150731014462 |
| Provider Name | Wendy S Killham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114336351 PECOS PAC ID: 3870713001 Enrollment ID: I20150801017348 |
| Provider Name | Amy D Schneider |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407260102 PECOS PAC ID: 2668794314 Enrollment ID: I20150828002012 |
| Provider Name | Sarah L Robinson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437473402 PECOS PAC ID: 8123247244 Enrollment ID: I20150909001288 |
| Provider Name | Sydne R Skaer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033585815 PECOS PAC ID: 5799094801 Enrollment ID: I20151012000827 |
| Provider Name | Steven C Bailey |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1023084605 PECOS PAC ID: 7416990742 Enrollment ID: I20151015001165 |
| Provider Name | Sean B Dow |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871535096 PECOS PAC ID: 2961496369 Enrollment ID: I20151016000465 |
| Provider Name | Jill I Aitken |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1730386020 PECOS PAC ID: 4385739788 Enrollment ID: I20151102002159 |
| Provider Name | Jeffery A Palen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114906658 PECOS PAC ID: 9032139092 Enrollment ID: I20151111001949 |
| Provider Name | Amber Molnar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124499496 PECOS PAC ID: 0941501068 Enrollment ID: I20151215001312 |
| Provider Name | Nicole A Hanson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245237809 PECOS PAC ID: 4688664691 Enrollment ID: I20160108001461 |
| Provider Name | Amar G Pinto |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255395794 PECOS PAC ID: 8224060884 Enrollment ID: I20160113002766 |
| Provider Name | Shelley L Andrus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962786806 PECOS PAC ID: 5799080115 Enrollment ID: I20160223002366 |
| Provider Name | Don S Wipf |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265602353 PECOS PAC ID: 0840595138 Enrollment ID: I20160224001875 |
| Provider Name | Jamina Charles |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699054395 PECOS PAC ID: 6305168428 Enrollment ID: I20160425002265 |
| Provider Name | Pavel N Shevtsov |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174981450 PECOS PAC ID: 6103115159 Enrollment ID: I20160516001194 |
| Provider Name | Julia M Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851752745 PECOS PAC ID: 1456642461 Enrollment ID: I20160622002147 |
| Provider Name | Jayson Vincent Singson Lingan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326364902 PECOS PAC ID: 5395037097 Enrollment ID: I20160715000752 |
| Provider Name | Brittany Mayfield |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518300276 PECOS PAC ID: 8921300690 Enrollment ID: I20160720001122 |
| Provider Name | Tauqeer Rahat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316388549 PECOS PAC ID: 8022311752 Enrollment ID: I20160803003161 |
| Provider Name | Alexander M Bules |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932497088 PECOS PAC ID: 2163744541 Enrollment ID: I20160805001346 |
| Provider Name | Gulara Hajiyeva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649611872 PECOS PAC ID: 4981998143 Enrollment ID: I20160810001959 |
| Provider Name | Vilma Herrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861840514 PECOS PAC ID: 2769776772 Enrollment ID: I20160812001382 |
| Provider Name | Nathaniel Readal |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1275775025 PECOS PAC ID: 0749439198 Enrollment ID: I20160816001786 |
| Provider Name | Raheel Khalid |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962843979 PECOS PAC ID: 0547556201 Enrollment ID: I20160906001541 |
| Provider Name | Lily Avgustovskiy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093122335 PECOS PAC ID: 6800118795 Enrollment ID: I20160908002041 |
| Provider Name | Ryan M Luoma |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831392786 PECOS PAC ID: 8527112390 Enrollment ID: I20160909002408 |
| Provider Name | Dustin R Stuart |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316201429 PECOS PAC ID: 3476779158 Enrollment ID: I20160912000852 |
| Provider Name | Venkatachala Mohan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1194704106 PECOS PAC ID: 9537252754 Enrollment ID: I20160920001390 |
| Provider Name | Joseph Ghahari |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386681252 PECOS PAC ID: 2961409719 Enrollment ID: I20160920002421 |
| Provider Name | Samuel M Spanbauer |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1578791935 PECOS PAC ID: 4183849896 Enrollment ID: I20161017002394 |
| Provider Name | Aurelio Feliciano |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548201031 PECOS PAC ID: 8729979232 Enrollment ID: I20161028001952 |
| Provider Name | Erik C Mcclure |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1033471602 PECOS PAC ID: 0345497418 Enrollment ID: I20161028002193 |
| Provider Name | Henryk J Nikicicz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205856838 PECOS PAC ID: 3577514819 Enrollment ID: I20161123000932 |
| Provider Name | Thomas J Attaway |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922012442 PECOS PAC ID: 2264400084 Enrollment ID: I20170105000895 |
| Provider Name | Michael D Eisenhauer |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1821064510 PECOS PAC ID: 3476678996 Enrollment ID: I20170110003164 |
| Provider Name | Patrick Hugh Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043755119 PECOS PAC ID: 5597047076 Enrollment ID: I20170117002501 |
| Provider Name | Jill E Donaldson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497293864 PECOS PAC ID: 0042594483 Enrollment ID: I20170301002712 |
| Provider Name | Berilonson S Osiro |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1356748859 PECOS PAC ID: 7416233564 Enrollment ID: I20170404002251 |
| Provider Name | John E Venditti |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336408442 PECOS PAC ID: 5294011003 Enrollment ID: I20170410002499 |
| Provider Name | Carolyn S Meyer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992097695 PECOS PAC ID: 9032335799 Enrollment ID: I20170419001001 |
| Provider Name | Berna Roig Demalignon |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1770560948 PECOS PAC ID: 0749252666 Enrollment ID: I20170421001550 |
| Provider Name | Rafael Martinez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508286451 PECOS PAC ID: 0244516466 Enrollment ID: I20170424000978 |
| Provider Name | Becky A Slater |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1477840080 PECOS PAC ID: 4587884168 Enrollment ID: I20170509002717 |
| Provider Name | Richard C Slater |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1285928754 PECOS PAC ID: 3173800695 Enrollment ID: I20170509002870 |
| Provider Name | Matthew Terrence Humbert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760892632 PECOS PAC ID: 4486931839 Enrollment ID: I20170511002669 |
| Provider Name | Rachel E Amthor |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598108433 PECOS PAC ID: 7315238847 Enrollment ID: I20170516002855 |
| Provider Name | Bradley S Hill |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1720321961 PECOS PAC ID: 6103143490 Enrollment ID: I20170518000639 |
| Provider Name | Jordan Lejeune |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093007452 PECOS PAC ID: 5496022402 Enrollment ID: I20170523001458 |
| Provider Name | Jason Wayne Defluiter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669780433 PECOS PAC ID: 2264681139 Enrollment ID: I20170620002169 |
| Provider Name | Kenneth I Oriordan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912075649 PECOS PAC ID: 3577586239 Enrollment ID: I20170628002471 |
| Provider Name | Cherie L Jennings |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831165505 PECOS PAC ID: 8527139294 Enrollment ID: I20170705003519 |
| Provider Name | Mark S Vantassell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750672960 PECOS PAC ID: 5698913408 Enrollment ID: I20170707001667 |
| Provider Name | Andrew Jon Lindekugel |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1790196350 PECOS PAC ID: 6608166624 Enrollment ID: I20170814001396 |
| Provider Name | Stephanie Burcusa |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235322421 PECOS PAC ID: 1052471075 Enrollment ID: I20170814003298 |
| Provider Name | Crystal M Bahnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932621240 PECOS PAC ID: 7214209667 Enrollment ID: I20170818001698 |
| Provider Name | Christopher Thacker |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497011662 PECOS PAC ID: 1254573934 Enrollment ID: I20170929001544 |
| Provider Name | Lindsay Rucinsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235680190 PECOS PAC ID: 3072888064 Enrollment ID: I20170929003194 |
| Provider Name | Melanie Marie Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982121760 PECOS PAC ID: 9739454612 Enrollment ID: I20171003004609 |
| Provider Name | Kathleen M Diller |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407053697 PECOS PAC ID: 1153598909 Enrollment ID: I20171016000803 |
| Provider Name | Camilla E Juhl-petersen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073809232 PECOS PAC ID: 2769637768 Enrollment ID: I20171107001581 |
| Provider Name | June C Murphy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912933771 PECOS PAC ID: 8921064486 Enrollment ID: I20171109002409 |
| Provider Name | Casey Elizabeth Barker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750816237 PECOS PAC ID: 1951668268 Enrollment ID: I20171121002977 |
| Provider Name | Charlsie C Woodard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609198761 PECOS PAC ID: 2668500620 Enrollment ID: I20171204002058 |
| Provider Name | Amanda H Lucas |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1386917714 PECOS PAC ID: 7214196559 Enrollment ID: I20171215002076 |
| Provider Name | John Craw |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1417117110 PECOS PAC ID: 9739494303 Enrollment ID: I20180103003122 |
| Provider Name | Puneet Victor Bansal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1417230855 PECOS PAC ID: 9830459932 Enrollment ID: I20180210000178 |
| Provider Name | Inga Shevtsova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770081614 PECOS PAC ID: 4385905694 Enrollment ID: I20180301001827 |
| Provider Name | Heather D Hansen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558750596 PECOS PAC ID: 8527320209 Enrollment ID: I20180315002376 |
| Provider Name | Somer Rose Mazzucola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053811844 PECOS PAC ID: 3476815887 Enrollment ID: I20180323001019 |
| Provider Name | Brandon Christopher French |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245612985 PECOS PAC ID: 1456614999 Enrollment ID: I20180413001601 |
| Provider Name | Francis M Filloux |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942389515 PECOS PAC ID: 6608819107 Enrollment ID: I20180523002856 |
| Provider Name | Rosetta D Hixson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104137496 PECOS PAC ID: 2860516036 Enrollment ID: I20180524002778 |
| Provider Name | Cheyenne N Babcock |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346203460 PECOS PAC ID: 6608884176 Enrollment ID: I20180621000927 |
| Provider Name | Travis James Boud |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336583665 PECOS PAC ID: 2769739168 Enrollment ID: I20180717000788 |
| Provider Name | Emily Michelle Grant |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881984227 PECOS PAC ID: 6901023548 Enrollment ID: I20180726002064 |
| Provider Name | Luke Romanow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528301116 PECOS PAC ID: 8325277825 Enrollment ID: I20180727002651 |
| Provider Name | Latoya Floyd |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386876795 PECOS PAC ID: 4981988730 Enrollment ID: I20180812000003 |
| Provider Name | Emily P Morrison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598177032 PECOS PAC ID: 1456579770 Enrollment ID: I20180820000664 |
| Provider Name | Shawn C Kelly |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932425329 PECOS PAC ID: 2062642978 Enrollment ID: I20180828002374 |
| Provider Name | Melissa Anne Papp |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700198983 PECOS PAC ID: 9133348048 Enrollment ID: I20180924001738 |
| Provider Name | Estela Mogrovejo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962757005 PECOS PAC ID: 1254562671 Enrollment ID: I20180928002103 |
| Provider Name | Morris Jessop |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1043655046 PECOS PAC ID: 4082915954 Enrollment ID: I20181002001586 |
| Provider Name | Mary Middagh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396279709 PECOS PAC ID: 3072883909 Enrollment ID: I20181004001159 |
| Provider Name | Whitney Barnekoff Mckinley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861979965 PECOS PAC ID: 3173876109 Enrollment ID: I20181022001573 |
| Provider Name | Joseph P Schowalter |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1811213473 PECOS PAC ID: 7012218373 Enrollment ID: I20181221000715 |
| Provider Name | Francisco B Rodriguez |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1063434504 PECOS PAC ID: 3678543394 Enrollment ID: I20181227001106 |
| Provider Name | Daniel J Pradere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518439371 PECOS PAC ID: 4385982008 Enrollment ID: I20190205000965 |
| Provider Name | Louay Joseph Toni |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215057765 PECOS PAC ID: 4789991787 Enrollment ID: I20190227001024 |
| Provider Name | Daniel A Tomlinson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053336487 PECOS PAC ID: 9032178405 Enrollment ID: I20190306002110 |
| Provider Name | Jean N Moore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1801938980 PECOS PAC ID: 4880724640 Enrollment ID: I20190308000904 |
| Provider Name | Jennifer Gunnell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386611234 PECOS PAC ID: 2860457264 Enrollment ID: I20190320003403 |
| Provider Name | Eric Michael Sievers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811469935 PECOS PAC ID: 5799025102 Enrollment ID: I20190321002659 |
| Provider Name | Blanche E Stutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962973776 PECOS PAC ID: 2769722800 Enrollment ID: I20190327001833 |
| Provider Name | Joshua Edward Friend |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891084448 PECOS PAC ID: 0648410613 Enrollment ID: I20190403003200 |
| Provider Name | Walter A Lajara-nanson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528050283 PECOS PAC ID: 1951335736 Enrollment ID: I20190508001580 |
| Provider Name | Durga Naga Malleswara Rao Jonnalagadda |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245606664 PECOS PAC ID: 3375877343 Enrollment ID: I20190625001537 |
| Provider Name | Chad Reihm |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407296098 PECOS PAC ID: 1658628052 Enrollment ID: I20190703002694 |
| Provider Name | Justin David Jackman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1457888950 PECOS PAC ID: 3971838269 Enrollment ID: I20190709001518 |
| Provider Name | Kami L Winnicki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649781550 PECOS PAC ID: 5294097804 Enrollment ID: I20190710002788 |
| Provider Name | Marwan Bakhach |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912347691 PECOS PAC ID: 8628304953 Enrollment ID: I20190724003742 |
| Provider Name | Matthew Burton Kunkel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1811316615 PECOS PAC ID: 0749526812 Enrollment ID: I20190726001645 |
| Provider Name | Jaimee Gregoire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114588381 PECOS PAC ID: 7911235577 Enrollment ID: I20190821002107 |
| Provider Name | Deepika Beereddy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730555152 PECOS PAC ID: 0042561912 Enrollment ID: I20190822000267 |
| Provider Name | Juan D'brot |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1700822442 PECOS PAC ID: 3274720040 Enrollment ID: I20190827003451 |
| Provider Name | Cody Do Davis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629463674 PECOS PAC ID: 8123397551 Enrollment ID: I20190906002859 |
| Provider Name | Jacob Reid Dees |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902265549 PECOS PAC ID: 0244537652 Enrollment ID: I20190910004065 |
| Provider Name | Samir Kapadia |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265675516 PECOS PAC ID: 4183873151 Enrollment ID: I20190913000865 |
| Provider Name | Jessica Ann Hart |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790121580 PECOS PAC ID: 0143450940 Enrollment ID: I20190918002872 |
| Provider Name | Ryann Christine Popa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477114114 PECOS PAC ID: 0648500256 Enrollment ID: I20190925000629 |
| Provider Name | Bernadette Borte |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366678344 PECOS PAC ID: 3072759604 Enrollment ID: I20191001003022 |
| Provider Name | Miroslaw Tadeusz Sochanski |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568447076 PECOS PAC ID: 4688697535 Enrollment ID: I20191015000645 |
| Provider Name | Vahid Behravan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871722520 PECOS PAC ID: 6507189123 Enrollment ID: I20191016002712 |
| Provider Name | Neetu Dhadwal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962842492 PECOS PAC ID: 4183852270 Enrollment ID: I20191016002938 |
| Provider Name | Katrina Mae Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114576543 PECOS PAC ID: 4385976364 Enrollment ID: I20191023003436 |
| Provider Name | Hanna Konarzewska |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1316936982 PECOS PAC ID: 3173504032 Enrollment ID: I20191024002491 |
| Provider Name | Michelle Boudreau |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346534864 PECOS PAC ID: 7416182480 Enrollment ID: I20191104000756 |
| Provider Name | Vivek Baluja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538205539 PECOS PAC ID: 0143408989 Enrollment ID: I20191111002087 |
| Provider Name | Kathryn E Hurlbut |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356728711 PECOS PAC ID: 1456602333 Enrollment ID: I20191210001261 |
| Provider Name | Marina Wilson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1518301548 PECOS PAC ID: 6901190537 Enrollment ID: I20191216000129 |
| Provider Name | Lauretha Uzoamaka Rogers |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295129179 PECOS PAC ID: 6800199233 Enrollment ID: I20191223001646 |
| Provider Name | Charlie E Campbell Mckinney |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467999805 PECOS PAC ID: 7911282330 Enrollment ID: I20191226000902 |
| Provider Name | Trevor Thorpe |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710482740 PECOS PAC ID: 0143583575 Enrollment ID: I20200106000167 |
| Provider Name | Matthew Thomas Sweney |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1568581551 PECOS PAC ID: 7719102045 Enrollment ID: I20200106000187 |
| Provider Name | Betsy E Ostrander |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679739395 PECOS PAC ID: 6901028380 Enrollment ID: I20200106000219 |
| Provider Name | Patricia Colon-garcia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427157270 PECOS PAC ID: 0446356216 Enrollment ID: I20200107000355 |
| Provider Name | Katherine Colleen Riordan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689832107 PECOS PAC ID: 8224174354 Enrollment ID: I20200107003401 |
| Provider Name | Jessica Floyd |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1386888113 PECOS PAC ID: 3779729868 Enrollment ID: I20200109000379 |
| Provider Name | Geetanjali Vajapey |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740523935 PECOS PAC ID: 5799087441 Enrollment ID: I20200110001234 |
| Provider Name | Vivian Marie Suarez Gonzalez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801107388 PECOS PAC ID: 7618145830 Enrollment ID: I20200115001632 |
| Provider Name | Chut Sombutmai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649320987 PECOS PAC ID: 4284807413 Enrollment ID: I20200115001660 |
| Provider Name | Stanley Garken Lue |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003017427 PECOS PAC ID: 6204005648 Enrollment ID: I20200120000429 |
| Provider Name | Mohammed Zaman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215126032 PECOS PAC ID: 4284882895 Enrollment ID: I20200121000340 |
| Provider Name | Yelena G Vidgop |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336300771 PECOS PAC ID: 0941444095 Enrollment ID: I20200121000380 |
| Provider Name | Mai Won |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871676676 PECOS PAC ID: 2860418175 Enrollment ID: I20200121000392 |
| Provider Name | Muhammad Masud |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700179231 PECOS PAC ID: 8628381662 Enrollment ID: I20200121001010 |
| Provider Name | Harsha Ghatge Nagaraja |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568606259 PECOS PAC ID: 5496983009 Enrollment ID: I20200121002210 |
| Provider Name | Theresa B. Sevilis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407111461 PECOS PAC ID: 6608191911 Enrollment ID: I20200203001313 |
| Provider Name | Carey A Wilson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255698726 PECOS PAC ID: 9032342563 Enrollment ID: I20200221001221 |
| Provider Name | Shubhangi Chumble |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881684074 PECOS PAC ID: 6305844242 Enrollment ID: I20200312001661 |
| Provider Name | Randle Corfman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1649314584 PECOS PAC ID: 9638275977 Enrollment ID: I20200401002909 |
| Provider Name | Stephen Bartsch |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1417179623 PECOS PAC ID: 6608930094 Enrollment ID: I20200409000281 |
| Provider Name | Sierra Lahti Cobb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538609623 PECOS PAC ID: 2062842362 Enrollment ID: I20200429002120 |
| Provider Name | Christopher Bixler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770575656 PECOS PAC ID: 8224100334 Enrollment ID: I20200618001935 |
| Provider Name | Richard Newman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1831199850 PECOS PAC ID: 2365415957 Enrollment ID: I20200630001761 |
| Provider Name | Nattasha Acevedo Ramirez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366786451 PECOS PAC ID: 7214217793 Enrollment ID: I20200701000833 |
| Provider Name | Rebecca R Phuoc |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619395480 PECOS PAC ID: 2961623541 Enrollment ID: I20200702001103 |
| Provider Name | Mark N Friedman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932181849 PECOS PAC ID: 5092732388 Enrollment ID: I20200702001499 |
| Provider Name | Mazen Almidani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912936725 PECOS PAC ID: 4587667282 Enrollment ID: I20200707000281 |
| Provider Name | Xuyen Tan Truong |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780111351 PECOS PAC ID: 6204108467 Enrollment ID: I20200713000757 |
| Provider Name | Tao Tong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942401815 PECOS PAC ID: 2961558168 Enrollment ID: I20200722002362 |
| Provider Name | Greg Vigna |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1376514190 PECOS PAC ID: 6901975036 Enrollment ID: I20200813002530 |
| Provider Name | Kevin H Kundis |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1265953822 PECOS PAC ID: 1456778018 Enrollment ID: I20200827000737 |
| Provider Name | Adedotun Ogunsua |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1922448661 PECOS PAC ID: 8022240019 Enrollment ID: I20200902001684 |
| Provider Name | Lorenzo Boccuzzi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598734980 PECOS PAC ID: 0749172252 Enrollment ID: I20200909001802 |
| Provider Name | Arun Joseph Kattakayam |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194255968 PECOS PAC ID: 1658623475 Enrollment ID: I20200910000711 |
| Provider Name | Jessica Ann Vlasie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700495454 PECOS PAC ID: 7113344599 Enrollment ID: I20200910002438 |
| Provider Name | Mosaes M Buchanan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1588951321 PECOS PAC ID: 3577786755 Enrollment ID: I20200917002589 |
| Provider Name | Neil J Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295155364 PECOS PAC ID: 5193076578 Enrollment ID: I20201007003228 |
| Provider Name | Joao Mc-oneil Plancher |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700142668 PECOS PAC ID: 9638317837 Enrollment ID: I20201014001952 |
| Provider Name | Birenkumar Rajandrakumar Patel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679900062 PECOS PAC ID: 0547533788 Enrollment ID: I20201014002095 |
| Provider Name | Leslie Stapp |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1154380020 PECOS PAC ID: 8224262647 Enrollment ID: I20201014002934 |
| Provider Name | Murtaza Amir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508971920 PECOS PAC ID: 4688602915 Enrollment ID: I20201014003482 |
| Provider Name | Cara Callison |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336527118 PECOS PAC ID: 7113211822 Enrollment ID: I20201014003658 |
| Provider Name | Heather Marie Halko |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1669963872 PECOS PAC ID: 6901226612 Enrollment ID: I20201019003153 |
| Provider Name | Carolyn Rutter |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1912016767 PECOS PAC ID: 1355434903 Enrollment ID: I20201021001539 |
| Provider Name | Holly M Bastian |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1588619043 PECOS PAC ID: 1850436007 Enrollment ID: I20201030000426 |
| Provider Name | Jeffrey Allen Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205445095 PECOS PAC ID: 3072923176 Enrollment ID: I20201030001427 |
| Provider Name | Brian Sorace |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639565997 PECOS PAC ID: 9032426697 Enrollment ID: I20201102001378 |
| Provider Name | Zeth Holbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144743097 PECOS PAC ID: 6103192513 Enrollment ID: I20201104002177 |
| Provider Name | Jennifer Stone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295968980 PECOS PAC ID: 4688714371 Enrollment ID: I20201109002605 |
| Provider Name | Darshana Pritesh Amin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407901382 PECOS PAC ID: 4082750468 Enrollment ID: I20201110001340 |
| Provider Name | Georgy Cherkassky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760827778 PECOS PAC ID: 7416197702 Enrollment ID: I20201111000226 |
| Provider Name | Sui Li |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992026371 PECOS PAC ID: 0345554929 Enrollment ID: I20201113000279 |
| Provider Name | Mark Mitchell Mcdonald |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366837429 PECOS PAC ID: 6709156334 Enrollment ID: I20201216002185 |
| Provider Name | Nina Grace Bradley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750692422 PECOS PAC ID: 6709025505 Enrollment ID: I20201217000702 |
| Provider Name | Craig D Smith |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1275602740 PECOS PAC ID: 7214021864 Enrollment ID: I20210120001978 |
| Provider Name | Krystal R Kackley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902394455 PECOS PAC ID: 3173879079 Enrollment ID: I20210120002358 |
| Provider Name | Ashley Iverson |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669985297 PECOS PAC ID: 2163762535 Enrollment ID: I20210122000708 |
| Provider Name | David Desertspring |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396750725 PECOS PAC ID: 2567552557 Enrollment ID: I20210212001304 |
| Provider Name | Terry Himes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700995438 PECOS PAC ID: 2567441181 Enrollment ID: I20210303002342 |
| Provider Name | Charles Edward Rollison |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356386387 PECOS PAC ID: 8325091382 Enrollment ID: I20210330002713 |
| Provider Name | Jacqueline Renee Mcgowan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1831365535 PECOS PAC ID: 8426291824 Enrollment ID: I20210331000525 |
| Provider Name | Nicolette C Strand |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013484187 PECOS PAC ID: 9335472992 Enrollment ID: I20210428000314 |
| Provider Name | David Crumley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760462816 PECOS PAC ID: 9638113319 Enrollment ID: I20210513002723 |
| Provider Name | Chad Baarson |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1790965085 PECOS PAC ID: 4385059005 Enrollment ID: I20210628002738 |
| Provider Name | Timothy Hiesterman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1508044421 PECOS PAC ID: 6709900319 Enrollment ID: I20210721004056 |
| Provider Name | Shie-pon Tzung |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023096252 PECOS PAC ID: 0446343669 Enrollment ID: I20210722002890 |
| Provider Name | Flint Ray |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1316473713 PECOS PAC ID: 1557764305 Enrollment ID: I20210730001729 |
| Provider Name | Merhala Balasubramaniam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629450333 PECOS PAC ID: 2668719766 Enrollment ID: I20210803003337 |
| Provider Name | Heidi Peynado De Pena |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1265883607 PECOS PAC ID: 1153665120 Enrollment ID: I20210812000737 |
| Provider Name | Kelsey Dressen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467848093 PECOS PAC ID: 3678863818 Enrollment ID: I20210817003894 |
| Provider Name | Jace Bullard |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306225917 PECOS PAC ID: 7618285396 Enrollment ID: I20210819002184 |
| Provider Name | Michael Dressen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891180022 PECOS PAC ID: 3577987635 Enrollment ID: I20210908003771 |
| Provider Name | Tara Louise Block |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538656913 PECOS PAC ID: 7719233154 Enrollment ID: I20210928003390 |
| Provider Name | Sumaiya Mahboob |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558855502 PECOS PAC ID: 4284986480 Enrollment ID: I20210930001159 |
| Provider Name | Jourdon Quinn Jaye Wichman |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1902471634 PECOS PAC ID: 4284031428 Enrollment ID: I20210930001225 |
| Provider Name | Taylor Wittrock |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134476971 PECOS PAC ID: 7416354600 Enrollment ID: I20210930003238 |
| Provider Name | Eric Fredrick Meyer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1982719589 PECOS PAC ID: 2466414495 Enrollment ID: I20211006002603 |
| Provider Name | Gabor Varju |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235342999 PECOS PAC ID: 9537260690 Enrollment ID: I20211006002810 |
| Provider Name | Adrienne Krysiak |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1023549847 PECOS PAC ID: 1557638392 Enrollment ID: I20211011001951 |
| Provider Name | Devn A Frandsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730316043 PECOS PAC ID: 9032344064 Enrollment ID: I20211012002435 |
| Provider Name | Robert Goldstein |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1972693935 PECOS PAC ID: 2668450768 Enrollment ID: I20211013001848 |
| Provider Name | Thomas Geddings |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1184845026 PECOS PAC ID: 9032233796 Enrollment ID: I20211018000914 |
| Provider Name | Leah J. Blake |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558757724 PECOS PAC ID: 0749544252 Enrollment ID: I20211101000275 |
| Provider Name | Nicole M Vanica |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316216898 PECOS PAC ID: 0749447621 Enrollment ID: I20211115000751 |
| Provider Name | Joel E. Colley |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487650305 PECOS PAC ID: 8224054010 Enrollment ID: I20211122000957 |
| Provider Name | Carlos Corral |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1245212539 PECOS PAC ID: 3072604750 Enrollment ID: I20211130002317 |
| Provider Name | Myriam Lacerte |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1104279868 PECOS PAC ID: 2264725464 Enrollment ID: I20211215002100 |
| Provider Name | Mark Hotchkiss |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366869653 PECOS PAC ID: 4880812981 Enrollment ID: I20211222000720 |
| Provider Name | Luba Hafkin |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942407028 PECOS PAC ID: 8527254440 Enrollment ID: I20220121002305 |
| Provider Name | Julie Christensen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013251545 PECOS PAC ID: 0941446579 Enrollment ID: I20220126001340 |
| Provider Name | David Hurray |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1376518829 PECOS PAC ID: 4082624218 Enrollment ID: I20220126002674 |
| Provider Name | Sylvia Rojas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851344329 PECOS PAC ID: 3870599335 Enrollment ID: I20220126002774 |
| Provider Name | Vincent G Conte |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124003033 PECOS PAC ID: 7012164833 Enrollment ID: I20220128001741 |
| Provider Name | Elias J Baied |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1023497708 PECOS PAC ID: 8527363480 Enrollment ID: I20220201000777 |
| Provider Name | Terence R Lichtor |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1114976289 PECOS PAC ID: 4880786920 Enrollment ID: I20220201001008 |
| Provider Name | Eleonor Quan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1770502254 PECOS PAC ID: 9739174814 Enrollment ID: I20220204001819 |
| Provider Name | Paul E Krug |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437250404 PECOS PAC ID: 0648228676 Enrollment ID: I20220217001393 |
| Provider Name | Hans J Amen |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1538426507 PECOS PAC ID: 8022266592 Enrollment ID: I20220218001153 |
| Provider Name | Hang T Vu |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1730140476 PECOS PAC ID: 7810921137 Enrollment ID: I20220224002603 |
| Provider Name | Vincent Shen |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1881751261 PECOS PAC ID: 7214918242 Enrollment ID: I20220302000881 |
| Provider Name | Scott A Longfellow |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124152368 PECOS PAC ID: 5698861912 Enrollment ID: I20220307000797 |
| Provider Name | Brooke Christiaens |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477896512 PECOS PAC ID: 8224326475 Enrollment ID: I20220307001018 |
| Provider Name | Stacey Sheffield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518563493 PECOS PAC ID: 7315352507 Enrollment ID: I20220315000992 |
| Provider Name | Kristin Huntoon |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1043650229 PECOS PAC ID: 5597064832 Enrollment ID: I20220321001705 |
| Provider Name | Stephanie Polochak |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1659751105 PECOS PAC ID: 4183931249 Enrollment ID: I20220321002300 |
| Provider Name | Michael Sheffield |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801867379 PECOS PAC ID: 1254469778 Enrollment ID: I20220321002587 |
| Provider Name | Kristopher Nj Poliakiwski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356864748 PECOS PAC ID: 4789912007 Enrollment ID: I20220324001340 |
| Provider Name | Brian M Corliss |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1821432840 PECOS PAC ID: 9335376862 Enrollment ID: I20220411001501 |
| Provider Name | Jennifer M Carter |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1891136644 PECOS PAC ID: 4789973819 Enrollment ID: I20220422001881 |
| Provider Name | Anna Mary Christensen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124007943 PECOS PAC ID: 9032491998 Enrollment ID: I20220428001291 |
| Provider Name | Stephanie Kouth Hang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952964512 PECOS PAC ID: 9537556147 Enrollment ID: I20220429001341 |
| Provider Name | Derik A Neilson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508362518 PECOS PAC ID: 7214285808 Enrollment ID: I20220503000481 |
| Provider Name | Crystal S Purdy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1841859071 PECOS PAC ID: 8729404090 Enrollment ID: I20220503002651 |
| Provider Name | Dirk S Sypherd |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1073593638 PECOS PAC ID: 8729176151 Enrollment ID: I20220504001929 |
| Provider Name | Michael Shun Yeen Yu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255993291 PECOS PAC ID: 6507253887 Enrollment ID: I20220505001154 |
| Provider Name | Mark J Mogul |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336113752 PECOS PAC ID: 0042244972 Enrollment ID: I20220505002547 |
| Provider Name | Anna E Denton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003331539 PECOS PAC ID: 7315213790 Enrollment ID: I20220511001939 |
| Provider Name | Andrew Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164803912 PECOS PAC ID: 3274836960 Enrollment ID: I20220511002572 |
| Provider Name | Thao H Vu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891787453 PECOS PAC ID: 8527053016 Enrollment ID: I20220603002570 |
| Provider Name | David Garcia |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265417893 PECOS PAC ID: 0840289005 Enrollment ID: I20220615000079 |
| Provider Name | Albert Whitesell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679588537 PECOS PAC ID: 6305893447 Enrollment ID: I20220616002667 |
| Provider Name | Althea Lucinda Robinson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205232808 PECOS PAC ID: 9436475720 Enrollment ID: I20220623003235 |
| Provider Name | Brett Starr |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1538579701 PECOS PAC ID: 0244539138 Enrollment ID: I20220630000394 |
| Provider Name | Jessica Marie Boso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295489870 PECOS PAC ID: 9133509359 Enrollment ID: I20220706002170 |
| Provider Name | Elizabeth Rook |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1881878759 PECOS PAC ID: 9234309618 Enrollment ID: I20220719002760 |
| Provider Name | Thomas Satterfield |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023060399 PECOS PAC ID: 5395756720 Enrollment ID: I20220725001782 |
| Provider Name | Keith R Carringer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386612281 PECOS PAC ID: 6305821356 Enrollment ID: I20220804001457 |
| Provider Name | Daphne A Kontos |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437579240 PECOS PAC ID: 4789922410 Enrollment ID: I20220805000745 |
| Provider Name | Andrew Ward |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356452056 PECOS PAC ID: 6305746694 Enrollment ID: I20220811003170 |
| Provider Name | William Carlton |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1568875995 PECOS PAC ID: 9133347230 Enrollment ID: I20220812001701 |
| Provider Name | Shams Jubouri |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871908806 PECOS PAC ID: 7012134125 Enrollment ID: I20220816003516 |
| Provider Name | Nicole Reece |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831823780 PECOS PAC ID: 3971988940 Enrollment ID: I20220913000627 |
| Provider Name | Andrew Mazzone |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1619402286 PECOS PAC ID: 2264785575 Enrollment ID: I20220913003937 |
| Provider Name | Joseph V Somers |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760435606 PECOS PAC ID: 1153380431 Enrollment ID: I20220914001254 |
| Provider Name | Ronald Evans |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255337770 PECOS PAC ID: 9830183490 Enrollment ID: I20220915001769 |
| Provider Name | Vu Luu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578726212 PECOS PAC ID: 2264590355 Enrollment ID: I20220915002435 |
| Provider Name | Michael Inniss |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891090734 PECOS PAC ID: 9638306855 Enrollment ID: I20220916001446 |
| Provider Name | Horst S Filtzer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417018862 PECOS PAC ID: 5395796841 Enrollment ID: I20220920003240 |
| Provider Name | Shirl L Schaffer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295712164 PECOS PAC ID: 2567402357 Enrollment ID: I20221011001855 |
| Provider Name | Kaylee Waldrep |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073920989 PECOS PAC ID: 6608131016 Enrollment ID: I20221012003389 |
| Provider Name | Aaron Michael Hasenkrug |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720510050 PECOS PAC ID: 5395014179 Enrollment ID: I20221018000791 |
| Provider Name | Breanna Noel Hudik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780318584 PECOS PAC ID: 7719353150 Enrollment ID: I20221026001237 |
| Provider Name | Samantha J Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245887538 PECOS PAC ID: 8022417294 Enrollment ID: I20221101000374 |
| Provider Name | Randy Everett |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1285680306 PECOS PAC ID: 4587665492 Enrollment ID: I20221102000786 |
| Provider Name | Wade Farrow |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1710957345 PECOS PAC ID: 5597749432 Enrollment ID: I20221103002544 |
| Provider Name | Caleb Hixson |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1053739227 PECOS PAC ID: 4688911746 Enrollment ID: I20221104000171 |
| Provider Name | Clayton D Killpack |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1528160769 PECOS PAC ID: 1850374133 Enrollment ID: I20221104000674 |
| Provider Name | Beatrice Zepeda |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235353954 PECOS PAC ID: 5294979530 Enrollment ID: I20221119000337 |
| Provider Name | Michael Lamb |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1104903582 PECOS PAC ID: 0648175125 Enrollment ID: I20221208001309 |
| Provider Name | Rebecca Bierden |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1003010802 PECOS PAC ID: 1254504475 Enrollment ID: I20221214001130 |
| Provider Name | Marcia K Maronn-johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063455418 PECOS PAC ID: 8527045558 Enrollment ID: I20221215002652 |
| Provider Name | Caitlyn Cayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922698489 PECOS PAC ID: 6103295837 Enrollment ID: I20221219002603 |
| Provider Name | Michael Knudsen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750340527 PECOS PAC ID: 3476798943 Enrollment ID: I20221221002318 |
| Provider Name | Jordan Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417547936 PECOS PAC ID: 2961872619 Enrollment ID: I20221221002680 |
| Provider Name | Michael D Mccallum |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1316910284 PECOS PAC ID: 4385604115 Enrollment ID: I20221226000059 |
| Provider Name | Edward A Cobb |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1720307325 PECOS PAC ID: 5193947810 Enrollment ID: I20221229002549 |
| Provider Name | Matthew Aaron Smith-cohn |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265811541 PECOS PAC ID: 7113207663 Enrollment ID: I20230110001590 |
| Provider Name | Brett Cavanaugh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821318502 PECOS PAC ID: 5991990103 Enrollment ID: I20230110002607 |
| Provider Name | Collette Jones |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427043504 PECOS PAC ID: 4183648157 Enrollment ID: I20230111000746 |
| Provider Name | Cynthia Leah Deschenes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306079900 PECOS PAC ID: 5092965319 Enrollment ID: I20230120002055 |
| Provider Name | Nicholas Zakovich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215490081 PECOS PAC ID: 6800209982 Enrollment ID: I20230131000883 |
| Provider Name | Carly Christine Gysler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1396270773 PECOS PAC ID: 3577935626 Enrollment ID: I20230217002082 |
| Provider Name | David Myers |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1609214493 PECOS PAC ID: 3274766910 Enrollment ID: I20230224002351 |
| Provider Name | Timothy Jardeleza |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871619361 PECOS PAC ID: 9830322395 Enrollment ID: I20230224002406 |
| Provider Name | Christopher David Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942761846 PECOS PAC ID: 1153794334 Enrollment ID: I20230309001118 |
| Provider Name | Rachael Joy Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699480202 PECOS PAC ID: 5496128696 Enrollment ID: I20230309001817 |
| Provider Name | Yvonne Daugherty |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780178541 PECOS PAC ID: 0840548434 Enrollment ID: I20230309002455 |
| Provider Name | William Michael Pitman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1902290356 PECOS PAC ID: 7113239054 Enrollment ID: I20230309002571 |
| Provider Name | Dimitrios Koudoumas |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1639456767 PECOS PAC ID: 6709123508 Enrollment ID: I20230309002725 |
| Provider Name | April Reynolds |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609219211 PECOS PAC ID: 3274768783 Enrollment ID: I20230310000553 |
| Provider Name | Samantha E Townsend |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205495439 PECOS PAC ID: 9032536602 Enrollment ID: I20230315001219 |
| Provider Name | Ali Alavi |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1508936592 PECOS PAC ID: 7012906688 Enrollment ID: I20230322002256 |
| Provider Name | Sydney Norris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225706526 PECOS PAC ID: 2961876149 Enrollment ID: I20230330001146 |
| Provider Name | Joie N Abner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881036119 PECOS PAC ID: 3476784497 Enrollment ID: I20230411001880 |
| Provider Name | Andrew Taecker |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952830481 PECOS PAC ID: 5991075830 Enrollment ID: I20230419000977 |
| Provider Name | Ali Banaie |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386613206 PECOS PAC ID: 3870573561 Enrollment ID: I20230419001169 |
| Provider Name | John M Canio |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598804346 PECOS PAC ID: 1355328006 Enrollment ID: I20230602000662 |
| Provider Name | Jamie Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447708649 PECOS PAC ID: 0840588000 Enrollment ID: I20230619000230 |
| Provider Name | Joseph Wright Clyde |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1710478698 PECOS PAC ID: 8123373461 Enrollment ID: I20230626002551 |
| Provider Name | John M Elibol |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1790282754 PECOS PAC ID: 8527306000 Enrollment ID: I20230628004479 |
| Provider Name | Nabiya Nadir Siddiqui |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1518451640 PECOS PAC ID: 1658619127 Enrollment ID: I20230629002577 |
| Provider Name | Tysen Timmer |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134614019 PECOS PAC ID: 2567823941 Enrollment ID: I20230801003862 |
| Provider Name | Jeffery David Young |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558822114 PECOS PAC ID: 3971964396 Enrollment ID: I20230802000715 |
| Provider Name | Bryce Mcbride |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417418476 PECOS PAC ID: 7810224003 Enrollment ID: I20230802001453 |
| Provider Name | Waldo Avello |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1922057322 PECOS PAC ID: 6800939240 Enrollment ID: I20230908003003 |
| Provider Name | Tirso Rojas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255338851 PECOS PAC ID: 2668467937 Enrollment ID: I20230911001206 |
| Provider Name | Thomas Aquinas Scileppi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598765430 PECOS PAC ID: 4587604731 Enrollment ID: I20230914000972 |
| Provider Name | James Clark |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1154954758 PECOS PAC ID: 3870908544 Enrollment ID: I20230925003295 |
| Provider Name | Jared Hooks |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750708038 PECOS PAC ID: 8729380480 Enrollment ID: I20230925003354 |
| Provider Name | Samantha Berman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639616543 PECOS PAC ID: 4486925229 Enrollment ID: I20230925003445 |
| Provider Name | Jack Hall |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1558337857 PECOS PAC ID: 6709861743 Enrollment ID: I20230926000485 |
| Provider Name | Robert Thurman |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1104905967 PECOS PAC ID: 6204739089 Enrollment ID: I20230926001138 |
| Provider Name | Kenneth Bania |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306504006 PECOS PAC ID: 9537559380 Enrollment ID: I20230926003455 |
| Provider Name | Kimberly Ellen Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942987144 PECOS PAC ID: 9335593003 Enrollment ID: I20230928002841 |
| Provider Name | Katherine Ann Zitello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427685270 PECOS PAC ID: 5991127706 Enrollment ID: I20231004003601 |
| Provider Name | Allayna Tyree |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376224030 PECOS PAC ID: 3173978442 Enrollment ID: I20231006002793 |
| Provider Name | Tawhid Gazi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1235236571 PECOS PAC ID: 9638271554 Enrollment ID: I20231009001400 |
| Provider Name | Carolyn Aks |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1518905678 PECOS PAC ID: 4183619752 Enrollment ID: I20231013000490 |
| Provider Name | Derek Johanson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598329237 PECOS PAC ID: 3577947738 Enrollment ID: I20231017001368 |
| Provider Name | Sheryl Logan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104820042 PECOS PAC ID: 3971789389 Enrollment ID: I20231027001966 |
| Provider Name | Felix Jorge Hernandez |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518072529 PECOS PAC ID: 4284776964 Enrollment ID: I20231030000495 |
| Provider Name | Michelle Estep |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063631141 PECOS PAC ID: 8628145687 Enrollment ID: I20231030001701 |
| Provider Name | Andrei Gasic |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184623407 PECOS PAC ID: 3779550009 Enrollment ID: I20231103001096 |
| Provider Name | Genci Babameto |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841264702 PECOS PAC ID: 0749388130 Enrollment ID: I20231109002444 |
| Provider Name | Barbara Ferdman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457308652 PECOS PAC ID: 3577513381 Enrollment ID: I20231114000656 |
| Provider Name | Teresa Frey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1336536291 PECOS PAC ID: 4981910395 Enrollment ID: I20231115002551 |
| Provider Name | Barry A Ross |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1699714931 PECOS PAC ID: 9436190071 Enrollment ID: I20231129002390 |
| Provider Name | Eric Tamesis |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1255305132 PECOS PAC ID: 1759272966 Enrollment ID: I20231215001160 |
| Provider Name | Sarah Fryberger |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366548935 PECOS PAC ID: 7517993140 Enrollment ID: I20231222000498 |
| Provider Name | Craig Hawkins |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659394112 PECOS PAC ID: 5193799252 Enrollment ID: I20240103002803 |
| Provider Name | Garrison Whitaker |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1467654509 PECOS PAC ID: 6002973302 Enrollment ID: I20240104004743 |
| Provider Name | Jorge Betancor |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1114241619 PECOS PAC ID: 2668609157 Enrollment ID: I20240105002525 |
| Provider Name | Robert Matthews |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1215965033 PECOS PAC ID: 3577460195 Enrollment ID: I20240106000443 |
| Provider Name | Kristen Larkin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942713771 PECOS PAC ID: 9739448457 Enrollment ID: I20240107000177 |
| Provider Name | Megan Collins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972039881 PECOS PAC ID: 1557783511 Enrollment ID: I20240108006023 |
| Provider Name | Kimberly Atianzar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1497917629 PECOS PAC ID: 9436330495 Enrollment ID: I20240124001185 |
| Provider Name | Mikhail Kirnus |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1922272228 PECOS PAC ID: 2860547452 Enrollment ID: I20240131003312 |
| Provider Name | Kristina Burton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033380381 PECOS PAC ID: 8123107455 Enrollment ID: I20240206001856 |
| Provider Name | Genevieve Jacobs |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1912369992 PECOS PAC ID: 0042582553 Enrollment ID: I20240206002550 |
| Provider Name | Sukant Gupta |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1588639454 PECOS PAC ID: 6608890751 Enrollment ID: I20240206003503 |
| Provider Name | Joanne Tsai |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346260148 PECOS PAC ID: 4082649983 Enrollment ID: I20240307003607 |
| Provider Name | Randolph Hutter |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1700047339 PECOS PAC ID: 6709005556 Enrollment ID: I20240311001511 |
| Provider Name | Jill A Cook |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134233604 PECOS PAC ID: 8921141573 Enrollment ID: I20240327003856 |
| Provider Name | Christopher Niehues |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518453448 PECOS PAC ID: 7315296357 Enrollment ID: I20240405001236 |
| Provider Name | Matthew Christopher Little |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396367389 PECOS PAC ID: 9436597689 Enrollment ID: I20240405003204 |
| Provider Name | Brook Elizabeth Clark |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831766146 PECOS PAC ID: 1557700325 Enrollment ID: I20240413000351 |
| Provider Name | William Deen Bowden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437916558 PECOS PAC ID: 4587003215 Enrollment ID: I20240415001990 |
| Provider Name | Jay Danto |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1225141641 PECOS PAC ID: 9032214358 Enrollment ID: I20240416003206 |
| Provider Name | Timothy Gardner |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851387229 PECOS PAC ID: 2163437906 Enrollment ID: I20240424004023 |
| Provider Name | Steven Mast |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1174522429 PECOS PAC ID: 7214987700 Enrollment ID: I20240503001488 |
| Provider Name | Nikki Sue Bonilla King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396500245 PECOS PAC ID: 9638519945 Enrollment ID: I20240503002000 |
| Provider Name | Justinn E Lahaye |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1376003400 PECOS PAC ID: 7719305374 Enrollment ID: I20240514003174 |
| Provider Name | Sara Colby |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1821178716 PECOS PAC ID: 3678536125 Enrollment ID: I20240523000824 |
| Provider Name | Carol Ann Cress |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679356869 PECOS PAC ID: 5193167898 Enrollment ID: I20240528000369 |
| Provider Name | Robert Waugh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003950569 PECOS PAC ID: 7113043183 Enrollment ID: I20240531001974 |
| Provider Name | J Cannon Clifton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1225219678 PECOS PAC ID: 4183775794 Enrollment ID: I20240604001019 |
| Provider Name | Scott Dudak |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1831139351 PECOS PAC ID: 1355415183 Enrollment ID: I20240604001969 |
| Provider Name | Suzanne Troup Duncan |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1285843185 PECOS PAC ID: 3274683164 Enrollment ID: I20240611001039 |
| Provider Name | Necia Marie Tierney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841041233 PECOS PAC ID: 9830631258 Enrollment ID: I20240612003474 |
Tim Weill Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2800 11th Ave S, Suite 13, Great Falls, MT 59405 Phone: 406-761-6880 | |
Indian Family Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1220 Central Ave, Ste. 1b, Great Falls, MT 59401 Phone: 406-268-1587 | |
Ideal Telemedicine Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 15th Ave S Ste 109, Great Falls, MT 59405 Phone: 509-222-1275 Fax: 509-491-3031 | |
Inner Reflections Healthcare Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1701 Central Ave, Great Falls, MT 59401 Phone: 406-453-1254 Fax: 106-453-0776 | |
Central Mt Laboratory, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3511 1st Ave N, Great Falls, MT 59401 Phone: 406-454-1211 Fax: 406-454-9916 | |
North Central Primary Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 400 13th Ave S Ste 206, Great Falls, MT 59405 Phone: 406-771-7300 | |
Patsy Vargo Md Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3511 1st Ave N, Ste 1, Great Falls, MT 59401 Phone: 406-727-5778 Fax: 406-761-7117 |