| Centracare - Monticello Specialty Clinic | |
|
1107 Hart Blvd Monticello MN 55362-8538 | |
| (763) 271-2276 | |
| (763) 271-1799 |
| Full Name | Centracare - Monticello Specialty Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1107 Hart Blvd, Monticello, Minnesota |
| Authorized Official Name and Position | Michael A. Blair (SR. VICE PRESIDENT AND CFO) |
| Authorized Official Contact | 3202555665 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Centracare - Monticello Specialty Clinic 1107 Hart Blvd Monticello MN 55362-8538 Ph: (763) 271-2276 | Centracare - Monticello Specialty Clinic 1107 Hart Blvd Monticello MN 55362-8538 Ph: (763) 271-2276 |
| NPI Number | 1558600874 |
|---|---|
| Provider Enumeration Date | 02/06/2013 |
| Last Update Date | 10/10/2019 |
| Medicare PECOS PAC ID | 3870739410 |
|---|---|
| Medicare Enrollment ID | O20130515000683 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558600874 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Olayiwola R Adetunji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578552477 PECOS PAC ID: 8123920865 Enrollment ID: I20040123000239 |
| Provider Name | Brett A Pinkerton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639160583 PECOS PAC ID: 6406758010 Enrollment ID: I20040123000685 |
| Provider Name | Joseph E Mccrone |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518931203 PECOS PAC ID: 8921997776 Enrollment ID: I20040311000573 |
| Provider Name | Thom G Dahle |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1760458673 PECOS PAC ID: 4688564081 Enrollment ID: I20040318001068 |
| Provider Name | Jason S Halvorson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033139159 PECOS PAC ID: 2860304300 Enrollment ID: I20040430000145 |
| Provider Name | Todd M Severnak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790775393 PECOS PAC ID: 2567452410 Enrollment ID: I20040513001105 |
| Provider Name | Sarah R Carter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508829037 PECOS PAC ID: 0446220362 Enrollment ID: I20040728001220 |
| Provider Name | Steven J Fuglestad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083694897 PECOS PAC ID: 7214908011 Enrollment ID: I20040804001341 |
| Provider Name | Ositadimma C Ugwu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013989417 PECOS PAC ID: 0042281628 Enrollment ID: I20040805000792 |
| Provider Name | Paul R Sander |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902918451 PECOS PAC ID: 4486626959 Enrollment ID: I20040806000546 |
| Provider Name | Thomas J Rossini |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194823179 PECOS PAC ID: 8628047701 Enrollment ID: I20040927000149 |
| Provider Name | Michael D Oborsky |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1053477406 PECOS PAC ID: 3173504867 Enrollment ID: I20041115000059 |
| Provider Name | Susan M Piehl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790767929 PECOS PAC ID: 0941264162 Enrollment ID: I20041117000757 |
| Provider Name | Albert J Mercuri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871557918 PECOS PAC ID: 3375507593 Enrollment ID: I20041117000782 |
| Provider Name | William B Scheig |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497735393 PECOS PAC ID: 3072577014 Enrollment ID: I20041118000594 |
| Provider Name | Chad R Welle |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427021716 PECOS PAC ID: 9830141407 Enrollment ID: I20050211000719 |
| Provider Name | Jimmy Ching |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891754693 PECOS PAC ID: 2860448834 Enrollment ID: I20050323000950 |
| Provider Name | John R Hering |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124048251 PECOS PAC ID: 0840247508 Enrollment ID: I20050405000500 |
| Provider Name | Walter L Sia Su |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477542371 PECOS PAC ID: 2466499744 Enrollment ID: I20050408000871 |
| Provider Name | Gemma C Lim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497726749 PECOS PAC ID: 0345288015 Enrollment ID: I20050502001067 |
| Provider Name | Christopher D Leville |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1699776310 PECOS PAC ID: 0749221398 Enrollment ID: I20050513000550 |
| Provider Name | Teague A Dombeck |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407815558 PECOS PAC ID: 1153363130 Enrollment ID: I20050601000029 |
| Provider Name | Paul L Marek |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134118920 PECOS PAC ID: 4183695505 Enrollment ID: I20050603000417 |
| Provider Name | Julia Montgomery |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1750497996 PECOS PAC ID: 1052357928 Enrollment ID: I20050630000437 |
| Provider Name | Teresa E Wrobbel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912916933 PECOS PAC ID: 8224940762 Enrollment ID: I20050711000161 |
| Provider Name | Jamie Michael Pelzel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1750340485 PECOS PAC ID: 9436186533 Enrollment ID: I20050720000652 |
| Provider Name | Joseph Michael Mayland |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679505093 PECOS PAC ID: 6709813306 Enrollment ID: I20050726000399 |
| Provider Name | Susanne S Rupert |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1386711661 PECOS PAC ID: 8123056983 Enrollment ID: I20050802000826 |
| Provider Name | Maria D Mallory |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689664344 PECOS PAC ID: 8628008109 Enrollment ID: I20050815000536 |
| Provider Name | Mark Janorschke |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720055171 PECOS PAC ID: 1153388129 Enrollment ID: I20050907001063 |
| Provider Name | Omer Qureishy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679534952 PECOS PAC ID: 0143253724 Enrollment ID: I20050914000645 |
| Provider Name | Melissa M Barry |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1700846425 PECOS PAC ID: 2769417278 Enrollment ID: I20051004000545 |
| Provider Name | James B Christenson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922019231 PECOS PAC ID: 1759300544 Enrollment ID: I20051122000570 |
| Provider Name | Mark William Bonneville |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336129626 PECOS PAC ID: 7315967585 Enrollment ID: I20051202000162 |
| Provider Name | Larry Burton Okerlund |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881630051 PECOS PAC ID: 3476598012 Enrollment ID: I20060105000780 |
| Provider Name | Mark I Holub |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720038714 PECOS PAC ID: 0749294635 Enrollment ID: I20060131000105 |
| Provider Name | Mohammed I Hussain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770557225 PECOS PAC ID: 6507871928 Enrollment ID: I20060207000251 |
| Provider Name | Jacob D Kotzian |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255387775 PECOS PAC ID: 6002826583 Enrollment ID: I20060427000574 |
| Provider Name | Kurt A Martinson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245281302 PECOS PAC ID: 8820066889 Enrollment ID: I20060605000148 |
| Provider Name | Daniel Brent Leslie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295779809 PECOS PAC ID: 0446263230 Enrollment ID: I20060721000005 |
| Provider Name | Wade T Schmidt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1629031190 PECOS PAC ID: 8820091986 Enrollment ID: I20060810000557 |
| Provider Name | John M Houle |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1073531885 PECOS PAC ID: 8426052507 Enrollment ID: I20060901000076 |
| Provider Name | Kelly S Collins |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1801999453 PECOS PAC ID: 3173528288 Enrollment ID: I20060925000157 |
| Provider Name | Charina H Wynia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770676728 PECOS PAC ID: 7416954508 Enrollment ID: I20061102000520 |
| Provider Name | Jennifer N Martinson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164526299 PECOS PAC ID: 7719986629 Enrollment ID: I20061204000083 |
| Provider Name | Theodore W Ruzanic |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932273943 PECOS PAC ID: 6002816113 Enrollment ID: I20070112000338 |
| Provider Name | Dahlia H Elkadi |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1902855109 PECOS PAC ID: 2668576299 Enrollment ID: I20070409000382 |
| Provider Name | Troy A Payne |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1083682561 PECOS PAC ID: 1759316318 Enrollment ID: I20070424000061 |
| Provider Name | Jacob R Dutcher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619000999 PECOS PAC ID: 4981795754 Enrollment ID: I20070808000365 |
| Provider Name | Joseph D Scuderi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043292253 PECOS PAC ID: 7517957988 Enrollment ID: I20070830000695 |
| Provider Name | Raza A Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669584249 PECOS PAC ID: 3173616950 Enrollment ID: I20070910000997 |
| Provider Name | Nickitas Ba Thomarios |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447394903 PECOS PAC ID: 6800983784 Enrollment ID: I20071025000285 |
| Provider Name | Charles Wolfe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376594457 PECOS PAC ID: 6901994979 Enrollment ID: I20071109000123 |
| Provider Name | Heather A Penning |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700071248 PECOS PAC ID: 5698863249 Enrollment ID: I20071114000443 |
| Provider Name | Monica K Pogatchnik |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568662658 PECOS PAC ID: 7810085412 Enrollment ID: I20071115000248 |
| Provider Name | Susan A Peterson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336334663 PECOS PAC ID: 3779663158 Enrollment ID: I20080110000572 |
| Provider Name | Carla M Severson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316132640 PECOS PAC ID: 1951482496 Enrollment ID: I20080122000768 |
| Provider Name | Elizabeth C Schaefer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063607083 PECOS PAC ID: 6800978339 Enrollment ID: I20080123000508 |
| Provider Name | Gregory A Cooper |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730179870 PECOS PAC ID: 1355334426 Enrollment ID: I20080205000078 |
| Provider Name | John F Knorp |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669530952 PECOS PAC ID: 5698876613 Enrollment ID: I20081028000833 |
| Provider Name | Ellen E Brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437135027 PECOS PAC ID: 1456412063 Enrollment ID: I20081201000544 |
| Provider Name | Robin C Marushin |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1154466209 PECOS PAC ID: 8527120518 Enrollment ID: I20081230000165 |
| Provider Name | Nelson L Adamson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1720155336 PECOS PAC ID: 1557425691 Enrollment ID: I20090204000156 |
| Provider Name | Christine E Mason |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750553194 PECOS PAC ID: 2860559531 Enrollment ID: I20090324000648 |
| Provider Name | Dennis L Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508885013 PECOS PAC ID: 5991781437 Enrollment ID: I20090408000331 |
| Provider Name | Kayla H Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962565333 PECOS PAC ID: 3476600859 Enrollment ID: I20090422000466 |
| Provider Name | Jacob R Tjaden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164688479 PECOS PAC ID: 5193873453 Enrollment ID: I20090427000239 |
| Provider Name | Mark D Nelson |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1487656344 PECOS PAC ID: 1052476439 Enrollment ID: I20090616000334 |
| Provider Name | Brandon M Smith |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1912108648 PECOS PAC ID: 8628120938 Enrollment ID: I20090717000285 |
| Provider Name | Richard J Backes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1871595686 PECOS PAC ID: 0648322750 Enrollment ID: I20090721000759 |
| Provider Name | Bernard R Erickson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1306848122 PECOS PAC ID: 1456403468 Enrollment ID: I20090722000049 |
| Provider Name | Timothy N Schuchard |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114913217 PECOS PAC ID: 1456403476 Enrollment ID: I20090722000059 |
| Provider Name | Daniel James Tiede |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1306839949 PECOS PAC ID: 8628121514 Enrollment ID: I20090724000104 |
| Provider Name | Hieu J Nguyen |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194710061 PECOS PAC ID: 8022162981 Enrollment ID: I20090812000596 |
| Provider Name | John Michael Mahowald |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952303570 PECOS PAC ID: 0042364788 Enrollment ID: I20090814000589 |
| Provider Name | Jessica R Baitani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285800466 PECOS PAC ID: 6507912334 Enrollment ID: I20090921000434 |
| Provider Name | Nathaniel Reuter |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457479446 PECOS PAC ID: 8921199373 Enrollment ID: I20090924000337 |
| Provider Name | Natalie R Roeser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497928337 PECOS PAC ID: 4385780154 Enrollment ID: I20091008000060 |
| Provider Name | Mark E Johnson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568454502 PECOS PAC ID: 2466592191 Enrollment ID: I20091210000497 |
| Provider Name | Lydia M Wade |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992926893 PECOS PAC ID: 0941340319 Enrollment ID: I20091215000531 |
| Provider Name | Terri T Gerdes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1932158789 PECOS PAC ID: 4082756572 Enrollment ID: I20100121000523 |
| Provider Name | John M Schmitz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1982653499 PECOS PAC ID: 1153428248 Enrollment ID: I20100121000555 |
| Provider Name | Jon C Bowar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1992755052 PECOS PAC ID: 9739221243 Enrollment ID: I20100121000695 |
| Provider Name | Dean D Watkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326097858 PECOS PAC ID: 6800938960 Enrollment ID: I20100127000820 |
| Provider Name | Jane K Willett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548236292 PECOS PAC ID: 4789727769 Enrollment ID: I20100130000350 |
| Provider Name | Avanti Mehrotra |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1699705491 PECOS PAC ID: 3577583152 Enrollment ID: I20100215000660 |
| Provider Name | Christian P Schmidt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497745152 PECOS PAC ID: 1052455318 Enrollment ID: I20100224000643 |
| Provider Name | David A Kroska |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528059185 PECOS PAC ID: 3870638042 Enrollment ID: I20100227000060 |
| Provider Name | Eric T Mcfarling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467437251 PECOS PAC ID: 9436061546 Enrollment ID: I20100302000100 |
| Provider Name | Darin D Willardsen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346230034 PECOS PAC ID: 5395880462 Enrollment ID: I20100302000141 |
| Provider Name | Paul Joseph Mitchell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770573420 PECOS PAC ID: 4284779174 Enrollment ID: I20100303000430 |
| Provider Name | Glenn G Nemec |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578578068 PECOS PAC ID: 1153233606 Enrollment ID: I20100511000077 |
| Provider Name | Timothy A Olson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659388064 PECOS PAC ID: 3678485125 Enrollment ID: I20100511000339 |
| Provider Name | Rajan Jhanjee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1871513929 PECOS PAC ID: 8729178298 Enrollment ID: I20100511000658 |
| Provider Name | Bernice M Kolb |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740200625 PECOS PAC ID: 5991617433 Enrollment ID: I20100511000762 |
| Provider Name | Dana M Carlson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1740255884 PECOS PAC ID: 8224092895 Enrollment ID: I20100604000239 |
| Provider Name | Mary Joy L Sia Su |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356374136 PECOS PAC ID: 1759411572 Enrollment ID: I20100604000718 |
| Provider Name | Timothy F Ebel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447286851 PECOS PAC ID: 3678558459 Enrollment ID: I20100616000805 |
| Provider Name | Tera A Wenzel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922324474 PECOS PAC ID: 0143352138 Enrollment ID: I20100708001062 |
| Provider Name | Alan D Reitz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336130517 PECOS PAC ID: 8123918877 Enrollment ID: I20100824001216 |
| Provider Name | Wayne R Jandik |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1174514731 PECOS PAC ID: 1254221971 Enrollment ID: I20100824001262 |
| Provider Name | Shih-an Hsieh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003076290 PECOS PAC ID: 1557485497 Enrollment ID: I20100830001137 |
| Provider Name | Chris A Rodahl |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053423343 PECOS PAC ID: 3173647682 Enrollment ID: I20100903000502 |
| Provider Name | Duane Eric Westberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578577656 PECOS PAC ID: 4688790496 Enrollment ID: I20100929001425 |
| Provider Name | Peter W Waldusky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194714097 PECOS PAC ID: 7012109895 Enrollment ID: I20101012000727 |
| Provider Name | Eric M Hernandez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154514487 PECOS PAC ID: 1557553351 Enrollment ID: I20101012001049 |
| Provider Name | Michael K Butts |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1235102039 PECOS PAC ID: 6406044759 Enrollment ID: I20101230000640 |
| Provider Name | Arihant Dalal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336333848 PECOS PAC ID: 8426247206 Enrollment ID: I20110110000384 |
| Provider Name | Evelyn J Erickson |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1568480366 PECOS PAC ID: 3476589227 Enrollment ID: I20110131000670 |
| Provider Name | Julie V Bechtel |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669638581 PECOS PAC ID: 5294762829 Enrollment ID: I20110217000244 |
| Provider Name | Somendra Vaishnav |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609043843 PECOS PAC ID: 1658552278 Enrollment ID: I20110301001136 |
| Provider Name | Kaylle Rose Schmit Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144533290 PECOS PAC ID: 0143402735 Enrollment ID: I20110302000839 |
| Provider Name | Hilary I Ufearo |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1366626343 PECOS PAC ID: 7416130307 Enrollment ID: I20110330000960 |
| Provider Name | Henry K Bong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831213438 PECOS PAC ID: 7517140353 Enrollment ID: I20110331000631 |
| Provider Name | Shweta Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407040892 PECOS PAC ID: 0648453407 Enrollment ID: I20110331000827 |
| Provider Name | Michael D Bond |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386946028 PECOS PAC ID: 2163607557 Enrollment ID: I20110428000629 |
| Provider Name | Rebecca A Petersen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336442144 PECOS PAC ID: 2264617349 Enrollment ID: I20110505000365 |
| Provider Name | Mark L Kassebaum |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205924776 PECOS PAC ID: 1052596012 Enrollment ID: I20110506000513 |
| Provider Name | Jessie L Roske |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124258686 PECOS PAC ID: 5092983981 Enrollment ID: I20110720000304 |
| Provider Name | Joseph I Levine |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1801074182 PECOS PAC ID: 1254509029 Enrollment ID: I20110726000298 |
| Provider Name | Nabeel B Ailabouni |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043479876 PECOS PAC ID: 6305032467 Enrollment ID: I20110919000714 |
| Provider Name | Muhammad Asad Khan Suri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174578785 PECOS PAC ID: 8325031297 Enrollment ID: I20110920000197 |
| Provider Name | Elizabeth A Sikes |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386750388 PECOS PAC ID: 7012820095 Enrollment ID: I20110921000818 |
| Provider Name | Henry P Yang |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1003863366 PECOS PAC ID: 4486541083 Enrollment ID: I20111006000780 |
| Provider Name | Rebecca K Campbell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457556144 PECOS PAC ID: 8224202395 Enrollment ID: I20111130000017 |
| Provider Name | Abby Rae Labounty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528359452 PECOS PAC ID: 9032365101 Enrollment ID: I20120806000020 |
| Provider Name | Amy M Railson |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1285990226 PECOS PAC ID: 5294981346 Enrollment ID: I20120806000901 |
| Provider Name | Derek R Weiland |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1336320225 PECOS PAC ID: 2264689454 Enrollment ID: I20120822000709 |
| Provider Name | Travis R Williams |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245465244 PECOS PAC ID: 3476700469 Enrollment ID: I20120827000444 |
| Provider Name | Oluyemi A Ajayi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972701217 PECOS PAC ID: 9931296761 Enrollment ID: I20121004000874 |
| Provider Name | Tiffany M Rickbeil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538303938 PECOS PAC ID: 7719137736 Enrollment ID: I20121026000472 |
| Provider Name | April M Stadtler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821360579 PECOS PAC ID: 1153576988 Enrollment ID: I20130228000474 |
| Provider Name | Andrea M Lundeen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730344664 PECOS PAC ID: 8426290826 Enrollment ID: I20130814000976 |
| Provider Name | James Christopher Lorge |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1376749192 PECOS PAC ID: 7719134865 Enrollment ID: I20130827000196 |
| Provider Name | Chinwe Oraka |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710042395 PECOS PAC ID: 1456548106 Enrollment ID: I20130926000149 |
| Provider Name | Kasy L Omann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477995272 PECOS PAC ID: 7214162205 Enrollment ID: I20131029000906 |
| Provider Name | Scott T Bertram |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801226923 PECOS PAC ID: 1658509195 Enrollment ID: I20140108001505 |
| Provider Name | Lucas P Bachmann |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003137449 PECOS PAC ID: 4183872310 Enrollment ID: I20140423001767 |
| Provider Name | Yaga Saine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053731752 PECOS PAC ID: 3476776576 Enrollment ID: I20140517000188 |
| Provider Name | Jennifer M Taves |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629344023 PECOS PAC ID: 4284857269 Enrollment ID: I20140520000833 |
| Provider Name | Sarah Jane Ibeling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962812503 PECOS PAC ID: 9436372067 Enrollment ID: I20140528001683 |
| Provider Name | Larry V Hook |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1780909168 PECOS PAC ID: 6800059833 Enrollment ID: I20140623000545 |
| Provider Name | Nichole Leigh Cummings |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558641951 PECOS PAC ID: 9931325339 Enrollment ID: I20140721001469 |
| Provider Name | Christopher W Wieland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093025801 PECOS PAC ID: 0941442164 Enrollment ID: I20140722000150 |
| Provider Name | Abigail L Taylor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356630636 PECOS PAC ID: 1153547294 Enrollment ID: I20140724002357 |
| Provider Name | Teresa J Devine |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255771911 PECOS PAC ID: 3375769110 Enrollment ID: I20140730002710 |
| Provider Name | Benjamin Faustich |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699092916 PECOS PAC ID: 8123246451 Enrollment ID: I20140828002108 |
| Provider Name | Jacob W Eiler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255656997 PECOS PAC ID: 8224261979 Enrollment ID: I20140926000795 |
| Provider Name | Erin L Hanson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871886523 PECOS PAC ID: 3577785542 Enrollment ID: I20141106000488 |
| Provider Name | Srikanth R Dakoji |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689932436 PECOS PAC ID: 7719209766 Enrollment ID: I20141203000765 |
| Provider Name | Maria A Smith |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811003478 PECOS PAC ID: 3274427349 Enrollment ID: I20141220000171 |
| Provider Name | Sarah Polcher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982991964 PECOS PAC ID: 0143451641 Enrollment ID: I20141230000527 |
| Provider Name | Kruti J Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043574262 PECOS PAC ID: 7012232218 Enrollment ID: I20150210002426 |
| Provider Name | Amadin O Osayomore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700198660 PECOS PAC ID: 2466694138 Enrollment ID: I20150218001454 |
| Provider Name | Timothy M Ehle |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1659575702 PECOS PAC ID: 2466510573 Enrollment ID: I20150508002165 |
| Provider Name | Sharath S Subramanian |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619047529 PECOS PAC ID: 6103956537 Enrollment ID: I20150623000954 |
| Provider Name | Kelsey J King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568845238 PECOS PAC ID: 6709190051 Enrollment ID: I20150731014432 |
| Provider Name | Eric David Hyun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831450170 PECOS PAC ID: 8527374388 Enrollment ID: I20150825004478 |
| Provider Name | Anand Mahesh Joshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801187794 PECOS PAC ID: 3072743806 Enrollment ID: I20150915002666 |
| Provider Name | Ngozi O Nwakamma-okoro |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1134147713 PECOS PAC ID: 6608876560 Enrollment ID: I20150918001989 |
| Provider Name | Larae A Lymer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417327651 PECOS PAC ID: 2567771462 Enrollment ID: I20151015001080 |
| Provider Name | Kristy E Peterfeso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598140881 PECOS PAC ID: 9032428677 Enrollment ID: I20151021001178 |
| Provider Name | Sarah Catherine Babst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154799781 PECOS PAC ID: 4688984891 Enrollment ID: I20151029003022 |
| Provider Name | Mahesh Kumar |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1871835900 PECOS PAC ID: 6002126588 Enrollment ID: I20151112002744 |
| Provider Name | Benjamin Keith Johnson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255627790 PECOS PAC ID: 6305145129 Enrollment ID: I20160601001033 |
| Provider Name | Christopher B Miller |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1114201514 PECOS PAC ID: 7911145982 Enrollment ID: I20160715002167 |
| Provider Name | Brian M Stegman |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1447425160 PECOS PAC ID: 9830314608 Enrollment ID: I20160721000888 |
| Provider Name | Mithun R Suresh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326483702 PECOS PAC ID: 7315242856 Enrollment ID: I20160830002979 |
| Provider Name | Patrick Wayne Odens |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780023846 PECOS PAC ID: 6608162706 Enrollment ID: I20160915000322 |
| Provider Name | Kelsey M Mcanally |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548608235 PECOS PAC ID: 0244552305 Enrollment ID: I20161103001574 |
| Provider Name | Christopher D Elness |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649622200 PECOS PAC ID: 8426337205 Enrollment ID: I20161118000658 |
| Provider Name | Angie L Paschke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518410612 PECOS PAC ID: 2466732789 Enrollment ID: I20161202001222 |
| Provider Name | Kelly M Awes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619429180 PECOS PAC ID: 4587944665 Enrollment ID: I20161207000455 |
| Provider Name | Kadir O Mullings |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1639611288 PECOS PAC ID: 8325320468 Enrollment ID: I20170124003138 |
| Provider Name | Mari A Tran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124562970 PECOS PAC ID: 3971888637 Enrollment ID: I20170320000853 |
| Provider Name | Roxanne M Boser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134558109 PECOS PAC ID: 8820373178 Enrollment ID: I20170328002545 |
| Provider Name | Adam J Shapin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1487068938 PECOS PAC ID: 5597980854 Enrollment ID: I20170606002296 |
| Provider Name | Jenine M Graham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619404928 PECOS PAC ID: 4880965383 Enrollment ID: I20170802000149 |
| Provider Name | Brenna L Radermacher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619499860 PECOS PAC ID: 6507137775 Enrollment ID: I20170807000837 |
| Provider Name | Heidi Renae Nichol |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538514658 PECOS PAC ID: 9931489895 Enrollment ID: I20170812000338 |
| Provider Name | Alicia Grace Floyd |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033408505 PECOS PAC ID: 2567680713 Enrollment ID: I20170814001669 |
| Provider Name | Erin N Hennen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881037356 PECOS PAC ID: 6608149331 Enrollment ID: I20170831002155 |
| Provider Name | Evan L Dyce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013437110 PECOS PAC ID: 8022382654 Enrollment ID: I20170921000115 |
| Provider Name | Joshua M Kenzie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477072247 PECOS PAC ID: 3577820992 Enrollment ID: I20171120002114 |
| Provider Name | Jaclyn H Possin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396275848 PECOS PAC ID: 0840557062 Enrollment ID: I20171127000825 |
| Provider Name | Maggie L Thronaum |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821384678 PECOS PAC ID: 0244460582 Enrollment ID: I20171201000971 |
| Provider Name | Daniel B Janiczak |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295198539 PECOS PAC ID: 0941592711 Enrollment ID: I20180417002493 |
| Provider Name | Yogesh A Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1154646883 PECOS PAC ID: 9739305293 Enrollment ID: I20180509002467 |
| Provider Name | Pavan K Bhamidipati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548490840 PECOS PAC ID: 9931358256 Enrollment ID: I20180616000010 |
| Provider Name | Matthew E Emerson |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1861888653 PECOS PAC ID: 4082927355 Enrollment ID: I20180619003502 |
| Provider Name | Daniel B Pickett |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174866644 PECOS PAC ID: 9133475478 Enrollment ID: I20180628003150 |
| Provider Name | Eric Stephen Wise |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518252857 PECOS PAC ID: 6507155207 Enrollment ID: I20180703002320 |
| Provider Name | Damon M Campbell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518285816 PECOS PAC ID: 3375771744 Enrollment ID: I20180716000172 |
| Provider Name | Rena A Shah |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1750670667 PECOS PAC ID: 4587885603 Enrollment ID: I20180723000248 |
| Provider Name | Jacob B Dubay |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831514686 PECOS PAC ID: 2769758895 Enrollment ID: I20180806002971 |
| Provider Name | Ryan Michael Finn |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558898684 PECOS PAC ID: 7810269008 Enrollment ID: I20180806003180 |
| Provider Name | Paul K Perry |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043448095 PECOS PAC ID: 4284888462 Enrollment ID: I20180807002336 |
| Provider Name | Clarence O Ojo |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1053650630 PECOS PAC ID: 3072747021 Enrollment ID: I20180810003100 |
| Provider Name | Jacqueline K Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285138719 PECOS PAC ID: 7618226457 Enrollment ID: I20180828000496 |
| Provider Name | Shaun Fernandes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548640436 PECOS PAC ID: 9133432610 Enrollment ID: I20180828000595 |
| Provider Name | Andrea M Petersen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508344466 PECOS PAC ID: 2365795234 Enrollment ID: I20181023000210 |
| Provider Name | Brandon M Philippi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548743446 PECOS PAC ID: 9739432410 Enrollment ID: I20181025002608 |
| Provider Name | Tatyana Zharkova |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336521608 PECOS PAC ID: 9638460553 Enrollment ID: I20190529002532 |
| Provider Name | Elizabeth Edlavitch Levin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578907846 PECOS PAC ID: 1557694189 Enrollment ID: I20190613000011 |
| Provider Name | Adewale O Odofin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972955375 PECOS PAC ID: 3375876899 Enrollment ID: I20190614000699 |
| Provider Name | Haleigh N Storkel |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1144748765 PECOS PAC ID: 8628344298 Enrollment ID: I20190619002661 |
| Provider Name | Paul C Peterson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902805518 PECOS PAC ID: 2668453564 Enrollment ID: I20190709002811 |
| Provider Name | Nicole J Lyons |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013336106 PECOS PAC ID: 0143525303 Enrollment ID: I20190731001185 |
| Provider Name | Keary Lee Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417335050 PECOS PAC ID: 9234448010 Enrollment ID: I20190801002035 |
| Provider Name | Fatima Sharifmohamed |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285011635 PECOS PAC ID: 0547599193 Enrollment ID: I20190909000733 |
| Provider Name | Amanda S Delaney |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154778942 PECOS PAC ID: 8123311222 Enrollment ID: I20190912003145 |
| Provider Name | Kelly C Hanson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750736252 PECOS PAC ID: 4385931849 Enrollment ID: I20190927001035 |
| Provider Name | Sakshi Kaul |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1184044067 PECOS PAC ID: 6305141169 Enrollment ID: I20191002000804 |
| Provider Name | Trenton J Smolik |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477903573 PECOS PAC ID: 6204128176 Enrollment ID: I20191016001518 |
| Provider Name | Michael D Forster |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366823692 PECOS PAC ID: 5890099329 Enrollment ID: I20191023001859 |
| Provider Name | Merryssa L Wood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215579461 PECOS PAC ID: 5991137739 Enrollment ID: I20191115000593 |
| Provider Name | Wade E Paulson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447645916 PECOS PAC ID: 1355656984 Enrollment ID: I20200526000075 |
| Provider Name | Sade M Finn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1578099545 PECOS PAC ID: 5799057899 Enrollment ID: I20200609001866 |
| Provider Name | Morgan N Matter |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1629681119 PECOS PAC ID: 2264852698 Enrollment ID: I20201023000050 |
| Provider Name | Mahad A Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184144057 PECOS PAC ID: 2163832239 Enrollment ID: I20201030000037 |
| Provider Name | Cameron C Hendrickson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487264164 PECOS PAC ID: 0648681882 Enrollment ID: I20201119002300 |
| Provider Name | Crystal L Fleischhacker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356956601 PECOS PAC ID: 5698187185 Enrollment ID: I20201207000657 |
| Provider Name | Chelsey R Paulson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891308813 PECOS PAC ID: 6305250317 Enrollment ID: I20210203001769 |
| Provider Name | Sarah M Pelletier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629667035 PECOS PAC ID: 7315352861 Enrollment ID: I20210216002132 |
| Provider Name | Julie A Wolke |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1457943771 PECOS PAC ID: 3173939436 Enrollment ID: I20210310003079 |
| Provider Name | Evan Michael Mariash |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1285850784 PECOS PAC ID: 4385822626 Enrollment ID: I20210528002308 |
| Provider Name | Benjamin P Morey |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1629430012 PECOS PAC ID: 6709173610 Enrollment ID: I20210623001353 |
| Provider Name | Stephen K Kidd |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477816304 PECOS PAC ID: 6901024777 Enrollment ID: I20210708002787 |
| Provider Name | Vanessa L Baca |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1922494624 PECOS PAC ID: 5890090922 Enrollment ID: I20210715004156 |
| Provider Name | Claire F Drom |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710331814 PECOS PAC ID: 0941568968 Enrollment ID: I20210716001742 |
| Provider Name | Robert H Krieger |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912367103 PECOS PAC ID: 0143625749 Enrollment ID: I20210819002716 |
| Provider Name | Kelly Marie Kerber |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871904292 PECOS PAC ID: 4789956475 Enrollment ID: I20210819002896 |
| Provider Name | Elizabeth A Tacl |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093194706 PECOS PAC ID: 7618289554 Enrollment ID: I20210923003000 |
| Provider Name | Janelle Marie Thoreson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245906395 PECOS PAC ID: 4981001518 Enrollment ID: I20210924001580 |
| Provider Name | Eric Derocher |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194288357 PECOS PAC ID: 3072848597 Enrollment ID: I20210927002339 |
| Provider Name | Elizabeth M Ongera |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215478433 PECOS PAC ID: 6507264868 Enrollment ID: I20211018002045 |
| Provider Name | Michael P Schultz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750953709 PECOS PAC ID: 0749678274 Enrollment ID: I20211102001764 |
| Provider Name | Benjamin Shapiro |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1154804896 PECOS PAC ID: 4183978513 Enrollment ID: I20211110001285 |
| Provider Name | Cassondra Opatz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467021147 PECOS PAC ID: 0941693436 Enrollment ID: I20220204001251 |
| Provider Name | Rebecca Jarratt Petersen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306403183 PECOS PAC ID: 6103152756 Enrollment ID: I20220308000702 |
| Provider Name | Wesley J Halseth |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891227971 PECOS PAC ID: 3678844867 Enrollment ID: I20220921002720 |
| Provider Name | Aric A Wogsland |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1649664822 PECOS PAC ID: 8729464482 Enrollment ID: I20221003002920 |
| Provider Name | Michael E. Siergiej |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962123331 PECOS PAC ID: 8224405626 Enrollment ID: I20221027001105 |
| Provider Name | Emily Felzenberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063684702 PECOS PAC ID: 5890872329 Enrollment ID: I20221222002211 |
| Provider Name | Nicole Samudio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831712355 PECOS PAC ID: 7113345612 Enrollment ID: I20230117001661 |
| Provider Name | Peter Francis Tierney |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710696745 PECOS PAC ID: 3577934447 Enrollment ID: I20230201001198 |
| Provider Name | Talha Baloch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1548640535 PECOS PAC ID: 8820319114 Enrollment ID: I20230209001398 |
| Provider Name | Hannah Krog |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1831802453 PECOS PAC ID: 1658743802 Enrollment ID: I20230216000098 |
| Provider Name | Dustin P Heck |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164126637 PECOS PAC ID: 7315302627 Enrollment ID: I20230420000425 |
| Provider Name | Nicholas Olson |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1558704338 PECOS PAC ID: 0840596169 Enrollment ID: I20230512002500 |
| Provider Name | Sydni Imel |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689034027 PECOS PAC ID: 3870977267 Enrollment ID: I20230707001671 |
| Provider Name | Austin Grant Hewitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699451740 PECOS PAC ID: 0446610653 Enrollment ID: I20230720000212 |
| Provider Name | Juliette E Power |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194102806 PECOS PAC ID: 2860780467 Enrollment ID: I20230804002654 |
| Provider Name | James Drinane |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1508271099 PECOS PAC ID: 3870718836 Enrollment ID: I20230901003611 |
| Provider Name | Mohamad Hani Lababidi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295081412 PECOS PAC ID: 7810270485 Enrollment ID: I20230929003253 |
| Provider Name | Subbumeenakshi Alagappan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124688759 PECOS PAC ID: 0042542805 Enrollment ID: I20231002003640 |
| Provider Name | Nataliia Baker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063862746 PECOS PAC ID: 0547508087 Enrollment ID: I20231009003283 |
| Provider Name | Megan Alisen Rothstein |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1396419099 PECOS PAC ID: 2860842036 Enrollment ID: I20231229002455 |
| Provider Name | Jeffrey T Hunt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245641760 PECOS PAC ID: 9931401478 Enrollment ID: I20240102001117 |
| Provider Name | Rishi Seth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962790832 PECOS PAC ID: 0840411658 Enrollment ID: I20240216002329 |
| Provider Name | Emma Sheforgen |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1184481418 PECOS PAC ID: 8123466729 Enrollment ID: I20240402001481 |
| Provider Name | Sushrit Bisht |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558936765 PECOS PAC ID: 5991108797 Enrollment ID: I20240408000379 |
| Provider Name | Caleb Hansen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275119851 PECOS PAC ID: 3274934666 Enrollment ID: I20240508000726 |
| Provider Name | Jennifer Schmitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295312049 PECOS PAC ID: 7810306735 Enrollment ID: I20240510002529 |
| Provider Name | Hassan Haji |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720666522 PECOS PAC ID: 1052714276 Enrollment ID: I20240528001797 |
Stellis Health - Monticello Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Hart Blvd Ste 100, Monticello, MN 55362 Phone: 763-295-2921 Fax: 763-271-3810 | |
River Place Clinic Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 114 West 3rd Street, Monticello, MN 55362 Phone: 763-295-3100 Fax: 763-295-6196 | |
Barker Family Chiropractic, Pa Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 219 W Broadway, Suite 100, Monticello, MN 55362 Phone: 763-314-0707 | |
Legacy Staffing Agency Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2205 Meadow Oak Ave Apt 358, Monticello, MN 55362 Phone: 612-709-5006 | |
Studer Chiropractic, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 113 Locust St, Monticello, MN 55362 Phone: 763-295-4797 Fax: 763-295-2302 |