| Fairview Heights Medical Group Sc | |
|
670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 | |
| (314) 996-7644 | |
| (314) 996-7658 |
| Full Name | Fairview Heights Medical Group Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 670 Mason Ridge Center Dr, Saint Louis, Missouri |
| Authorized Official Name and Position | Karen Canter-koester (VP OPERATIONS AND STRATEGY) |
| Authorized Official Contact | 3149967610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Fairview Heights Medical Group Sc 670 Mason Ridge Center Dr Ste 300 Saint Louis MO 63141-8573 Ph: (314) 996-7644 | Fairview Heights Medical Group Sc 670 Mason Ridge Center Dr Suite 300 Saint Louis MO 63141-8573 Ph: (314) 996-7644 |
| NPI Number | 1679503668 |
|---|---|
| Provider Enumeration Date | 07/04/2006 |
| Last Update Date | 07/16/2020 |
| Medicare PECOS PAC ID | 6800784083 |
|---|---|
| Medicare Enrollment ID | O20040309000650 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679503668 | NPI | - | NPPES |
| 500720107 | Medicaid | MO |
| Provider Name | Syed M Ala |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235233792 PECOS PAC ID: 7214836469 Enrollment ID: I20040107000216 |
| Provider Name | Gregory Simmons |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1194729871 PECOS PAC ID: 9830092865 Enrollment ID: I20040129000064 |
| Provider Name | Erik C Stabell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609868108 PECOS PAC ID: 6608779350 Enrollment ID: I20040129000845 |
| Provider Name | Scott F Morrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508858713 PECOS PAC ID: 4587559463 Enrollment ID: I20040219000093 |
| Provider Name | John A Hoelscher |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447267810 PECOS PAC ID: 7517868003 Enrollment ID: I20040329000799 |
| Provider Name | Christine M Taylor |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942223409 PECOS PAC ID: 0042202053 Enrollment ID: I20040331000810 |
| Provider Name | Joseph Mark Talsky |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629026208 PECOS PAC ID: 2668465303 Enrollment ID: I20040407000686 |
| Provider Name | Sekou K Kelsey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982661567 PECOS PAC ID: 8628062221 Enrollment ID: I20040414000908 |
| Provider Name | Benedict Painter |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154314839 PECOS PAC ID: 6305831769 Enrollment ID: I20040419001147 |
| Provider Name | William A Chadwick |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568454775 PECOS PAC ID: 2365349172 Enrollment ID: I20040510000876 |
| Provider Name | Nidal Shawahin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245236884 PECOS PAC ID: 0244213379 Enrollment ID: I20040610000436 |
| Provider Name | Cesar Munoz |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1710979208 PECOS PAC ID: 8325023195 Enrollment ID: I20040624000245 |
| Provider Name | William R Bartley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134112097 PECOS PAC ID: 7012811987 Enrollment ID: I20040717000055 |
| Provider Name | Kashif S Bhutto |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1083791651 PECOS PAC ID: 3971578204 Enrollment ID: I20040831000598 |
| Provider Name | Craig K Harms |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598878373 PECOS PAC ID: 7012976871 Enrollment ID: I20041007000178 |
| Provider Name | Christopher L Schenewerk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154328722 PECOS PAC ID: 0941262109 Enrollment ID: I20041029000782 |
| Provider Name | Steven R Horner |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932154051 PECOS PAC ID: 6709848997 Enrollment ID: I20041030000054 |
| Provider Name | Erica L Uppstrom |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1366441339 PECOS PAC ID: 8628970134 Enrollment ID: I20041101000599 |
| Provider Name | Kristen M Stabell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689667529 PECOS PAC ID: 0042114951 Enrollment ID: I20041217000483 |
| Provider Name | Tariq L Quadri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275525271 PECOS PAC ID: 1254387392 Enrollment ID: I20050322001081 |
| Provider Name | Omer M Badahman |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1851371231 PECOS PAC ID: 5991751489 Enrollment ID: I20050331001195 |
| Provider Name | Rafael M De La Cruz |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1669460655 PECOS PAC ID: 6204873292 Enrollment ID: I20050412000220 |
| Provider Name | Carlos M Yu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1417934894 PECOS PAC ID: 6901845817 Enrollment ID: I20050510000438 |
| Provider Name | Shadi Adel Altwal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417992520 PECOS PAC ID: 2365486552 Enrollment ID: I20050617000984 |
| Provider Name | Cynthia L Kues |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578582441 PECOS PAC ID: 8729024419 Enrollment ID: I20050705000219 |
| Provider Name | Charlotte H Albinson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1366400608 PECOS PAC ID: 4688605058 Enrollment ID: I20050825000333 |
| Provider Name | Douglas W Dothager |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871599738 PECOS PAC ID: 2769441153 Enrollment ID: I20050920000931 |
| Provider Name | Beatriz C Pardo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780670844 PECOS PAC ID: 3779517081 Enrollment ID: I20050926000222 |
| Provider Name | Robert Walton Garner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285612242 PECOS PAC ID: 2264467364 Enrollment ID: I20050928000030 |
| Provider Name | Donna Lynn Koenig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871564898 PECOS PAC ID: 2264457696 Enrollment ID: I20051013000932 |
| Provider Name | Keith A Moss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588601819 PECOS PAC ID: 4587680137 Enrollment ID: I20051026000380 |
| Provider Name | Hans H Moosa |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1194768432 PECOS PAC ID: 1658393020 Enrollment ID: I20051229000366 |
| Provider Name | Deborah F D Bross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487692430 PECOS PAC ID: 1557383809 Enrollment ID: I20051229000600 |
| Provider Name | Syed A Abdulaziz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114906005 PECOS PAC ID: 9234152588 Enrollment ID: I20060112000494 |
| Provider Name | Hatim A Mahmood |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1174556583 PECOS PAC ID: 9830112101 Enrollment ID: I20060112000619 |
| Provider Name | Prasad V Kandula |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164518460 PECOS PAC ID: 9234152505 Enrollment ID: I20060112000662 |
| Provider Name | Michele M Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326020041 PECOS PAC ID: 6800833138 Enrollment ID: I20060112000733 |
| Provider Name | James M Hitchcock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295725174 PECOS PAC ID: 8123023298 Enrollment ID: I20060925000595 |
| Provider Name | Richard J Hehmann |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1215922067 PECOS PAC ID: 9436155942 Enrollment ID: I20061005000526 |
| Provider Name | Ajitesh Rai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205883097 PECOS PAC ID: 1456358548 Enrollment ID: I20061102000488 |
| Provider Name | Mary R Hoffman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316984057 PECOS PAC ID: 1850357526 Enrollment ID: I20061116000374 |
| Provider Name | David J Nyquist |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114966611 PECOS PAC ID: 2163423807 Enrollment ID: I20070124000326 |
| Provider Name | Michael W Nash |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376577825 PECOS PAC ID: 8325040942 Enrollment ID: I20070212000373 |
| Provider Name | Ahmad A Karadaghy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619963063 PECOS PAC ID: 0244285781 Enrollment ID: I20070620000347 |
| Provider Name | Eileen Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083668750 PECOS PAC ID: 2668485277 Enrollment ID: I20070621000379 |
| Provider Name | Niraja Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346275724 PECOS PAC ID: 4183723448 Enrollment ID: I20070627000304 |
| Provider Name | Hollie A Yoder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548476922 PECOS PAC ID: 9234221615 Enrollment ID: I20070815000863 |
| Provider Name | Wael F Girgis |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1508053802 PECOS PAC ID: 5991891046 Enrollment ID: I20071019000509 |
| Provider Name | David Andrew O'neill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922092394 PECOS PAC ID: 4284723271 Enrollment ID: I20071128000570 |
| Provider Name | Satyen Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154482131 PECOS PAC ID: 8527142777 Enrollment ID: I20080226000675 |
| Provider Name | Kirby L Klostermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285829572 PECOS PAC ID: 7517041437 Enrollment ID: I20080229000493 |
| Provider Name | Pathanjali Saravanan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639284862 PECOS PAC ID: 6002991833 Enrollment ID: I20080304000584 |
| Provider Name | Vibhu Dhawan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033315965 PECOS PAC ID: 6901979111 Enrollment ID: I20080722000262 |
| Provider Name | Mohammad Sajed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396785127 PECOS PAC ID: 3577567528 Enrollment ID: I20080804000521 |
| Provider Name | Ahsan Usman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215016571 PECOS PAC ID: 6507864998 Enrollment ID: I20080823000101 |
| Provider Name | Ann T Laney |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1497904213 PECOS PAC ID: 8426116922 Enrollment ID: I20081028000560 |
| Provider Name | Abdulsalam Jamous |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891778221 PECOS PAC ID: 4587607809 Enrollment ID: I20081103000126 |
| Provider Name | Barry M Mossman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053516294 PECOS PAC ID: 8224199468 Enrollment ID: I20081206000206 |
| Provider Name | James M Goldring |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992715775 PECOS PAC ID: 6507933157 Enrollment ID: I20090127000135 |
| Provider Name | David A Harmon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033175633 PECOS PAC ID: 2860383098 Enrollment ID: I20090211000074 |
| Provider Name | Matthew J Koch |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1962420448 PECOS PAC ID: 0042292765 Enrollment ID: I20090216000389 |
| Provider Name | Jeffrey D Parks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215044367 PECOS PAC ID: 1153210596 Enrollment ID: I20090324000319 |
| Provider Name | Walter A Dimmitt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1467532267 PECOS PAC ID: 6709892888 Enrollment ID: I20090810000440 |
| Provider Name | Michael X Liu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1851402721 PECOS PAC ID: 0547314452 Enrollment ID: I20090812000094 |
| Provider Name | Matthew Alan Fraley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326187352 PECOS PAC ID: 5092766824 Enrollment ID: I20090812000126 |
| Provider Name | David R Riedel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073505004 PECOS PAC ID: 7911811146 Enrollment ID: I20091118000600 |
| Provider Name | Kim M Mank |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639406879 PECOS PAC ID: 1951443530 Enrollment ID: I20100120000246 |
| Provider Name | Blake C Rodgers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366501140 PECOS PAC ID: 6507992419 Enrollment ID: I20100331000230 |
| Provider Name | Craig Lotz |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1194879288 PECOS PAC ID: 9436288677 Enrollment ID: I20100526000154 |
| Provider Name | Christina H Dothager |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508067596 PECOS PAC ID: 9133251614 Enrollment ID: I20100719000863 |
| Provider Name | Matthew D Hageman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376540930 PECOS PAC ID: 7214957109 Enrollment ID: I20100819000968 |
| Provider Name | Steven P Zenker |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861485708 PECOS PAC ID: 3779487657 Enrollment ID: I20100825000991 |
| Provider Name | Muhammad Farooq Asghar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447416342 PECOS PAC ID: 3678697737 Enrollment ID: I20100826000946 |
| Provider Name | Kelly J Lindsey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225021165 PECOS PAC ID: 9931003829 Enrollment ID: I20101005001309 |
| Provider Name | Sultan A Hayat |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548248453 PECOS PAC ID: 3577598713 Enrollment ID: I20101027001543 |
| Provider Name | Douglas Anthony Kruse |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1194830661 PECOS PAC ID: 5294929444 Enrollment ID: I20101101001357 |
| Provider Name | Aaron P Omotola |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1841461134 PECOS PAC ID: 8325232465 Enrollment ID: I20101102000931 |
| Provider Name | David P Rawdon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376549139 PECOS PAC ID: 6406041235 Enrollment ID: I20101105001260 |
| Provider Name | Rehan M Rafiq |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407924954 PECOS PAC ID: 2062467756 Enrollment ID: I20101116000116 |
| Provider Name | Michael J Fleissner |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1942289459 PECOS PAC ID: 5395755110 Enrollment ID: I20101124000698 |
| Provider Name | Salma Mannan-hilaly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699772251 PECOS PAC ID: 9537357587 Enrollment ID: I20110104001233 |
| Provider Name | Lisa R Reno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306871538 PECOS PAC ID: 3779763743 Enrollment ID: I20110208000621 |
| Provider Name | Farid Roman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1851366355 PECOS PAC ID: 3870574585 Enrollment ID: I20110511000511 |
| Provider Name | Carol Marie Kadonsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124326145 PECOS PAC ID: 4880871326 Enrollment ID: I20110609000042 |
| Provider Name | Deepak Koul |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1417155672 PECOS PAC ID: 6709910649 Enrollment ID: I20110628000319 |
| Provider Name | Jacqueline Sue Baalman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912236183 PECOS PAC ID: 0244418861 Enrollment ID: I20110630000529 |
| Provider Name | Shannon Joy Hopen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184822371 PECOS PAC ID: 6709054711 Enrollment ID: I20110719000137 |
| Provider Name | Narine Sargsyan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609032598 PECOS PAC ID: 2769651587 Enrollment ID: I20110812000374 |
| Provider Name | Olusegun Adebayo Coker |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295998748 PECOS PAC ID: 6103095922 Enrollment ID: I20110812000393 |
| Provider Name | Cynthia Whitcher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275827917 PECOS PAC ID: 4789842808 Enrollment ID: I20120221000759 |
| Provider Name | Donald G Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508842352 PECOS PAC ID: 6901864230 Enrollment ID: I20120224000459 |
| Provider Name | Akhil Chapagain |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346525235 PECOS PAC ID: 6002078276 Enrollment ID: I20120504000098 |
| Provider Name | Vikram Patney |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1699744235 PECOS PAC ID: 4981680394 Enrollment ID: I20120514000729 |
| Provider Name | Michael S Hughes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558470617 PECOS PAC ID: 6406011543 Enrollment ID: I20120622000510 |
| Provider Name | Ron Mark Oren |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1366422438 PECOS PAC ID: 5395761134 Enrollment ID: I20120806000746 |
| Provider Name | Christopher R Aldridge |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104026707 PECOS PAC ID: 0941459713 Enrollment ID: I20121011000439 |
| Provider Name | Hannah B Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649526013 PECOS PAC ID: 8628228269 Enrollment ID: I20121017000433 |
| Provider Name | Pankaj Kaul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376771105 PECOS PAC ID: 8123211919 Enrollment ID: I20130110000495 |
| Provider Name | Melissa A Kershaw |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518178730 PECOS PAC ID: 9133372378 Enrollment ID: I20130121000088 |
| Provider Name | Sumbul Meraj |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285931261 PECOS PAC ID: 9436394228 Enrollment ID: I20130327000332 |
| Provider Name | Puja Gurung |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1063727832 PECOS PAC ID: 1355580648 Enrollment ID: I20130618000142 |
| Provider Name | Philip S Dudak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720067051 PECOS PAC ID: 7911946421 Enrollment ID: I20130620000254 |
| Provider Name | Kristen N Massey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003159450 PECOS PAC ID: 1355581158 Enrollment ID: I20130627000605 |
| Provider Name | Vicki K Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518179654 PECOS PAC ID: 9638310246 Enrollment ID: I20130724000601 |
| Provider Name | Olayiwola C Olagbegi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912011255 PECOS PAC ID: 1355347741 Enrollment ID: I20130731000366 |
| Provider Name | Charles L Lehmann |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033371992 PECOS PAC ID: 2264673300 Enrollment ID: I20130801000124 |
| Provider Name | Ziad Alaani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730398959 PECOS PAC ID: 1254429962 Enrollment ID: I20130815000450 |
| Provider Name | Rachel E Durham |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1730318890 PECOS PAC ID: 3577705771 Enrollment ID: I20130819000592 |
| Provider Name | Niraj Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134440969 PECOS PAC ID: 9830332741 Enrollment ID: I20130826000017 |
| Provider Name | Sai Prashanth Babu Palepu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558673152 PECOS PAC ID: 3072757616 Enrollment ID: I20130920000142 |
| Provider Name | John W Stirton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1851598429 PECOS PAC ID: 4587899372 Enrollment ID: I20131104000046 |
| Provider Name | Thomas H Smith |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306070636 PECOS PAC ID: 6103082227 Enrollment ID: I20140130000530 |
| Provider Name | Denise R Schleeper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144642539 PECOS PAC ID: 1557594439 Enrollment ID: I20140429002133 |
| Provider Name | Patrick M Neville |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1588959548 PECOS PAC ID: 0244454411 Enrollment ID: I20140609000674 |
| Provider Name | Jennifer L Neville |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528292299 PECOS PAC ID: 6901053933 Enrollment ID: I20140626001878 |
| Provider Name | Brandy Michele Byrd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902217540 PECOS PAC ID: 6305061904 Enrollment ID: I20140715000496 |
| Provider Name | Bushra Shaukat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033486758 PECOS PAC ID: 0749406478 Enrollment ID: I20140801000070 |
| Provider Name | Umesh I Gandhi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205056660 PECOS PAC ID: 8527111384 Enrollment ID: I20140828001007 |
| Provider Name | Dana M Grosch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447651708 PECOS PAC ID: 4284855099 Enrollment ID: I20141021000034 |
| Provider Name | Jennifer D Szalkowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275524290 PECOS PAC ID: 2163556002 Enrollment ID: I20141031000129 |
| Provider Name | Mary L Schinkel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1386892172 PECOS PAC ID: 2860663630 Enrollment ID: I20141118001359 |
| Provider Name | Frederick D Turpin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376536029 PECOS PAC ID: 8224110754 Enrollment ID: I20141223000635 |
| Provider Name | Mahmud Al Furgani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528369782 PECOS PAC ID: 2365670809 Enrollment ID: I20141231000517 |
| Provider Name | Briana R Waldeck |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477952067 PECOS PAC ID: 7618290180 Enrollment ID: I20150108002144 |
| Provider Name | Anne Leslie Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326441478 PECOS PAC ID: 0345564787 Enrollment ID: I20150113002191 |
| Provider Name | Bethany I Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609293372 PECOS PAC ID: 9335464361 Enrollment ID: I20150213000546 |
| Provider Name | Christopher Louis Beuer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144482563 PECOS PAC ID: 0345498143 Enrollment ID: I20150415000313 |
| Provider Name | Srinivasarao C Yaganti |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245252972 PECOS PAC ID: 7012004351 Enrollment ID: I20150519000257 |
| Provider Name | Jessica M Willis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588057848 PECOS PAC ID: 5991025108 Enrollment ID: I20150528002171 |
| Provider Name | Farhanaz Chowdhury |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518253160 PECOS PAC ID: 9931327947 Enrollment ID: I20150617000700 |
| Provider Name | Ranita R Keller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083096895 PECOS PAC ID: 5890007900 Enrollment ID: I20150702000564 |
| Provider Name | Christopher G Janson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659425148 PECOS PAC ID: 8022322726 Enrollment ID: I20150807014086 |
| Provider Name | Huzaifa Quaizar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326334343 PECOS PAC ID: 7416198486 Enrollment ID: I20150825003517 |
| Provider Name | Supriya Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245593201 PECOS PAC ID: 3274849435 Enrollment ID: I20150902001447 |
| Provider Name | Timothy J Leeburton |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104823574 PECOS PAC ID: 4183695364 Enrollment ID: I20150902001876 |
| Provider Name | Rouba G Ghoussoub |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1396964599 PECOS PAC ID: 5092883686 Enrollment ID: I20151005002948 |
| Provider Name | Marianne Torbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982017976 PECOS PAC ID: 4981913688 Enrollment ID: I20151020002348 |
| Provider Name | Amy E Witkus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710355565 PECOS PAC ID: 1951610278 Enrollment ID: I20151027001331 |
| Provider Name | Beth A Jacobs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508110776 PECOS PAC ID: 7416258447 Enrollment ID: I20151217000134 |
| Provider Name | Julie A Jackson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922492271 PECOS PAC ID: 9133449846 Enrollment ID: I20160107001313 |
| Provider Name | Krista N Ludwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437523677 PECOS PAC ID: 2264736826 Enrollment ID: I20160203000028 |
| Provider Name | John J Lehman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568480374 PECOS PAC ID: 3779616156 Enrollment ID: I20160405000468 |
| Provider Name | Kristine M Costello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922469402 PECOS PAC ID: 5496053183 Enrollment ID: I20160413001232 |
| Provider Name | Kiley M Faires |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366806838 PECOS PAC ID: 6800186297 Enrollment ID: I20160525002708 |
| Provider Name | Angie Harris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972694685 PECOS PAC ID: 5193621233 Enrollment ID: I20160620000759 |
| Provider Name | Keiko Sawano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114369881 PECOS PAC ID: 8224345343 Enrollment ID: I20160621000770 |
| Provider Name | Arjun Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780619957 PECOS PAC ID: 5991829400 Enrollment ID: I20160627001217 |
| Provider Name | Ahmad Zabad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780021774 PECOS PAC ID: 9638460306 Enrollment ID: I20160628000951 |
| Provider Name | Amanda Sue Schmitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912361411 PECOS PAC ID: 7618268392 Enrollment ID: I20160628001372 |
| Provider Name | Michael G Guignon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942542931 PECOS PAC ID: 3779886791 Enrollment ID: I20160630001414 |
| Provider Name | Catherine F Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427504042 PECOS PAC ID: 2365738507 Enrollment ID: I20160914000933 |
| Provider Name | Adnan Y Siddiqui |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1134194327 PECOS PAC ID: 7810910460 Enrollment ID: I20161012002016 |
| Provider Name | Zandra N Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528496437 PECOS PAC ID: 9739319120 Enrollment ID: I20161110001828 |
| Provider Name | Christine A Testa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013121383 PECOS PAC ID: 7113012931 Enrollment ID: I20161118000605 |
| Provider Name | Supraja Reddy Reddy |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1134432479 PECOS PAC ID: 5597903583 Enrollment ID: I20161202000543 |
| Provider Name | Veronica O Abegunde |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740500826 PECOS PAC ID: 5294960357 Enrollment ID: I20170213000242 |
| Provider Name | Jareer Farah |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073784583 PECOS PAC ID: 6002977246 Enrollment ID: I20170320001619 |
| Provider Name | Timothy Michael Kamp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932633443 PECOS PAC ID: 9638456809 Enrollment ID: I20170426001946 |
| Provider Name | Imtiaz Bangash |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003216953 PECOS PAC ID: 4688951288 Enrollment ID: I20170509001464 |
| Provider Name | Ashley N Altman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457882417 PECOS PAC ID: 6901174960 Enrollment ID: I20170615000045 |
| Provider Name | Emily M Cottrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295262459 PECOS PAC ID: 5193093946 Enrollment ID: I20170620000286 |
| Provider Name | Kaycee M Eyers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750818522 PECOS PAC ID: 4981972445 Enrollment ID: I20170626000861 |
| Provider Name | Anthony Tarr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821530304 PECOS PAC ID: 9133494479 Enrollment ID: I20171012000748 |
| Provider Name | Aftab Awan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316971880 PECOS PAC ID: 2860473998 Enrollment ID: I20171018003682 |
| Provider Name | Omar Ali Mohammad Mahasneh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124361746 PECOS PAC ID: 3274831417 Enrollment ID: I20171101000858 |
| Provider Name | Nikita Tihonov |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1215128194 PECOS PAC ID: 6002087129 Enrollment ID: I20171103001060 |
| Provider Name | Leah M Trower |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306365556 PECOS PAC ID: 8123384252 Enrollment ID: I20171106003208 |
| Provider Name | Juletta Avagyan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013278944 PECOS PAC ID: 4789821323 Enrollment ID: I20171229001093 |
| Provider Name | Shazia Abbas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205086998 PECOS PAC ID: 3779751086 Enrollment ID: I20180102000080 |
| Provider Name | Adrienne B Kinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710489349 PECOS PAC ID: 7012271554 Enrollment ID: I20180508002788 |
| Provider Name | Kimberly Janean King |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508306952 PECOS PAC ID: 9830464551 Enrollment ID: I20180621000212 |
| Provider Name | Asikhame Ahonkhai Oikeh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720444110 PECOS PAC ID: 2163779273 Enrollment ID: I20180720000949 |
| Provider Name | Nilupa Sewwandi Gaspe Mudiyanselage |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598147407 PECOS PAC ID: 8729336367 Enrollment ID: I20180730002679 |
| Provider Name | Daniel P Berg |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164817722 PECOS PAC ID: 1557663903 Enrollment ID: I20180813000944 |
| Provider Name | Amanda Willane Michaels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275027344 PECOS PAC ID: 1850641481 Enrollment ID: I20180831001973 |
| Provider Name | Stephanie Gabathuler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457647927 PECOS PAC ID: 0941458541 Enrollment ID: I20180924003685 |
| Provider Name | Mohammed Ismail Al Hamati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851779920 PECOS PAC ID: 3375845886 Enrollment ID: I20181002003280 |
| Provider Name | Sarah E Nangle |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487940961 PECOS PAC ID: 3375846827 Enrollment ID: I20181015002079 |
| Provider Name | Tracie Lynn Eilerman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619456472 PECOS PAC ID: 8325392459 Enrollment ID: I20181108001411 |
| Provider Name | Katherine Ruth Richards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942599808 PECOS PAC ID: 6204057391 Enrollment ID: I20181201000083 |
| Provider Name | Altressa Drummond |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891722849 PECOS PAC ID: 5496717456 Enrollment ID: I20181224000231 |
| Provider Name | Cedric Emden Davis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356534994 PECOS PAC ID: 9931243128 Enrollment ID: I20181226000001 |
| Provider Name | Kelly S Evans |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508341181 PECOS PAC ID: 4688910672 Enrollment ID: I20190111002367 |
| Provider Name | Elizabeth J Johns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164832705 PECOS PAC ID: 9537054622 Enrollment ID: I20190226001626 |
| Provider Name | Ibrahim Mourad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164497525 PECOS PAC ID: 5395765788 Enrollment ID: I20190226002250 |
| Provider Name | Andrea Volkerding |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922412717 PECOS PAC ID: 8527364819 Enrollment ID: I20190305001298 |
| Provider Name | Amy M Maher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639679756 PECOS PAC ID: 5890035695 Enrollment ID: I20190313002742 |
| Provider Name | Mindy Marie Faraone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336619782 PECOS PAC ID: 6608116124 Enrollment ID: I20190401000354 |
| Provider Name | Manuel Emilio Lopez |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437158052 PECOS PAC ID: 0143224212 Enrollment ID: I20190401000615 |
| Provider Name | Bindu Finnell |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851327340 PECOS PAC ID: 8729180245 Enrollment ID: I20190523001415 |
| Provider Name | John A Richards |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508276288 PECOS PAC ID: 2163724642 Enrollment ID: I20190808001274 |
| Provider Name | Kaitlin Mcclenahan Campbell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376989186 PECOS PAC ID: 5890062111 Enrollment ID: I20190809001071 |
| Provider Name | Bryson Thomas Whalen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1255727301 PECOS PAC ID: 9436468428 Enrollment ID: I20191011000682 |
| Provider Name | Matthew C Musielak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477781177 PECOS PAC ID: 2062720436 Enrollment ID: I20191014000115 |
| Provider Name | Sarah J Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457911810 PECOS PAC ID: 3971935289 Enrollment ID: I20191107000084 |
| Provider Name | Alice Halliday |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245871243 PECOS PAC ID: 2769814946 Enrollment ID: I20191108000253 |
| Provider Name | Monica Marie Magowan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114493723 PECOS PAC ID: 4981036092 Enrollment ID: I20191111002953 |
| Provider Name | Darcee Bair Schmitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477198596 PECOS PAC ID: 8628400033 Enrollment ID: I20191122000695 |
| Provider Name | Jason Wiechert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235545971 PECOS PAC ID: 3678829132 Enrollment ID: I20200115002232 |
| Provider Name | Jared Todd Winston |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881056265 PECOS PAC ID: 0648541623 Enrollment ID: I20200115002858 |
| Provider Name | Linda M Fields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770121980 PECOS PAC ID: 9931535333 Enrollment ID: I20200203002067 |
| Provider Name | Elsayed Abo-salem |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1629207477 PECOS PAC ID: 7719116490 Enrollment ID: I20200211001246 |
| Provider Name | Lisa K James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083253413 PECOS PAC ID: 4981032653 Enrollment ID: I20200311000341 |
| Provider Name | Ashley N Mehochko |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861048605 PECOS PAC ID: 9234567686 Enrollment ID: I20200317002353 |
| Provider Name | Concepcion Santillan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083647408 PECOS PAC ID: 2567402100 Enrollment ID: I20200326002163 |
| Provider Name | Megan M Cox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326504135 PECOS PAC ID: 5193066793 Enrollment ID: I20200330002459 |
| Provider Name | Shadab Muhammad Bhutto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396753018 PECOS PAC ID: 1557389970 Enrollment ID: I20200403001128 |
| Provider Name | James Christopher Tanner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1194107532 PECOS PAC ID: 5597077792 Enrollment ID: I20200408000148 |
| Provider Name | Salik Choudhary |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1386986578 PECOS PAC ID: 1951603422 Enrollment ID: I20200413001552 |
| Provider Name | Kimberly A Spano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750927182 PECOS PAC ID: 1850721291 Enrollment ID: I20200425000161 |
| Provider Name | Maureen Julia Dunajcik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407304728 PECOS PAC ID: 3173811270 Enrollment ID: I20200520000078 |
| Provider Name | Yaimet V Bucknor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902030836 PECOS PAC ID: 4880745470 Enrollment ID: I20200528003290 |
| Provider Name | Aloka S Amarakone |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407051329 PECOS PAC ID: 7315117827 Enrollment ID: I20200622000419 |
| Provider Name | Jenny M Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346783230 PECOS PAC ID: 1456638048 Enrollment ID: I20200623000225 |
| Provider Name | Chandni Sinha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1265960058 PECOS PAC ID: 4385069830 Enrollment ID: I20200731000859 |
| Provider Name | Kathryn Renner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699121897 PECOS PAC ID: 0143517144 Enrollment ID: I20200731001823 |
| Provider Name | Sumit Tiwari |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215048574 PECOS PAC ID: 5597909952 Enrollment ID: I20200803000994 |
| Provider Name | Sisay Michael Abraham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184088312 PECOS PAC ID: 6800182759 Enrollment ID: I20200812002963 |
| Provider Name | Dany Jose Saturno Arias |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275052318 PECOS PAC ID: 6204253586 Enrollment ID: I20200901002039 |
| Provider Name | Elissa Davis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629496203 PECOS PAC ID: 7214238898 Enrollment ID: I20200909003465 |
| Provider Name | Omar A Al-abboud |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740693449 PECOS PAC ID: 9638471493 Enrollment ID: I20200910002352 |
| Provider Name | James Edward Alonso |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063506566 PECOS PAC ID: 8325214562 Enrollment ID: I20201002002044 |
| Provider Name | Roohi Siraj |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1760885693 PECOS PAC ID: 2961834908 Enrollment ID: I20201019000250 |
| Provider Name | Adam Arnold Shpigel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1417223447 PECOS PAC ID: 2567612161 Enrollment ID: I20201118003044 |
| Provider Name | Eric Colton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790723492 PECOS PAC ID: 0244271245 Enrollment ID: I20201214002071 |
| Provider Name | Garri Priyampolskiy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659760833 PECOS PAC ID: 6406129212 Enrollment ID: I20201224000209 |
| Provider Name | Kathryn F Mckenna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902416134 PECOS PAC ID: 3072926120 Enrollment ID: I20210108001182 |
| Provider Name | Cody E Bilderback |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467890657 PECOS PAC ID: 5092949537 Enrollment ID: I20210122002485 |
| Provider Name | Ginny Mense |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043816374 PECOS PAC ID: 5395159461 Enrollment ID: I20210201001633 |
| Provider Name | Elizabeth M Kemper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043802754 PECOS PAC ID: 0446667398 Enrollment ID: I20210322001438 |
| Provider Name | Christen E Rincker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073128518 PECOS PAC ID: 8022425735 Enrollment ID: I20210325000145 |
| Provider Name | Christy Anne Kay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487209045 PECOS PAC ID: 5193132546 Enrollment ID: I20210401000062 |
| Provider Name | Mary E Maloney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710592175 PECOS PAC ID: 6608285234 Enrollment ID: I20210511001054 |
| Provider Name | Mari Jane Collins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659974764 PECOS PAC ID: 6103225693 Enrollment ID: I20210603002259 |
| Provider Name | Alicia M Whorton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508490806 PECOS PAC ID: 4486082740 Enrollment ID: I20210622001508 |
| Provider Name | Mena Metias |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295229573 PECOS PAC ID: 6406102128 Enrollment ID: I20210713000720 |
| Provider Name | Kenechukwu Olufemi Chudy-onwugaje |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861749780 PECOS PAC ID: 1355632233 Enrollment ID: I20210713000932 |
| Provider Name | Paul Michael Eckerle |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1215317409 PECOS PAC ID: 6103138540 Enrollment ID: I20210714003763 |
| Provider Name | Evan Neville |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1245694538 PECOS PAC ID: 0749682649 Enrollment ID: I20210715000562 |
| Provider Name | Raffy Gutman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861980872 PECOS PAC ID: 6204172331 Enrollment ID: I20210721000960 |
| Provider Name | Megan E Sauer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144753237 PECOS PAC ID: 7517232267 Enrollment ID: I20210723000102 |
| Provider Name | Sohaib Sajjad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578057873 PECOS PAC ID: 2860740214 Enrollment ID: I20210802000088 |
| Provider Name | Timothy R. Isakson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487790168 PECOS PAC ID: 9335128388 Enrollment ID: I20210802003062 |
| Provider Name | Megan J Land |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053981423 PECOS PAC ID: 1658775390 Enrollment ID: I20210803002308 |
| Provider Name | Jelena Nikolic |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689174682 PECOS PAC ID: 5991109985 Enrollment ID: I20210813000016 |
| Provider Name | Yu Lun |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740771823 PECOS PAC ID: 5193071322 Enrollment ID: I20210830000200 |
| Provider Name | Jaleesa Gilbert-gortman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710484332 PECOS PAC ID: 0648514877 Enrollment ID: I20210830001246 |
| Provider Name | Shereece N Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104338318 PECOS PAC ID: 1557627049 Enrollment ID: I20210830003376 |
| Provider Name | Cristina Bardita |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1861809295 PECOS PAC ID: 8325338577 Enrollment ID: I20211001001882 |
| Provider Name | Kristen L Kustermann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396312419 PECOS PAC ID: 3072911106 Enrollment ID: I20211004003372 |
| Provider Name | Caren Pauline Schaecher |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326067711 PECOS PAC ID: 6800911033 Enrollment ID: I20211005001053 |
| Provider Name | Carly Galli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669145686 PECOS PAC ID: 6305244807 Enrollment ID: I20211014000722 |
| Provider Name | Bertram Drury |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366822918 PECOS PAC ID: 7113239591 Enrollment ID: I20211015001491 |
| Provider Name | Shabreen Abdul Sharief |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992025118 PECOS PAC ID: 5991921215 Enrollment ID: I20211029000257 |
| Provider Name | Safiya Mcneese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962818823 PECOS PAC ID: 6901024579 Enrollment ID: I20211216000206 |
| Provider Name | Mathew Kalapurayil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295182459 PECOS PAC ID: 6800210188 Enrollment ID: I20220107001095 |
| Provider Name | Yolanda L Hoag |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053815423 PECOS PAC ID: 5799032207 Enrollment ID: I20220118002698 |
| Provider Name | Mohamad A Albsheri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447508874 PECOS PAC ID: 3779891379 Enrollment ID: I20220125002720 |
| Provider Name | Chiedozie K Anokwute |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811272438 PECOS PAC ID: 9133432362 Enrollment ID: I20220321000484 |
| Provider Name | Christopher M Chambers |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1184831869 PECOS PAC ID: 8628141785 Enrollment ID: I20220505001950 |
| Provider Name | Abraham D Bezuneh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508238130 PECOS PAC ID: 4385990183 Enrollment ID: I20220603001120 |
| Provider Name | Amy C Mcclintock |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073809141 PECOS PAC ID: 0840504684 Enrollment ID: I20220615000388 |
| Provider Name | Katherine Ann Combs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013677699 PECOS PAC ID: 5193104495 Enrollment ID: I20220616001016 |
| Provider Name | Anuj Sharma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932420957 PECOS PAC ID: 6204075450 Enrollment ID: I20220628003402 |
| Provider Name | Kari Leanne Hart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760131957 PECOS PAC ID: 8022498054 Enrollment ID: I20220707002406 |
| Provider Name | Blakelyn Busse |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1093238230 PECOS PAC ID: 9436531407 Enrollment ID: I20220808002024 |
| Provider Name | Manideep Duttuluri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164912341 PECOS PAC ID: 8224410220 Enrollment ID: I20220808003093 |
| Provider Name | Andrew E Berdy |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1821425067 PECOS PAC ID: 3173896230 Enrollment ID: I20220818003134 |
| Provider Name | Yixi Tu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861854929 PECOS PAC ID: 4981975729 Enrollment ID: I20220819001447 |
| Provider Name | Sai Si Thu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063875722 PECOS PAC ID: 1254678386 Enrollment ID: I20220823002502 |
| Provider Name | Colleen R Gilmore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285966739 PECOS PAC ID: 9335554310 Enrollment ID: I20220826000490 |
| Provider Name | Susannah K Koch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063906352 PECOS PAC ID: 4183008014 Enrollment ID: I20220826000828 |
| Provider Name | Parth Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548722713 PECOS PAC ID: 7012241763 Enrollment ID: I20220829001814 |
| Provider Name | Jordyn M Hoemmen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649916875 PECOS PAC ID: 3870977622 Enrollment ID: I20220829002298 |
| Provider Name | Ripa K Patel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1811372980 PECOS PAC ID: 3577815612 Enrollment ID: I20220830001661 |
| Provider Name | Anand P Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1043503972 PECOS PAC ID: 3779883723 Enrollment ID: I20220906003396 |
| Provider Name | Ekanga Sunday Petters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144751827 PECOS PAC ID: 8527331321 Enrollment ID: I20220907001693 |
| Provider Name | Devin R Cash |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740774835 PECOS PAC ID: 5597194597 Enrollment ID: I20220914003767 |
| Provider Name | Daniel Elizondo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366002362 PECOS PAC ID: 1456687672 Enrollment ID: I20220927002210 |
| Provider Name | Mohammed Ahmed |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932691672 PECOS PAC ID: 1052718574 Enrollment ID: I20220930001742 |
| Provider Name | Kashif A Janjua |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558522730 PECOS PAC ID: 5597938282 Enrollment ID: I20221017000820 |
| Provider Name | Kourtney Cecelia Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932799400 PECOS PAC ID: 3072980259 Enrollment ID: I20221031002752 |
| Provider Name | Ashley Liou |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1023402229 PECOS PAC ID: 8123336070 Enrollment ID: I20221103001722 |
| Provider Name | Karley Christopher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881321651 PECOS PAC ID: 1759758550 Enrollment ID: I20221108002239 |
| Provider Name | Taylor D Reno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366192908 PECOS PAC ID: 1658749965 Enrollment ID: I20221117001216 |
| Provider Name | Christian G Caceres |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255787628 PECOS PAC ID: 6002194701 Enrollment ID: I20221121002651 |
| Provider Name | Tiffany R Anzalone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881153815 PECOS PAC ID: 1355683525 Enrollment ID: I20221123000498 |
| Provider Name | Kaylee Anne Bowen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043927957 PECOS PAC ID: 1153799150 Enrollment ID: I20221123000712 |
| Provider Name | Alyssa M Branson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245953470 PECOS PAC ID: 8123497575 Enrollment ID: I20221207002096 |
| Provider Name | Melissa Armstead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326599911 PECOS PAC ID: 5294114773 Enrollment ID: I20221208001755 |
| Provider Name | Crista L Jamous |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710535794 PECOS PAC ID: 4082083258 Enrollment ID: I20221209001046 |
| Provider Name | Meaghan E Baumgardner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760020531 PECOS PAC ID: 7810304631 Enrollment ID: I20221213001862 |
| Provider Name | Holly L Steiner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083907844 PECOS PAC ID: 0446494967 Enrollment ID: I20230105002304 |
| Provider Name | Jennifer Feder |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669109971 PECOS PAC ID: 7416327440 Enrollment ID: I20230106002485 |
| Provider Name | Christina Marie Zagorski |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1154058493 PECOS PAC ID: 3476923400 Enrollment ID: I20230106002737 |
| Provider Name | Audrey M Brennan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679231690 PECOS PAC ID: 7416348255 Enrollment ID: I20230203002682 |
| Provider Name | Yahia Al Turk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487114682 PECOS PAC ID: 6507197357 Enrollment ID: I20230220001324 |
| Provider Name | Amber Nichole Dreiling |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962018234 PECOS PAC ID: 0042682072 Enrollment ID: I20230221000159 |
| Provider Name | Takeysha L Lowe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174007868 PECOS PAC ID: 4183977689 Enrollment ID: I20230222000484 |
| Provider Name | Marina Weinstein |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124339262 PECOS PAC ID: 1355584574 Enrollment ID: I20230301000456 |
| Provider Name | Uzma Kothawala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083069819 PECOS PAC ID: 7214225127 Enrollment ID: I20230309000393 |
| Provider Name | Asim Ayaz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144509563 PECOS PAC ID: 7416279807 Enrollment ID: I20230322000034 |
| Provider Name | Umair J Ashraf |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255773396 PECOS PAC ID: 4284914326 Enrollment ID: I20230508001087 |
| Provider Name | Jessica R Therien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164122974 PECOS PAC ID: 5799141396 Enrollment ID: I20230524002960 |
| Provider Name | Adnan Shahid Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558865097 PECOS PAC ID: 8628324852 Enrollment ID: I20230606002178 |
| Provider Name | Lito T Rufin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003431560 PECOS PAC ID: 6709245491 Enrollment ID: I20230628002541 |
| Provider Name | Matthew A Nations |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073017638 PECOS PAC ID: 3476809542 Enrollment ID: I20230710001819 |
| Provider Name | Jaime Shoemaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861108185 PECOS PAC ID: 0648630558 Enrollment ID: I20230724001488 |
| Provider Name | Paul C Menell |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1548820210 PECOS PAC ID: 8820415466 Enrollment ID: I20230808001942 |
| Provider Name | Saim Mustafa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1952939308 PECOS PAC ID: 9638592389 Enrollment ID: I20230809001735 |
| Provider Name | Hardikkumar M Patel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1790165736 PECOS PAC ID: 4486997616 Enrollment ID: I20230814003346 |
| Provider Name | Samuel M Lindner |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1831517051 PECOS PAC ID: 3678831112 Enrollment ID: I20230829000266 |
| Provider Name | Abhilash Makkar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750603270 PECOS PAC ID: 1254463961 Enrollment ID: I20230905001975 |
| Provider Name | Joya A Keys |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982199287 PECOS PAC ID: 2961759980 Enrollment ID: I20230906002953 |
| Provider Name | Lainey Jean Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265182786 PECOS PAC ID: 9234593112 Enrollment ID: I20230911002922 |
| Provider Name | Sobhana K Potluri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801419304 PECOS PAC ID: 3072938513 Enrollment ID: I20230913002260 |
| Provider Name | Cesar Abraham Santillana |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063974889 PECOS PAC ID: 9133508146 Enrollment ID: I20230914000155 |
| Provider Name | Kemuel E Telemaque |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437770690 PECOS PAC ID: 3274954037 Enrollment ID: I20230915002846 |
| Provider Name | Melissa K Whitworth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871295188 PECOS PAC ID: 9830543024 Enrollment ID: I20230921001779 |
| Provider Name | Neil Shachter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942336516 PECOS PAC ID: 2860576980 Enrollment ID: I20231107002060 |
| Provider Name | Henry M Ogbuagu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992029987 PECOS PAC ID: 6507288032 Enrollment ID: I20231114000232 |
| Provider Name | Emily Vanuytven |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295490159 PECOS PAC ID: 8022495621 Enrollment ID: I20231219002684 |
| Provider Name | Kevin M Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235752650 PECOS PAC ID: 8325498371 Enrollment ID: I20240103001701 |
| Provider Name | Hannah Neumeyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689455024 PECOS PAC ID: 3375994965 Enrollment ID: I20240108005422 |
| Provider Name | Joanna M Lindauer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396320271 PECOS PAC ID: 1153701248 Enrollment ID: I20240118001531 |
| Provider Name | Abdullah H Malik |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245680164 PECOS PAC ID: 9931495405 Enrollment ID: I20240125003107 |
| Provider Name | Elisha Boyd |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649895038 PECOS PAC ID: 2264875376 Enrollment ID: I20240206001719 |
| Provider Name | Alexander Bolton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639581127 PECOS PAC ID: 0446477350 Enrollment ID: I20240207003743 |
| Provider Name | Naveen Bondalapati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1104147214 PECOS PAC ID: 3779724406 Enrollment ID: I20240409004603 |
| Provider Name | Howard Epstein |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1306818182 PECOS PAC ID: 5092845230 Enrollment ID: I20240415001472 |
| Provider Name | Margaret Louise Goetten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629845045 PECOS PAC ID: 9931548179 Enrollment ID: I20240419002599 |
| Provider Name | Stephanie Marie Hardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942078068 PECOS PAC ID: 5294175238 Enrollment ID: I20240424003096 |
| Provider Name | Katy Helene Wine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174150726 PECOS PAC ID: 0446690259 Enrollment ID: I20240426002050 |
| Provider Name | Michael Clay Brown |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1386817468 PECOS PAC ID: 6002065083 Enrollment ID: I20240509002889 |
| Provider Name | Kathryn L Davis |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1871791301 PECOS PAC ID: 7618290719 Enrollment ID: I20240521000397 |
| Provider Name | Salman Saeed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1497106983 PECOS PAC ID: 9032401989 Enrollment ID: I20240531000635 |
St. Louis Center For Preventive And Longevity Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 777 S New Ballas Rd, Suite 200 E, Saint Louis, MO 63141 Phone: 314-994-1536 Fax: 314-692-0241 | |
Town And Country Primary Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3009 N Ballas Rd, Suite 300a, Saint Louis, MO 63131 Phone: 314-872-8999 | |
Family Care Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Lynch St, Saint Louis, MO 63118 Phone: 314-531-5444 Fax: 314-531-0063 | |
Wusm Bjc Aco Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Campus Box 8081, Saint Louis, MO 63110 Phone: 314-273-0770 | |
Victus Physician Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12607 Olive Blvd, Saint Louis, MO 63141 Phone: 314-327-8070 | |
Salvation Army Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2900 Washington Ave, Saint Louis, MO 63103 Phone: 314-898-1700 Fax: 314-814-8542 | |
Dtg Ii Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3819 Tesson Ct, Saint Louis, MO 63123 Phone: 800-268-7713 Fax: 415-704-3294 |