| Gpha Woodland Ave. Behavioral Healthcare | |
|
5501 Woodland Ave Philadelphia PA 19143-5607 | |
| (215) 724-4700 | |
| (215) 724-3111 |
| Full Name | Gpha Woodland Ave. Behavioral Healthcare |
|---|---|
| Speciality | Clinic/Center |
| Location | 5501 Woodland Ave, Philadelphia, Pennsylvania |
| Authorized Official Name and Position | D Tina Smith (PROVIDER ENROLLMENT SPEC.) |
| Authorized Official Contact | 2159252400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gpha Woodland Ave. Behavioral Healthcare 1401 S 31st St 2nd Floor Philadelphia PA 19146-3506 Ph: (215) 925-2400 | Gpha Woodland Ave. Behavioral Healthcare 5501 Woodland Ave Philadelphia PA 19143-5607 Ph: (215) 724-4700 |
| NPI Number | 1205140902 |
|---|---|
| Provider Enumeration Date | 08/05/2010 |
| Last Update Date | 03/15/2017 |
| Medicare PECOS PAC ID | 9537064977 |
|---|---|
| Medicare Enrollment ID | O20110602000389 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205140902 | NPI | - | NPPES |
| Provider Name | Carrie Jordan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619027737 PECOS PAC ID: 6204740939 Enrollment ID: I20031118000000 |
| Provider Name | Steven C Wilbraham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366485864 PECOS PAC ID: 6305741356 Enrollment ID: I20031203000287 |
| Provider Name | Julia A Elcock Vengen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578575940 PECOS PAC ID: 0941103725 Enrollment ID: I20040129000438 |
| Provider Name | Enakeme S Dogun |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477649135 PECOS PAC ID: 2860389558 Enrollment ID: I20040227000836 |
| Provider Name | Barbara K Davis |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093835548 PECOS PAC ID: 9931096765 Enrollment ID: I20040304000407 |
| Provider Name | Michel J Bien Aime |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225084411 PECOS PAC ID: 6709854938 Enrollment ID: I20040924000085 |
| Provider Name | Bonnie Lynn Vanuitert |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891712618 PECOS PAC ID: 0345207049 Enrollment ID: I20041214001011 |
| Provider Name | Peter Boutros Edde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265471940 PECOS PAC ID: 0840255691 Enrollment ID: I20041217000213 |
| Provider Name | Jeffrey K Dunbar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659344695 PECOS PAC ID: 1052364213 Enrollment ID: I20050228000689 |
| Provider Name | Zamir Ul Hassan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891788188 PECOS PAC ID: 6002862422 Enrollment ID: I20050329000247 |
| Provider Name | Binh L Luong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063415610 PECOS PAC ID: 3274573332 Enrollment ID: I20050509000099 |
| Provider Name | Christos Ballas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1629005673 PECOS PAC ID: 6103857123 Enrollment ID: I20050829000943 |
| Provider Name | Ron David Mahlab |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053452755 PECOS PAC ID: 3779514724 Enrollment ID: I20050830000106 |
| Provider Name | Elaine Johnson Douglas |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558347369 PECOS PAC ID: 7012938640 Enrollment ID: I20051212000349 |
| Provider Name | Pamela Joann Ralph |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205953858 PECOS PAC ID: 1951318302 Enrollment ID: I20060310000006 |
| Provider Name | Heather A Morphy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912908294 PECOS PAC ID: 4385624030 Enrollment ID: I20070419000075 |
| Provider Name | Kathleen M Nishida |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1003913823 PECOS PAC ID: 4284732967 Enrollment ID: I20070604000367 |
| Provider Name | Crystal Bianchi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790999076 PECOS PAC ID: 2961502760 Enrollment ID: I20070710000078 |
| Provider Name | Tameka P Lafayette |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972782878 PECOS PAC ID: 5799862926 Enrollment ID: I20080411000264 |
| Provider Name | Sarah C Goldfine-ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992872196 PECOS PAC ID: 3476632647 Enrollment ID: I20080430000246 |
| Provider Name | Anne Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619183175 PECOS PAC ID: 8022101070 Enrollment ID: I20080919000532 |
| Provider Name | Pamneit Bhogal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609045251 PECOS PAC ID: 7416025440 Enrollment ID: I20081004000015 |
| Provider Name | Wakengo Mahaniah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710156294 PECOS PAC ID: 4486713187 Enrollment ID: I20081111000070 |
| Provider Name | Robert F Hoffman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609001668 PECOS PAC ID: 1355492265 Enrollment ID: I20090706000082 |
| Provider Name | Gina Simoncini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972755544 PECOS PAC ID: 5991850984 Enrollment ID: I20090826000755 |
| Provider Name | Myrlita S Clark |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871729889 PECOS PAC ID: 3577619485 Enrollment ID: I20090917000607 |
| Provider Name | Shubha Kulkarni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386971778 PECOS PAC ID: 3173665007 Enrollment ID: I20100115000073 |
| Provider Name | Andrew R. Quint |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821064015 PECOS PAC ID: 3779529649 Enrollment ID: I20101221000572 |
| Provider Name | Courtney M Powell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801058417 PECOS PAC ID: 8527239607 Enrollment ID: I20110921000471 |
| Provider Name | Tracy L Collins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1194863639 PECOS PAC ID: 9436313590 Enrollment ID: I20120621000300 |
| Provider Name | Lei Olivia Zhang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336465848 PECOS PAC ID: 9335338300 Enrollment ID: I20121017000316 |
| Provider Name | Anthony Luistro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396922076 PECOS PAC ID: 4981854023 Enrollment ID: I20121025000324 |
| Provider Name | Jayne Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083653505 PECOS PAC ID: 2365693124 Enrollment ID: I20121105000256 |
| Provider Name | Monica Mallory-whitmore |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447267042 PECOS PAC ID: 7214939123 Enrollment ID: I20121116000495 |
| Provider Name | Oluwatoyin Fawole |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710166236 PECOS PAC ID: 1052563624 Enrollment ID: I20121205000180 |
| Provider Name | Janet Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962459859 PECOS PAC ID: 2163674177 Enrollment ID: I20121219000487 |
| Provider Name | William S Leopold |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043564370 PECOS PAC ID: 2163676867 Enrollment ID: I20130205000355 |
| Provider Name | Patricia Weir |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770762759 PECOS PAC ID: 4284889304 Enrollment ID: I20130221000136 |
| Provider Name | Alan Lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306886452 PECOS PAC ID: 3476798539 Enrollment ID: I20130321000187 |
| Provider Name | Amanda Micucio |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780887448 PECOS PAC ID: 3971740804 Enrollment ID: I20130513000213 |
| Provider Name | Urmila Gujrathi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1912952789 PECOS PAC ID: 5395982219 Enrollment ID: I20130514000470 |
| Provider Name | Jacqueline Ioli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275786964 PECOS PAC ID: 8123265758 Enrollment ID: I20130520000004 |
| Provider Name | Robert F. Grant |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720229024 PECOS PAC ID: 1456537265 Enrollment ID: I20130619000425 |
| Provider Name | Carli A Remy |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1477998110 PECOS PAC ID: 9234379173 Enrollment ID: I20130717000362 |
| Provider Name | Lisa A Marcus |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1669637732 PECOS PAC ID: 8224271580 Enrollment ID: I20130905000679 |
| Provider Name | Deniz Eker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1386635068 PECOS PAC ID: 5294637880 Enrollment ID: I20130925000599 |
| Provider Name | Ronald Smith |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1053350272 PECOS PAC ID: 5698901379 Enrollment ID: I20131203000038 |
| Provider Name | Shwetha Shrivatsa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699000158 PECOS PAC ID: 6800023771 Enrollment ID: I20131221000021 |
| Provider Name | Sally D Maurer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356517502 PECOS PAC ID: 2769610229 Enrollment ID: I20140109000208 |
| Provider Name | Wilhelmina Garrison |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164520904 PECOS PAC ID: 9234131210 Enrollment ID: I20140207000077 |
| Provider Name | Megan Gilbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295164259 PECOS PAC ID: 1153551684 Enrollment ID: I20140303001055 |
| Provider Name | Yana Sigal Banerjee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447597695 PECOS PAC ID: 4385875822 Enrollment ID: I20140326000015 |
| Provider Name | Alexandra C Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568886463 PECOS PAC ID: 3971735556 Enrollment ID: I20140414001098 |
| Provider Name | Hanna Miller |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1205249208 PECOS PAC ID: 0547486516 Enrollment ID: I20140728001945 |
| Provider Name | Katina E Papasifakis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902225204 PECOS PAC ID: 7618194515 Enrollment ID: I20140818001235 |
| Provider Name | Ehidiamen A Anetor-jamison |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1588892608 PECOS PAC ID: 2062647274 Enrollment ID: I20141002000603 |
| Provider Name | Aqiyla Muhammad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174685689 PECOS PAC ID: 5799905147 Enrollment ID: I20141007000209 |
| Provider Name | Adam Rom |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447544457 PECOS PAC ID: 5991925075 Enrollment ID: I20141014000353 |
| Provider Name | Jennifer Swarr |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194120576 PECOS PAC ID: 3870817125 Enrollment ID: I20150115001471 |
| Provider Name | Margaret Ferris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497085948 PECOS PAC ID: 8123342722 Enrollment ID: I20150129002003 |
| Provider Name | Rebekah Nussbaum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568867471 PECOS PAC ID: 2567788292 Enrollment ID: I20150224000523 |
| Provider Name | Ramon A Gadea |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144557216 PECOS PAC ID: 9931413457 Enrollment ID: I20150728005645 |
| Provider Name | Renee Marie Betancourt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104111830 PECOS PAC ID: 5890926414 Enrollment ID: I20150902001466 |
| Provider Name | Melissa S Naser |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1659491074 PECOS PAC ID: 5294770129 Enrollment ID: I20150922000660 |
| Provider Name | Mary Riendeau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952655979 PECOS PAC ID: 0840594149 Enrollment ID: I20160208000139 |
| Provider Name | Lauren E Stuart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053740985 PECOS PAC ID: 4486950821 Enrollment ID: I20160310000541 |
| Provider Name | Elana R Marcus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1659648475 PECOS PAC ID: 1850698887 Enrollment ID: I20160318000753 |
| Provider Name | Rebecca A Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346619111 PECOS PAC ID: 6709184039 Enrollment ID: I20160419002553 |
| Provider Name | Yahaya Enakhimion |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770940827 PECOS PAC ID: 1254620883 Enrollment ID: I20160520000114 |
| Provider Name | Ashna Nanavati |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003246737 PECOS PAC ID: 3072804905 Enrollment ID: I20160623000082 |
| Provider Name | George Zappalorta |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033556303 PECOS PAC ID: 6608169263 Enrollment ID: I20160720001484 |
| Provider Name | Sigy George |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356796619 PECOS PAC ID: 4486947264 Enrollment ID: I20160802000080 |
| Provider Name | Mohsin Ahmad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700127917 PECOS PAC ID: 4587942438 Enrollment ID: I20161027000041 |
| Provider Name | Donald Leveille |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720353022 PECOS PAC ID: 9830478403 Enrollment ID: I20161123000053 |
| Provider Name | Nidhi Girishchandra Shah |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1093147217 PECOS PAC ID: 5991001349 Enrollment ID: I20170113000173 |
| Provider Name | Angela M Jacobs |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144481425 PECOS PAC ID: 5698921344 Enrollment ID: I20170125001679 |
| Provider Name | Siu-kuen Azor Hui |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1336685916 PECOS PAC ID: 7416231519 Enrollment ID: I20170309002393 |
| Provider Name | Ryan B Sholinsky |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922544923 PECOS PAC ID: 3173807138 Enrollment ID: I20170313000309 |
| Provider Name | Elisabeth Barclay |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326245366 PECOS PAC ID: 4587698451 Enrollment ID: I20170321002481 |
| Provider Name | Tiffany A Reid |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912447533 PECOS PAC ID: 0840567822 Enrollment ID: I20170523000434 |
| Provider Name | Ha Lai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578006904 PECOS PAC ID: 1951678770 Enrollment ID: I20170530000343 |
| Provider Name | Janine Layendecker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164965885 PECOS PAC ID: 0446527105 Enrollment ID: I20170531000097 |
| Provider Name | Nausheen Hussain |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881907673 PECOS PAC ID: 9234361528 Enrollment ID: I20170613001596 |
| Provider Name | Amanda Vanpelt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467995936 PECOS PAC ID: 4284902388 Enrollment ID: I20170614000415 |
| Provider Name | Deborah Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104367713 PECOS PAC ID: 4880962505 Enrollment ID: I20170621000153 |
| Provider Name | Robert Willis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407250665 PECOS PAC ID: 8921377060 Enrollment ID: I20170706000922 |
| Provider Name | Tina Ahmadinejad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114331337 PECOS PAC ID: 4789956905 Enrollment ID: I20170823002908 |
| Provider Name | Zeshen Wu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578909826 PECOS PAC ID: 3971894114 Enrollment ID: I20171011002745 |
| Provider Name | Paula Waddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679656441 PECOS PAC ID: 3274721881 Enrollment ID: I20171028000222 |
| Provider Name | Decosy Dd Hercules |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1356778542 PECOS PAC ID: 3173880127 Enrollment ID: I20171129000168 |
| Provider Name | Linda Hobbs |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699108688 PECOS PAC ID: 6204193261 Enrollment ID: I20171129000993 |
| Provider Name | Nandita Patnaik |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1881956092 PECOS PAC ID: 5597023283 Enrollment ID: I20180102000629 |
| Provider Name | Rachel S Oram |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346756426 PECOS PAC ID: 5092075374 Enrollment ID: I20180206000424 |
| Provider Name | Ning Jiang |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679989305 PECOS PAC ID: 2961763370 Enrollment ID: I20180228000506 |
| Provider Name | Ngozi Okoh |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1831457290 PECOS PAC ID: 4486958337 Enrollment ID: I20180312001939 |
| Provider Name | Thuan Tran |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1053460758 PECOS PAC ID: 3971771353 Enrollment ID: I20180412002520 |
| Provider Name | Joshua Nathaniel Mathews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770090375 PECOS PAC ID: 5294098380 Enrollment ID: I20180425000714 |
| Provider Name | Anoop Manikarnika Raman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770825242 PECOS PAC ID: 9436414661 Enrollment ID: I20180517001608 |
| Provider Name | Paula V Dockery |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275061202 PECOS PAC ID: 7113273608 Enrollment ID: I20180713002056 |
| Provider Name | Sarah Onafowora |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265847644 PECOS PAC ID: 8729339411 Enrollment ID: I20180919001187 |
| Provider Name | Emily Anne Kravinsky |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205954138 PECOS PAC ID: 0143571752 Enrollment ID: I20180920002529 |
| Provider Name | Benjamin Frank Cocchiaro |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1336529890 PECOS PAC ID: 9537413521 Enrollment ID: I20181109001111 |
| Provider Name | Kiet Vi Thai |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1750329892 PECOS PAC ID: 0143564914 Enrollment ID: I20181205000984 |
| Provider Name | Jared Carter-davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245705748 PECOS PAC ID: 6103161989 Enrollment ID: I20181226000423 |
| Provider Name | Margaret Oduro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417443367 PECOS PAC ID: 9335486901 Enrollment ID: I20190122000734 |
| Provider Name | Patricia Porche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578939120 PECOS PAC ID: 5092053298 Enrollment ID: I20190213003000 |
| Provider Name | Annette M Redguard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659720290 PECOS PAC ID: 9739428178 Enrollment ID: I20190304000555 |
| Provider Name | Christine Van Nguyen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508063918 PECOS PAC ID: 9335489251 Enrollment ID: I20190312003096 |
| Provider Name | Aaron Wan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407327141 PECOS PAC ID: 7810238839 Enrollment ID: I20190401000628 |
| Provider Name | Qaisar Hasan Usmani |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1548364896 PECOS PAC ID: 0143296012 Enrollment ID: I20190415002427 |
| Provider Name | Olga M Lomanovitch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376057323 PECOS PAC ID: 2466794425 Enrollment ID: I20190424000381 |
| Provider Name | Nicole M Hartman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518437615 PECOS PAC ID: 2163765967 Enrollment ID: I20190520000046 |
| Provider Name | Elizabeth Walters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255800207 PECOS PAC ID: 0547503138 Enrollment ID: I20190522003123 |
| Provider Name | Manish Shah |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1902001936 PECOS PAC ID: 3971786690 Enrollment ID: I20190529001902 |
| Provider Name | Zaifang Yu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962975425 PECOS PAC ID: 5092041319 Enrollment ID: I20190724003312 |
| Provider Name | Adam Hofbauer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578012266 PECOS PAC ID: 0941530315 Enrollment ID: I20190927000504 |
| Provider Name | Afshan Ranjha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1851735047 PECOS PAC ID: 3072946318 Enrollment ID: I20191127001738 |
| Provider Name | Qinzhuola Qi |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1144887886 PECOS PAC ID: 5496181943 Enrollment ID: I20200203000033 |
| Provider Name | Emily R Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326686528 PECOS PAC ID: 0749616829 Enrollment ID: I20200210000246 |
| Provider Name | Travis E Perry |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1104266824 PECOS PAC ID: 1951673268 Enrollment ID: I20200218001290 |
| Provider Name | Naeemah Selby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437613395 PECOS PAC ID: 8921435025 Enrollment ID: I20200303000229 |
| Provider Name | Joseph Salerno |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235614892 PECOS PAC ID: 6406286343 Enrollment ID: I20200417000033 |
| Provider Name | Nancy Po Lim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215010061 PECOS PAC ID: 9638277114 Enrollment ID: I20200419000150 |
| Provider Name | Patricia S Correa-illidge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598715179 PECOS PAC ID: 0143642462 Enrollment ID: I20200615002545 |
| Provider Name | Kadian Sasha-gay Ennis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083911408 PECOS PAC ID: 4880016740 Enrollment ID: I20200623000121 |
| Provider Name | Monika Katherine Wasik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700425584 PECOS PAC ID: 6800218645 Enrollment ID: I20200623003506 |
| Provider Name | Eric M Finch |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396817342 PECOS PAC ID: 4486077922 Enrollment ID: I20200701000095 |
| Provider Name | Christine Kim |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1518442086 PECOS PAC ID: 7012330574 Enrollment ID: I20200701000804 |
| Provider Name | Mutiat L Ajibade |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407480155 PECOS PAC ID: 9032532437 Enrollment ID: I20200701002602 |
| Provider Name | Casey Prammanasudh |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1114314622 PECOS PAC ID: 1052610433 Enrollment ID: I20200814002367 |
| Provider Name | Hannah Abinteh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568070449 PECOS PAC ID: 5799102570 Enrollment ID: I20200825000960 |
| Provider Name | Lasongia Morton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376579573 PECOS PAC ID: 0244229847 Enrollment ID: I20200917001199 |
| Provider Name | Isabel Cristina Castillo Hernandez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1558881581 PECOS PAC ID: 2062831134 Enrollment ID: I20200923002707 |
| Provider Name | Michelle Sanchez |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710510870 PECOS PAC ID: 5395174924 Enrollment ID: I20201214002730 |
| Provider Name | Diana Sherpa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093221269 PECOS PAC ID: 7911266622 Enrollment ID: I20210407003158 |
| Provider Name | Kareema Hilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316541576 PECOS PAC ID: 4486061546 Enrollment ID: I20210408000009 |
| Provider Name | Garrett Dylan Blaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215538087 PECOS PAC ID: 3072921204 Enrollment ID: I20210428000066 |
| Provider Name | Sharonn Celeste Daniels-archie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588265250 PECOS PAC ID: 6204241045 Enrollment ID: I20210503001880 |
| Provider Name | Adin Kreiger Benson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841840956 PECOS PAC ID: 6204241185 Enrollment ID: I20210602001106 |
| Provider Name | Kendra Deanne French |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790180149 PECOS PAC ID: 6406257435 Enrollment ID: I20210629001261 |
| Provider Name | Elena Carianna |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508464918 PECOS PAC ID: 0143622407 Enrollment ID: I20210708001862 |
| Provider Name | Amanda Marie Bernard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770088551 PECOS PAC ID: 3375946593 Enrollment ID: I20210726003745 |
| Provider Name | Kayla Blaker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871194456 PECOS PAC ID: 3779972427 Enrollment ID: I20211118000284 |
| Provider Name | Xuan Yang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275298812 PECOS PAC ID: 6002206273 Enrollment ID: I20211201002742 |
| Provider Name | Madeline Holt |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1285396150 PECOS PAC ID: 9032509054 Enrollment ID: I20211207001024 |
| Provider Name | Elisabeth Offenberger |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1093161580 PECOS PAC ID: 0547549180 Enrollment ID: I20211215001861 |
| Provider Name | Diana Julia Calano |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1477828622 PECOS PAC ID: 4981855897 Enrollment ID: I20220103001777 |
| Provider Name | Lingli Zhang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851056568 PECOS PAC ID: 2567853336 Enrollment ID: I20220105001674 |
| Provider Name | Dana Ikeda |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1144980368 PECOS PAC ID: 4486046778 Enrollment ID: I20220118002321 |
| Provider Name | Wai Ying Lam |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962170571 PECOS PAC ID: 9335532746 Enrollment ID: I20220316003103 |
| Provider Name | Shira Alberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083369649 PECOS PAC ID: 0648667634 Enrollment ID: I20220421000319 |
| Provider Name | Natalie Mathurin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962588806 PECOS PAC ID: 1951397645 Enrollment ID: I20220906000025 |
| Provider Name | Rebecca E Simon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851755813 PECOS PAC ID: 9436448214 Enrollment ID: I20230201001980 |
| Provider Name | Brittany Rebecca Speers |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1679658447 PECOS PAC ID: 4789056615 Enrollment ID: I20230202001128 |
| Provider Name | Kinaye Weaver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487124004 PECOS PAC ID: 6406257450 Enrollment ID: I20230227000129 |
| Provider Name | Brynne E Kessler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285342667 PECOS PAC ID: 0941673370 Enrollment ID: I20230306000056 |
| Provider Name | Marc Iacona |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790281970 PECOS PAC ID: 8820348097 Enrollment ID: I20230309001133 |
| Provider Name | Christine Elaine Schultheiss |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255786430 PECOS PAC ID: 4981931391 Enrollment ID: I20230405001372 |
| Provider Name | Sergey Zavilyansky |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1194770610 PECOS PAC ID: 3274578562 Enrollment ID: I20230405003123 |
| Provider Name | Lauren Welch |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215630769 PECOS PAC ID: 6406221084 Enrollment ID: I20230413000374 |
| Provider Name | Sandra Farah Louiya-pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366170813 PECOS PAC ID: 1951766823 Enrollment ID: I20230427002184 |
| Provider Name | Brenda Alexander O Neil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467905778 PECOS PAC ID: 1658651260 Enrollment ID: I20230621000099 |
| Provider Name | Sharon Lucia Chen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144824939 PECOS PAC ID: 7810357761 Enrollment ID: I20230724002910 |
| Provider Name | Oluyemi Olaore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144913427 PECOS PAC ID: 2163883539 Enrollment ID: I20230801003525 |
| Provider Name | Nichelle Jana Ruffin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396364998 PECOS PAC ID: 7214359934 Enrollment ID: I20231010002540 |
| Provider Name | Gabriel Sabbaj Spieler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538788591 PECOS PAC ID: 7416303847 Enrollment ID: I20231021000138 |
| Provider Name | Tulsi J Mehta |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1033698485 PECOS PAC ID: 1052755865 Enrollment ID: I20240220004373 |
| Provider Name | Alea Gloria Frazier |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1275297319 PECOS PAC ID: 5991140311 Enrollment ID: I20240226001344 |
| Provider Name | Damani Paul Irby |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1639503154 PECOS PAC ID: 3779847223 Enrollment ID: I20240229000617 |
| Provider Name | Ahmez J Jasper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1306146956 PECOS PAC ID: 6507202462 Enrollment ID: I20240313003788 |
| Provider Name | Chenchen Zheng |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1053920298 PECOS PAC ID: 4981041662 Enrollment ID: I20240318003262 |
| Provider Name | Susan Ann Jackson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1629402995 PECOS PAC ID: 5092152413 Enrollment ID: I20240321000994 |
| Provider Name | Adedamola Fawole |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1669116430 PECOS PAC ID: 1658718705 Enrollment ID: I20240325002320 |
| Provider Name | Anisha J Gadikar |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1750899555 PECOS PAC ID: 8224476767 Enrollment ID: I20240403002709 |
| Provider Name | Hinal Haresh Jatania |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1477070035 PECOS PAC ID: 5294174678 Enrollment ID: I20240418000212 |
| Provider Name | Natalie Elaine Douglas-battick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033891858 PECOS PAC ID: 6709226418 Enrollment ID: I20240429002133 |
| Provider Name | Kelsey Hassig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750888384 PECOS PAC ID: 5890045173 Enrollment ID: I20240503002618 |
Laura Yatvin Nutrition Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4231 N. 5th Street, Philadelphia, PA 19140 Phone: 215-455-5370 Fax: 215-455-5374 | |
Health Hero Pa Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 217 Dickinson St, Philadelphia, PA 19147 Phone: 484-667-3382 | |
Vo Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1735 Market St Fl 52, Philadelphia, PA 19103 Phone: 267-314-7252 | |
Rooted Healthcare, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3101 Tyson Ave, Philadelphia, PA 19149 Phone: 917-861-2531 | |
Care Health Partners Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1308 Cottman Ave, Philadelphia, PA 19111 Phone: 732-766-1827 Fax: 609-890-0950 | |
University Of Penn - Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3400 Spruce St, 3 Ravdin, Suite F, Pulmonary & Critical Care, Philadelphia, PA 19104 Phone: 215-662-3202 | |
Drexel Infectious Disease Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 219 N Broad St, 5th Floor, Philadelphia, PA 19107 Phone: 215-762-6555 Fax: 215-762-3031 |