| Hallmark Health Medical Associates Inc | |
|
170 Governors Ave Attn: Provider Enrollment Medford MA 02155-1643 | |
| (781) 338-7521 | |
| (781) 338-7531 |
| Full Name | Hallmark Health Medical Associates Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 170 Governors Ave, Medford, Massachusetts |
| Authorized Official Name and Position | Michael S Turilli (VICE PRESIDENT FISCAL SERVICES) |
| Authorized Official Contact | 7813387415 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hallmark Health Medical Associates Inc Po Box 3237 Woburn MA 01888-3237 Ph: (781) 338-7170 | Hallmark Health Medical Associates Inc 170 Governors Ave Attn: Provider Enrollment Medford MA 02155-1643 Ph: (781) 338-7521 |
| NPI Number | 1770563900 |
|---|---|
| Provider Enumeration Date | 01/23/2006 |
| Last Update Date | 11/18/2009 |
| Medicare PECOS PAC ID | 4385638782 |
|---|---|
| Medicare Enrollment ID | O20040409000006 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770563900 | NPI | - | NPPES |
| M15828 | Other | MA | BLUE CROSS GROUP PROV # |
| 9771336 | Medicaid | MA |
| Provider Name | Yvonne Smikle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457314049 PECOS PAC ID: 9234043571 Enrollment ID: I20031119000474 |
| Provider Name | Susanne Pariente |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629100417 PECOS PAC ID: 6305743808 Enrollment ID: I20031215000031 |
| Provider Name | Cristina Holt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336139849 PECOS PAC ID: 4183521693 Enrollment ID: I20031215000061 |
| Provider Name | David M. Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275547622 PECOS PAC ID: 0244127496 Enrollment ID: I20040302000803 |
| Provider Name | Matthew N Siu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467441816 PECOS PAC ID: 0840282158 Enrollment ID: I20040330000637 |
| Provider Name | Timothy Smith |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649391715 PECOS PAC ID: 1254233869 Enrollment ID: I20040419000213 |
| Provider Name | Lakshmi Mudunuri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508847823 PECOS PAC ID: 5496740235 Enrollment ID: I20040420000150 |
| Provider Name | Jonathan D Rothberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972582682 PECOS PAC ID: 2264429620 Enrollment ID: I20040428000018 |
| Provider Name | Eleanor P Moresco |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790775211 PECOS PAC ID: 0749271559 Enrollment ID: I20040520000896 |
| Provider Name | Erin E O'sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558339887 PECOS PAC ID: 8628052040 Enrollment ID: I20040615000225 |
| Provider Name | Kathi G Whittier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578546834 PECOS PAC ID: 9436121605 Enrollment ID: I20040809000634 |
| Provider Name | Patricia A Sereno |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154310076 PECOS PAC ID: 1759355779 Enrollment ID: I20040824001255 |
| Provider Name | Joseph L Pennacchio |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1053387795 PECOS PAC ID: 6608841762 Enrollment ID: I20040901000112 |
| Provider Name | Andras Sandor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548238843 PECOS PAC ID: 5698744720 Enrollment ID: I20040927000466 |
| Provider Name | Young B Kim |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1790875540 PECOS PAC ID: 1052372570 Enrollment ID: I20041019000788 |
| Provider Name | Laurence A Conway |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427011840 PECOS PAC ID: 0547229833 Enrollment ID: I20050113000336 |
| Provider Name | Padmavati S Pimrale |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578550885 PECOS PAC ID: 4385695907 Enrollment ID: I20050201000527 |
| Provider Name | Roy A Epstein |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1558342709 PECOS PAC ID: 9032165048 Enrollment ID: I20050323000512 |
| Provider Name | John D Mudrock |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780675751 PECOS PAC ID: 1456307271 Enrollment ID: I20050324000794 |
| Provider Name | Saeid Elmi |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1023105459 PECOS PAC ID: 3072569466 Enrollment ID: I20050329000874 |
| Provider Name | Donald R Monteiro |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013080605 PECOS PAC ID: 8022064328 Enrollment ID: I20050330000354 |
| Provider Name | Thomas R Jevon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104898022 PECOS PAC ID: 9234186719 Enrollment ID: I20050406000952 |
| Provider Name | Sunita B Schurgin |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1740271311 PECOS PAC ID: 3173560190 Enrollment ID: I20050412000463 |
| Provider Name | Doru C Iancovici |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841307691 PECOS PAC ID: 6204873185 Enrollment ID: I20050412001072 |
| Provider Name | Timothy A Tierney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306989066 PECOS PAC ID: 4880582782 Enrollment ID: I20050414000703 |
| Provider Name | Thomas G Salines |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821051749 PECOS PAC ID: 3173561388 Enrollment ID: I20050419000824 |
| Provider Name | Parra Tomkins |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366433666 PECOS PAC ID: 9931141090 Enrollment ID: I20050531000037 |
| Provider Name | Lisa D Brengola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841289212 PECOS PAC ID: 8325084379 Enrollment ID: I20050630000187 |
| Provider Name | Davis T Bu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154303550 PECOS PAC ID: 7315983855 Enrollment ID: I20050706000508 |
| Provider Name | Deborah A Vanetten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942240197 PECOS PAC ID: 4789610254 Enrollment ID: I20050715000496 |
| Provider Name | Michael G Newman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487704276 PECOS PAC ID: 7315909421 Enrollment ID: I20050728000507 |
| Provider Name | Elizabeth J Donahue-valeri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669461034 PECOS PAC ID: 7012945702 Enrollment ID: I20050803000393 |
| Provider Name | Beatrix S Thomas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255329652 PECOS PAC ID: 7719918598 Enrollment ID: I20050823000100 |
| Provider Name | Francisco J Brincheiro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881753903 PECOS PAC ID: 2466483565 Enrollment ID: I20050829000685 |
| Provider Name | Gary S Pransky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1124102637 PECOS PAC ID: 8921039934 Enrollment ID: I20050829000856 |
| Provider Name | Richard Olans |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1477584217 PECOS PAC ID: 8729012364 Enrollment ID: I20050922000659 |
| Provider Name | David H Richman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285623645 PECOS PAC ID: 3072548254 Enrollment ID: I20050927001340 |
| Provider Name | Paul G Mckeough |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1851330856 PECOS PAC ID: 5294753547 Enrollment ID: I20051105000156 |
| Provider Name | Catherine Tucker |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1730130832 PECOS PAC ID: 1951322841 Enrollment ID: I20051207000439 |
| Provider Name | Marcia L Zuckerman |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083653224 PECOS PAC ID: 4385665918 Enrollment ID: I20051212000345 |
| Provider Name | Mary H Ohanley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104914936 PECOS PAC ID: 5294757936 Enrollment ID: I20051222000317 |
| Provider Name | Maryhelen A Darcy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316935455 PECOS PAC ID: 3375557283 Enrollment ID: I20060131000285 |
| Provider Name | Lynn Jumper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396714499 PECOS PAC ID: 3072529981 Enrollment ID: I20060302000173 |
| Provider Name | Dolores Ann Foley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063635795 PECOS PAC ID: 9537177928 Enrollment ID: I20060327000515 |
| Provider Name | Bruce G Watrous |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609859958 PECOS PAC ID: 4789692179 Enrollment ID: I20060327000540 |
| Provider Name | Steven J Dakoyannis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013908318 PECOS PAC ID: 4284642125 Enrollment ID: I20060404000097 |
| Provider Name | Steve G Massaquoi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1811934813 PECOS PAC ID: 9436168143 Enrollment ID: I20060407000188 |
| Provider Name | Candan Yorgancioglu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1306804901 PECOS PAC ID: 4789695107 Enrollment ID: I20060524000216 |
| Provider Name | Anne E Lebowitz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1760404586 PECOS PAC ID: 6002810405 Enrollment ID: I20060825000432 |
| Provider Name | Maher K Tabba |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1700812310 PECOS PAC ID: 1355345109 Enrollment ID: I20060908000319 |
| Provider Name | Jong Woo Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376640094 PECOS PAC ID: 4688671639 Enrollment ID: I20061103000470 |
| Provider Name | La-keisha R Milord |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649366212 PECOS PAC ID: 5597765669 Enrollment ID: I20070115000108 |
| Provider Name | Pamela M Schwedler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902991797 PECOS PAC ID: 9537160296 Enrollment ID: I20070123000354 |
| Provider Name | Tarajean Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730240607 PECOS PAC ID: 3971505967 Enrollment ID: I20070205000024 |
| Provider Name | Madelon A King |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477658896 PECOS PAC ID: 3173628930 Enrollment ID: I20070424000140 |
| Provider Name | Eugenia Blank |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922143296 PECOS PAC ID: 7618073560 Enrollment ID: I20070509000474 |
| Provider Name | Lina Feldman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801877634 PECOS PAC ID: 1951492362 Enrollment ID: I20070814000514 |
| Provider Name | Kenneth Shieh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609902287 PECOS PAC ID: 6103918461 Enrollment ID: I20070816000725 |
| Provider Name | Ann M Pianka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720294820 PECOS PAC ID: 7012000284 Enrollment ID: I20070904000387 |
| Provider Name | Nicoleta Coconcea |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285729624 PECOS PAC ID: 8123091774 Enrollment ID: I20071103000058 |
| Provider Name | Regine Tillmanns |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417981960 PECOS PAC ID: 1355447467 Enrollment ID: I20080219000196 |
| Provider Name | Khether Raby |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1447241922 PECOS PAC ID: 3971577230 Enrollment ID: I20080531000051 |
| Provider Name | Elizabeth O Bettencourt |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1366436974 PECOS PAC ID: 7517037112 Enrollment ID: I20080609000765 |
| Provider Name | Sarah B Sullivan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811061716 PECOS PAC ID: 5496722928 Enrollment ID: I20080726000035 |
| Provider Name | Ronald Ste. Marie |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932254786 PECOS PAC ID: 0547334138 Enrollment ID: I20080730000585 |
| Provider Name | Natalia D. Yurkovetsky |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750394581 PECOS PAC ID: 4284633017 Enrollment ID: I20080923000713 |
| Provider Name | Tony Luongo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1164520417 PECOS PAC ID: 6002839248 Enrollment ID: I20080925000057 |
| Provider Name | David John Lesnik |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1871564831 PECOS PAC ID: 4082654835 Enrollment ID: I20080927000067 |
| Provider Name | Mark J Sterling |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306822069 PECOS PAC ID: 9133287089 Enrollment ID: I20081021000472 |
| Provider Name | Matthew W Brown |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154436210 PECOS PAC ID: 4284634791 Enrollment ID: I20081031000167 |
| Provider Name | Wanda P Blanton |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417123431 PECOS PAC ID: 8729149752 Enrollment ID: I20081209000229 |
| Provider Name | Christopher Leung |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1538257464 PECOS PAC ID: 2961566492 Enrollment ID: I20090128000581 |
| Provider Name | Maurice J Maher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487710059 PECOS PAC ID: 6103982244 Enrollment ID: I20090225000624 |
| Provider Name | Michelle L Rubin -digirolamo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528209343 PECOS PAC ID: 3870640907 Enrollment ID: I20090407000506 |
| Provider Name | Harmony V Allison |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1245240704 PECOS PAC ID: 4486704152 Enrollment ID: I20090618000407 |
| Provider Name | Imrana Qawi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417061318 PECOS PAC ID: 0244381614 Enrollment ID: I20090624000515 |
| Provider Name | Ashley A Warner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790714079 PECOS PAC ID: 5092711176 Enrollment ID: I20090915000697 |
| Provider Name | Bindiya Thakkar |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1801070727 PECOS PAC ID: 6002952041 Enrollment ID: I20091006000350 |
| Provider Name | Rebecca Warburton |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518012996 PECOS PAC ID: 9234277807 Enrollment ID: I20091119000233 |
| Provider Name | Rebecca L Longo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679809255 PECOS PAC ID: 5698819258 Enrollment ID: I20100219000483 |
| Provider Name | Matthias Muenzer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689655839 PECOS PAC ID: 9032246798 Enrollment ID: I20100428000878 |
| Provider Name | Swetal R Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407914716 PECOS PAC ID: 4688708068 Enrollment ID: I20100820000492 |
| Provider Name | Julia V Niss |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801011002 PECOS PAC ID: 8527253095 Enrollment ID: I20101110000055 |
| Provider Name | James A Lech |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245397819 PECOS PAC ID: 6608056635 Enrollment ID: I20110209000134 |
| Provider Name | Jennifer S Wu |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1568446151 PECOS PAC ID: 1850353160 Enrollment ID: I20110427000594 |
| Provider Name | Ellen D Klee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013206572 PECOS PAC ID: 2961689286 Enrollment ID: I20110613000853 |
| Provider Name | Partha S. Sinha |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1578749719 PECOS PAC ID: 2062680382 Enrollment ID: I20110712000487 |
| Provider Name | Aarti Kakkar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1992971824 PECOS PAC ID: 5092986539 Enrollment ID: I20110914000242 |
| Provider Name | Eva Zasloff |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346403029 PECOS PAC ID: 9436321247 Enrollment ID: I20111019000912 |
| Provider Name | Louis Reines |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1225236151 PECOS PAC ID: 4385816131 Enrollment ID: I20111020000461 |
| Provider Name | Tammy Lynn Chamberland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528348745 PECOS PAC ID: 6800054032 Enrollment ID: I20120220000831 |
| Provider Name | Marie Angeli C Adamczyk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487756375 PECOS PAC ID: 6103085394 Enrollment ID: I20120307000495 |
| Provider Name | Kelley S Gregorovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649570854 PECOS PAC ID: 1759543689 Enrollment ID: I20120510000143 |
| Provider Name | Caroline T Tigere |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821307398 PECOS PAC ID: 2961667944 Enrollment ID: I20120625000293 |
| Provider Name | Samantha Morrison-ma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588929947 PECOS PAC ID: 1153571047 Enrollment ID: I20121031000248 |
| Provider Name | Kristyn M Newhall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275760027 PECOS PAC ID: 7214188077 Enrollment ID: I20121105000209 |
| Provider Name | Kelly A Carignan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285967968 PECOS PAC ID: 5193864478 Enrollment ID: I20130425000644 |
| Provider Name | Amy Beth Devlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417120726 PECOS PAC ID: 0042457939 Enrollment ID: I20130514000049 |
| Provider Name | Elizabeth H Tsai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700105293 PECOS PAC ID: 6507047719 Enrollment ID: I20130718000082 |
| Provider Name | Liyan Zhuang |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1578728200 PECOS PAC ID: 7214171313 Enrollment ID: I20130913000196 |
| Provider Name | Xiaohui L Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982862967 PECOS PAC ID: 6507000817 Enrollment ID: I20130926000044 |
| Provider Name | Stephanie S Bjork |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093949778 PECOS PAC ID: 4880820422 Enrollment ID: I20131204000352 |
| Provider Name | Esperanza Knight |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447683636 PECOS PAC ID: 0042447864 Enrollment ID: I20131224000046 |
| Provider Name | Julie Rombaut |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528389863 PECOS PAC ID: 6507094604 Enrollment ID: I20140117001005 |
| Provider Name | Kimberly H Principato |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669810222 PECOS PAC ID: 8820227689 Enrollment ID: I20140128000631 |
| Provider Name | Elizabeth W Keane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689827164 PECOS PAC ID: 2062645690 Enrollment ID: I20140505002082 |
| Provider Name | Phillip J. Gray |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1801071725 PECOS PAC ID: 6103084892 Enrollment ID: I20140623001785 |
| Provider Name | Jingli Ma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740501550 PECOS PAC ID: 7911123955 Enrollment ID: I20140728001081 |
| Provider Name | Alla Goldburt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467747816 PECOS PAC ID: 8729216924 Enrollment ID: I20140904001954 |
| Provider Name | Ashley Riley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184058703 PECOS PAC ID: 6800017914 Enrollment ID: I20141014001650 |
| Provider Name | Carmen M Antonellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295151058 PECOS PAC ID: 8224250469 Enrollment ID: I20141104000901 |
| Provider Name | Mary Beth Sweeney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710387907 PECOS PAC ID: 8921220948 Enrollment ID: I20141106001805 |
| Provider Name | Olena Murthy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700287893 PECOS PAC ID: 7315261781 Enrollment ID: I20150114000589 |
| Provider Name | Xuan M Luu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1902053788 PECOS PAC ID: 2163733064 Enrollment ID: I20150618002314 |
| Provider Name | Nicole A Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821423237 PECOS PAC ID: 0941512917 Enrollment ID: I20150706000086 |
| Provider Name | Brian T Clark |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114193612 PECOS PAC ID: 2264619667 Enrollment ID: I20150708001089 |
| Provider Name | Payam Salehi |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1578737532 PECOS PAC ID: 8820227960 Enrollment ID: I20150820010855 |
| Provider Name | May-tal Sauerbrun-cutler |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1881900496 PECOS PAC ID: 0042527004 Enrollment ID: I20150923002550 |
| Provider Name | Jessica Stevenson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912266982 PECOS PAC ID: 6103133178 Enrollment ID: I20150923003059 |
| Provider Name | Parul Nagar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1295087914 PECOS PAC ID: 1052629755 Enrollment ID: I20150930000086 |
| Provider Name | Aarti Grover |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1538315668 PECOS PAC ID: 6406919612 Enrollment ID: I20151015001529 |
| Provider Name | Maura A. Previte |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356718860 PECOS PAC ID: 8628388790 Enrollment ID: I20151103000743 |
| Provider Name | Elinor Milder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295097251 PECOS PAC ID: 8224287891 Enrollment ID: I20151110000019 |
| Provider Name | Jeffrey S Gorodetsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780613935 PECOS PAC ID: 2668424573 Enrollment ID: I20151113000959 |
| Provider Name | Rebecca Tharaud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932361920 PECOS PAC ID: 3779756556 Enrollment ID: I20151120000255 |
| Provider Name | Krista Radford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811365307 PECOS PAC ID: 4385946342 Enrollment ID: I20160107001504 |
| Provider Name | Ying Ma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326403809 PECOS PAC ID: 5799081220 Enrollment ID: I20160309002774 |
| Provider Name | Kathleen Ammon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104282136 PECOS PAC ID: 1456659358 Enrollment ID: I20160408001431 |
| Provider Name | Kathryn A. Zioto |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1114283108 PECOS PAC ID: 1951623545 Enrollment ID: I20160502001544 |
| Provider Name | Fatima Abdalla |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326407529 PECOS PAC ID: 2062701949 Enrollment ID: I20160516002347 |
| Provider Name | Luis B Suarez |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1205086030 PECOS PAC ID: 9830480326 Enrollment ID: I20160613002088 |
| Provider Name | Gerard H. Daly |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003179599 PECOS PAC ID: 7810289097 Enrollment ID: I20160708000170 |
| Provider Name | Josephine M Gaviola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194189902 PECOS PAC ID: 6608169487 Enrollment ID: I20160801002777 |
| Provider Name | Jennifer L Powell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942648639 PECOS PAC ID: 6204133887 Enrollment ID: I20160824000003 |
| Provider Name | Kristen J Camara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477710515 PECOS PAC ID: 5496041709 Enrollment ID: I20160913002551 |
| Provider Name | Mina G. Safain |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1821228883 PECOS PAC ID: 4486943156 Enrollment ID: I20160919002499 |
| Provider Name | Salvatore M Nardello |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730401811 PECOS PAC ID: 1456667062 Enrollment ID: I20160928000168 |
| Provider Name | Suzanne Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548618465 PECOS PAC ID: 1557658754 Enrollment ID: I20160930001403 |
| Provider Name | David E Miller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689960197 PECOS PAC ID: 1052531167 Enrollment ID: I20161025001554 |
| Provider Name | Jessica A Zaks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285079319 PECOS PAC ID: 6305125261 Enrollment ID: I20161116002083 |
| Provider Name | Elliot J Schaeffer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588984579 PECOS PAC ID: 8527286962 Enrollment ID: I20170222001624 |
| Provider Name | Sarwada Tuladhar Jha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023459419 PECOS PAC ID: 5092001792 Enrollment ID: I20170223001130 |
| Provider Name | Jaime Standley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1336691419 PECOS PAC ID: 9638453871 Enrollment ID: I20170307000619 |
| Provider Name | Crystal T Zilic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811441355 PECOS PAC ID: 5496030793 Enrollment ID: I20170329001652 |
| Provider Name | Margarette Pierre |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508223496 PECOS PAC ID: 7911282199 Enrollment ID: I20170330002367 |
| Provider Name | Kristen M Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912448622 PECOS PAC ID: 4486930179 Enrollment ID: I20170412000575 |
| Provider Name | Isaac Kasper |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1871889881 PECOS PAC ID: 9335373059 Enrollment ID: I20170602001681 |
| Provider Name | Adam J Blau |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922325679 PECOS PAC ID: 3971892647 Enrollment ID: I20170725002245 |
| Provider Name | Rachel N Lehouillier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841716503 PECOS PAC ID: 3678847944 Enrollment ID: I20170926000386 |
| Provider Name | Gregory A Westmoreland |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457659518 PECOS PAC ID: 1759656648 Enrollment ID: I20171003004994 |
| Provider Name | Joshua Tessier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023271087 PECOS PAC ID: 0143374108 Enrollment ID: I20171011000390 |
| Provider Name | Brittany Paskal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770002818 PECOS PAC ID: 7911272240 Enrollment ID: I20171012000089 |
| Provider Name | Lara Sullivan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528270345 PECOS PAC ID: 0648537779 Enrollment ID: I20171128002729 |
| Provider Name | Paige Nunes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689080483 PECOS PAC ID: 0648537688 Enrollment ID: I20171130000728 |
| Provider Name | Onala T Telford |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1497989685 PECOS PAC ID: 3274785894 Enrollment ID: I20180209000005 |
| Provider Name | Lieu T Tran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497140297 PECOS PAC ID: 1254649502 Enrollment ID: I20180525000708 |
| Provider Name | Marie Roguski |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1285954966 PECOS PAC ID: 9739434838 Enrollment ID: I20180613001658 |
| Provider Name | Bernice M Burkarth |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1194715367 PECOS PAC ID: 1052594991 Enrollment ID: I20180619000708 |
| Provider Name | Kara Allen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699797415 PECOS PAC ID: 4385999051 Enrollment ID: I20180620002464 |
| Provider Name | Caroline A Curran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639610959 PECOS PAC ID: 7810245842 Enrollment ID: I20180807002396 |
| Provider Name | Namoode S Rana |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447691134 PECOS PAC ID: 6103117957 Enrollment ID: I20180820000161 |
| Provider Name | Caitrin F Macdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538611918 PECOS PAC ID: 8224380068 Enrollment ID: I20181005002506 |
| Provider Name | Sylvia Cho |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215340070 PECOS PAC ID: 4981910056 Enrollment ID: I20181008001806 |
| Provider Name | Grace Y Lee |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821409335 PECOS PAC ID: 8820214687 Enrollment ID: I20181012000565 |
| Provider Name | Greta Seiriol R Gania |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306225016 PECOS PAC ID: 3072867696 Enrollment ID: I20181119001454 |
| Provider Name | Eric B Samuel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013941939 PECOS PAC ID: 6709818024 Enrollment ID: I20181220002466 |
| Provider Name | Kristin M Tammaro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043780554 PECOS PAC ID: 2264771377 Enrollment ID: I20190307003035 |
| Provider Name | Diane Cammarata |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881739282 PECOS PAC ID: 5193796795 Enrollment ID: I20190404001925 |
| Provider Name | Lindsay A Lawler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871078949 PECOS PAC ID: 0941533947 Enrollment ID: I20190606000906 |
| Provider Name | Anas Ashfaq Ahmed |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1629410824 PECOS PAC ID: 4880929959 Enrollment ID: I20190711001073 |
| Provider Name | Eduardo Rodriguez Diaz |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1124431044 PECOS PAC ID: 7618240557 Enrollment ID: I20190724000097 |
| Provider Name | Elizabeth G King |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1740500107 PECOS PAC ID: 2567694623 Enrollment ID: I20190823000251 |
| Provider Name | Yuan Yao |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992151179 PECOS PAC ID: 5890048797 Enrollment ID: I20190912001989 |
| Provider Name | Sowmya R Thadisina |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972793370 PECOS PAC ID: 1557531308 Enrollment ID: I20191016002489 |
| Provider Name | Kelly St. Bernard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215411749 PECOS PAC ID: 4587996434 Enrollment ID: I20191028000653 |
| Provider Name | Bridget Schulz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184104648 PECOS PAC ID: 4183977937 Enrollment ID: I20200212002269 |
| Provider Name | Concepcion Gan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922651157 PECOS PAC ID: 7810326840 Enrollment ID: I20200326001895 |
| Provider Name | Lauren Spendley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063844454 PECOS PAC ID: 5193950111 Enrollment ID: I20200403000379 |
| Provider Name | Emily Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891261665 PECOS PAC ID: 0446594386 Enrollment ID: I20200414000940 |
| Provider Name | Christopher Firely |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104354737 PECOS PAC ID: 3476826660 Enrollment ID: I20200511002924 |
| Provider Name | Heather Bell |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881758563 PECOS PAC ID: 1456402809 Enrollment ID: I20200604000098 |
| Provider Name | Rajesh R Zacharias |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1952534364 PECOS PAC ID: 8921313826 Enrollment ID: I20200714002454 |
| Provider Name | Robert Barling Lurvey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013203165 PECOS PAC ID: 0648540971 Enrollment ID: I20200930000735 |
| Provider Name | Hassan O Khalil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538678297 PECOS PAC ID: 7719307057 Enrollment ID: I20201026002094 |
| Provider Name | Emily M Sy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437501814 PECOS PAC ID: 9335431436 Enrollment ID: I20201106000208 |
| Provider Name | Namgyal Tsewang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023308038 PECOS PAC ID: 1355664244 Enrollment ID: I20201207002910 |
| Provider Name | Shams Abbas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639607963 PECOS PAC ID: 5294006169 Enrollment ID: I20201208001580 |
| Provider Name | Justin Wage |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1730561275 PECOS PAC ID: 2860804259 Enrollment ID: I20201208002571 |
| Provider Name | Zoe W Livingston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801495817 PECOS PAC ID: 9133533698 Enrollment ID: I20210126000132 |
| Provider Name | Hannah Cheeseman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366921637 PECOS PAC ID: 2860806049 Enrollment ID: I20210129000684 |
| Provider Name | Douglas R Schulte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114906617 PECOS PAC ID: 6002041951 Enrollment ID: I20210326001268 |
| Provider Name | Seda C Babroudi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962906636 PECOS PAC ID: 2062762404 Enrollment ID: I20210505003136 |
| Provider Name | Carissa Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841653334 PECOS PAC ID: 2567873474 Enrollment ID: I20210615003472 |
| Provider Name | Megan Mistretta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497343065 PECOS PAC ID: 5193127553 Enrollment ID: I20210708001611 |
| Provider Name | Anne Marie Dicredico |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902411341 PECOS PAC ID: 7517361991 Enrollment ID: I20210806001372 |
| Provider Name | Melissa Rowe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205282563 PECOS PAC ID: 3375882129 Enrollment ID: I20210923002408 |
| Provider Name | Allyson Grant |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407526858 PECOS PAC ID: 7517364797 Enrollment ID: I20210930002706 |
| Provider Name | Mohammed Bawazeer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134700776 PECOS PAC ID: 5597163766 Enrollment ID: I20211004000259 |
| Provider Name | Constance E Cammarata |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467958629 PECOS PAC ID: 4486902475 Enrollment ID: I20211203001809 |
| Provider Name | Samantha Ann Covelle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639645435 PECOS PAC ID: 6305183385 Enrollment ID: I20220314001033 |
| Provider Name | Adrianna M Clemente |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780337113 PECOS PAC ID: 2264827062 Enrollment ID: I20220314001532 |
| Provider Name | Courtney Mcneil |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598421638 PECOS PAC ID: 1153718275 Enrollment ID: I20220420000642 |
| Provider Name | Helena N Pham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134876139 PECOS PAC ID: 3072992650 Enrollment ID: I20220628002970 |
| Provider Name | Jeong Hwan Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1982024295 PECOS PAC ID: 4981907151 Enrollment ID: I20220721001805 |
| Provider Name | Elizabeth M Mathew |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104389816 PECOS PAC ID: 7113269689 Enrollment ID: I20220829001633 |
| Provider Name | Lisa C Cefalo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619613460 PECOS PAC ID: 5092191452 Enrollment ID: I20221007002638 |
| Provider Name | Katharine T Veale |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770089047 PECOS PAC ID: 7517218266 Enrollment ID: I20221012000985 |
| Provider Name | Eileen K Wegener |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174181630 PECOS PAC ID: 5193192714 Enrollment ID: I20221110000753 |
| Provider Name | Ambika Kattula |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1891226940 PECOS PAC ID: 9234409756 Enrollment ID: I20221115003299 |
| Provider Name | Beverley Anne Wyman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346548872 PECOS PAC ID: 9537337324 Enrollment ID: I20221229000636 |
| Provider Name | Roshan Razik |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1306353347 PECOS PAC ID: 9032478375 Enrollment ID: I20230103000605 |
| Provider Name | Yaneris Pena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467109652 PECOS PAC ID: 2567832579 Enrollment ID: I20230110000094 |
| Provider Name | Megan Mariano |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447683412 PECOS PAC ID: 2466823240 Enrollment ID: I20230116000592 |
| Provider Name | Julianna B Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841907607 PECOS PAC ID: 5294106449 Enrollment ID: I20230125003291 |
| Provider Name | Sandy Lam Alvarado |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184236432 PECOS PAC ID: 5294102901 Enrollment ID: I20230131000839 |
| Provider Name | Erik A. Holzwanger |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1457747776 PECOS PAC ID: 2769790906 Enrollment ID: I20230309001083 |
| Provider Name | Jennifer Collar |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881390029 PECOS PAC ID: 6103290036 Enrollment ID: I20230316000754 |
| Provider Name | Melissa Baldwin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114467347 PECOS PAC ID: 1951679240 Enrollment ID: I20230421000946 |
| Provider Name | Craig W Cooper |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538622881 PECOS PAC ID: 2264767219 Enrollment ID: I20230517001619 |
| Provider Name | Venkata Ravi Satyam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275074460 PECOS PAC ID: 2365713294 Enrollment ID: I20230518003285 |
| Provider Name | Phoenix Fung |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619214285 PECOS PAC ID: 3476773458 Enrollment ID: I20230623002075 |
| Provider Name | Aditi Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700412640 PECOS PAC ID: 6002270337 Enrollment ID: I20230919003643 |
| Provider Name | Hollie J Bauman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477034775 PECOS PAC ID: 2668726159 Enrollment ID: I20230919004175 |
| Provider Name | Suzanne Danielle |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518468180 PECOS PAC ID: 1153684121 Enrollment ID: I20230922001890 |
| Provider Name | Samuel M Stone |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750944971 PECOS PAC ID: 1052767589 Enrollment ID: I20231019002348 |
| Provider Name | Hannah Slavitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346781432 PECOS PAC ID: 1456707991 Enrollment ID: I20231019002611 |
| Provider Name | Alyssa Carroll |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336833870 PECOS PAC ID: 9830545029 Enrollment ID: I20231024002741 |
| Provider Name | Tran Nguyen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750878831 PECOS PAC ID: 8022464007 Enrollment ID: I20231026003967 |
| Provider Name | Lisa Callahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528261583 PECOS PAC ID: 6305135336 Enrollment ID: I20231030002510 |
| Provider Name | Shae C Fiorentino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861127367 PECOS PAC ID: 2163873654 Enrollment ID: I20240109003222 |
| Provider Name | Kimberly A Wall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689310849 PECOS PAC ID: 0840641353 Enrollment ID: I20240109003967 |
| Provider Name | Kayla M Yee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598547374 PECOS PAC ID: 0446694483 Enrollment ID: I20240219001634 |
| Provider Name | Michelle R Ellis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851743017 PECOS PAC ID: 3678858024 Enrollment ID: I20240219002530 |
| Provider Name | Erika L Gallagher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760077739 PECOS PAC ID: 6204270101 Enrollment ID: I20240220000129 |
| Provider Name | Evelyn Babcock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912138207 PECOS PAC ID: 6800233669 Enrollment ID: I20240328001942 |
| Provider Name | Alicia Musto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962982587 PECOS PAC ID: 0042563348 Enrollment ID: I20240521002302 |
Riverside Chiropractic Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 65 Riverside Ave Ste C, Medford, MA 02155 Phone: 781-395-0003 Fax: 781-395-2223 | |
Winchester Wound Care Specialists Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 75 Riverside Ave Ste 4, Medford, MA 02155 Phone: 781-756-7095 | |
Riverside Healthcare Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 75 Riverside Ave, Suite 3, Medford, MA 02155 Phone: 781-396-3701 Fax: 781-396-7716 | |
Waterlily Wellness, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 0 Governors Ave Ste 2, Medford, MA 02155 Phone: 179-028-7696 Fax: 617-977-9728 | |
Robert P. Williamson Md, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 43 Forest St, Medford, MA 02155 Phone: 781-396-4048 | |
Mystic Medical Group, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 170 Governors Ave, Medford, MA 02155 Phone: 781-391-4106 Fax: 781-391-3043 | |
Iora Health Massachusetts, P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 287 Middlesex Ave, Medford, MA 02155 Phone: 781-222-3033 Fax: 781-281-9927 |