Kettering Health Medical Group - Medicare Primary Care in Kettering, OH

Kettering Health Medical Group is a medicare enrolled primary clinic (Family Medicine) in Kettering, Ohio. The current practice location for Kettering Health Medical Group is 1827 Woodman Center Dr, Kettering, Ohio. For appointments, you can reach them via phone at (937) 558-3223. The mailing address for Kettering Health Medical Group is 1 Prestige Pl, Suite 550, Miamisburg, Ohio and phone number is (937) 762-1300.

Kettering Health Medical Group is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1437125572. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (937) 558-3223.

Contact Information

Kettering Health Medical Group
1827 Woodman Center Dr
Kettering
OH 45420-1157
(937) 558-3223
(937) 558-3247

Map and Direction


Primary Care Clinic Profile

Full NameKettering Health Medical Group
SpecialityFamily Medicine
Location1827 Woodman Center Dr, Kettering, Ohio
Authorized Official Name and PositionTimothy Y Ko (CFO)
Authorized Official Contact9375583223
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kettering Health Medical Group
1 Prestige Pl
Suite 550
Miamisburg
OH 45342-3794

Ph: (937) 762-1300
Kettering Health Medical Group
1827 Woodman Center Dr
Kettering
OH 45420-1157

Ph: (937) 558-3223

NPI Details:

NPI Number1437125572
Provider Enumeration Date02/28/2006
Last Update Date01/10/2023

Medicare PECOS Information:

Medicare PECOS PAC ID0840104360
Medicare Enrollment IDO20031118000529

Medical Identifiers

Medical identifiers for Kettering Health Medical Group such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1437125572NPI-NPPES
2712872MedicaidOH

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (Not Available))Primary
207QS0010XFamily Medicine - Sports Medicine (* (Not Available))Secondary
207R00000XInternal Medicine (* (Not Available))Secondary
261QU0200XClinic/center - Urgent Care (* (Not Available))Secondary
363LA2200XNurse Practitioner - Adult Health (* (Not Available))Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Kettering Health Medical Group acts as a billing entity for following providers:
Provider NameSudhathi Chennuru
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1689740326
PECOS PAC ID: 6800700915
Enrollment ID: I20031113000476
Provider NameKathryn M Pitchford
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1982750857
PECOS PAC ID: 2365356284
Enrollment ID: I20031114000672
Provider NameBihu G Sandhir
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1447243746
PECOS PAC ID: 0042124356
Enrollment ID: I20031119000308
Provider NameJames H Sabiers
Provider TypePractitioner - Medical Oncology
Provider IdentifiersNPI Number: 1447205638
PECOS PAC ID: 5395649321
Enrollment ID: I20031121000540
Provider NameMarvin D Almquist
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1750384871
PECOS PAC ID: 9638073232
Enrollment ID: I20031125000419
Provider NameKelly Lynn Nagel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1003927138
PECOS PAC ID: 7113821612
Enrollment ID: I20031125000938
Provider NameJohn Eugene Wade
Provider TypePractitioner - Clinical Psychologist
Provider IdentifiersNPI Number: 1619021276
PECOS PAC ID: 7214832195
Enrollment ID: I20031204000111
Provider NameDavid Paul Buck
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1609849264
PECOS PAC ID: 4284539750
Enrollment ID: I20031208000031
Provider NameAmmar Safar
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1558334581
PECOS PAC ID: 6709783988
Enrollment ID: I20031216000488
Provider NameKevin L Riddle
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932202710
PECOS PAC ID: 1052218146
Enrollment ID: I20031218000141
Provider NameKeren Ray
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1417978263
PECOS PAC ID: 1557268265
Enrollment ID: I20031218000851
Provider NameRaenell J Poynter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396812467
PECOS PAC ID: 8527966696
Enrollment ID: I20031229000106
Provider NameMohamed F Khan
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1376502500
PECOS PAC ID: 3274432752
Enrollment ID: I20040105000011
Provider NameJoseph N Gunasekera
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1346242534
PECOS PAC ID: 4082513569
Enrollment ID: I20040105000018
Provider NameTimothy F Peters
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1558385526
PECOS PAC ID: 2264332972
Enrollment ID: I20040109000834
Provider NameFredrick M Reeve
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1881618858
PECOS PAC ID: 0042110777
Enrollment ID: I20040109000911
Provider NamePeter Michael Lewis
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1700869161
PECOS PAC ID: 7315847522
Enrollment ID: I20040113000366
Provider NameHari M Polenakovik
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1902966690
PECOS PAC ID: 3375444946
Enrollment ID: I20040116000267
Provider NameQuinton E Moss
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1306993985
PECOS PAC ID: 4880595271
Enrollment ID: I20040119000282
Provider NameRaymond J Poelstra
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1972530848
PECOS PAC ID: 5294638938
Enrollment ID: I20040202000640
Provider NameSaraswathi Kalvakota
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1548382062
PECOS PAC ID: 0345133070
Enrollment ID: I20040205000669
Provider NameVictoria Surdulescu
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1326005877
PECOS PAC ID: 8426942269
Enrollment ID: I20040213000347
Provider NameErrol Singh
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1629141577
PECOS PAC ID: 6901793942
Enrollment ID: I20040303000950
Provider NameMalek Mohamad Safa
Provider TypePractitioner - Medical Oncology
Provider IdentifiersNPI Number: 1427016914
PECOS PAC ID: 9537056494
Enrollment ID: I20040304000024
Provider NameJohn J Haluschak
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1407895535
PECOS PAC ID: 9234033259
Enrollment ID: I20040305000369
Provider NameReginald M Sequeira
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1215933387
PECOS PAC ID: 3274423413
Enrollment ID: I20040319000301
Provider NameMustafa Quadri
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1619989258
PECOS PAC ID: 9638069719
Enrollment ID: I20040320000460
Provider NameJohn W Sawvel
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1780682146
PECOS PAC ID: 9032000260
Enrollment ID: I20040324001299
Provider NameDarla R Baker
Provider TypePractitioner - Certified Nurse Midwife (cnm)
Provider IdentifiersNPI Number: 1194718171
PECOS PAC ID: 1456344324
Enrollment ID: I20040406001184
Provider NameRobert E Bulow
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1477552271
PECOS PAC ID: 6608869334
Enrollment ID: I20040407000583
Provider NamePatrick J. Lytle
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1811996580
PECOS PAC ID: 3375536006
Enrollment ID: I20040407000621
Provider NameThomas M Ruff
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1639178304
PECOS PAC ID: 3678566312
Enrollment ID: I20040407000674
Provider NameAnwar Din
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1225039688
PECOS PAC ID: 8123011699
Enrollment ID: I20040408000545
Provider NameSusan K Jordan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871580506
PECOS PAC ID: 9436146297
Enrollment ID: I20040428000673
Provider NameChowdry Mujahid Bashir
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1881685840
PECOS PAC ID: 8426046442
Enrollment ID: I20040506000096
Provider NameGrenetta Linn Ritenour
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891781696
PECOS PAC ID: 6406845346
Enrollment ID: I20040507000039
Provider NameBruce G Hymon
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1366424806
PECOS PAC ID: 2567362759
Enrollment ID: I20040510000687
Provider NameMilton F Nathan
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1114909744
PECOS PAC ID: 1557261740
Enrollment ID: I20040510000742
Provider NameBruce H Rank
Provider TypePractitioner - Thoracic Surgery
Provider IdentifiersNPI Number: 1679551618
PECOS PAC ID: 9638074271
Enrollment ID: I20040510000776
Provider NameNkoli Anigbogu
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1184710121
PECOS PAC ID: 8123017266
Enrollment ID: I20040512000594
Provider NameKathleen Lang
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1427057421
PECOS PAC ID: 8426049412
Enrollment ID: I20040519000818
Provider NameShanthi Rajaratnam
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1083613129
PECOS PAC ID: 4981695996
Enrollment ID: I20040519000959
Provider NameHarvey Sung Ha Hahn
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1811971039
PECOS PAC ID: 5991796708
Enrollment ID: I20040520000914
Provider NameAmy Byerly
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1023094091
PECOS PAC ID: 3173514486
Enrollment ID: I20040524000853
Provider NameCaroline Elizabeth Peterson
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1851377956
PECOS PAC ID: 2163413485
Enrollment ID: I20040524000926
Provider NameKimberly Ann Warren
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1932104106
PECOS PAC ID: 5991796260
Enrollment ID: I20040524001299
Provider NameShari L Gabbard
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1932119096
PECOS PAC ID: 4789665399
Enrollment ID: I20040528000723
Provider NameSunita Mall
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1962455634
PECOS PAC ID: 6507848728
Enrollment ID: I20040602000952
Provider NameDena Elise Mason-zied
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1982661864
PECOS PAC ID: 5597748079
Enrollment ID: I20040608000465
Provider NameAram M Donigian
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1033120621
PECOS PAC ID: 9032194386
Enrollment ID: I20040621001420
Provider NameSameh N Khouzam
Provider TypePractitioner - Cardiac Electrophysiology
Provider IdentifiersNPI Number: 1881696060
PECOS PAC ID: 4688659493
Enrollment ID: I20040623001542
Provider NameMelissa M Butler
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1225029549
PECOS PAC ID: 3779569611
Enrollment ID: I20040629001453
Provider NameLewis Andrew Mahran
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1003873068
PECOS PAC ID: 1052398716
Enrollment ID: I20040701000512
Provider NameAnn Trzaska Moell
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1457378978
PECOS PAC ID: 4981682960
Enrollment ID: I20040708000237
Provider NameAndrew Louis Archer
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1336142603
PECOS PAC ID: 7315925492
Enrollment ID: I20040713001621
Provider NameThomas Joseph Reid
Provider TypePractitioner - Gynecological Oncology
Provider IdentifiersNPI Number: 1245296409
PECOS PAC ID: 8123008018
Enrollment ID: I20040721001530
Provider NameRoxane Weighall
Provider TypePractitioner - Surgical Oncology
Provider IdentifiersNPI Number: 1497711493
PECOS PAC ID: 3678543931
Enrollment ID: I20040728001658
Provider NameDennis M Anthony
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1396784963
PECOS PAC ID: 7517938772
Enrollment ID: I20040804000001
Provider NameBrian Wayne Ondulick
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1336129485
PECOS PAC ID: 2860463676
Enrollment ID: I20040805001043
Provider NameRichard K Smith
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1700886041
PECOS PAC ID: 6406828953
Enrollment ID: I20040806000386
Provider NameThomas J Merle
Provider TypePractitioner - Thoracic Surgery
Provider IdentifiersNPI Number: 1730187469
PECOS PAC ID: 3072418615
Enrollment ID: I20040811001446
Provider NamePaul Francis Hanley
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1760507057
PECOS PAC ID: 4789657131
Enrollment ID: I20040816000055
Provider NameCarla M Myers
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1770581951
PECOS PAC ID: 9739070335
Enrollment ID: I20040824000951
Provider NameTerri Riddiford
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1649279498
PECOS PAC ID: 9931173911
Enrollment ID: I20040825000111
Provider NameLinda M Davidson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1891785309
PECOS PAC ID: 5991770547
Enrollment ID: I20040827000918
Provider NameMujeeb Ur-rahman Siddiqui
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1619974797
PECOS PAC ID: 3476528936
Enrollment ID: I20040827001057
Provider NameSandra Lee Kimball
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1033117932
PECOS PAC ID: 9436126521
Enrollment ID: I20040916001108
Provider NameMarcia J Thomas
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1386741429
PECOS PAC ID: 5890763791
Enrollment ID: I20040920000143
Provider NameSteven Warren Crawford
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1386603611
PECOS PAC ID: 2365434800
Enrollment ID: I20040920001029
Provider NamePhilip Stephen Perona
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1346296399
PECOS PAC ID: 7012985773
Enrollment ID: I20040921000270
Provider NameRichard Wayne Winger
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1861468597
PECOS PAC ID: 3870561319
Enrollment ID: I20040922000338
Provider NameHoward Lee Bernie
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1033158217
PECOS PAC ID: 6002884087
Enrollment ID: I20040922001127
Provider NamePeter Derussy
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1649251174
PECOS PAC ID: 0648239483
Enrollment ID: I20041007000004
Provider NameDaniel J Dunaway
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1669483152
PECOS PAC ID: 7416944103
Enrollment ID: I20041019000059
Provider NameJohn J Lochner
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1013928456
PECOS PAC ID: 6709873409
Enrollment ID: I20041019000247
Provider NameSteven M Kleinhenz
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1285645861
PECOS PAC ID: 4688634546
Enrollment ID: I20041019000323
Provider NameMichael C Welker
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1942211305
PECOS PAC ID: 7416917372
Enrollment ID: I20041019001402
Provider NameDonald W Ames
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1306857891
PECOS PAC ID: 5395720122
Enrollment ID: I20041019001431
Provider NameEugene S Chung
Provider TypePractitioner - Advanced Heart Failure And Transplant Cardiology
Provider IdentifiersNPI Number: 1003893926
PECOS PAC ID: 0143281444
Enrollment ID: I20041020000818
Provider NameSyed Ashfaq Hussain Najeed
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1972560662
PECOS PAC ID: 3779545694
Enrollment ID: I20041102000621
Provider NameKevin L Sharrett
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1528007754
PECOS PAC ID: 0749243723
Enrollment ID: I20041110000727
Provider NameThomas L Brunsman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1215976428
PECOS PAC ID: 6507829587
Enrollment ID: I20041110000763
Provider NameGail Tari Askew
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629147749
PECOS PAC ID: 5092770735
Enrollment ID: I20041122001249
Provider NameFrank P Mannarino
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1356346985
PECOS PAC ID: 7911994694
Enrollment ID: I20041201000010
Provider NameBarry A Fisher
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1184617409
PECOS PAC ID: 2264497262
Enrollment ID: I20041201000129
Provider NameRichard L Chamberlain
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1164427019
PECOS PAC ID: 0547161119
Enrollment ID: I20041202000165
Provider NameRaymond Scott Russell
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1447206933
PECOS PAC ID: 6002717618
Enrollment ID: I20041202000849
Provider NameLaurie Ann Bankston
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1295790343
PECOS PAC ID: 6507823374
Enrollment ID: I20041213001039
Provider NameCeferino J Cata
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1306815808
PECOS PAC ID: 7719969997
Enrollment ID: I20050106000864
Provider NameDavid L Schumacher
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1336132547
PECOS PAC ID: 7214922798
Enrollment ID: I20050119000234
Provider NameCarol A Amfahr
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1245305051
PECOS PAC ID: 6406805027
Enrollment ID: I20050120000530
Provider NameMark W Day
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1225050560
PECOS PAC ID: 6709836034
Enrollment ID: I20050125000636
Provider NameTrisha Ann Kall
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1811187933
PECOS PAC ID: 9032160494
Enrollment ID: I20050203000241
Provider NameJohn Michael Smith
Provider TypePractitioner - Thoracic Surgery
Provider IdentifiersNPI Number: 1316971757
PECOS PAC ID: 3779472279
Enrollment ID: I20050203000645
Provider NamePriya G Jain
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1912093360
PECOS PAC ID: 2668423310
Enrollment ID: I20050210000012
Provider NameKristy A Zechiel
Provider TypePractitioner - Geriatric Medicine
Provider IdentifiersNPI Number: 1376520353
PECOS PAC ID: 7416909809
Enrollment ID: I20050214000744
Provider NameLazaro J Pages
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1821098419
PECOS PAC ID: 9335191345
Enrollment ID: I20050217000974
Provider NameBruce B Banias
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1639134703
PECOS PAC ID: 8325938954
Enrollment ID: I20050401000533
Provider NameAlejandro R Calvo
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1457341760
PECOS PAC ID: 0840286522
Enrollment ID: I20050419001306
Provider NameJoseph Anigbogu
Provider TypePractitioner - Pulmonary Disease
Provider IdentifiersNPI Number: 1972583508
PECOS PAC ID: 9133015894
Enrollment ID: I20050510000546
Provider NameErin Lindsay Mathews
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1326005711
PECOS PAC ID: 4183668643
Enrollment ID: I20050615000402
Provider NameShelli A Powell
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1114941176
PECOS PAC ID: 4981648417
Enrollment ID: I20050616000337
Provider NameJoseph W Lavelle
Provider TypePractitioner - Hematology/oncology
Provider IdentifiersNPI Number: 1629027727
PECOS PAC ID: 5395781264
Enrollment ID: I20050630000454
Provider NameIrshad Hussain
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1073582201
PECOS PAC ID: 1355379884
Enrollment ID: I20050727000260
Provider NameRaja A Nazir
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1003871963
PECOS PAC ID: 6507894409
Enrollment ID: I20050802000131
Provider NameJohn C Sefton
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1679559470
PECOS PAC ID: 2466480363
Enrollment ID: I20050802000180
Provider NameMichelle Marie Russell
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1366428476
PECOS PAC ID: 5890723712
Enrollment ID: I20050802000313
Provider NameLisa K Heinemeyer Foster
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1750384277
PECOS PAC ID: 5597793414
Enrollment ID: I20050802000344
Provider NameJames E Foster
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1508869025
PECOS PAC ID: 5395773212
Enrollment ID: I20050802000364
Provider NameJohn M Duchak
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1841269057
PECOS PAC ID: 2264414440
Enrollment ID: I20050808000274
Provider NameZahra Heidari
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1215934856
PECOS PAC ID: 3476586850
Enrollment ID: I20050915000835
Provider NameChristopher K Madison
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1326015504
PECOS PAC ID: 8426082983
Enrollment ID: I20050923000305
Provider NameBhairavi Krishnakant Patel Brittain
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1457359069
PECOS PAC ID: 1951336080
Enrollment ID: I20050928000394
Provider NameDavid Joseph Doucette
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1679570543
PECOS PAC ID: 8325073455
Enrollment ID: I20051013000153
Provider NameMary Ellen Leary
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1730186602
PECOS PAC ID: 3779518808
Enrollment ID: I20051013000172
Provider NameWilliam M Mccullough
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1740287572
PECOS PAC ID: 0840224812
Enrollment ID: I20051013000198
Provider NameRobert Alan Little
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1013915610
PECOS PAC ID: 8224063359
Enrollment ID: I20051013000235
Provider NameEleia Serrano Reyes
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1245293513
PECOS PAC ID: 2668499070
Enrollment ID: I20051025000904
Provider NameHerbert B Newton
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1770667164
PECOS PAC ID: 8123045085
Enrollment ID: I20051031000019
Provider NameAlicia Marie Buterbaugh
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1073126389
PECOS PAC ID: 0648290288
Enrollment ID: I20051129000222
Provider NameFrederick Simpson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1477503928
PECOS PAC ID: 4789604836
Enrollment ID: I20051205000000
Provider NameMargaret M Dunn
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1700842788
PECOS PAC ID: 6002836004
Enrollment ID: I20051206000567
Provider NameJacob Bradley Gibson
Provider TypePractitioner - Interventional Cardiology
Provider IdentifiersNPI Number: 1780698811
PECOS PAC ID: 4385665280
Enrollment ID: I20051207000531
Provider NameLisa Renee Vantrease
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1437198066
PECOS PAC ID: 4688697584
Enrollment ID: I20060106000016
Provider NameEdward Jacobs
Provider TypePractitioner - Urology
Provider IdentifiersNPI Number: 1255330676
PECOS PAC ID: 0840213302
Enrollment ID: I20060111000000
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PECOS PAC ID: 7315335361
Enrollment ID: I20211214001335
Provider NameAbhi H Kapuria
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1730542812
PECOS PAC ID: 8820493935
Enrollment ID: I20211214001785
Provider NameArielle M Mason
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1730843079
PECOS PAC ID: 3577954163
Enrollment ID: I20211215000360
Provider NameColby A. Richardson
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1558724799
PECOS PAC ID: 2567866973
Enrollment ID: I20211215001708
Provider NameGuha K Venkatraman
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1356517593
PECOS PAC ID: 3476721887
Enrollment ID: I20211215002197
Provider NameSatinder Kaur Grewal
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1386085546
PECOS PAC ID: 7618229436
Enrollment ID: I20211215002321
Provider NameTherese M Lango
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1235136821
PECOS PAC ID: 5092764910
Enrollment ID: I20211229001690
Provider NameCody J Cappel
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1497415335
PECOS PAC ID: 7113319609
Enrollment ID: I20220112002610
Provider NameNeetu Gupta
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1194012484
PECOS PAC ID: 2062706716
Enrollment ID: I20220118002551
Provider NameKyle D Blasser
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1285132852
PECOS PAC ID: 3274880950
Enrollment ID: I20220124001214
Provider NameCharles T Swafford
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700537362
PECOS PAC ID: 3274926993
Enrollment ID: I20220201002541
Provider NameBobby D Robinson
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1629488960
PECOS PAC ID: 9234410416
Enrollment ID: I20220207002155
Provider NameRukan Ahmed
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1447799754
PECOS PAC ID: 7012288558
Enrollment ID: I20220208000866
Provider NameBernadette Joy Medina
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1376201020
PECOS PAC ID: 6800289125
Enrollment ID: I20220209002764
Provider NameTarun Mullick
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1912906462
PECOS PAC ID: 9032161054
Enrollment ID: I20220210001539
Provider NameLinda Y. Jiang
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1427476456
PECOS PAC ID: 3678870276
Enrollment ID: I20220218000969
Provider NameRavi Yarlagadda
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1679531636
PECOS PAC ID: 7911975560
Enrollment ID: I20220222000343
Provider NameYu-hsuan Liao
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1063868677
PECOS PAC ID: 9133523350
Enrollment ID: I20220302001534
Provider NameDavid M Welker
Provider TypePractitioner - Orthopedic Surgery
Provider IdentifiersNPI Number: 1356307326
PECOS PAC ID: 3072414309
Enrollment ID: I20220317002286
Provider NameVanessa Moore Salupo Wehrley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164000857
PECOS PAC ID: 7416342605
Enrollment ID: I20220325001015
Provider NameHilary Rose Haley
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1619624731
PECOS PAC ID: 1557757341
Enrollment ID: I20220404001329
Provider NameLakshmi Mukundan
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1619137015
PECOS PAC ID: 6800111303
Enrollment ID: I20220404002539
Provider NameBrandon Specht
Provider TypePractitioner - Plastic And Reconstructive Surgery
Provider IdentifiersNPI Number: 1538427141
PECOS PAC ID: 3476784380
Enrollment ID: I20220408000126
Provider NameRachael M Polak
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1346882974
PECOS PAC ID: 9234563420
Enrollment ID: I20220408001334
Provider NameHampton Lee Mcclendon
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1801053103
PECOS PAC ID: 3274852140
Enrollment ID: I20220409000365
Provider NameAla Shiyab
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1265679187
PECOS PAC ID: 7517099112
Enrollment ID: I20220411001827
Provider NameDavid Cha
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1477014694
PECOS PAC ID: 2466785118
Enrollment ID: I20220413002527
Provider NameShannon Douglas Murphy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215602628
PECOS PAC ID: 8325434624
Enrollment ID: I20220414000741
Provider NameCarmen Cornelia Elisabeth Gruia
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548726755
PECOS PAC ID: 1456746999
Enrollment ID: I20220420001049
Provider NameAjibola A Adesanya
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306504543
PECOS PAC ID: 2466849971
Enrollment ID: I20220503000457
Provider NameJames Andry
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1205192838
PECOS PAC ID: 6002119633
Enrollment ID: I20220504000579
Provider NameSteven Gangloff
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1952756058
PECOS PAC ID: 4587951637
Enrollment ID: I20220506001373
Provider NameGrant Andrew Huish
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1376074849
PECOS PAC ID: 2466729702
Enrollment ID: I20220509001838
Provider NameAmmar Ahmad
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1366905390
PECOS PAC ID: 0345574331
Enrollment ID: I20220518000426
Provider NamePaul J Kreinbrink
Provider TypePractitioner - Radiation Oncology
Provider IdentifiersNPI Number: 1073044640
PECOS PAC ID: 1951671130
Enrollment ID: I20220601000581
Provider NameJames Parker
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1477947653
PECOS PAC ID: 1759632458
Enrollment ID: I20220608002304
Provider NameAnant Shenoy
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1194998005
PECOS PAC ID: 5991855140
Enrollment ID: I20220608003120
Provider NameBrooke Bender
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225701584
PECOS PAC ID: 6204228141
Enrollment ID: I20220610001771
Provider NameStephen K Paul
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1700310943
PECOS PAC ID: 2668740911
Enrollment ID: I20220610001851
Provider NameSrivani Chunchulu
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1881009538
PECOS PAC ID: 0648598474
Enrollment ID: I20220615002735
Provider NameHarold Johannes Duarte
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1508326182
PECOS PAC ID: 8224371976
Enrollment ID: I20220616000449
Provider NameAudrey Nathalie Grenga
Provider TypePractitioner - Neurosurgery
Provider IdentifiersNPI Number: 1467849448
PECOS PAC ID: 0547513277
Enrollment ID: I20220617002499
Provider NameRyna Then
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1427346303
PECOS PAC ID: 4587891080
Enrollment ID: I20220621001939
Provider NameDale Scott Guinther
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1851966899
PECOS PAC ID: 6507246576
Enrollment ID: I20220707003991
Provider NameJaclyn P Carr
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1023749983
PECOS PAC ID: 2466833520
Enrollment ID: I20220720002277
Provider NameRachael F Lamb
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720711898
PECOS PAC ID: 5799167300
Enrollment ID: I20220728003558
Provider NameLuke M Lewis
Provider TypePractitioner - Radiation Oncology
Provider IdentifiersNPI Number: 1083147474
PECOS PAC ID: 8325317241
Enrollment ID: I20220729001480
Provider NameMatthew Ralston Yeager
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1083176697
PECOS PAC ID: 4880935972
Enrollment ID: I20220729002704
Provider NameZechariah J Rhodes
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1801328760
PECOS PAC ID: 7214201821
Enrollment ID: I20220731000147
Provider NameMohamed Ahmed Eltigani Abdelrahman
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1396299483
PECOS PAC ID: 4688056831
Enrollment ID: I20220804000177
Provider NameErica Lillyan Anderson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265191456
PECOS PAC ID: 2567859465
Enrollment ID: I20220815000520
Provider NameDakshin Gangadharamurthy
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1609005578
PECOS PAC ID: 9133398357
Enrollment ID: I20220816001078
Provider NameMckayla B Johnson Riggs
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1942690060
PECOS PAC ID: 4284963182
Enrollment ID: I20220818002142
Provider NameAllyson K Halderman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1699237057
PECOS PAC ID: 0648512152
Enrollment ID: I20220819002426
Provider NameRachelle M Dulan
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1386102176
PECOS PAC ID: 1456686500
Enrollment ID: I20220822002537
Provider NameDawn Marie Lyon
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275871105
PECOS PAC ID: 6103209176
Enrollment ID: I20220824001659
Provider NameTimothy Robert Bennett
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1629535612
PECOS PAC ID: 6901130806
Enrollment ID: I20220825002504
Provider NameCarlos J Ventura
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1174842884
PECOS PAC ID: 4082856745
Enrollment ID: I20220825004309
Provider NameErica C Seabold
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932767142
PECOS PAC ID: 2769718428
Enrollment ID: I20220907000824
Provider NameWendi I Kulin
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1043411333
PECOS PAC ID: 5193857647
Enrollment ID: I20220909003044
Provider NameCord Neal Gothard
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1750879797
PECOS PAC ID: 4981952934
Enrollment ID: I20220914003604
Provider NameEsther Simmons
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1356801831
PECOS PAC ID: 8325375074
Enrollment ID: I20220920001395
Provider NameJordan M Knox
Provider TypePractitioner - Sports Medicine
Provider IdentifiersNPI Number: 1396130902
PECOS PAC ID: 2062794159
Enrollment ID: I20220922001355
Provider NameNessrine Ktaich
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1952535049
PECOS PAC ID: 1355488552
Enrollment ID: I20220923000815
Provider NameRachael Nicole Spady
Provider TypePractitioner - Obstetrics/gynecology
Provider IdentifiersNPI Number: 1205329547
PECOS PAC ID: 6204212350
Enrollment ID: I20220927003957
Provider NameSai Konduru
Provider TypePractitioner - Cardiac Electrophysiology
Provider IdentifiersNPI Number: 1972714889
PECOS PAC ID: 8628231859
Enrollment ID: I20220929001983
Provider NameJaykumar Patel
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1326401647
PECOS PAC ID: 3072842830
Enrollment ID: I20221003002458
Provider NameAmna Ramzan
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1063953297
PECOS PAC ID: 0244612356
Enrollment ID: I20221004003379
Provider NameJoann R Heuker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1275251605
PECOS PAC ID: 9032595434
Enrollment ID: I20221010000663
Provider NameHaley R Schneider
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1841922713
PECOS PAC ID: 7315313293
Enrollment ID: I20221018000989
Provider NameOlaoye J Jegede
Provider TypePractitioner - Hospitalist
Provider IdentifiersNPI Number: 1629634753
PECOS PAC ID: 1254665334
Enrollment ID: I20221018001987
Provider NameHeather L Lavoy
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1669196150
PECOS PAC ID: 3476929969
Enrollment ID: I20221025002613
Provider NameBenjamin C Groves
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1396242202
PECOS PAC ID: 7012399033
Enrollment ID: I20221026002912
Provider NameKristen L Veal
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1821594789
PECOS PAC ID: 5698141604
Enrollment ID: I20221027001526
Provider NameIgor Alexandrovich Malenky
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1740714054
PECOS PAC ID: 8820361330
Enrollment ID: I20221027002618
Provider NameMohamed Hegazy
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1811280100
PECOS PAC ID: 9335435254
Enrollment ID: I20221031002012
Provider NameDrew William Guisinger
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760102123
PECOS PAC ID: 6103293311
Enrollment ID: I20221101000866
Provider NameJimmy Diep Nguyen
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1285815605
PECOS PAC ID: 5799837621
Enrollment ID: I20221109002569
Provider NameJaspreet Kaur Sandhu
Provider TypePractitioner - General Surgery
Provider IdentifiersNPI Number: 1033521679
PECOS PAC ID: 9931576626
Enrollment ID: I20221109002638
Provider NameSrijana Zarkou
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1649482340
PECOS PAC ID: 3779617139
Enrollment ID: I20221114002371
Provider NameJoseph Kenneth Waugh
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1881238160
PECOS PAC ID: 5890163356
Enrollment ID: I20221115001961
Provider NameJorge Torres
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1134652134
PECOS PAC ID: 2668725417
Enrollment ID: I20221117003283
Provider NameAgnelio Silverio Cardentey
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1164957452
PECOS PAC ID: 3870960412
Enrollment ID: I20221121000278
Provider NameDavid S Feldman
Provider TypePractitioner - Cardiovascular Disease (cardiology)
Provider IdentifiersNPI Number: 1386688711
PECOS PAC ID: 2062493125
Enrollment ID: I20221122002271
Provider NameEdward George Boyer
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1073953683
PECOS PAC ID: 3779885678
Enrollment ID: I20221122002505
Provider NameJason P Stabley
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1992713234
PECOS PAC ID: 8022904036
Enrollment ID: I20221122002719
Provider NameEdward N Misulis
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1902396559
PECOS PAC ID: 8123409125
Enrollment ID: I20221128001196
Provider NameIndira De Jesus Alvelo
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1700074796
PECOS PAC ID: 2264651207
Enrollment ID: I20221129000320
Provider NameArvind Vasudevan
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1770503526
PECOS PAC ID: 2860414091
Enrollment ID: I20221129000476
Provider NameNicholas Anthony Ressa
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1366974867
PECOS PAC ID: 8921370404
Enrollment ID: I20221129000684
Provider NameCintasha Redmond
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1639437452
PECOS PAC ID: 8628344728
Enrollment ID: I20221129001177
Provider NameNathanael J Lee
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1255794525
PECOS PAC ID: 0648560250
Enrollment ID: I20221129001889
Provider NameShao-hwa P Wei
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1205062361
PECOS PAC ID: 7517278146
Enrollment ID: I20221129002004
Provider NameMonica M Noya Santana
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1598297228
PECOS PAC ID: 1658755574
Enrollment ID: I20221129002607
Provider NameFelix Rivera-perez
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1003078692
PECOS PAC ID: 4981755733
Enrollment ID: I20221129002792
Provider NameMindy Sue Kahlhamer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578296364
PECOS PAC ID: 6800266545
Enrollment ID: I20221221002033
Provider NameMichael Jaje
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1538571468
PECOS PAC ID: 6305111691
Enrollment ID: I20221228002194
Provider NameMaritess Gay Asumen
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1588003222
PECOS PAC ID: 1153609458
Enrollment ID: I20230109000415
Provider NameFaith Madeline Connovich
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598479438
PECOS PAC ID: 1557735685
Enrollment ID: I20230313001486
Provider NameJennifer Darlene Otterbacher
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1184156358
PECOS PAC ID: 8426327636
Enrollment ID: I20230314000521
Provider NameJoseph Clayton King
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1770046872
PECOS PAC ID: 6608101506
Enrollment ID: I20230404001763
Provider NameKristen E Young
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1790105518
PECOS PAC ID: 3779805932
Enrollment ID: I20230522001422
Provider NameCorinna Marie Bayes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508594169
PECOS PAC ID: 0547627408
Enrollment ID: I20230607003334
Provider NameMatthew S Lyman
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1588292403
PECOS PAC ID: 6103255468
Enrollment ID: I20230613001070
Provider NameDaniela I Rosu
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1063948305
PECOS PAC ID: 7214200153
Enrollment ID: I20230725000360
Provider NameAdam Glendon Bussey
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1306308986
PECOS PAC ID: 5193067197
Enrollment ID: I20230725002332
Provider NameKishley Bhalla
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1457976656
PECOS PAC ID: 7113349234
Enrollment ID: I20230727003489
Provider NameAlyssa Ann Jones
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1508545591
PECOS PAC ID: 3375905946
Enrollment ID: I20230814002180
Provider NameSarah Nicole Dula
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1447887922
PECOS PAC ID: 2567893266
Enrollment ID: I20230821001573
Provider NameJalpa S Soni
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1235767187
PECOS PAC ID: 1951732445
Enrollment ID: I20230905002673
Provider NameEmily Mahran
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1568091254
PECOS PAC ID: 5496186397
Enrollment ID: I20230912004083
Provider NameDeanna Mae Morgan
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982480042
PECOS PAC ID: 9830544550
Enrollment ID: I20231016000897
Provider NameRena Michelle Kalter
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1629508494
PECOS PAC ID: 9335412063
Enrollment ID: I20240226001014
Provider NameKira Haubach
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720567514
PECOS PAC ID: 5991055451
Enrollment ID: I20240409002238

Reviews and Comments


Family Medicine in Kettering, OH

Kevin G Malloy Md, Llc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 5250 Far Hills Ave, Ste 250, Kettering, OH 45429
Phone: 937-435-6500    Fax: 937-435-6514
Kettering Breast Evaluation Center
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 580 Lincoln Park Boulevard, Suite 200, Kettering Breast Evaluation Center, Kettering, OH 45429
Phone: 937-299-0099    
Post Acute Solutions, Llc
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 1251 E Dorothy Ln, Suite A, Kettering, OH 45419
Phone: 513-575-6325    Fax: 937-853-0552
Infectious Diseases Associates Inc
Primary Care Clinic
Medicare: Medicare Enrolled
Practice Location: 3533 Southern Blvd Ste 4200, Kettering, OH 45429
Phone: 937-572-7648    Fax: 937-832-8279
Coumadin Clinic
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 3535 Southern Blvd, Kettering, OH 45429
Phone: 937-384-6845    Fax: 937-384-6939
Khn Ip Med
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 3535 Southern Blvd, Kettering, OH 45429
Phone: 937-395-6665    Fax: 937-522-9260
Fred L Tanzer
Primary Care Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 4750 Hempstead Station Dr, Kettering, OH 45429
Phone: 513-543-3746    Fax: 513-557-3347

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.