| Lac Qui Parle Clinic Of Madison Inc | |
|
820 3rd Ave Madison MN 56256-1014 | |
| (320) 598-7551 | |
| (320) 598-7553 |
| Full Name | Lac Qui Parle Clinic Of Madison Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 820 3rd Ave, Madison, Minnesota |
| Authorized Official Name and Position | Carol M Borgerson (CFO) |
| Authorized Official Contact | 3206987152 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lac Qui Parle Clinic Of Madison Inc 900 2nd Ave Madison MN 56256-1006 Ph: (320) 598-7551 | Lac Qui Parle Clinic Of Madison Inc 820 3rd Ave Madison MN 56256-1014 Ph: (320) 598-7551 |
| NPI Number | 1144266156 |
|---|---|
| Provider Enumeration Date | 06/20/2006 |
| Last Update Date | 05/16/2024 |
| Medicare PECOS PAC ID | 5799727707 |
|---|---|
| Medicare Enrollment ID | O20050531000484 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144266156 | NPI | - | NPPES |
| 106646 | Other | MN | UCARE |
| 3F739LA | Other | MN | BCBS |
| 933813600 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
| Provider Name | Martin H Janning |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1396963922 PECOS PAC ID: 0749194991 Enrollment ID: I20031113000156 |
| Provider Name | Martin J Asis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598743833 PECOS PAC ID: 3678477353 Enrollment ID: I20031124000575 |
| Provider Name | Nathan D Block |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871571125 PECOS PAC ID: 0648174334 Enrollment ID: I20031124000644 |
| Provider Name | Michael H Wittmer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427029859 PECOS PAC ID: 1658275094 Enrollment ID: I20031126000227 |
| Provider Name | Eleazar P Briones |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255338067 PECOS PAC ID: 7315843869 Enrollment ID: I20031208000476 |
| Provider Name | David A Freeman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871583211 PECOS PAC ID: 5496651044 Enrollment ID: I20031212000289 |
| Provider Name | Matthew M Schaar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1790765600 PECOS PAC ID: 5698678944 Enrollment ID: I20040202000713 |
| Provider Name | Nihar S Shah |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245218759 PECOS PAC ID: 4688667645 Enrollment ID: I20040406000322 |
| Provider Name | Suzanne C Moffit |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487687406 PECOS PAC ID: 7214926120 Enrollment ID: I20040506001666 |
| Provider Name | James Goddard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770562639 PECOS PAC ID: 0749279214 Enrollment ID: I20040510000914 |
| Provider Name | John T Olsen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801814132 PECOS PAC ID: 8224933973 Enrollment ID: I20040512001342 |
| Provider Name | Sonia Lucille Wright |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104804343 PECOS PAC ID: 1557323136 Enrollment ID: I20041027000760 |
| Provider Name | Mark E Wilson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134161128 PECOS PAC ID: 2163485178 Enrollment ID: I20041110000943 |
| Provider Name | David Asinger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205886819 PECOS PAC ID: 8426953142 Enrollment ID: I20041110000973 |
| Provider Name | Thomas R Frerichs |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629028329 PECOS PAC ID: 9436114634 Enrollment ID: I20041130000530 |
| Provider Name | Jeffrey R Brace |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619905924 PECOS PAC ID: 7618933326 Enrollment ID: I20041204000145 |
| Provider Name | Brant N Hacker |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1679633655 PECOS PAC ID: 6608834718 Enrollment ID: I20041221000544 |
| Provider Name | Dominic F Frecentese |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144209008 PECOS PAC ID: 8022922798 Enrollment ID: I20050208000057 |
| Provider Name | Jonathan K Wood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932143583 PECOS PAC ID: 8022007392 Enrollment ID: I20050603000436 |
| Provider Name | Torrey Bergman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861442493 PECOS PAC ID: 5890762124 Enrollment ID: I20050606001011 |
| Provider Name | Mark Veldman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538188511 PECOS PAC ID: 6305889478 Enrollment ID: I20050609000274 |
| Provider Name | Brian T Sullivan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1780604835 PECOS PAC ID: 9436193802 Enrollment ID: I20050616000255 |
| Provider Name | Michael D Heaney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245287549 PECOS PAC ID: 7416991880 Enrollment ID: I20050616000269 |
| Provider Name | Jonathan W Mellema |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1083680458 PECOS PAC ID: 6305882861 Enrollment ID: I20050706000707 |
| Provider Name | Fareed A Siddiqui |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1235236530 PECOS PAC ID: 8921031535 Enrollment ID: I20050914000881 |
| Provider Name | Mark W Berger |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962481747 PECOS PAC ID: 0749194777 Enrollment ID: I20050920000198 |
| Provider Name | Curt Behrns |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801869227 PECOS PAC ID: 1850318379 Enrollment ID: I20051025000024 |
| Provider Name | Peter B Wold |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861471633 PECOS PAC ID: 0749260404 Enrollment ID: I20060424000306 |
| Provider Name | David P Lambert |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154384527 PECOS PAC ID: 9436162120 Enrollment ID: I20060725000249 |
| Provider Name | Gregory M Phelan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427090133 PECOS PAC ID: 2860397510 Enrollment ID: I20060726000019 |
| Provider Name | Matthew J Loe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1861419293 PECOS PAC ID: 2769486117 Enrollment ID: I20060828000166 |
| Provider Name | Don E Wiese |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114908159 PECOS PAC ID: 7810971843 Enrollment ID: I20060830000035 |
| Provider Name | Azhar T Ali |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538187786 PECOS PAC ID: 0143228809 Enrollment ID: I20061227000270 |
| Provider Name | Jeffrey Paul Lassig |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558459032 PECOS PAC ID: 6507896578 Enrollment ID: I20070329000258 |
| Provider Name | Gregory A Rathmann |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891990404 PECOS PAC ID: 9739270182 Enrollment ID: I20070814000512 |
| Provider Name | Paul R Carolan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144427055 PECOS PAC ID: 3971695214 Enrollment ID: I20070816000583 |
| Provider Name | Andrew Hartigan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1093793234 PECOS PAC ID: 5294649976 Enrollment ID: I20070928000639 |
| Provider Name | Jason M Como |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316137680 PECOS PAC ID: 1557441011 Enrollment ID: I20080109000586 |
| Provider Name | Michael Thomas Madison |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1821077876 PECOS PAC ID: 5890609580 Enrollment ID: I20080130000624 |
| Provider Name | Anne M Reddy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1659340180 PECOS PAC ID: 9335040633 Enrollment ID: I20080208000464 |
| Provider Name | Keith H Wittenberg |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154300929 PECOS PAC ID: 3173437886 Enrollment ID: I20080530000327 |
| Provider Name | Anuradha K Tummala |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972582732 PECOS PAC ID: 2567376270 Enrollment ID: I20080530000396 |
| Provider Name | Susan M Truman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356320105 PECOS PAC ID: 6507859840 Enrollment ID: I20080530000403 |
| Provider Name | Alexandra L Muschenheim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184603607 PECOS PAC ID: 2668452335 Enrollment ID: I20080531000068 |
| Provider Name | Paul F Mulcahy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467431262 PECOS PAC ID: 9234043928 Enrollment ID: I20080531000071 |
| Provider Name | Steven C Hommeyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356329593 PECOS PAC ID: 8325952005 Enrollment ID: I20080602000034 |
| Provider Name | Todd M Arsenault |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902890726 PECOS PAC ID: 4688588619 Enrollment ID: I20080602000082 |
| Provider Name | Joseph J Baraga |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1730167073 PECOS PAC ID: 8022922053 Enrollment ID: I20080602000094 |
| Provider Name | Jeffrey M Barkmeier |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871571083 PECOS PAC ID: 4385558311 Enrollment ID: I20080602000101 |
| Provider Name | John M Caspers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750369989 PECOS PAC ID: 2567376221 Enrollment ID: I20080602000293 |
| Provider Name | Matthew T Baldwin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487632725 PECOS PAC ID: 5496669426 Enrollment ID: I20080602000307 |
| Provider Name | Timothy Goertzen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821076068 PECOS PAC ID: 3577477256 Enrollment ID: I20080602000518 |
| Provider Name | John P Knoedler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023097078 PECOS PAC ID: 7911811609 Enrollment ID: I20080603000224 |
| Provider Name | Jorge Leon |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1013996065 PECOS PAC ID: 2860394210 Enrollment ID: I20080611000310 |
| Provider Name | Anne Weisensee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992784755 PECOS PAC ID: 8729992433 Enrollment ID: I20080620000583 |
| Provider Name | David Drake |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528046612 PECOS PAC ID: 7517871288 Enrollment ID: I20080620000617 |
| Provider Name | Kevin P Henseler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1952358129 PECOS PAC ID: 6800977810 Enrollment ID: I20080703000478 |
| Provider Name | John William Colford |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164575411 PECOS PAC ID: 1254426141 Enrollment ID: I20080721000076 |
| Provider Name | Andrew Deh-an Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1124070883 PECOS PAC ID: 2769581578 Enrollment ID: I20080721000162 |
| Provider Name | Mark D Mcmillan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508884826 PECOS PAC ID: 4981785995 Enrollment ID: I20080809000057 |
| Provider Name | Janice D Briones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386804532 PECOS PAC ID: 4183782568 Enrollment ID: I20081029000614 |
| Provider Name | Steven G Thiel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427229541 PECOS PAC ID: 1456411735 Enrollment ID: I20090624000713 |
| Provider Name | Brian F Decesare |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1194871798 PECOS PAC ID: 5395811863 Enrollment ID: I20090625000117 |
| Provider Name | Benjamin J May |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710172960 PECOS PAC ID: 0547313918 Enrollment ID: I20090803000113 |
| Provider Name | Jacob Hodge |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811158256 PECOS PAC ID: 3072668193 Enrollment ID: I20090825000751 |
| Provider Name | Kendall J Strand |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518987668 PECOS PAC ID: 3577468222 Enrollment ID: I20100525000619 |
| Provider Name | Joshua Johnson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811127905 PECOS PAC ID: 7416081591 Enrollment ID: I20100811000156 |
| Provider Name | Jennifer M Williams |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194917302 PECOS PAC ID: 1355467507 Enrollment ID: I20100925000196 |
| Provider Name | Evelyn L Slomka |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437388378 PECOS PAC ID: 3577689629 Enrollment ID: I20100925000280 |
| Provider Name | Mohamed Abdihalim |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912141243 PECOS PAC ID: 6204010994 Enrollment ID: I20110404000745 |
| Provider Name | Trisha R Prescott |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487895660 PECOS PAC ID: 8123205655 Enrollment ID: I20110608000802 |
| Provider Name | Jessica Ann Axmacher |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912148867 PECOS PAC ID: 6305023839 Enrollment ID: I20110608000812 |
| Provider Name | Angela W Tai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336212810 PECOS PAC ID: 8022161819 Enrollment ID: I20110610000570 |
| Provider Name | David Aamodt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578876496 PECOS PAC ID: 0244401461 Enrollment ID: I20110920000701 |
| Provider Name | Franklin Liu |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265540405 PECOS PAC ID: 1951454644 Enrollment ID: I20111011000500 |
| Provider Name | Brian D Lindaman |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912121229 PECOS PAC ID: 4183718315 Enrollment ID: I20120131000565 |
| Provider Name | Lucas B Ludeman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205080744 PECOS PAC ID: 2668537069 Enrollment ID: I20120625000418 |
| Provider Name | Mathew So |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1215126503 PECOS PAC ID: 1254597487 Enrollment ID: I20120716000497 |
| Provider Name | Michael Grogan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518015627 PECOS PAC ID: 6608044334 Enrollment ID: I20120723000798 |
| Provider Name | Benjamin A Gilloon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902919376 PECOS PAC ID: 5597880989 Enrollment ID: I20120810000007 |
| Provider Name | Erich N Bryan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740459551 PECOS PAC ID: 5799932489 Enrollment ID: I20120831000495 |
| Provider Name | Sameer Nevile |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447556584 PECOS PAC ID: 5991957425 Enrollment ID: I20121210000252 |
| Provider Name | Adam B Jeffers |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1255539748 PECOS PAC ID: 8325293038 Enrollment ID: I20130702000112 |
| Provider Name | Thomas C Bryson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1811101116 PECOS PAC ID: 0749436491 Enrollment ID: I20130715000353 |
| Provider Name | Ryan C Cusic |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699091686 PECOS PAC ID: 2264667443 Enrollment ID: I20131023001741 |
| Provider Name | Andrew Bunney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114246113 PECOS PAC ID: 5597998096 Enrollment ID: I20140508000511 |
| Provider Name | Jonathan P Williams |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003079112 PECOS PAC ID: 1153569710 Enrollment ID: I20140520002247 |
| Provider Name | Jeff Werner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1417152885 PECOS PAC ID: 7113180258 Enrollment ID: I20140821002741 |
| Provider Name | Assefa M Ayalew |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912240235 PECOS PAC ID: 5597985358 Enrollment ID: I20140930001982 |
| Provider Name | Jacob Waxman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1972946937 PECOS PAC ID: 8820238322 Enrollment ID: I20141224001241 |
| Provider Name | Kyle R Shipley |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841408200 PECOS PAC ID: 6507995339 Enrollment ID: I20150521002513 |
| Provider Name | Caroline L Ho |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689664534 PECOS PAC ID: 0446277016 Enrollment ID: I20150521002607 |
| Provider Name | John F Brunner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1740423870 PECOS PAC ID: 2365680204 Enrollment ID: I20150528002417 |
| Provider Name | Caroline L Ho |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689664534 PECOS PAC ID: 0446277016 Enrollment ID: I20150602002218 |
| Provider Name | Ryan T Whitesell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1245465301 PECOS PAC ID: 2466690540 Enrollment ID: I20150602002888 |
| Provider Name | Veena R Iyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932426004 PECOS PAC ID: 0941511141 Enrollment ID: I20150615001242 |
| Provider Name | Matthew Adam Rischall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750607248 PECOS PAC ID: 5890006415 Enrollment ID: I20150623000895 |
| Provider Name | Eric Carolan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679899389 PECOS PAC ID: 6800037623 Enrollment ID: I20150623002728 |
| Provider Name | Kevin Q Nguyen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1407090632 PECOS PAC ID: 2668793514 Enrollment ID: I20150722005555 |
| Provider Name | Bryan M Donald |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396064465 PECOS PAC ID: 5698089555 Enrollment ID: I20150805008603 |
| Provider Name | Paul E Hodge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215308077 PECOS PAC ID: 1557671450 Enrollment ID: I20151106000420 |
| Provider Name | Megan T Elgethun |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558785311 PECOS PAC ID: 9931324654 Enrollment ID: I20160217002165 |
| Provider Name | Brian S Martell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1689991432 PECOS PAC ID: 9931419793 Enrollment ID: I20160511002723 |
| Provider Name | Cory Lewis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699092445 PECOS PAC ID: 1355580671 Enrollment ID: I20160517000260 |
| Provider Name | Timothy Meehan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558686030 PECOS PAC ID: 4486811395 Enrollment ID: I20160525002962 |
| Provider Name | Michael Powell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700027166 PECOS PAC ID: 9234262148 Enrollment ID: I20160603001177 |
| Provider Name | Deepak Somashekar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1710116918 PECOS PAC ID: 6901118843 Enrollment ID: I20160801001484 |
| Provider Name | Lester Fahrner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295995900 PECOS PAC ID: 7618115981 Enrollment ID: I20160803001810 |
| Provider Name | Maria E Nolte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134462765 PECOS PAC ID: 1658502372 Enrollment ID: I20160804002714 |
| Provider Name | Jonathan Phelan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437323128 PECOS PAC ID: 4183866353 Enrollment ID: I20160902001217 |
| Provider Name | Jamie Fort |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568589083 PECOS PAC ID: 3375711542 Enrollment ID: I20170327002753 |
| Provider Name | Andrew Sundblad |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447411772 PECOS PAC ID: 3375781487 Enrollment ID: I20170329000219 |
| Provider Name | Cory Nordman |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1679771521 PECOS PAC ID: 2961689427 Enrollment ID: I20170517000985 |
| Provider Name | Andrew T Babcock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609134436 PECOS PAC ID: 3870898992 Enrollment ID: I20170609000332 |
| Provider Name | Amanjit Baadh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1003061367 PECOS PAC ID: 3870750029 Enrollment ID: I20170905001562 |
| Provider Name | Melanie Rae Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225548738 PECOS PAC ID: 9537426069 Enrollment ID: I20171207002899 |
| Provider Name | Scott Hunter |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1700930344 PECOS PAC ID: 2062681059 Enrollment ID: I20180207001598 |
| Provider Name | Lashonda W Soma |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1831330851 PECOS PAC ID: 7214155076 Enrollment ID: I20180320002414 |
| Provider Name | Jason Carroll |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033417571 PECOS PAC ID: 4789843285 Enrollment ID: I20180620003349 |
| Provider Name | Craig Rodriguez |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467667774 PECOS PAC ID: 7618021429 Enrollment ID: I20180621000799 |
| Provider Name | Zachary Royce |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326307760 PECOS PAC ID: 8325340938 Enrollment ID: I20180628003496 |
| Provider Name | Eric Jonathan Hartman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104172782 PECOS PAC ID: 3870716343 Enrollment ID: I20180629000734 |
| Provider Name | Kushal Parikh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1518233642 PECOS PAC ID: 6305127390 Enrollment ID: I20180702002014 |
| Provider Name | Justin Gross |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558676817 PECOS PAC ID: 1355573643 Enrollment ID: I20180703000252 |
| Provider Name | Joshua Theodore Olson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1992237754 PECOS PAC ID: 1850649674 Enrollment ID: I20180809005149 |
| Provider Name | Laurent Grignon |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1538366752 PECOS PAC ID: 9638301849 Enrollment ID: I20181005000882 |
| Provider Name | Douglas Sheafor |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1669438610 PECOS PAC ID: 7517970148 Enrollment ID: I20181012000040 |
| Provider Name | Kevin Mcelroy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184151110 PECOS PAC ID: 6204106644 Enrollment ID: I20181228000615 |
| Provider Name | Brandon W Welsh |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467730143 PECOS PAC ID: 3274830856 Enrollment ID: I20190408001050 |
| Provider Name | Leslie L Teng |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1679916423 PECOS PAC ID: 7012262579 Enrollment ID: I20190619000396 |
| Provider Name | Matthew S Manganaro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1609118710 PECOS PAC ID: 9234431321 Enrollment ID: I20190619000866 |
| Provider Name | John M Sherwood |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1821121088 PECOS PAC ID: 6800988700 Enrollment ID: I20190619001148 |
| Provider Name | John A Coburn |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205273083 PECOS PAC ID: 3476797317 Enrollment ID: I20190620001507 |
| Provider Name | Brendan M O'shea |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396972584 PECOS PAC ID: 4385888130 Enrollment ID: I20190621001041 |
| Provider Name | Mehmet Gencturk |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134508054 PECOS PAC ID: 9335444520 Enrollment ID: I20190711001260 |
| Provider Name | David M Miller |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1750721593 PECOS PAC ID: 5597075135 Enrollment ID: I20190717001219 |
| Provider Name | Leif E Jensen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205053832 PECOS PAC ID: 3678602992 Enrollment ID: I20190722000668 |
| Provider Name | Nicholas J Lange |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285650952 PECOS PAC ID: 3971780701 Enrollment ID: I20190724001386 |
| Provider Name | Ahmad R Hatem Al Samaraee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1447593173 PECOS PAC ID: 7810292828 Enrollment ID: I20190801000035 |
| Provider Name | Justin M Nelson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1326455239 PECOS PAC ID: 7810114527 Enrollment ID: I20200716000249 |
| Provider Name | Anna R F Gregoire |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1700231891 PECOS PAC ID: 9739432170 Enrollment ID: I20200831002994 |
| Provider Name | Yuan Y Stevenson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598152829 PECOS PAC ID: 0244521300 Enrollment ID: I20210715004179 |
| Provider Name | Glen C Gross |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1467814467 PECOS PAC ID: 4880986884 Enrollment ID: I20210803003763 |
| Provider Name | Pegah Entezari |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1639517881 PECOS PAC ID: 7214156702 Enrollment ID: I20210913002899 |
| Provider Name | Anna Christance Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124795596 PECOS PAC ID: 8820496920 Enrollment ID: I20211004001848 |
| Provider Name | Nicholas G Cain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588326128 PECOS PAC ID: 3870985310 Enrollment ID: I20220113001363 |
| Provider Name | Patrick Hackler |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1205282746 PECOS PAC ID: 0345531091 Enrollment ID: I20220610001459 |
| Provider Name | Ashley C Anderson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770938607 PECOS PAC ID: 6305242959 Enrollment ID: I20220610002027 |
| Provider Name | Dennis Heaton |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1144453978 PECOS PAC ID: 6901944669 Enrollment ID: I20220613001256 |
| Provider Name | Jennifer Laroy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942654983 PECOS PAC ID: 3870885254 Enrollment ID: I20220630000947 |
| Provider Name | Benjamin D Meyer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619324043 PECOS PAC ID: 2264726397 Enrollment ID: I20220802001611 |
| Provider Name | Hannah Elena Schwartz Fields |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1568857662 PECOS PAC ID: 8426363151 Enrollment ID: I20221115003410 |
| Provider Name | Tristan R Lawson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295260552 PECOS PAC ID: 4082986385 Enrollment ID: I20230328000764 |
| Provider Name | Amber R Boyens |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1447637889 PECOS PAC ID: 9638544851 Enrollment ID: I20230403000083 |
| Provider Name | Maarten L Galantowicz |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194257899 PECOS PAC ID: 6608146063 Enrollment ID: I20230526001606 |
| Provider Name | James Austin Campbell |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437687167 PECOS PAC ID: 3476823915 Enrollment ID: I20230708000431 |
| Provider Name | James Arthur Erickson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1306378344 PECOS PAC ID: 1850660705 Enrollment ID: I20230711003910 |
| Provider Name | Amanda Marie Kleppe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1336678689 PECOS PAC ID: 7416226477 Enrollment ID: I20230713002262 |
| Provider Name | Benjamin Scott Levy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1053745273 PECOS PAC ID: 9638421050 Enrollment ID: I20230713002678 |
| Provider Name | Adam S Nygard |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871021816 PECOS PAC ID: 3173895232 Enrollment ID: I20230801001541 |
| Provider Name | Molly A Wingfield |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1649709411 PECOS PAC ID: 1052683133 Enrollment ID: I20230802000432 |
| Provider Name | Scott Mauch |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1598290272 PECOS PAC ID: 3173893104 Enrollment ID: I20230808002941 |
| Provider Name | Trevor Everett |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134654908 PECOS PAC ID: 0446520654 Enrollment ID: I20230809001624 |
| Provider Name | Anand Rao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1629102918 PECOS PAC ID: 9436217858 Enrollment ID: I20230810000565 |
| Provider Name | Jack Chen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1104356500 PECOS PAC ID: 2668744426 Enrollment ID: I20230816003429 |
| Provider Name | Bradley John Otto |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841649084 PECOS PAC ID: 6800189697 Enrollment ID: I20240214000194 |
| Provider Name | Mandeep M Sahani |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1811080633 PECOS PAC ID: 9739150517 Enrollment ID: I20240409002641 |
| Provider Name | Lisa Kuechenmeister |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851864789 PECOS PAC ID: 2264874544 Enrollment ID: I20240531003215 |
Madison Healthcare Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 2nd Ave, Madison, MN 56256 Phone: 320-598-7551 | |
Madison Lutheran Home Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 2nd Ave, Madison, MN 56256 Phone: 320-598-7551 |