| Lutheran Medical Group Llc | |
|
7916 W Jefferson Blvd Fort Wayne IN 46804-4140 | |
| (260) 432-2297 | |
| Not Available |
| Full Name | Lutheran Medical Group Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 7916 W Jefferson Blvd, Fort Wayne, Indiana |
| Authorized Official Name and Position | Kristina Music (DIRECTOR, PROVIDER ENROLLMENT) |
| Authorized Official Contact | 6154657377 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lutheran Medical Group Llc Po Box 689022 Franklin TN 37068-9022 Ph: (888) 304-1116 | Lutheran Medical Group Llc 7916 W Jefferson Blvd Fort Wayne IN 46804-4140 Ph: (260) 432-2297 |
| NPI Number | 1164662805 |
|---|---|
| Provider Enumeration Date | 02/20/2009 |
| Last Update Date | 10/01/2024 |
| Medicare PECOS PAC ID | 4981751617 |
|---|---|
| Medicare Enrollment ID | O20090414000705 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164662805 | NPI | - | NPPES |
| 2938843 | Medicaid | OH | |
| 200934510 | Medicaid | IN |
| Provider Name | Scott A Waters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235233867 PECOS PAC ID: 6507778966 Enrollment ID: I20031104000224 |
| Provider Name | Jason K Sprunger |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1306850904 PECOS PAC ID: 9830087253 Enrollment ID: I20040308000982 |
| Provider Name | Maryann Meo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1265412266 PECOS PAC ID: 1355233172 Enrollment ID: I20040326000810 |
| Provider Name | Alan Peterson |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1477555225 PECOS PAC ID: 8628978384 Enrollment ID: I20040422000645 |
| Provider Name | William P Deschner |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1811999626 PECOS PAC ID: 4284534942 Enrollment ID: I20040422000913 |
| Provider Name | Vincent A Scavo |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1679575435 PECOS PAC ID: 9133115389 Enrollment ID: I20040422001010 |
| Provider Name | Bhaktavatsala R Apuri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902960966 PECOS PAC ID: 7315938354 Enrollment ID: I20040522000295 |
| Provider Name | Gregory T Bales |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1184789919 PECOS PAC ID: 8224011937 Enrollment ID: I20040611000948 |
| Provider Name | Ryan C Rolf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801992235 PECOS PAC ID: 1153305503 Enrollment ID: I20040615000397 |
| Provider Name | Anil K Rao |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1649216391 PECOS PAC ID: 8820074461 Enrollment ID: I20040625000108 |
| Provider Name | Sadie S Kintz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508825142 PECOS PAC ID: 6507846938 Enrollment ID: I20040724000316 |
| Provider Name | Karen R Ringwald |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1922075084 PECOS PAC ID: 7810963436 Enrollment ID: I20040906000034 |
| Provider Name | Salah Elsaharty |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982625224 PECOS PAC ID: 3072581800 Enrollment ID: I20040920001132 |
| Provider Name | Sheikh S Ahmed |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1265541361 PECOS PAC ID: 1254309404 Enrollment ID: I20040924000293 |
| Provider Name | Maria Theresa A Cabe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336187335 PECOS PAC ID: 3274582960 Enrollment ID: I20050120000252 |
| Provider Name | Sanjay J Patel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447227319 PECOS PAC ID: 8426000399 Enrollment ID: I20050218000597 |
| Provider Name | Steven D Ko |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1992771257 PECOS PAC ID: 9436101243 Enrollment ID: I20050219000019 |
| Provider Name | Andrew E Katz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548237951 PECOS PAC ID: 1153373964 Enrollment ID: I20050219000028 |
| Provider Name | Sushil K Jain |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1649247057 PECOS PAC ID: 7416909221 Enrollment ID: I20050219000033 |
| Provider Name | Manuel I Cervoni |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1780651430 PECOS PAC ID: 5496747594 Enrollment ID: I20050222000856 |
| Provider Name | Sudheer K Meesa |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245207984 PECOS PAC ID: 8729031224 Enrollment ID: I20050224000503 |
| Provider Name | Erin Lynn Shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093721862 PECOS PAC ID: 3577516004 Enrollment ID: I20050224000740 |
| Provider Name | Kent Farnsworth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144296088 PECOS PAC ID: 1254231400 Enrollment ID: I20050228000038 |
| Provider Name | Sanjay S Jain |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1205803632 PECOS PAC ID: 6204727548 Enrollment ID: I20050301000307 |
| Provider Name | Thaddeus R Weghorst |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912083155 PECOS PAC ID: 2264472075 Enrollment ID: I20050510001186 |
| Provider Name | Mark A Meier |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1831169960 PECOS PAC ID: 7416990981 Enrollment ID: I20050606000754 |
| Provider Name | Eustace S Fernandes |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1821040791 PECOS PAC ID: 3577508613 Enrollment ID: I20050620001168 |
| Provider Name | Thomas A Kintanar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750326351 PECOS PAC ID: 7517912637 Enrollment ID: I20050718000543 |
| Provider Name | Shelby Ann Kenner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538170832 PECOS PAC ID: 8123057932 Enrollment ID: I20050811000275 |
| Provider Name | Scott Thomas Armstrong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861402760 PECOS PAC ID: 7113956830 Enrollment ID: I20050811000966 |
| Provider Name | Glenn L Goldstein |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1346336575 PECOS PAC ID: 2668402157 Enrollment ID: I20050817000156 |
| Provider Name | April Renee Morrison |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1194759456 PECOS PAC ID: 4587697586 Enrollment ID: I20050912000154 |
| Provider Name | Dana Rae Forrest |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902831167 PECOS PAC ID: 3870510456 Enrollment ID: I20051102000370 |
| Provider Name | Cheng Du |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245209246 PECOS PAC ID: 2668491168 Enrollment ID: I20051114001121 |
| Provider Name | Akindolapo O Akinwande |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1891766309 PECOS PAC ID: 2860411246 Enrollment ID: I20051115000501 |
| Provider Name | Venkata Rama Prasad Nalamolu |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801866934 PECOS PAC ID: 1951322759 Enrollment ID: I20051208000242 |
| Provider Name | Horia Draghiciu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1912975525 PECOS PAC ID: 8527082528 Enrollment ID: I20060117001117 |
| Provider Name | Sunil Ramrakhiani |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1407805849 PECOS PAC ID: 4880603810 Enrollment ID: I20060419000253 |
| Provider Name | Brett J. Guinn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083683783 PECOS PAC ID: 3375541568 Enrollment ID: I20061122000455 |
| Provider Name | Daniel Abraha |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063419166 PECOS PAC ID: 3779565858 Enrollment ID: I20061226000041 |
| Provider Name | Suzanne B Smith-elekes |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1447242599 PECOS PAC ID: 0446259147 Enrollment ID: I20070124000399 |
| Provider Name | Amy E Nugent |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245299288 PECOS PAC ID: 1456352780 Enrollment ID: I20070129000548 |
| Provider Name | Brian A Adams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013927904 PECOS PAC ID: 3678678448 Enrollment ID: I20070424000178 |
| Provider Name | Thomas L Lazoff |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1457354433 PECOS PAC ID: 4981605870 Enrollment ID: I20070504000379 |
| Provider Name | Amit N Sanghvi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1366472755 PECOS PAC ID: 2668570904 Enrollment ID: I20070609000087 |
| Provider Name | Peter Anthony Jakacki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669463089 PECOS PAC ID: 9830290212 Enrollment ID: I20070730000419 |
| Provider Name | Tyler E Emley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1407989932 PECOS PAC ID: 3678660289 Enrollment ID: I20071030000035 |
| Provider Name | Bryon J Stephens |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639170491 PECOS PAC ID: 7315937067 Enrollment ID: I20071212000350 |
| Provider Name | David S Lippie |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558362319 PECOS PAC ID: 0345230090 Enrollment ID: I20071213000806 |
| Provider Name | Dale A Sloan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598766107 PECOS PAC ID: 8426048174 Enrollment ID: I20071218000081 |
| Provider Name | Emmanuel C Cabe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215928791 PECOS PAC ID: 3476649393 Enrollment ID: I20080206000165 |
| Provider Name | Duane Johnson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750392676 PECOS PAC ID: 7517042880 Enrollment ID: I20080311000378 |
| Provider Name | Brenda S Wiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801064266 PECOS PAC ID: 2567547730 Enrollment ID: I20080312000167 |
| Provider Name | Vicente Rodriguez |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1407832694 PECOS PAC ID: 5597734756 Enrollment ID: I20080401000672 |
| Provider Name | Abdullah M Al-rashdan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588831721 PECOS PAC ID: 8628142882 Enrollment ID: I20080806000161 |
| Provider Name | Monica Reddy |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1619178811 PECOS PAC ID: 2769565019 Enrollment ID: I20080825000569 |
| Provider Name | Anvita Sinha |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1467463422 PECOS PAC ID: 8729154679 Enrollment ID: I20080829000347 |
| Provider Name | Nikkiya Fraser |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1013132109 PECOS PAC ID: 1658447289 Enrollment ID: I20080905000384 |
| Provider Name | Angela Karl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700088333 PECOS PAC ID: 4688775448 Enrollment ID: I20081001000790 |
| Provider Name | Deborah S Tannehill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437306990 PECOS PAC ID: 6608937701 Enrollment ID: I20081208000611 |
| Provider Name | Houda A Trabulsi-younis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1598721128 PECOS PAC ID: 9830256213 Enrollment ID: I20090330000641 |
| Provider Name | Yu Liu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043415706 PECOS PAC ID: 5395846901 Enrollment ID: I20090413000037 |
| Provider Name | Brandi Ross-douglas |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1588779904 PECOS PAC ID: 0941205876 Enrollment ID: I20090415000079 |
| Provider Name | Stanley D Rich |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437129111 PECOS PAC ID: 1658428321 Enrollment ID: I20090415000335 |
| Provider Name | H Stephen Beyer |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1518915800 PECOS PAC ID: 8527048719 Enrollment ID: I20090421000367 |
| Provider Name | Krishnan Ramani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1518937630 PECOS PAC ID: 7810896990 Enrollment ID: I20090421000735 |
| Provider Name | Subhash K Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821068511 PECOS PAC ID: 1254488620 Enrollment ID: I20090422000410 |
| Provider Name | Stephen K Reed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053381764 PECOS PAC ID: 5294882684 Enrollment ID: I20090422000564 |
| Provider Name | Catherine S Roberts |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447210778 PECOS PAC ID: 8628125010 Enrollment ID: I20090422000588 |
| Provider Name | Peter C Hanley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1346220993 PECOS PAC ID: 2062560360 Enrollment ID: I20090424000206 |
| Provider Name | Vijay K Chilakamarri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548230758 PECOS PAC ID: 4981752060 Enrollment ID: I20090429000191 |
| Provider Name | Brandy M Dantzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558505131 PECOS PAC ID: 8628126232 Enrollment ID: I20090508000069 |
| Provider Name | Dinesh Agnihotri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932186723 PECOS PAC ID: 9133171390 Enrollment ID: I20090623000355 |
| Provider Name | Denise Elaine Blad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710988282 PECOS PAC ID: 5799761763 Enrollment ID: I20090908000615 |
| Provider Name | Crystal L Jencks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508877788 PECOS PAC ID: 8426103755 Enrollment ID: I20090909000701 |
| Provider Name | Justin Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134358005 PECOS PAC ID: 5799830923 Enrollment ID: I20090911000172 |
| Provider Name | Lubna W Ahmed |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1144345075 PECOS PAC ID: 7113089566 Enrollment ID: I20091030000338 |
| Provider Name | Philip A Rettenmaier |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1871593418 PECOS PAC ID: 1658345400 Enrollment ID: I20091218000191 |
| Provider Name | David Paul J Almdale |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669475745 PECOS PAC ID: 2163527649 Enrollment ID: I20100129000766 |
| Provider Name | John B Addo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922063189 PECOS PAC ID: 8123163391 Enrollment ID: I20100227000090 |
| Provider Name | Dorothea O Addo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063478360 PECOS PAC ID: 1759426927 Enrollment ID: I20100227000106 |
| Provider Name | Cynthia K Gorrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316932734 PECOS PAC ID: 4880729524 Enrollment ID: I20100323000059 |
| Provider Name | David J Paris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134110430 PECOS PAC ID: 3870680515 Enrollment ID: I20100727000224 |
| Provider Name | Hubert Fornalik |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1255549812 PECOS PAC ID: 8224119128 Enrollment ID: I20100730000661 |
| Provider Name | Patrick M Holly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811933583 PECOS PAC ID: 5496743585 Enrollment ID: I20100807000088 |
| Provider Name | Andreana L Hodgini |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821033317 PECOS PAC ID: 4082669106 Enrollment ID: I20100807000089 |
| Provider Name | Lorie L Dwyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538479845 PECOS PAC ID: 3274727045 Enrollment ID: I20101105000381 |
| Provider Name | Barbara L Rondot |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609071125 PECOS PAC ID: 0749477784 Enrollment ID: I20101203000130 |
| Provider Name | Vinit J Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1649415084 PECOS PAC ID: 3476740630 Enrollment ID: I20101214000590 |
| Provider Name | Tariq Akbar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1386692143 PECOS PAC ID: 6305941139 Enrollment ID: I20101221000862 |
| Provider Name | Rakesh Khatri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437360732 PECOS PAC ID: 6406901586 Enrollment ID: I20110610000000 |
| Provider Name | Matthew L Bilodeau |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1457408320 PECOS PAC ID: 5193809358 Enrollment ID: I20110613000468 |
| Provider Name | Benjamin G Martin |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1942414800 PECOS PAC ID: 1557539566 Enrollment ID: I20110719000097 |
| Provider Name | David J Choi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285864702 PECOS PAC ID: 8921147745 Enrollment ID: I20110811000341 |
| Provider Name | Anupma Lal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487600599 PECOS PAC ID: 8527237171 Enrollment ID: I20110816000502 |
| Provider Name | Zeeshan Ehsan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1518174598 PECOS PAC ID: 7113198334 Enrollment ID: I20110920000640 |
| Provider Name | Melissa K Gephart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174893531 PECOS PAC ID: 4880860048 Enrollment ID: I20120110000623 |
| Provider Name | Motaz M Shaher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427058825 PECOS PAC ID: 1456333137 Enrollment ID: I20120213000744 |
| Provider Name | Srinivas R Pamidi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1598725913 PECOS PAC ID: 5395649701 Enrollment ID: I20120430000005 |
| Provider Name | Carrie B Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275891640 PECOS PAC ID: 2365607884 Enrollment ID: I20120709000536 |
| Provider Name | Austin R Schlie |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871721332 PECOS PAC ID: 6800042102 Enrollment ID: I20120801000647 |
| Provider Name | Deanna L Massie |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1205117454 PECOS PAC ID: 2163678475 Enrollment ID: I20120801000755 |
| Provider Name | Leah A Keena |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518226471 PECOS PAC ID: 2365699279 Enrollment ID: I20120829000135 |
| Provider Name | Laura E Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144573890 PECOS PAC ID: 5698927291 Enrollment ID: I20121205000528 |
| Provider Name | My Padmalingam |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1275795379 PECOS PAC ID: 6709952781 Enrollment ID: I20121219000429 |
| Provider Name | Michelle Estep |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1063631141 PECOS PAC ID: 8628145687 Enrollment ID: I20121219000449 |
| Provider Name | Can Talug |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1972708535 PECOS PAC ID: 9830243708 Enrollment ID: I20130225000403 |
| Provider Name | Linda M Toth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184965329 PECOS PAC ID: 1759528375 Enrollment ID: I20130518000054 |
| Provider Name | Keith J Derickson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538480439 PECOS PAC ID: 4880845619 Enrollment ID: I20130724000656 |
| Provider Name | Shakeel Ahmed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922084862 PECOS PAC ID: 6103848957 Enrollment ID: I20130913000455 |
| Provider Name | Sarah J Turner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609162676 PECOS PAC ID: 7416107024 Enrollment ID: I20131112001984 |
| Provider Name | Christi Ann Wallace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346535358 PECOS PAC ID: 6800046418 Enrollment ID: I20131119000657 |
| Provider Name | Christina M Griggs |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093075624 PECOS PAC ID: 2264689595 Enrollment ID: I20131211001316 |
| Provider Name | Michelle D Hessell Solter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316370018 PECOS PAC ID: 7012145147 Enrollment ID: I20140116000855 |
| Provider Name | David S Mohan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578876785 PECOS PAC ID: 6002002722 Enrollment ID: I20140409000096 |
| Provider Name | Christopher A Baltes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992090971 PECOS PAC ID: 4284884305 Enrollment ID: I20140626000724 |
| Provider Name | Julia A Ellingwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790199255 PECOS PAC ID: 5294950887 Enrollment ID: I20140716001056 |
| Provider Name | Gregory C Dowling |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487916698 PECOS PAC ID: 7911157532 Enrollment ID: I20140915001650 |
| Provider Name | Leia A Becktell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447668579 PECOS PAC ID: 8123248713 Enrollment ID: I20141002001065 |
| Provider Name | Jeffrey Levenda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619298411 PECOS PAC ID: 1254582083 Enrollment ID: I20141003000660 |
| Provider Name | Rami S Wali |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235183203 PECOS PAC ID: 1658376777 Enrollment ID: I20141113000644 |
| Provider Name | Marena Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467842344 PECOS PAC ID: 0941512818 Enrollment ID: I20150707000605 |
| Provider Name | Paul Bauer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083697874 PECOS PAC ID: 3779564802 Enrollment ID: I20150731015441 |
| Provider Name | Mohammed A Shaikh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1992747869 PECOS PAC ID: 1456327923 Enrollment ID: I20150819008749 |
| Provider Name | Chimi Nusbaum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265809321 PECOS PAC ID: 1153638762 Enrollment ID: I20150915001456 |
| Provider Name | Abdillahi M Abdinoor |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336377043 PECOS PAC ID: 2163731183 Enrollment ID: I20151014000989 |
| Provider Name | Christine Springer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871969220 PECOS PAC ID: 2264741925 Enrollment ID: I20151020000421 |
| Provider Name | Deborah A Gill Henry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881075059 PECOS PAC ID: 1759690480 Enrollment ID: I20151021000334 |
| Provider Name | Matthew Connor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427429943 PECOS PAC ID: 8628388691 Enrollment ID: I20151103000772 |
| Provider Name | Ahmed Muhammad S Ghadai |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1447504402 PECOS PAC ID: 1254573884 Enrollment ID: I20151231000195 |
| Provider Name | Maribel Pastran |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1033446711 PECOS PAC ID: 7012219785 Enrollment ID: I20160112002536 |
| Provider Name | Judith E Ritholz |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1043247042 PECOS PAC ID: 4284683426 Enrollment ID: I20160420000598 |
| Provider Name | Matthew A Byers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1124314398 PECOS PAC ID: 5294025185 Enrollment ID: I20160606001204 |
| Provider Name | Ibad Ul-haq Farooqui |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427499318 PECOS PAC ID: 8224260062 Enrollment ID: I20160726000218 |
| Provider Name | Kanika Jaggi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073954962 PECOS PAC ID: 7618109448 Enrollment ID: I20160726000383 |
| Provider Name | Janelle J Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497111991 PECOS PAC ID: 7315231537 Enrollment ID: I20160811000902 |
| Provider Name | Nicole Sanderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013465152 PECOS PAC ID: 6709165855 Enrollment ID: I20161114001908 |
| Provider Name | Nicholas Ramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114370152 PECOS PAC ID: 9436438223 Enrollment ID: I20161118001066 |
| Provider Name | Hari Krishna Puttagunta |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1841451218 PECOS PAC ID: 5597999516 Enrollment ID: I20170317000459 |
| Provider Name | Emanuel E Nearing |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346564390 PECOS PAC ID: 4486890308 Enrollment ID: I20170629002574 |
| Provider Name | Reid R Pflueger |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1013201995 PECOS PAC ID: 1052559549 Enrollment ID: I20170711002860 |
| Provider Name | Brandon Mcintire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912420977 PECOS PAC ID: 9234400615 Enrollment ID: I20170803000138 |
| Provider Name | Patrick J Noonan |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972892958 PECOS PAC ID: 7719106459 Enrollment ID: I20170815001495 |
| Provider Name | Kirsten L Hansen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740719210 PECOS PAC ID: 3072887165 Enrollment ID: I20170928001869 |
| Provider Name | Krishna S Ayyagari |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1336400019 PECOS PAC ID: 3072882323 Enrollment ID: I20170928002008 |
| Provider Name | David Furman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831548510 PECOS PAC ID: 2769773555 Enrollment ID: I20171010000083 |
| Provider Name | Aaron James Lehman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871012732 PECOS PAC ID: 3072889161 Enrollment ID: I20171017002111 |
| Provider Name | Jennifer K Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184142903 PECOS PAC ID: 1052687035 Enrollment ID: I20171018002093 |
| Provider Name | Walfredo J. Leon |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1881689313 PECOS PAC ID: 3173706868 Enrollment ID: I20171030003485 |
| Provider Name | Anna K Menze |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1831547124 PECOS PAC ID: 7810288693 Enrollment ID: I20171113000550 |
| Provider Name | Justin Weirich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992154686 PECOS PAC ID: 4880986470 Enrollment ID: I20171121003272 |
| Provider Name | Melissa A. Willard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801310610 PECOS PAC ID: 8628335726 Enrollment ID: I20171128001361 |
| Provider Name | Stephanie A Clouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003314246 PECOS PAC ID: 1658631171 Enrollment ID: I20180201000808 |
| Provider Name | Charles Morgan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174813497 PECOS PAC ID: 3971897463 Enrollment ID: I20180212001944 |
| Provider Name | Gregory Ridenour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447708979 PECOS PAC ID: 4688935331 Enrollment ID: I20180221001148 |
| Provider Name | Eamon Boyce O'reilly |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1326097932 PECOS PAC ID: 5496977167 Enrollment ID: I20180404001589 |
| Provider Name | Jeffrey W Fidone |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1316945694 PECOS PAC ID: 0446164859 Enrollment ID: I20180604000634 |
| Provider Name | Dedrick K. Bowe |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1235481755 PECOS PAC ID: 7113229469 Enrollment ID: I20180621002849 |
| Provider Name | Muzammil Hanif Musani |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093945651 PECOS PAC ID: 4981851268 Enrollment ID: I20180716001487 |
| Provider Name | Yan Ortiz-pomales |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1346448537 PECOS PAC ID: 6002110988 Enrollment ID: I20180718000621 |
| Provider Name | Abdul Hamid Khan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134401896 PECOS PAC ID: 3870767734 Enrollment ID: I20180801002588 |
| Provider Name | Sotirios Papafragkou |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669623724 PECOS PAC ID: 9133275985 Enrollment ID: I20180828002412 |
| Provider Name | Tamika Rozema |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912265836 PECOS PAC ID: 3678823325 Enrollment ID: I20180830001660 |
| Provider Name | Nikki Mo Wynn |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1184979882 PECOS PAC ID: 5395987788 Enrollment ID: I20180907001200 |
| Provider Name | Fouad Kutuby |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1114367067 PECOS PAC ID: 9931419207 Enrollment ID: I20180917000425 |
| Provider Name | George F Barker |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1245221696 PECOS PAC ID: 7719877232 Enrollment ID: I20181121002726 |
| Provider Name | Ashish Sharma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003992736 PECOS PAC ID: 5890924963 Enrollment ID: I20181213001133 |
| Provider Name | Fahim Zaman Khan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1245527803 PECOS PAC ID: 4981874666 Enrollment ID: I20181213001821 |
| Provider Name | Shoaib Alam |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1962451245 PECOS PAC ID: 6800866914 Enrollment ID: I20181227000745 |
| Provider Name | Crystal Trabel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912480039 PECOS PAC ID: 8820341340 Enrollment ID: I20190124000627 |
| Provider Name | Erasmo Ruggiero |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467617605 PECOS PAC ID: 6901055524 Enrollment ID: I20190125002387 |
| Provider Name | Armais V Akovbyan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1730472945 PECOS PAC ID: 6507014404 Enrollment ID: I20190311002502 |
| Provider Name | Maryann Albaugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740491901 PECOS PAC ID: 8123240520 Enrollment ID: I20190323000054 |
| Provider Name | Joyce A. Bell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497217277 PECOS PAC ID: 5597007070 Enrollment ID: I20190502001854 |
| Provider Name | Mohammad Q. Najib |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1578510103 PECOS PAC ID: 5991790024 Enrollment ID: I20190520001273 |
| Provider Name | Ford W Lee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467019349 PECOS PAC ID: 1153657861 Enrollment ID: I20190801001170 |
| Provider Name | Brian Michael Orr |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1295145159 PECOS PAC ID: 5991920076 Enrollment ID: I20190801001785 |
| Provider Name | Kelsey A. Harner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306498241 PECOS PAC ID: 2466789433 Enrollment ID: I20190814000492 |
| Provider Name | Nickolay Peter Markov |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1598927824 PECOS PAC ID: 8123377090 Enrollment ID: I20190814001847 |
| Provider Name | Regina Ann Rogers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174817563 PECOS PAC ID: 8820325772 Enrollment ID: I20190814004020 |
| Provider Name | Azriel Avezbadalov |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376833129 PECOS PAC ID: 2961780499 Enrollment ID: I20190823000572 |
| Provider Name | Kimberly Million |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871154401 PECOS PAC ID: 0244568681 Enrollment ID: I20190823000735 |
| Provider Name | Melissa Stemen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568023950 PECOS PAC ID: 3375872336 Enrollment ID: I20190917001758 |
| Provider Name | Asim A. Mohammed |
|---|---|
| Provider Type | Practitioner - Advanced Heart Failure And Transplant Cardiology |
| Provider Identifiers | NPI Number: 1922285139 PECOS PAC ID: 9032260609 Enrollment ID: I20190920001279 |
| Provider Name | J. Rod Gimbel |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1932199627 PECOS PAC ID: 2961484837 Enrollment ID: I20191015001605 |
| Provider Name | Wen-chou Tang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033405626 PECOS PAC ID: 9537385315 Enrollment ID: I20191120001444 |
| Provider Name | Richard E Caesar |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1538251715 PECOS PAC ID: 6305887738 Enrollment ID: I20191205002990 |
| Provider Name | Christopher Edwin Bowman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841713229 PECOS PAC ID: 4385905603 Enrollment ID: I20191211003159 |
| Provider Name | Lyndi S Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659917771 PECOS PAC ID: 1850727645 Enrollment ID: I20200215000126 |
| Provider Name | Caitlin Rea Mckay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477106649 PECOS PAC ID: 6002243458 Enrollment ID: I20200224002193 |
| Provider Name | Lindsey P. Felger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902444144 PECOS PAC ID: 8527497239 Enrollment ID: I20200401000758 |
| Provider Name | Nathan D. Nicola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154956209 PECOS PAC ID: 5890124507 Enrollment ID: I20200401000808 |
| Provider Name | Kathryn M. Mckible |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407481468 PECOS PAC ID: 6204265705 Enrollment ID: I20200404000023 |
| Provider Name | Natasha L. Myers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841824893 PECOS PAC ID: 7012347008 Enrollment ID: I20200414003754 |
| Provider Name | Lucas Gregory Berghoff |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1821521394 PECOS PAC ID: 9830468511 Enrollment ID: I20200508001764 |
| Provider Name | Jason Rodriguez |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1093078339 PECOS PAC ID: 5092020859 Enrollment ID: I20200520003457 |
| Provider Name | Allen Maertin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790206977 PECOS PAC ID: 3577832336 Enrollment ID: I20200604002077 |
| Provider Name | Andrew Wieging |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689104242 PECOS PAC ID: 8729357926 Enrollment ID: I20200622002470 |
| Provider Name | Kelsey Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972126217 PECOS PAC ID: 7416379052 Enrollment ID: I20200626001906 |
| Provider Name | David Shafran |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1568480606 PECOS PAC ID: 9830125210 Enrollment ID: I20200826002289 |
| Provider Name | Andre Gilbert |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1639110885 PECOS PAC ID: 4082669361 Enrollment ID: I20200923001858 |
| Provider Name | Natasha Sinanon-oyeneye |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992311849 PECOS PAC ID: 7214357789 Enrollment ID: I20201022000135 |
| Provider Name | Kelly Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699388496 PECOS PAC ID: 4183034192 Enrollment ID: I20201103001362 |
| Provider Name | Alexis Kate Felger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528665585 PECOS PAC ID: 7618387648 Enrollment ID: I20201103002289 |
| Provider Name | Osun Kwon |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1528016243 PECOS PAC ID: 4688625502 Enrollment ID: I20201211001526 |
| Provider Name | Kaylee Marie Casper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770172728 PECOS PAC ID: 1759795891 Enrollment ID: I20210201000570 |
| Provider Name | Emily Mastelou-page |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538717848 PECOS PAC ID: 0941614051 Enrollment ID: I20210202000525 |
| Provider Name | Angela S. Ebersole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851987853 PECOS PAC ID: 3375958424 Enrollment ID: I20210223001102 |
| Provider Name | Andrea J Evans-seibert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518556117 PECOS PAC ID: 8527473685 Enrollment ID: I20210223001537 |
| Provider Name | Kalie M. Hayes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184200222 PECOS PAC ID: 7618385410 Enrollment ID: I20210415001937 |
| Provider Name | Paul Wisniewski |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063674190 PECOS PAC ID: 0042342990 Enrollment ID: I20210416001693 |
| Provider Name | Brittney L Hetrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316513146 PECOS PAC ID: 9133529563 Enrollment ID: I20210607002061 |
| Provider Name | Kuwong Bomwara Mwamukonda |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1689849192 PECOS PAC ID: 5395877849 Enrollment ID: I20210624001995 |
| Provider Name | Megan Louise Trotter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922605336 PECOS PAC ID: 6800297060 Enrollment ID: I20210624002591 |
| Provider Name | Allison Laine Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235706805 PECOS PAC ID: 0143621995 Enrollment ID: I20210630001968 |
| Provider Name | Danielle Kemp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225521107 PECOS PAC ID: 4284980046 Enrollment ID: I20210712001210 |
| Provider Name | Sergey Kozyr |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1174937130 PECOS PAC ID: 8820332414 Enrollment ID: I20210714002320 |
| Provider Name | Adam J Zuber |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144895574 PECOS PAC ID: 3274936919 Enrollment ID: I20210719003336 |
| Provider Name | Grant Michael Blauvelt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477122711 PECOS PAC ID: 8123421625 Enrollment ID: I20210721002301 |
| Provider Name | Douglas S Reed |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174192421 PECOS PAC ID: 6002210739 Enrollment ID: I20210803001956 |
| Provider Name | Rachel W Saunders |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639551674 PECOS PAC ID: 6002129095 Enrollment ID: I20210824002286 |
| Provider Name | Benjamin Monson |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1063588812 PECOS PAC ID: 2567600513 Enrollment ID: I20210824002452 |
| Provider Name | Kevin D. Waldo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356018543 PECOS PAC ID: 0840697181 Enrollment ID: I20210929000840 |
| Provider Name | Andrea Place |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467024455 PECOS PAC ID: 6204234271 Enrollment ID: I20211005001910 |
| Provider Name | Jacey A Lepage |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1790166494 PECOS PAC ID: 1254622541 Enrollment ID: I20211102000426 |
| Provider Name | Ali Reza Abtahi |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1518224401 PECOS PAC ID: 0840428231 Enrollment ID: I20211116002218 |
| Provider Name | Erin Dodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346661428 PECOS PAC ID: 9537559547 Enrollment ID: I20211207000820 |
| Provider Name | Andrew J. Schlatter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659035277 PECOS PAC ID: 4486045630 Enrollment ID: I20211222001285 |
| Provider Name | Kristen A. Bradtmueller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093482598 PECOS PAC ID: 0244622249 Enrollment ID: I20220125002473 |
| Provider Name | Julie N Shaffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144989443 PECOS PAC ID: 9133513351 Enrollment ID: I20220303000870 |
| Provider Name | Casey R Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427714898 PECOS PAC ID: 6305230558 Enrollment ID: I20220303002088 |
| Provider Name | Hanh Truong |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881854024 PECOS PAC ID: 8224184882 Enrollment ID: I20220307001395 |
| Provider Name | Deepak Joshi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154506582 PECOS PAC ID: 4789733940 Enrollment ID: I20220315002368 |
| Provider Name | Aaron Daniel Winters |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942973888 PECOS PAC ID: 4082000187 Enrollment ID: I20220329001138 |
| Provider Name | Colin Linke |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1417318304 PECOS PAC ID: 4284927575 Enrollment ID: I20220412001263 |
| Provider Name | Allison Soldner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538554399 PECOS PAC ID: 9931595261 Enrollment ID: I20220413000881 |
| Provider Name | David Reed |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912945791 PECOS PAC ID: 0547394082 Enrollment ID: I20220428000717 |
| Provider Name | Alaa Akhras |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1992108005 PECOS PAC ID: 8527486877 Enrollment ID: I20220603001034 |
| Provider Name | Stephanie Ann Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750033957 PECOS PAC ID: 0941688808 Enrollment ID: I20220606000187 |
| Provider Name | Nina Ramessar |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1467763201 PECOS PAC ID: 3577874718 Enrollment ID: I20220606001025 |
| Provider Name | Darcy Rose Wyss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275287559 PECOS PAC ID: 2264810837 Enrollment ID: I20220610000137 |
| Provider Name | Yasser Etman |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1295949980 PECOS PAC ID: 6204901937 Enrollment ID: I20220629001124 |
| Provider Name | Robert Douglas Roether |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1801278841 PECOS PAC ID: 2062725609 Enrollment ID: I20220706002298 |
| Provider Name | Christopher L Petrey |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1245551795 PECOS PAC ID: 6002052644 Enrollment ID: I20220719002332 |
| Provider Name | Candie Jo Nicole Schleter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558094193 PECOS PAC ID: 8921480567 Enrollment ID: I20220729000794 |
| Provider Name | Haris Uzair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922568179 PECOS PAC ID: 9739417197 Enrollment ID: I20220801000284 |
| Provider Name | Brandon Richard Baccari |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588125330 PECOS PAC ID: 9739422239 Enrollment ID: I20220802000321 |
| Provider Name | Aubrey Evans |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1538389200 PECOS PAC ID: 1759476500 Enrollment ID: I20220802001733 |
| Provider Name | Anuradha Bommakanti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003265455 PECOS PAC ID: 2961884374 Enrollment ID: I20220802001841 |
| Provider Name | Issa H. Kutkut |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1528449220 PECOS PAC ID: 6406168525 Enrollment ID: I20220803000177 |
| Provider Name | Navjot Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952324170 PECOS PAC ID: 9436138567 Enrollment ID: I20220803001392 |
| Provider Name | Saeed Chowdhry |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1780837922 PECOS PAC ID: 8325190416 Enrollment ID: I20220811001462 |
| Provider Name | Ajit Nandkumar Chary |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1396184214 PECOS PAC ID: 0143453043 Enrollment ID: I20220824001894 |
| Provider Name | Daryl Gene N Magada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487388492 PECOS PAC ID: 7113301698 Enrollment ID: I20220901000618 |
| Provider Name | Mitra Sahebazamani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1780814392 PECOS PAC ID: 3476691353 Enrollment ID: I20220907001291 |
| Provider Name | Robert Piotrowski |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1134382898 PECOS PAC ID: 0547442212 Enrollment ID: I20220921000386 |
| Provider Name | Mustafa Abdul-hussein |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972759173 PECOS PAC ID: 2466620380 Enrollment ID: I20220929000822 |
| Provider Name | Kayla L. Strine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053039750 PECOS PAC ID: 5496121949 Enrollment ID: I20221025001089 |
| Provider Name | Ashley Dixon |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1710331699 PECOS PAC ID: 1456731306 Enrollment ID: I20221025002809 |
| Provider Name | Melinda Cusack |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932580909 PECOS PAC ID: 4183936792 Enrollment ID: I20221027001190 |
| Provider Name | Jessica Lynn Ross |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629792221 PECOS PAC ID: 5092182410 Enrollment ID: I20221027001808 |
| Provider Name | Craig Alan Nicholson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033223318 PECOS PAC ID: 3375517600 Enrollment ID: I20221031002690 |
| Provider Name | Terry D. Bauch |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790774768 PECOS PAC ID: 8628170065 Enrollment ID: I20221102000788 |
| Provider Name | Chiduzie C. Madubata |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1053639344 PECOS PAC ID: 8325288475 Enrollment ID: I20221104001300 |
| Provider Name | Brian S. Cooper |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1134286792 PECOS PAC ID: 1355585175 Enrollment ID: I20221104001684 |
| Provider Name | Sourabh Prabhakar |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1679875892 PECOS PAC ID: 3870873961 Enrollment ID: I20221104002134 |
| Provider Name | Kent Hall |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1184935983 PECOS PAC ID: 5395165757 Enrollment ID: I20221110002500 |
| Provider Name | Shaheen Alanee |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1326231390 PECOS PAC ID: 6800051582 Enrollment ID: I20221117000847 |
| Provider Name | William R. Peery |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821294588 PECOS PAC ID: 7719150481 Enrollment ID: I20221222001553 |
| Provider Name | Madhu G Jyothinagaram |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114983491 PECOS PAC ID: 8224027016 Enrollment ID: I20221222001601 |
| Provider Name | Albert Attah-kofi Sey |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396051785 PECOS PAC ID: 0143464271 Enrollment ID: I20221223001314 |
| Provider Name | Josiah David Freemyer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952622797 PECOS PAC ID: 1951772102 Enrollment ID: I20230125003105 |
| Provider Name | Amir Gendy |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1124361019 PECOS PAC ID: 4880913763 Enrollment ID: I20230202000619 |
| Provider Name | Lanie E. Murphy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114634722 PECOS PAC ID: 5890168298 Enrollment ID: I20230306002684 |
| Provider Name | Evangelos J Bibidakis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1821357849 PECOS PAC ID: 1951565225 Enrollment ID: I20230424000506 |
| Provider Name | Terah C. Joy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801597315 PECOS PAC ID: 4789041278 Enrollment ID: I20230526000365 |
| Provider Name | Louisdon Pierre |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1477569549 PECOS PAC ID: 3971649070 Enrollment ID: I20230601002696 |
| Provider Name | Matthew Banti |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1780909184 PECOS PAC ID: 2163648957 Enrollment ID: I20230601002999 |
| Provider Name | Stephanie A. Robbins |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1497448971 PECOS PAC ID: 2567829278 Enrollment ID: I20230611000167 |
| Provider Name | Billy R Preece |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417525759 PECOS PAC ID: 5991109522 Enrollment ID: I20230616000967 |
| Provider Name | Adebayo Adeyinka |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205912524 PECOS PAC ID: 2365588217 Enrollment ID: I20230712000624 |
| Provider Name | Jason Arthur Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326739087 PECOS PAC ID: 2567822299 Enrollment ID: I20230713000990 |
| Provider Name | Steven M Paris |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982228755 PECOS PAC ID: 3274956743 Enrollment ID: I20230715000230 |
| Provider Name | Cassidy J Okai |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316635048 PECOS PAC ID: 2365802865 Enrollment ID: I20230715000294 |
| Provider Name | Nathaline Chiu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194346726 PECOS PAC ID: 6608236104 Enrollment ID: I20230715000418 |
| Provider Name | Laura M Macy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598381295 PECOS PAC ID: 4082037502 Enrollment ID: I20230719003227 |
| Provider Name | Emily Metzinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598444846 PECOS PAC ID: 7416318357 Enrollment ID: I20230725003255 |
| Provider Name | Corey Snyder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417571209 PECOS PAC ID: 9335562859 Enrollment ID: I20230726000835 |
| Provider Name | Markian Iwaszko |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1659380939 PECOS PAC ID: 0143224006 Enrollment ID: I20230727001917 |
| Provider Name | Kingsley Saahene Okai |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114456696 PECOS PAC ID: 6406124460 Enrollment ID: I20230727001967 |
| Provider Name | Rachael Springer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457589186 PECOS PAC ID: 9133436900 Enrollment ID: I20230815001914 |
| Provider Name | Abigail E. Creigh |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1164115648 PECOS PAC ID: 2961866199 Enrollment ID: I20230906004119 |
| Provider Name | Mohannad H. Alhasani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1801243548 PECOS PAC ID: 5698179273 Enrollment ID: I20230912001365 |
| Provider Name | Lauren J Stipp |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093133704 PECOS PAC ID: 7810113610 Enrollment ID: I20230913000780 |
| Provider Name | Christopher Maroules |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1285861708 PECOS PAC ID: 6507050036 Enrollment ID: I20230913003095 |
| Provider Name | Shawna L Boyle |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1518347913 PECOS PAC ID: 8628338993 Enrollment ID: I20230918002316 |
| Provider Name | Husayn Aslam Ladhani |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1851718902 PECOS PAC ID: 1850685900 Enrollment ID: I20231004002487 |
| Provider Name | Mohammad R Choudhary |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1477965739 PECOS PAC ID: 7214303585 Enrollment ID: I20231108003361 |
| Provider Name | Richard Dilorenzo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528090164 PECOS PAC ID: 4789633900 Enrollment ID: I20231109001636 |
| Provider Name | Kori B Engdahl |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1518262807 PECOS PAC ID: 8123475118 Enrollment ID: I20231113003155 |
| Provider Name | Leah Vanderhorst |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1861103749 PECOS PAC ID: 0345697355 Enrollment ID: I20231114000551 |
| Provider Name | Kendra E. Greathouse |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376325126 PECOS PAC ID: 2062869985 Enrollment ID: I20231114001040 |
| Provider Name | Claire Elizabeth Aubrey |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1033523808 PECOS PAC ID: 8729382932 Enrollment ID: I20231115002706 |
| Provider Name | Michael Allen Rudoff |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1134570690 PECOS PAC ID: 9234421298 Enrollment ID: I20231115003392 |
| Provider Name | Theresa Hufford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336929892 PECOS PAC ID: 4284081050 Enrollment ID: I20231116000144 |
| Provider Name | Andrew James Stephenson |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366478455 PECOS PAC ID: 3375563091 Enrollment ID: I20231121003004 |
| Provider Name | Aubrey Brinneman Hawk |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1083330088 PECOS PAC ID: 0345698767 Enrollment ID: I20231127000402 |
| Provider Name | Vaneska Bottino Da Costa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003292525 PECOS PAC ID: 5294083721 Enrollment ID: I20231206001598 |
| Provider Name | Heather J Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326728601 PECOS PAC ID: 9931558301 Enrollment ID: I20231211001420 |
| Provider Name | Karen E. Troxel |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376768952 PECOS PAC ID: 6305295668 Enrollment ID: I20231212001506 |
| Provider Name | Colleen R. Incremona |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1740057843 PECOS PAC ID: 7618327305 Enrollment ID: I20231220003956 |
| Provider Name | Lindsay Fairfax |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952512980 PECOS PAC ID: 7113157124 Enrollment ID: I20231221002033 |
| Provider Name | Seth Bellister |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1891043956 PECOS PAC ID: 9537433727 Enrollment ID: I20231229001295 |
| Provider Name | Stephanie M Vanderhorst |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1598859506 PECOS PAC ID: 9234580150 Enrollment ID: I20240104003441 |
| Provider Name | Chinenye Iwuchukwu |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780909713 PECOS PAC ID: 6305181694 Enrollment ID: I20240108004378 |
| Provider Name | Steven Lacey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104229210 PECOS PAC ID: 2668776576 Enrollment ID: I20240117001608 |
| Provider Name | Allissa M. Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194593491 PECOS PAC ID: 5698127892 Enrollment ID: I20240123002433 |
| Provider Name | Hussain Aboud |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1902046246 PECOS PAC ID: 5890965834 Enrollment ID: I20240130000286 |
| Provider Name | Kayleen M Grashoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487421251 PECOS PAC ID: 8820433774 Enrollment ID: I20240229004374 |
| Provider Name | Parth Anantbhai Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326655630 PECOS PAC ID: 7517303225 Enrollment ID: I20240315001229 |
| Provider Name | Matthew Mackowsky |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104276542 PECOS PAC ID: 2769850031 Enrollment ID: I20240315002406 |
| Provider Name | Quantel V. Rolle |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1700204583 PECOS PAC ID: 4981038270 Enrollment ID: I20240319001503 |
| Provider Name | Kevin A Vaught |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1689623811 PECOS PAC ID: 6103875901 Enrollment ID: I20240415002469 |
| Provider Name | Muhammad Usman Mirza |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588197917 PECOS PAC ID: 8729428248 Enrollment ID: I20240501002655 |
| Provider Name | Tianli Du |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205217148 PECOS PAC ID: 8820389190 Enrollment ID: I20240522000841 |
| Provider Name | Stacy L Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649038308 PECOS PAC ID: 8628410388 Enrollment ID: I20240525000175 |
| Provider Name | Jacqueline J. Hernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265289839 PECOS PAC ID: 4183066558 Enrollment ID: I20240530002760 |
| Provider Name | Eric Hick |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1346236353 PECOS PAC ID: 9436283025 Enrollment ID: I20240611004303 |
Aptcare In 1 Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11718 Woodstream Ridge Ct, Fort Wayne, IN 46845 Phone: 260-602-9574 | |
Northeast Medical Associates, Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1234 E. Dupont Rd., Suite 6, Fort Wayne, IN 46825 Phone: 260-480-2600 Fax: 260-496-8077 | |
Anthony Medical Associates P C Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1330 N Coliseum Blvd, Fort Wayne, IN 46805 Phone: 260-447-8982 Fax: 260-447-4483 | |
Brooklyn Medical Associates Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3534 Brooklyn Ave, Fort Wayne, IN 46809 Phone: 260-747-6171 Fax: 260-478-5125 | |
Community Open Mri Of Auburn Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2428 Lake Ave, Fort Wayne, IN 46805 Phone: 260-422-1491 Fax: 260-423-1421 | |
Ashraf H. Hanna, M.d., P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4306 Lake Avenue, Fort Wayne, IN 46815 Phone: 260-422-1906 Fax: 260-422-1925 | |
Act 3 Care Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7309 Trier Rd, Fort Wayne, IN 46815 Phone: 260-515-3275 |