| Mclaren Northern Michigan | |
|
416 Connable Ave Petoskey MI 49770-2212 | |
| (231) 487-4000 | |
| Not Available |
| Full Name | Mclaren Northern Michigan |
|---|---|
| Speciality | Family Medicine |
| Location | 416 Connable Ave, Petoskey, Michigan |
| Authorized Official Name and Position | Steven Thompson (VP/CFO) |
| Authorized Official Contact | 2314874094 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mclaren Northern Michigan Po Box 775366 Chicago IL 60677-5366 Ph: (231) 487-4094 | Mclaren Northern Michigan 416 Connable Ave Petoskey MI 49770-2212 Ph: (231) 487-4000 |
| NPI Number | 1760736094 |
|---|---|
| Provider Enumeration Date | 11/08/2012 |
| Last Update Date | 10/01/2020 |
| Medicare PECOS PAC ID | 9931018181 |
|---|---|
| Medicare Enrollment ID | O20040415001193 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760736094 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Shawn M Pertunen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548266158 PECOS PAC ID: 7416851456 Enrollment ID: I20031121000441 |
| Provider Name | Hassan Almaat |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467418467 PECOS PAC ID: 3678479425 Enrollment ID: I20031211000361 |
| Provider Name | Carrie J Bollmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417935040 PECOS PAC ID: 4789587692 Enrollment ID: I20040129000015 |
| Provider Name | Joel C Engel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1255337689 PECOS PAC ID: 0547163933 Enrollment ID: I20040202000306 |
| Provider Name | Todd M Sheperd |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679597785 PECOS PAC ID: 5890689459 Enrollment ID: I20040212000879 |
| Provider Name | Eric L Zimmerman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053316059 PECOS PAC ID: 2961393848 Enrollment ID: I20040322000594 |
| Provider Name | Kehinde A Ayeni |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366520470 PECOS PAC ID: 8729073580 Enrollment ID: I20040420000261 |
| Provider Name | Paul N Rodriguez |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1790709996 PECOS PAC ID: 1951386358 Enrollment ID: I20040621000950 |
| Provider Name | Christine Margaret Rattin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396844700 PECOS PAC ID: 0840261178 Enrollment ID: I20040802001018 |
| Provider Name | John K Grebe |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1477610020 PECOS PAC ID: 9032180666 Enrollment ID: I20040805000497 |
| Provider Name | Nancy Jean Frantz |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1578545398 PECOS PAC ID: 3779559281 Enrollment ID: I20040907000741 |
| Provider Name | Loren M Wise |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972573442 PECOS PAC ID: 3274592688 Enrollment ID: I20041008001435 |
| Provider Name | Erik Sinka |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730133539 PECOS PAC ID: 3971565086 Enrollment ID: I20041101000897 |
| Provider Name | Eric Basmaji |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497745061 PECOS PAC ID: 1153388657 Enrollment ID: I20041216000399 |
| Provider Name | Irene Connolly |
|---|---|
| Provider Type | Practitioner - Hematology |
| Provider Identifiers | NPI Number: 1740265834 PECOS PAC ID: 4183674583 Enrollment ID: I20050124000784 |
| Provider Name | Michael G Cotant |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1326003633 PECOS PAC ID: 1052363835 Enrollment ID: I20050221000406 |
| Provider Name | Sanjay Batra |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1114981917 PECOS PAC ID: 8426034406 Enrollment ID: I20050314000252 |
| Provider Name | Jon Anton Sangeorzan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1306820378 PECOS PAC ID: 9436198256 Enrollment ID: I20050429000792 |
| Provider Name | Parmod Kumar Mukhi |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1144215492 PECOS PAC ID: 1759320609 Enrollment ID: I20050527000240 |
| Provider Name | Jon D Begos |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689617003 PECOS PAC ID: 1759325202 Enrollment ID: I20050615000387 |
| Provider Name | Roger Curtis Gietzen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508808072 PECOS PAC ID: 0042254120 Enrollment ID: I20050620000582 |
| Provider Name | Paul D Blanchard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588661086 PECOS PAC ID: 8123097300 Enrollment ID: I20051215000446 |
| Provider Name | Melanie S Manary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437156940 PECOS PAC ID: 6305815580 Enrollment ID: I20051215000629 |
| Provider Name | Vlad Motoc |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1164462693 PECOS PAC ID: 5496715690 Enrollment ID: I20060106000375 |
| Provider Name | Janean Ruth Haggins-dabney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033183637 PECOS PAC ID: 1557378940 Enrollment ID: I20060309000279 |
| Provider Name | Caleb John Fleming |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1497791529 PECOS PAC ID: 6608879523 Enrollment ID: I20060815000397 |
| Provider Name | Obiora Udeozo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578582714 PECOS PAC ID: 5890790323 Enrollment ID: I20060915000400 |
| Provider Name | Jeffrey B Washington |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1205056272 PECOS PAC ID: 8628178092 Enrollment ID: I20070713000638 |
| Provider Name | Emanuel L Pires |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578754040 PECOS PAC ID: 7810082906 Enrollment ID: I20071004000357 |
| Provider Name | Andrea H Naylor |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1093725764 PECOS PAC ID: 6204922818 Enrollment ID: I20071012000112 |
| Provider Name | Daniel M Buerkel |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1417075987 PECOS PAC ID: 1153407234 Enrollment ID: I20080331000079 |
| Provider Name | David J Bradley |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1184703654 PECOS PAC ID: 8426014986 Enrollment ID: I20080520000317 |
| Provider Name | Michele K Sturt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932106135 PECOS PAC ID: 5597838243 Enrollment ID: I20080718000186 |
| Provider Name | Amanda L Harding |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1255543179 PECOS PAC ID: 0143300483 Enrollment ID: I20080726000052 |
| Provider Name | Craig A Duncan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275540544 PECOS PAC ID: 0547215808 Enrollment ID: I20080731000681 |
| Provider Name | Donald Watson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053337535 PECOS PAC ID: 0941379572 Enrollment ID: I20080904000203 |
| Provider Name | Robert F Allum |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407826613 PECOS PAC ID: 8426118944 Enrollment ID: I20081113000479 |
| Provider Name | Bhawana Arora |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962661504 PECOS PAC ID: 1658437280 Enrollment ID: I20090306000289 |
| Provider Name | Vishal Gupta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114162625 PECOS PAC ID: 2264585728 Enrollment ID: I20090730000315 |
| Provider Name | Elena C Coppola |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1760689665 PECOS PAC ID: 8325193238 Enrollment ID: I20090828000239 |
| Provider Name | Rita N Balistreri |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184868762 PECOS PAC ID: 6002954674 Enrollment ID: I20091119000279 |
| Provider Name | John K Everett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881628253 PECOS PAC ID: 9638213762 Enrollment ID: I20100212000473 |
| Provider Name | Marvin K Coy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508882275 PECOS PAC ID: 3375612906 Enrollment ID: I20100217000646 |
| Provider Name | Paula K Dekeyser |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487670162 PECOS PAC ID: 3577692755 Enrollment ID: I20100526000602 |
| Provider Name | Catherine S Zimmerman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891711370 PECOS PAC ID: 4587793765 Enrollment ID: I20100526000721 |
| Provider Name | Amged A Abdelaziz |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1972703536 PECOS PAC ID: 1759573835 Enrollment ID: I20101007000681 |
| Provider Name | Chaitanya V Brundavanam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669699211 PECOS PAC ID: 5799839627 Enrollment ID: I20101018000600 |
| Provider Name | Iftiker K Ahmad |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1184673402 PECOS PAC ID: 0749271245 Enrollment ID: I20101118000559 |
| Provider Name | Bryan Visser |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1588756340 PECOS PAC ID: 3971413725 Enrollment ID: I20101216000842 |
| Provider Name | Michael Raymond Warmoth |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1215932207 PECOS PAC ID: 4587852454 Enrollment ID: I20101217000918 |
| Provider Name | Joshua Dean Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134421084 PECOS PAC ID: 5890745111 Enrollment ID: I20110401000826 |
| Provider Name | Chris W Akins |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1164418026 PECOS PAC ID: 8527162536 Enrollment ID: I20110407000612 |
| Provider Name | Chandra Delorenzo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376588897 PECOS PAC ID: 5597890012 Enrollment ID: I20110525000526 |
| Provider Name | Margaret L Rorick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699771857 PECOS PAC ID: 4284803925 Enrollment ID: I20110812000662 |
| Provider Name | Erica Michiels |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1295831568 PECOS PAC ID: 8729171962 Enrollment ID: I20111111000708 |
| Provider Name | Amy Martyanov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922270768 PECOS PAC ID: 3173681459 Enrollment ID: I20120319000074 |
| Provider Name | Christopher A Benner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659531374 PECOS PAC ID: 4183888944 Enrollment ID: I20120607000674 |
| Provider Name | Moshrik L Abd-alamir |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1386879054 PECOS PAC ID: 6002070356 Enrollment ID: I20120618000141 |
| Provider Name | Rebecca Lynn Wilson Wyatt |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1053573048 PECOS PAC ID: 9436305117 Enrollment ID: I20120813000290 |
| Provider Name | Jordan M Povich |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306071857 PECOS PAC ID: 4981635497 Enrollment ID: I20120831000684 |
| Provider Name | Eric J Kort |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033340450 PECOS PAC ID: 4587813902 Enrollment ID: I20120928000482 |
| Provider Name | Reginald Kapteyn |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1366601536 PECOS PAC ID: 8729152368 Enrollment ID: I20121105000242 |
| Provider Name | Adam Peterik |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1609089101 PECOS PAC ID: 1850484924 Enrollment ID: I20121213000285 |
| Provider Name | Sara M Belopavlovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487993440 PECOS PAC ID: 5193963213 Enrollment ID: I20130531000560 |
| Provider Name | Mahmoud Rayes |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942464961 PECOS PAC ID: 6507005428 Enrollment ID: I20130625000289 |
| Provider Name | Venkata S Etha |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1841501863 PECOS PAC ID: 7517101090 Enrollment ID: I20130924000294 |
| Provider Name | Paul J Spilotro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1982823159 PECOS PAC ID: 9133363567 Enrollment ID: I20130924000933 |
| Provider Name | Kalub A Fedak |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1225353139 PECOS PAC ID: 1850527375 Enrollment ID: I20131111001439 |
| Provider Name | Thomas J Czolgosz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1881904423 PECOS PAC ID: 2860621083 Enrollment ID: I20140211001678 |
| Provider Name | Shah-naz Khan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1063615904 PECOS PAC ID: 1254499809 Enrollment ID: I20140529000839 |
| Provider Name | Jordan R Sall |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811242753 PECOS PAC ID: 2062641194 Enrollment ID: I20140721000592 |
| Provider Name | Katie L Fulcher |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1851705727 PECOS PAC ID: 3577789486 Enrollment ID: I20140730001521 |
| Provider Name | Jon R Felt |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699060665 PECOS PAC ID: 5193954808 Enrollment ID: I20141107001309 |
| Provider Name | Kevin R Orloski |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1689667842 PECOS PAC ID: 3476555269 Enrollment ID: I20141209000201 |
| Provider Name | Omar Habib |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1689873010 PECOS PAC ID: 0648350538 Enrollment ID: I20150220001889 |
| Provider Name | Miranda Hillard |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1942597729 PECOS PAC ID: 1658698394 Enrollment ID: I20150318000512 |
| Provider Name | Bethany Lynne Beard |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1679891394 PECOS PAC ID: 1456593417 Enrollment ID: I20150615001959 |
| Provider Name | Sajid Mehmood |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467444950 PECOS PAC ID: 2860450095 Enrollment ID: I20150617003098 |
| Provider Name | Frederick Berg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1972815348 PECOS PAC ID: 7315250073 Enrollment ID: I20150723009054 |
| Provider Name | Augusta W Uwaje |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891101440 PECOS PAC ID: 7517270127 Enrollment ID: I20150724010733 |
| Provider Name | Larry James Mcmann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164866968 PECOS PAC ID: 0749598381 Enrollment ID: I20151001001914 |
| Provider Name | Jamal F Saleh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1306112776 PECOS PAC ID: 7517190168 Enrollment ID: I20160715000532 |
| Provider Name | Jay Marcus Anderson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902246465 PECOS PAC ID: 3476846668 Enrollment ID: I20160726001387 |
| Provider Name | Nitin Kumar Gupta |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1568620003 PECOS PAC ID: 0345561064 Enrollment ID: I20160810002238 |
| Provider Name | Gurmail Singh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639529951 PECOS PAC ID: 6103145339 Enrollment ID: I20160816002717 |
| Provider Name | Lisa I Wolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932151347 PECOS PAC ID: 2961570148 Enrollment ID: I20160829002699 |
| Provider Name | Rebecca M Woltman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437609146 PECOS PAC ID: 7719266311 Enrollment ID: I20161123001317 |
| Provider Name | Kenneth C Kreuchauf |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1871880757 PECOS PAC ID: 5294951240 Enrollment ID: I20170518000857 |
| Provider Name | Julie Anne Brownell |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1316246192 PECOS PAC ID: 2769615756 Enrollment ID: I20170719002722 |
| Provider Name | Jennifer Lee Hemberg |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1114330685 PECOS PAC ID: 6305152794 Enrollment ID: I20170914000133 |
| Provider Name | Hilton M Hudson |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1689614828 PECOS PAC ID: 7911984513 Enrollment ID: I20170928002599 |
| Provider Name | Tammy Broz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609392802 PECOS PAC ID: 0244596674 Enrollment ID: I20171117000585 |
| Provider Name | Gretchen Burrus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376057976 PECOS PAC ID: 7719246529 Enrollment ID: I20180123002461 |
| Provider Name | Christina Waugh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316455843 PECOS PAC ID: 2365703840 Enrollment ID: I20180223002289 |
| Provider Name | Dawn Alita Hernandez |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1265449854 PECOS PAC ID: 3577599786 Enrollment ID: I20180529000327 |
| Provider Name | Timothy Amborski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629578703 PECOS PAC ID: 3375808983 Enrollment ID: I20180601001293 |
| Provider Name | Ali A Siddiqui |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1265478275 PECOS PAC ID: 0547261190 Enrollment ID: I20181022001333 |
| Provider Name | Marcia Ward |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1124016290 PECOS PAC ID: 4880606599 Enrollment ID: I20181026001955 |
| Provider Name | Milan Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1558756460 PECOS PAC ID: 7315256161 Enrollment ID: I20181106001717 |
| Provider Name | Yusef Canaan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1881963452 PECOS PAC ID: 9739493248 Enrollment ID: I20181127000261 |
| Provider Name | Eileen V Pinkard |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1093135501 PECOS PAC ID: 0446477921 Enrollment ID: I20190108001664 |
| Provider Name | Rita M Aouad |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164777926 PECOS PAC ID: 9133369200 Enrollment ID: I20190112000272 |
| Provider Name | Rebecca L Roth |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568659126 PECOS PAC ID: 4385981356 Enrollment ID: I20190129002100 |
| Provider Name | Jules G Molina |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730371337 PECOS PAC ID: 8123158011 Enrollment ID: I20190327002323 |
| Provider Name | Bakri Kaakeh |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1245588326 PECOS PAC ID: 6204071970 Enrollment ID: I20190410002648 |
| Provider Name | Tanya Scurry |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1225243009 PECOS PAC ID: 9133400237 Enrollment ID: I20190416002984 |
| Provider Name | Jason W Moyns |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063889244 PECOS PAC ID: 3870893365 Enrollment ID: I20190510000352 |
| Provider Name | Matthew Mckenna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578729588 PECOS PAC ID: 6002053287 Enrollment ID: I20190515000634 |
| Provider Name | Joseph Zebelian |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831624063 PECOS PAC ID: 2769756931 Enrollment ID: I20191023002810 |
| Provider Name | Murphy Lauren Gillespie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699332668 PECOS PAC ID: 8022340025 Enrollment ID: I20191024000377 |
| Provider Name | Hannah Rose Duby |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336708643 PECOS PAC ID: 2668704966 Enrollment ID: I20191105001935 |
| Provider Name | Osamuedemen Iyoha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144616079 PECOS PAC ID: 6608127170 Enrollment ID: I20191204001099 |
| Provider Name | Lance Edgerton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417596875 PECOS PAC ID: 4082042916 Enrollment ID: I20200306002333 |
| Provider Name | Andrew Morton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619242005 PECOS PAC ID: 8426288630 Enrollment ID: I20200507000359 |
| Provider Name | Cale M Sebald |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609281401 PECOS PAC ID: 4385068303 Enrollment ID: I20200723002426 |
| Provider Name | Syed I Rahman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619396942 PECOS PAC ID: 2365720745 Enrollment ID: I20200730003063 |
| Provider Name | Ethan Michael Coucke |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1487188710 PECOS PAC ID: 6305264235 Enrollment ID: I20200909002453 |
| Provider Name | Tate Richelle Battilana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649704107 PECOS PAC ID: 4284903543 Enrollment ID: I20201001000751 |
| Provider Name | Erik Battilana |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871022202 PECOS PAC ID: 0042575201 Enrollment ID: I20201002001878 |
| Provider Name | Emily Joy Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518571231 PECOS PAC ID: 2062832959 Enrollment ID: I20201014002624 |
| Provider Name | Richard Craig Cardillo |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1477520807 PECOS PAC ID: 1153233689 Enrollment ID: I20210119002260 |
| Provider Name | Michael P Dick |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1013936814 PECOS PAC ID: 2264326743 Enrollment ID: I20210222002028 |
| Provider Name | Alexandra Monica Rukstelo |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1467985143 PECOS PAC ID: 8729487699 Enrollment ID: I20210525003306 |
| Provider Name | James M Crane |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1992865257 PECOS PAC ID: 9133133176 Enrollment ID: I20210721003282 |
| Provider Name | Annette Lyn Kelly |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407427990 PECOS PAC ID: 0042614315 Enrollment ID: I20210809002017 |
| Provider Name | Christine L Ceglarek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487226924 PECOS PAC ID: 8022413764 Enrollment ID: I20210818004105 |
| Provider Name | Lawrence Ward |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1770978629 PECOS PAC ID: 6608188164 Enrollment ID: I20210825000759 |
| Provider Name | Matthew A Rohloff |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1275984056 PECOS PAC ID: 4082907548 Enrollment ID: I20211026000614 |
| Provider Name | Ahmad Alsarah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134644941 PECOS PAC ID: 0143619478 Enrollment ID: I20211108002072 |
| Provider Name | Preya Sharma |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649581414 PECOS PAC ID: 0547586745 Enrollment ID: I20211228002261 |
| Provider Name | Mohammed W Akhter |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1740485390 PECOS PAC ID: 8921143959 Enrollment ID: I20220119000656 |
| Provider Name | Pedro Frank Lucero |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942291950 PECOS PAC ID: 4183624554 Enrollment ID: I20220124001098 |
| Provider Name | Atul Sheth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942392212 PECOS PAC ID: 4284530288 Enrollment ID: I20220217000245 |
| Provider Name | Dalia F Mansour |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699127548 PECOS PAC ID: 3173800836 Enrollment ID: I20220630002329 |
| Provider Name | Kirtan Patel |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750709143 PECOS PAC ID: 8729348107 Enrollment ID: I20220729000305 |
| Provider Name | Michael J Christofis |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1710337878 PECOS PAC ID: 9739472440 Enrollment ID: I20220822000858 |
| Provider Name | Ashley G Matusz-fisher |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1356703722 PECOS PAC ID: 2365778446 Enrollment ID: I20220823004063 |
| Provider Name | Cory Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083231963 PECOS PAC ID: 1951778018 Enrollment ID: I20221102000114 |
| Provider Name | Benjamin Montgomery |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1598921546 PECOS PAC ID: 4284701533 Enrollment ID: I20221107001936 |
| Provider Name | Kristi Huisinga Vito |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1770960098 PECOS PAC ID: 6608182100 Enrollment ID: I20230110002970 |
| Provider Name | Andrew D Michaels |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1588618250 PECOS PAC ID: 9234132317 Enrollment ID: I20230221002110 |
| Provider Name | Lafi Saba Khalil |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386176717 PECOS PAC ID: 6103195847 Enrollment ID: I20230516002839 |
| Provider Name | Gamal M Marey |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1548418759 PECOS PAC ID: 2062785330 Enrollment ID: I20230607002630 |
| Provider Name | George Eromosele Eigbire |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093165367 PECOS PAC ID: 7113213455 Enrollment ID: I20230630000551 |
| Provider Name | Thomas A Schwann |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1134125727 PECOS PAC ID: 9032179437 Enrollment ID: I20230705000586 |
| Provider Name | Gerardo Kalife |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1538132030 PECOS PAC ID: 2466467055 Enrollment ID: I20230713001201 |
| Provider Name | Alan M Schwartz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376659813 PECOS PAC ID: 6305868282 Enrollment ID: I20230718003824 |
| Provider Name | David Kovar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1770536179 PECOS PAC ID: 9638151400 Enrollment ID: I20230802000686 |
| Provider Name | Caleb Migda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437727641 PECOS PAC ID: 2668833096 Enrollment ID: I20230802001262 |
| Provider Name | Juan Ronderos |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1407875016 PECOS PAC ID: 8628019437 Enrollment ID: I20230817001274 |
| Provider Name | Ayobami O Eluwole |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1598198111 PECOS PAC ID: 5799065843 Enrollment ID: I20230817001500 |
| Provider Name | Matthew P Mead |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659721926 PECOS PAC ID: 4082986831 Enrollment ID: I20230823001946 |
| Provider Name | Philip D Vanderkooy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457988628 PECOS PAC ID: 0840654992 Enrollment ID: I20230908000294 |
| Provider Name | Rajiv Sharma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770797359 PECOS PAC ID: 5294923272 Enrollment ID: I20230921002269 |
| Provider Name | Stephanie Marshall |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1124002738 PECOS PAC ID: 8527024397 Enrollment ID: I20230921003035 |
| Provider Name | Deborah Tabachnick |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1790074912 PECOS PAC ID: 2567689607 Enrollment ID: I20231012001107 |
| Provider Name | Daniel Dunker |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1407809544 PECOS PAC ID: 3678478567 Enrollment ID: I20231030003804 |
| Provider Name | Adam D Kessler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1174684229 PECOS PAC ID: 0840510806 Enrollment ID: I20231107001966 |
| Provider Name | Gary Bloomgarden |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1710993381 PECOS PAC ID: 4486748514 Enrollment ID: I20231219003658 |
| Provider Name | Ioannis Papayannis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013250554 PECOS PAC ID: 3173853405 Enrollment ID: I20240226000986 |
| Provider Name | Richard Juda |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1912998709 PECOS PAC ID: 5496705154 Enrollment ID: I20240226003579 |
| Provider Name | Todd M James |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1467764498 PECOS PAC ID: 3476700105 Enrollment ID: I20240307000989 |
| Provider Name | Navin S Thakur |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1639146566 PECOS PAC ID: 9830127448 Enrollment ID: I20240314002487 |
| Provider Name | Dudley A Hudspeth |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1205835493 PECOS PAC ID: 1759276397 Enrollment ID: I20240412001044 |
| Provider Name | Michael V Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609643766 PECOS PAC ID: 4082054937 Enrollment ID: I20240425003619 |
| Provider Name | Eric T Hansen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154396570 PECOS PAC ID: 9133116007 Enrollment ID: I20240429001790 |
| Provider Name | Gretchen Lamarche |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700641461 PECOS PAC ID: 8628419827 Enrollment ID: I20240517001934 |
| Provider Name | Ashley C Proal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114378114 PECOS PAC ID: 3476833559 Enrollment ID: I20240518000350 |
| Provider Name | Stephen F Trombley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396326112 PECOS PAC ID: 7517368392 Enrollment ID: I20240530003463 |
| Provider Name | Arlyn L Camacho |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699931030 PECOS PAC ID: 7214090356 Enrollment ID: I20240605001184 |
| Provider Name | Nicholas Coriasso |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1194257709 PECOS PAC ID: 9830465715 Enrollment ID: I20240613002458 |
| Provider Name | Michael Kongnyuy |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1952833006 PECOS PAC ID: 8921461377 Enrollment ID: I20240626000420 |
| Provider Name | Jeffrey Keith Haus |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1225667116 PECOS PAC ID: 3072937499 Enrollment ID: I20240718000243 |
| Provider Name | Mary Huerter |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1043502008 PECOS PAC ID: 2264742949 Enrollment ID: I20240812000817 |
| Provider Name | Sheila Algan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629071543 PECOS PAC ID: 6608967740 Enrollment ID: I20240819000553 |
| Provider Name | Lynda Chowdhury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407415219 PECOS PAC ID: 0042548216 Enrollment ID: I20240819000738 |
| Provider Name | Ghazanfar A Khan |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437327756 PECOS PAC ID: 9537326806 Enrollment ID: I20240909004094 |
| Provider Name | Nanette S Nuessle |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1184630741 PECOS PAC ID: 7618008244 Enrollment ID: I20240918000208 |
| Provider Name | Mark David Miceli |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1184658858 PECOS PAC ID: 1951305036 Enrollment ID: I20240926001670 |
| Provider Name | Sharnee Michaela Mead |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1811457963 PECOS PAC ID: 8325372139 Enrollment ID: I20241003000203 |
| Provider Name | Darya Falamarzi |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245850346 PECOS PAC ID: 8022477769 Enrollment ID: I20241004000294 |
| Provider Name | Jonathan Yu Xia |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1578094918 PECOS PAC ID: 9830434463 Enrollment ID: I20241012000044 |
| Provider Name | Amanda R Marn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790006286 PECOS PAC ID: 4880835354 Enrollment ID: I20241023003374 |
| Provider Name | Chris Jacob |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790163962 PECOS PAC ID: 0749595908 Enrollment ID: I20241203000776 |
| Provider Name | Nikhil P Jaik Theckumparampil |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1477749083 PECOS PAC ID: 9638306442 Enrollment ID: I20241206001052 |
Petoskey Family Medicine P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1890 S Us 131, Suite 3, Petoskey, MI 49770 Phone: 231-487-6000 Fax: 231-487-6014 | |
Little Traverse Bay Bands Of Odawa Indians Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1250 Lears Rd., Petoskey, MI 49770 Phone: 231-242-1700 Fax: 231-242-1717 | |
Bay Urgent Care And Family Practice Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 624 Charlevoix Ave, Petoskey, MI 49770 Phone: 231-753-1400 | |
Clear The Dermatology Clinic Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 116 W Mitchell St, Petoskey, MI 49770 Phone: 231-348-0766 | |
Northern Michigan Cosmetic & Reconstructive Surgery Center P C Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 560 W Mitchell St, Suite 360, Petoskey, MI 49770 Phone: 231-487-6070 Fax: 231-487-6073 | |
Great Lakes Digestive Health Assc Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 560 W Mitchell St, Ste M40, Petoskey, MI 49770 Phone: 231-487-2391 Fax: 231-487-6513 |