| Mercy Jfk Clinic | |
|
615 S New Ballas Rd Saint Louis MO 63141-8221 | |
| (314) 251-6382 | |
| (314) 251-4454 |
| Full Name | Mercy Jfk Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 615 S New Ballas Rd, Saint Louis, Missouri |
| Authorized Official Name and Position | Jeffrey A Johnston (PRESIDENT) |
| Authorized Official Contact | 3142516000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mercy Jfk Clinic 615 S New Ballas Rd Saint Louis MO 63141-8221 Ph: (314) 251-6382 | Mercy Jfk Clinic 615 S New Ballas Rd Saint Louis MO 63141-8221 Ph: (314) 251-6382 |
| NPI Number | 1851431738 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 12/09/2014 |
| Medicare PECOS PAC ID | 1658276811 |
|---|---|
| Medicare Enrollment ID | O20031218000107 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851431738 | NPI | - | NPPES |
| 505289207 | Medicaid | MO | |
| 000000000524 | Other | MO | MERCYCARE PLUS |
| CD5432 | Other | MO | RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (Missouri) | Primary |
| Provider Name | Barbara J Green |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497783997 PECOS PAC ID: 0547172686 Enrollment ID: I20031105000612 |
| Provider Name | Kyeong P Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770511271 PECOS PAC ID: 8820900970 Enrollment ID: I20031105000644 |
| Provider Name | Thomas R Whalen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356364541 PECOS PAC ID: 9436054293 Enrollment ID: I20031204000579 |
| Provider Name | David T Walden |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1770554024 PECOS PAC ID: 4183520661 Enrollment ID: I20031208000692 |
| Provider Name | Tracy M Riordan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124094362 PECOS PAC ID: 5698672509 Enrollment ID: I20031218000167 |
| Provider Name | Justin Glass |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659327559 PECOS PAC ID: 8921906827 Enrollment ID: I20031230000409 |
| Provider Name | Ksenija Kos |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265454987 PECOS PAC ID: 2961305529 Enrollment ID: I20040130000283 |
| Provider Name | Bret A Riegel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1851375323 PECOS PAC ID: 2567355209 Enrollment ID: I20040205000787 |
| Provider Name | Lee R Choo-kang |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144366196 PECOS PAC ID: 4385538768 Enrollment ID: I20040209000738 |
| Provider Name | William R Logan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750311395 PECOS PAC ID: 4789575085 Enrollment ID: I20040324000993 |
| Provider Name | Octavio R Chirino |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598718058 PECOS PAC ID: 7810889052 Enrollment ID: I20040325000191 |
| Provider Name | Renee M Stein |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023064284 PECOS PAC ID: 9436041035 Enrollment ID: I20040329000183 |
| Provider Name | Daniel F Mcneive |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134194830 PECOS PAC ID: 6002808839 Enrollment ID: I20040401000606 |
| Provider Name | William O Imbeah |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932240249 PECOS PAC ID: 1153311964 Enrollment ID: I20040514000003 |
| Provider Name | Brian P Miller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487723540 PECOS PAC ID: 9537149984 Enrollment ID: I20040726000005 |
| Provider Name | Ann L Peick |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518935568 PECOS PAC ID: 3476526146 Enrollment ID: I20040902001126 |
| Provider Name | Anthony A Mikulec |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1104843176 PECOS PAC ID: 6800862913 Enrollment ID: I20040909000179 |
| Provider Name | Maryjo Hernandez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1023036746 PECOS PAC ID: 9638131873 Enrollment ID: I20041101000259 |
| Provider Name | Keith J Odegard |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083609614 PECOS PAC ID: 6608833801 Enrollment ID: I20041220000003 |
| Provider Name | Bryan R Troop |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497802490 PECOS PAC ID: 1951369651 Enrollment ID: I20041228000729 |
| Provider Name | Darla J Bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083654073 PECOS PAC ID: 6709834013 Enrollment ID: I20050104000237 |
| Provider Name | Abdul Muhammud |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780690008 PECOS PAC ID: 5890745509 Enrollment ID: I20050129000167 |
| Provider Name | Michael J Cleary |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1124098546 PECOS PAC ID: 0749230456 Enrollment ID: I20050129000222 |
| Provider Name | Mary E Chismarich |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1871600379 PECOS PAC ID: 8426008079 Enrollment ID: I20050201000006 |
| Provider Name | Luis J Anglo |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437112547 PECOS PAC ID: 3375594989 Enrollment ID: I20050201000433 |
| Provider Name | Keith Steinbecker |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1992763197 PECOS PAC ID: 8426007394 Enrollment ID: I20050201000555 |
| Provider Name | Sean B Bailey |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1013908714 PECOS PAC ID: 1658322813 Enrollment ID: I20050204000180 |
| Provider Name | Shayne S Keddy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861465627 PECOS PAC ID: 0446202873 Enrollment ID: I20050215000019 |
| Provider Name | Diliane M Pelikan |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1508811787 PECOS PAC ID: 3870546682 Enrollment ID: I20050222000032 |
| Provider Name | Subramani E Paranjothi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1992777270 PECOS PAC ID: 6103879192 Enrollment ID: I20050302000489 |
| Provider Name | Michael R Laue |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1295707818 PECOS PAC ID: 4587622857 Enrollment ID: I20050314000111 |
| Provider Name | Dharam P Goel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1326155664 PECOS PAC ID: 4486694056 Enrollment ID: I20050504000016 |
| Provider Name | Daniel A Rey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336288356 PECOS PAC ID: 8123060894 Enrollment ID: I20050524000713 |
| Provider Name | Thomas R Sanford |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1568489151 PECOS PAC ID: 9032163621 Enrollment ID: I20050607000113 |
| Provider Name | Kamran Baig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285711747 PECOS PAC ID: 5991618225 Enrollment ID: I20050624000268 |
| Provider Name | Theresa E Hughes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417036047 PECOS PAC ID: 8527094721 Enrollment ID: I20050711000313 |
| Provider Name | Stephen J Wen |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447329537 PECOS PAC ID: 9638105331 Enrollment ID: I20050714000072 |
| Provider Name | Pranati Ivaturi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811918071 PECOS PAC ID: 9234165945 Enrollment ID: I20050714000114 |
| Provider Name | James M Hartman |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1598756280 PECOS PAC ID: 9234188996 Enrollment ID: I20050801000656 |
| Provider Name | Christina M Hugge |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992793459 PECOS PAC ID: 3577592914 Enrollment ID: I20050805000833 |
| Provider Name | Veronica P Mcgregor |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1154395614 PECOS PAC ID: 6709818206 Enrollment ID: I20050906000794 |
| Provider Name | Carolyn L Koenig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063488278 PECOS PAC ID: 8921032095 Enrollment ID: I20050920000067 |
| Provider Name | James A Stokes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134111628 PECOS PAC ID: 4183644941 Enrollment ID: I20051123000268 |
| Provider Name | Michael J Zerega |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073505178 PECOS PAC ID: 0042231250 Enrollment ID: I20051215000647 |
| Provider Name | Stephen G Sanders |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942277884 PECOS PAC ID: 7618991290 Enrollment ID: I20060123000334 |
| Provider Name | James A Bartelsmeyer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1265469860 PECOS PAC ID: 5597779298 Enrollment ID: I20060202000091 |
| Provider Name | Sue A Moore |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164459772 PECOS PAC ID: 5294749990 Enrollment ID: I20060202000117 |
| Provider Name | Gayathri Dundoo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114981008 PECOS PAC ID: 2365457389 Enrollment ID: I20060215000050 |
| Provider Name | Wegdan Andrews |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972511723 PECOS PAC ID: 6709821267 Enrollment ID: I20060217000622 |
| Provider Name | Donald H Lange |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1356332761 PECOS PAC ID: 1850380148 Enrollment ID: I20060420000005 |
| Provider Name | Dionysios K Veronikis |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629047626 PECOS PAC ID: 8325051998 Enrollment ID: I20060727000001 |
| Provider Name | Yulia M Lifits Podorozhansky |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689607277 PECOS PAC ID: 7719982008 Enrollment ID: I20060920000037 |
| Provider Name | Jason A Hand |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083631519 PECOS PAC ID: 4486659430 Enrollment ID: I20060925000589 |
| Provider Name | Jagpal S Sahota |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083712202 PECOS PAC ID: 1456359611 Enrollment ID: I20061122000152 |
| Provider Name | Daniel Schlesinger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497868343 PECOS PAC ID: 4688672736 Enrollment ID: I20061128000126 |
| Provider Name | Arturo C Taca |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1295846319 PECOS PAC ID: 9739187683 Enrollment ID: I20061201000234 |
| Provider Name | Gregory R Galakatos |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104868058 PECOS PAC ID: 2163433749 Enrollment ID: I20070130000486 |
| Provider Name | Craig W Boyd |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821171927 PECOS PAC ID: 0547262784 Enrollment ID: I20070201000138 |
| Provider Name | Rajesh S Shah |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912066382 PECOS PAC ID: 4284736570 Enrollment ID: I20070216000093 |
| Provider Name | Dayton E Dmello |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1699723890 PECOS PAC ID: 5991807836 Enrollment ID: I20070224000035 |
| Provider Name | Sean Gravely |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134295009 PECOS PAC ID: 3072615772 Enrollment ID: I20070227000544 |
| Provider Name | Jason M Hanson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1063522597 PECOS PAC ID: 5092711648 Enrollment ID: I20070409000007 |
| Provider Name | Thomas S Sommers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710946504 PECOS PAC ID: 5597862698 Enrollment ID: I20070524000544 |
| Provider Name | Bernard J Mcguire |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942274030 PECOS PAC ID: 3173620192 Enrollment ID: I20070525000059 |
| Provider Name | Philip Conway |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730154477 PECOS PAC ID: 3173620093 Enrollment ID: I20070529000359 |
| Provider Name | Edward J Kunst |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467428672 PECOS PAC ID: 7517963994 Enrollment ID: I20070531000231 |
| Provider Name | David J Anderson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1306802343 PECOS PAC ID: 1254439771 Enrollment ID: I20070607000240 |
| Provider Name | Rachel Keech |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558589572 PECOS PAC ID: 8224137187 Enrollment ID: I20070619000334 |
| Provider Name | Marketa Kasalova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922200617 PECOS PAC ID: 8426158403 Enrollment ID: I20070703000611 |
| Provider Name | Jay L Padratzik |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1467427161 PECOS PAC ID: 8527013937 Enrollment ID: I20070726000009 |
| Provider Name | Anna M Conti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275731267 PECOS PAC ID: 0446342299 Enrollment ID: I20070823000910 |
| Provider Name | Binu S Mathew |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1740323617 PECOS PAC ID: 8921194655 Enrollment ID: I20071011000103 |
| Provider Name | Margaret Reiker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1902915853 PECOS PAC ID: 7012099898 Enrollment ID: I20080201000148 |
| Provider Name | Thomas R Forget |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1417903022 PECOS PAC ID: 5991891301 Enrollment ID: I20080407000114 |
| Provider Name | Peter K W Yoon |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1013917715 PECOS PAC ID: 0446346852 Enrollment ID: I20080407000121 |
| Provider Name | Margaret Marcrander |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1972555332 PECOS PAC ID: 0345348637 Enrollment ID: I20080509000145 |
| Provider Name | Jordan A Freie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366592925 PECOS PAC ID: 3779504394 Enrollment ID: I20080512000266 |
| Provider Name | Jamie Christine Joyce |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184825358 PECOS PAC ID: 1658440367 Enrollment ID: I20080521000537 |
| Provider Name | Karen L Austin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649398926 PECOS PAC ID: 3274606033 Enrollment ID: I20080728000067 |
| Provider Name | Gary M Wasserman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740382746 PECOS PAC ID: 5597830927 Enrollment ID: I20080820000386 |
| Provider Name | Jodi M Smith |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689875106 PECOS PAC ID: 6406922962 Enrollment ID: I20080906000081 |
| Provider Name | Jason D Dausman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235187899 PECOS PAC ID: 1759349533 Enrollment ID: I20080916000205 |
| Provider Name | Nicole L Duncan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578739561 PECOS PAC ID: 0547322604 Enrollment ID: I20081224000082 |
| Provider Name | Peter W Warner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093756017 PECOS PAC ID: 9133217599 Enrollment ID: I20090105000091 |
| Provider Name | Mariya L Lyubenova Ivanova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538389390 PECOS PAC ID: 6305909615 Enrollment ID: I20090113000642 |
| Provider Name | Iana P Jeliazkova |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689887432 PECOS PAC ID: 6901960400 Enrollment ID: I20090128000312 |
| Provider Name | Melissa A Portell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164667838 PECOS PAC ID: 8527122936 Enrollment ID: I20090130000086 |
| Provider Name | Scott A Trail |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437110798 PECOS PAC ID: 3173673605 Enrollment ID: I20090604000146 |
| Provider Name | Marc J Bernstein |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336110543 PECOS PAC ID: 8921049826 Enrollment ID: I20090629000066 |
| Provider Name | Brian R Ringhofer |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1538380076 PECOS PAC ID: 2365543287 Enrollment ID: I20090630000372 |
| Provider Name | David A Wathen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811190408 PECOS PAC ID: 0749331676 Enrollment ID: I20090706000348 |
| Provider Name | Anjul Sharma |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1720299084 PECOS PAC ID: 9133272081 Enrollment ID: I20090724000658 |
| Provider Name | Kiranmaye Tiriveedhi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609916824 PECOS PAC ID: 3577660745 Enrollment ID: I20090806000782 |
| Provider Name | Gena M Gardiner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699702472 PECOS PAC ID: 2365596228 Enrollment ID: I20090812000631 |
| Provider Name | Kimberly A Twyman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1508942921 PECOS PAC ID: 5890849186 Enrollment ID: I20090820000880 |
| Provider Name | John J Kakkanathu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346458411 PECOS PAC ID: 3375698491 Enrollment ID: I20090825000716 |
| Provider Name | Kevin P King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174733620 PECOS PAC ID: 5294881421 Enrollment ID: I20090914000183 |
| Provider Name | Melanie Janette Wahl |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1609072933 PECOS PAC ID: 4385790765 Enrollment ID: I20090928000115 |
| Provider Name | Devika Rani Nagaraj |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881644714 PECOS PAC ID: 2163562661 Enrollment ID: I20091214000633 |
| Provider Name | Danielle S Koonce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629304977 PECOS PAC ID: 6002958337 Enrollment ID: I20100125000182 |
| Provider Name | Paul E Buse |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1114993664 PECOS PAC ID: 2860393808 Enrollment ID: I20100215000051 |
| Provider Name | George M Matuschak |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1881780021 PECOS PAC ID: 1759425655 Enrollment ID: I20100216000402 |
| Provider Name | Bruce H Witte |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174593578 PECOS PAC ID: 7012958911 Enrollment ID: I20100305000623 |
| Provider Name | David W Irvine |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386681138 PECOS PAC ID: 7315028032 Enrollment ID: I20100421000558 |
| Provider Name | Judd Martin Jensen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1154308112 PECOS PAC ID: 4981649100 Enrollment ID: I20100421000886 |
| Provider Name | David S Lotsoff |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205807328 PECOS PAC ID: 0749221646 Enrollment ID: I20100424000049 |
| Provider Name | Attila L Varga |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528011061 PECOS PAC ID: 2769510429 Enrollment ID: I20100517000810 |
| Provider Name | John F Eisenbeis |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1659398246 PECOS PAC ID: 7214986975 Enrollment ID: I20100601000355 |
| Provider Name | Eduardo Luis Garcia-ferrer |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619917101 PECOS PAC ID: 8820128077 Enrollment ID: I20100614000814 |
| Provider Name | Joseph M Duvall |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1588775241 PECOS PAC ID: 3375632987 Enrollment ID: I20100621000161 |
| Provider Name | Jastin L Antisdel |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1073714564 PECOS PAC ID: 4486709490 Enrollment ID: I20100702000378 |
| Provider Name | James H Petersen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831169275 PECOS PAC ID: 5698670164 Enrollment ID: I20100721000971 |
| Provider Name | Mouner N Salem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124091145 PECOS PAC ID: 4587796701 Enrollment ID: I20100722000874 |
| Provider Name | Irini E Veronikis |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1578508701 PECOS PAC ID: 4789716986 Enrollment ID: I20100723000671 |
| Provider Name | Scott H Hardeman |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1770571721 PECOS PAC ID: 2365495041 Enrollment ID: I20100723000795 |
| Provider Name | Nickole H Forget |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437126927 PECOS PAC ID: 8729111653 Enrollment ID: I20100729000424 |
| Provider Name | Saad Alkaade |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033433594 PECOS PAC ID: 9436283652 Enrollment ID: I20100810000548 |
| Provider Name | Tanya M Quinn |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174605588 PECOS PAC ID: 5698809796 Enrollment ID: I20100811000456 |
| Provider Name | Bhavana Choudhary |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1508022401 PECOS PAC ID: 0648304659 Enrollment ID: I20100812000691 |
| Provider Name | Katherine Lynne Garland |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568634533 PECOS PAC ID: 0941334684 Enrollment ID: I20100817000159 |
| Provider Name | David H Cort |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1023083938 PECOS PAC ID: 7315848355 Enrollment ID: I20100817000192 |
| Provider Name | Robert K Gaughan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1720076987 PECOS PAC ID: 0547213233 Enrollment ID: I20100817000284 |
| Provider Name | Diane E Rosen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740490879 PECOS PAC ID: 8820112527 Enrollment ID: I20100902000117 |
| Provider Name | Akgun Ince |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1053372334 PECOS PAC ID: 8921133158 Enrollment ID: I20100910000924 |
| Provider Name | Farrin A Manian |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1659480283 PECOS PAC ID: 4082713243 Enrollment ID: I20100920000443 |
| Provider Name | Steven D Goodrich |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1942285259 PECOS PAC ID: 4486758695 Enrollment ID: I20101004000534 |
| Provider Name | Joshua L Hentzelman |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1588865091 PECOS PAC ID: 7810180817 Enrollment ID: I20101022000638 |
| Provider Name | Muddasani B Reddy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013930585 PECOS PAC ID: 5395732036 Enrollment ID: I20101027001048 |
| Provider Name | Daniel J Martin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1710092275 PECOS PAC ID: 3072566769 Enrollment ID: I20110427000794 |
| Provider Name | Alicia C Rushing |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740589365 PECOS PAC ID: 7315123163 Enrollment ID: I20110512000548 |
| Provider Name | David Ulrich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811124886 PECOS PAC ID: 0648323444 Enrollment ID: I20110526000717 |
| Provider Name | Timothy J Brinker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114181948 PECOS PAC ID: 0749467439 Enrollment ID: I20110606000678 |
| Provider Name | Randall A Clary |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1306801600 PECOS PAC ID: 4880871441 Enrollment ID: I20110607000800 |
| Provider Name | James W Forsen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1255396636 PECOS PAC ID: 3779532437 Enrollment ID: I20110607000811 |
| Provider Name | Sameer Kirtane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871755777 PECOS PAC ID: 7517145725 Enrollment ID: I20110616000649 |
| Provider Name | Husam T Nawas |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1134319510 PECOS PAC ID: 0941479125 Enrollment ID: I20110808000062 |
| Provider Name | Wei Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952569642 PECOS PAC ID: 0143393637 Enrollment ID: I20110815000641 |
| Provider Name | Sara C Wood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619177680 PECOS PAC ID: 8224208855 Enrollment ID: I20110908002128 |
| Provider Name | Christina L Byron |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1528266400 PECOS PAC ID: 1355513714 Enrollment ID: I20111006000251 |
| Provider Name | Gretchen H Levey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518167261 PECOS PAC ID: 9133391592 Enrollment ID: I20111006000291 |
| Provider Name | Margaretta L Mendenhall |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1275730111 PECOS PAC ID: 2668644022 Enrollment ID: I20111006000313 |
| Provider Name | Venkata Kenguva |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497911374 PECOS PAC ID: 1456523612 Enrollment ID: I20111012000030 |
| Provider Name | Christian M Sutter |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881867497 PECOS PAC ID: 2769654946 Enrollment ID: I20111012000364 |
| Provider Name | Vaishaliben J Ahir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376706861 PECOS PAC ID: 6204008360 Enrollment ID: I20111013000615 |
| Provider Name | Layla Hajjafar |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528195484 PECOS PAC ID: 7911074745 Enrollment ID: I20111031000552 |
| Provider Name | Ali Husain |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154525707 PECOS PAC ID: 3971674540 Enrollment ID: I20120119000751 |
| Provider Name | Gurdarshan Sandhu |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1083902852 PECOS PAC ID: 1456528926 Enrollment ID: I20120124000672 |
| Provider Name | Natalya Rukhman |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1063616506 PECOS PAC ID: 0244407575 Enrollment ID: I20120126000823 |
| Provider Name | Christina Meddows Jackson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1407150337 PECOS PAC ID: 1951560192 Enrollment ID: I20120308000105 |
| Provider Name | Robert Anthony Bergamini |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1962462846 PECOS PAC ID: 0345401295 Enrollment ID: I20120419000693 |
| Provider Name | Angela D Stratton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033482757 PECOS PAC ID: 3577726298 Enrollment ID: I20120516000535 |
| Provider Name | Alvan C Omeni |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1285965855 PECOS PAC ID: 2769645118 Enrollment ID: I20120522000889 |
| Provider Name | Shayna N Conner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417112764 PECOS PAC ID: 3779747886 Enrollment ID: I20120620000656 |
| Provider Name | Shawana Star Branch-rowles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689762742 PECOS PAC ID: 5698930543 Enrollment ID: I20120627000720 |
| Provider Name | Jennifer M Goldkamp |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225291636 PECOS PAC ID: 9234395377 Enrollment ID: I20120718000431 |
| Provider Name | Sharon Shiu-ming Sung |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619130192 PECOS PAC ID: 9537315924 Enrollment ID: I20120820000549 |
| Provider Name | David A Rempe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285742171 PECOS PAC ID: 4082809157 Enrollment ID: I20120829000367 |
| Provider Name | Kevin M Tompkins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1124257142 PECOS PAC ID: 3274780960 Enrollment ID: I20120831000457 |
| Provider Name | Sarah Md Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417120577 PECOS PAC ID: 7517115819 Enrollment ID: I20120911000633 |
| Provider Name | Kimberly N Hackney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083842454 PECOS PAC ID: 6103074737 Enrollment ID: I20120924000349 |
| Provider Name | Mikael G Garri |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1306076120 PECOS PAC ID: 7618127978 Enrollment ID: I20121022000586 |
| Provider Name | Joseph Anthony Pantelis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700097128 PECOS PAC ID: 9032200688 Enrollment ID: I20121101000502 |
| Provider Name | Mykale R Elbe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356697726 PECOS PAC ID: 7517118417 Enrollment ID: I20121126000454 |
| Provider Name | Larae Smedley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083988802 PECOS PAC ID: 0648422584 Enrollment ID: I20121128000693 |
| Provider Name | Inna Treskov |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1528261146 PECOS PAC ID: 2769634062 Enrollment ID: I20121213000274 |
| Provider Name | Robert N Long |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639300262 PECOS PAC ID: 7810140662 Enrollment ID: I20130104000141 |
| Provider Name | Stuart D Waite |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1740379320 PECOS PAC ID: 4587817796 Enrollment ID: I20130118000292 |
| Provider Name | Ann M Hennessey |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1053471581 PECOS PAC ID: 6800041914 Enrollment ID: I20130221000056 |
| Provider Name | David M Smock |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780850214 PECOS PAC ID: 2466624028 Enrollment ID: I20130328000434 |
| Provider Name | Jason Rhee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1770799314 PECOS PAC ID: 4284782384 Enrollment ID: I20130405000248 |
| Provider Name | Justin M Sweeney |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1689871998 PECOS PAC ID: 6507012184 Enrollment ID: I20130429000556 |
| Provider Name | Muhammad U Ali |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790986024 PECOS PAC ID: 2163510207 Enrollment ID: I20130705000198 |
| Provider Name | Ernesto Jose Negron |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841475845 PECOS PAC ID: 8628194347 Enrollment ID: I20130716000900 |
| Provider Name | Emily M Wood |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265743025 PECOS PAC ID: 0547402596 Enrollment ID: I20130805000357 |
| Provider Name | Sabrina N Padgett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568777365 PECOS PAC ID: 3072757509 Enrollment ID: I20130923000536 |
| Provider Name | Christopher B Hamm |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730490830 PECOS PAC ID: 5294969267 Enrollment ID: I20131004000461 |
| Provider Name | Corey A Wagner |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144428038 PECOS PAC ID: 4587842380 Enrollment ID: I20131007000652 |
| Provider Name | Jason R Collier |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750692232 PECOS PAC ID: 9830324227 Enrollment ID: I20131018001600 |
| Provider Name | Laura Vricella |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316150907 PECOS PAC ID: 5092846006 Enrollment ID: I20131022002140 |
| Provider Name | Leah R Glass |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093942997 PECOS PAC ID: 5294960472 Enrollment ID: I20131023001959 |
| Provider Name | Nancy Elise Gruchala |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1740484534 PECOS PAC ID: 7719049576 Enrollment ID: I20131025000254 |
| Provider Name | Maya E Moody |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659682946 PECOS PAC ID: 6305071317 Enrollment ID: I20131029001274 |
| Provider Name | Timothy J Bucci |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689985012 PECOS PAC ID: 9335374024 Enrollment ID: I20131105001998 |
| Provider Name | Alison J Gildehaus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104023886 PECOS PAC ID: 2668607284 Enrollment ID: I20131106001073 |
| Provider Name | Jennifer Oldham |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790100089 PECOS PAC ID: 7517199748 Enrollment ID: I20140422001181 |
| Provider Name | Erica Robinson Mitchell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629366521 PECOS PAC ID: 1557586724 Enrollment ID: I20140701001731 |
| Provider Name | Jahnavi Avula |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821236316 PECOS PAC ID: 9133384746 Enrollment ID: I20140711002064 |
| Provider Name | Scott A Mcclain |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1114034469 PECOS PAC ID: 9436375110 Enrollment ID: I20140801002108 |
| Provider Name | Margaret M Whitcraft |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1093001604 PECOS PAC ID: 6305063454 Enrollment ID: I20140813001235 |
| Provider Name | Elizabeth L Cook |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1447589049 PECOS PAC ID: 2567587892 Enrollment ID: I20140821000600 |
| Provider Name | Gregory P Mclennan |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912160052 PECOS PAC ID: 8628209327 Enrollment ID: I20140828000428 |
| Provider Name | Katie S Schroeder |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1487818001 PECOS PAC ID: 1557581550 Enrollment ID: I20140925000398 |
| Provider Name | Ashley A Thill |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1811259518 PECOS PAC ID: 0244488161 Enrollment ID: I20141013002424 |
| Provider Name | Joseph D Brunworth |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1366694135 PECOS PAC ID: 5395992093 Enrollment ID: I20141105001790 |
| Provider Name | Francisco J Garcia-ferrer |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1477538627 PECOS PAC ID: 7315111861 Enrollment ID: I20141112000998 |
| Provider Name | Mohsin U Qazi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1437461084 PECOS PAC ID: 6507091469 Enrollment ID: I20141205001733 |
| Provider Name | Brandy M Hughes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740678226 PECOS PAC ID: 6406170034 Enrollment ID: I20150130000598 |
| Provider Name | Deborah Goldberg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326338849 PECOS PAC ID: 9436479318 Enrollment ID: I20150515001096 |
| Provider Name | Aaron Anthony Pickrell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295072866 PECOS PAC ID: 7911218938 Enrollment ID: I20150617002424 |
| Provider Name | Andrew B Kichura |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265794432 PECOS PAC ID: 3678885902 Enrollment ID: I20150630000240 |
| Provider Name | Daniel L Jackson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952561938 PECOS PAC ID: 6901056258 Enrollment ID: I20150701001461 |
| Provider Name | Damian H. Findlay |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1487854378 PECOS PAC ID: 7911210521 Enrollment ID: I20150724010889 |
| Provider Name | Huiyi Chen |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1851603609 PECOS PAC ID: 4183868805 Enrollment ID: I20150724012500 |
| Provider Name | Kirsten Dunn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356617443 PECOS PAC ID: 6709106057 Enrollment ID: I20150730011242 |
| Provider Name | Yochita Gullapalli |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235493842 PECOS PAC ID: 3173757028 Enrollment ID: I20150805007040 |
| Provider Name | Cassandra R Edwards |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598027203 PECOS PAC ID: 0345460846 Enrollment ID: I20150806012194 |
| Provider Name | Mark A Fernandez |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1245250224 PECOS PAC ID: 7719292804 Enrollment ID: I20150819006654 |
| Provider Name | Craig S Hollander |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1407876493 PECOS PAC ID: 0244546869 Enrollment ID: I20150827001841 |
| Provider Name | Ryan Kroeger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801150784 PECOS PAC ID: 9638397326 Enrollment ID: I20150923002776 |
| Provider Name | Mohamad A Albsheri |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447508874 PECOS PAC ID: 3779891379 Enrollment ID: I20151001000551 |
| Provider Name | Gautum Agarwal |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1780880633 PECOS PAC ID: 4183932791 Enrollment ID: I20151001000884 |
| Provider Name | Tamsin Marie Lewis |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1760489694 PECOS PAC ID: 7911955729 Enrollment ID: I20160115002192 |
| Provider Name | Erik Aubuchon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558596668 PECOS PAC ID: 2961674064 Enrollment ID: I20160204002169 |
| Provider Name | Heather A Mckeever |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962860510 PECOS PAC ID: 7719281526 Enrollment ID: I20160215000929 |
| Provider Name | Katherine Bleisch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477910719 PECOS PAC ID: 9133425366 Enrollment ID: I20160314001658 |
| Provider Name | Kimberly A Schaefermeier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366814766 PECOS PAC ID: 9436456480 Enrollment ID: I20160318001249 |
| Provider Name | Qin Zhang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831485630 PECOS PAC ID: 8224276019 Enrollment ID: I20160520000405 |
| Provider Name | Carolyn M Mcginnis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457714487 PECOS PAC ID: 0648560367 Enrollment ID: I20160608000497 |
| Provider Name | Tracey S Bertram |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720428592 PECOS PAC ID: 8426276163 Enrollment ID: I20160615001626 |
| Provider Name | Joseph A Stauber |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1548609779 PECOS PAC ID: 6406074111 Enrollment ID: I20160629003055 |
| Provider Name | Musi Ye |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154764132 PECOS PAC ID: 0446579841 Enrollment ID: I20160705001672 |
| Provider Name | David Zenk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194164509 PECOS PAC ID: 8224258728 Enrollment ID: I20160707001732 |
| Provider Name | Tatheer Zohra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457614430 PECOS PAC ID: 5890936033 Enrollment ID: I20160712000138 |
| Provider Name | Mark Edward Mcmellen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053597955 PECOS PAC ID: 2769784214 Enrollment ID: I20160714001802 |
| Provider Name | Tara Nicole Banaszek Daming |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750656955 PECOS PAC ID: 8022309111 Enrollment ID: I20160721000830 |
| Provider Name | Joseph Polcaro |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598716920 PECOS PAC ID: 6507045317 Enrollment ID: I20160801001438 |
| Provider Name | Woo J Moon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578889747 PECOS PAC ID: 1153615737 Enrollment ID: I20160804000350 |
| Provider Name | Eric J Shelley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477999167 PECOS PAC ID: 7315181245 Enrollment ID: I20160804000810 |
| Provider Name | Emily S Lee |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811332497 PECOS PAC ID: 5991931602 Enrollment ID: I20160805000376 |
| Provider Name | James Thomas Barber |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1013903665 PECOS PAC ID: 8527132778 Enrollment ID: I20160811001128 |
| Provider Name | Judith A Mead |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942273156 PECOS PAC ID: 1951347376 Enrollment ID: I20160815002230 |
| Provider Name | Kristy D Kennon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578919668 PECOS PAC ID: 3072802693 Enrollment ID: I20160816000959 |
| Provider Name | Shannon N Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245696228 PECOS PAC ID: 1153616966 Enrollment ID: I20160818000337 |
| Provider Name | Patricia Lee Fredrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336541549 PECOS PAC ID: 2264727502 Enrollment ID: I20160825000242 |
| Provider Name | April Parker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1821226408 PECOS PAC ID: 3870736903 Enrollment ID: I20160907002234 |
| Provider Name | Mark D Packer |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1760470686 PECOS PAC ID: 4284931916 Enrollment ID: I20161005002534 |
| Provider Name | James Richard Martin |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1326339045 PECOS PAC ID: 6507167319 Enrollment ID: I20161010000280 |
| Provider Name | Shirley N Okwuashi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417247693 PECOS PAC ID: 1153638549 Enrollment ID: I20161012000677 |
| Provider Name | Jody Np Sims |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184173585 PECOS PAC ID: 2860770211 Enrollment ID: I20161107000132 |
| Provider Name | Larry W Thomas |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1033226543 PECOS PAC ID: 4880975812 Enrollment ID: I20170104002360 |
| Provider Name | Chauncey D Tarrant |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154646156 PECOS PAC ID: 4486937091 Enrollment ID: I20170206001151 |
| Provider Name | Teresa T Dillard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689830168 PECOS PAC ID: 7012290398 Enrollment ID: I20170210001827 |
| Provider Name | Falak Bhatt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588928535 PECOS PAC ID: 1951622760 Enrollment ID: I20170301000326 |
| Provider Name | Pierre E Laughton |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578523999 PECOS PAC ID: 2860579778 Enrollment ID: I20170306000491 |
| Provider Name | Danielle N Kramer-smotherman |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1669886677 PECOS PAC ID: 2062630155 Enrollment ID: I20170612002300 |
| Provider Name | Nathan C Robertson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124439252 PECOS PAC ID: 2769784222 Enrollment ID: I20170615001038 |
| Provider Name | Sarah F Horn |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336559541 PECOS PAC ID: 8123320546 Enrollment ID: I20170621001356 |
| Provider Name | Charles V Tran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396159836 PECOS PAC ID: 0648497305 Enrollment ID: I20170627003131 |
| Provider Name | Alexandra M Edwards |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235498114 PECOS PAC ID: 5799063236 Enrollment ID: I20170628002073 |
| Provider Name | Laura J Weitzel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073927794 PECOS PAC ID: 6305115601 Enrollment ID: I20170629001999 |
| Provider Name | Margaret Mueller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295889244 PECOS PAC ID: 4688579659 Enrollment ID: I20170707001679 |
| Provider Name | Summer Vu Peters |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1295099299 PECOS PAC ID: 8527337427 Enrollment ID: I20170710001101 |
| Provider Name | Lauren R Counts |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255741351 PECOS PAC ID: 7719280726 Enrollment ID: I20170711001221 |
| Provider Name | Geeth Sandeep Nadella |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023425501 PECOS PAC ID: 4981913613 Enrollment ID: I20170718002005 |
| Provider Name | Kiran Relekar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245533231 PECOS PAC ID: 8426234774 Enrollment ID: I20170719000531 |
| Provider Name | Joshua M Sappington |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1366767766 PECOS PAC ID: 6406160332 Enrollment ID: I20170720000865 |
| Provider Name | Alexander D Mcclure |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1477083772 PECOS PAC ID: 0941570188 Enrollment ID: I20170721000529 |
| Provider Name | Rubin Jit Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942615992 PECOS PAC ID: 9537466115 Enrollment ID: I20170724002911 |
| Provider Name | Frederick Balch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154735439 PECOS PAC ID: 6800013368 Enrollment ID: I20170726003403 |
| Provider Name | Alpana Chandra |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1033212923 PECOS PAC ID: 6709952104 Enrollment ID: I20170803002803 |
| Provider Name | Ivana Vettraino |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417007428 PECOS PAC ID: 0446286249 Enrollment ID: I20170809002441 |
| Provider Name | Shady Hawatmeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922498617 PECOS PAC ID: 8325310725 Enrollment ID: I20170821000203 |
| Provider Name | Amanuel Yohannes |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164842621 PECOS PAC ID: 8224300579 Enrollment ID: I20170821002654 |
| Provider Name | Angela Reidner |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1972793016 PECOS PAC ID: 7719032655 Enrollment ID: I20170824001470 |
| Provider Name | Steven Nguyen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013353663 PECOS PAC ID: 8921371139 Enrollment ID: I20170911002281 |
| Provider Name | Jacob Paul Buhrow |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174967947 PECOS PAC ID: 1951675602 Enrollment ID: I20170920000589 |
| Provider Name | Gregory S Tentindo |
|---|---|
| Provider Type | Practitioner - Maxillofacial Surgery |
| Provider Identifiers | NPI Number: 1164866125 PECOS PAC ID: 4486929304 Enrollment ID: I20171003006037 |
| Provider Name | Varundeep K Rakhra |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1346507316 PECOS PAC ID: 6800104571 Enrollment ID: I20171005002056 |
| Provider Name | Justin T Hagen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811152044 PECOS PAC ID: 6608135967 Enrollment ID: I20180111001270 |
| Provider Name | Lauren M Sappington |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467773192 PECOS PAC ID: 7214231497 Enrollment ID: I20180522001354 |
| Provider Name | Grace L Paley |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1184038986 PECOS PAC ID: 1759508419 Enrollment ID: I20180531001037 |
| Provider Name | Kelsey M Manescalco |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1003338211 PECOS PAC ID: 8921353137 Enrollment ID: I20180612000689 |
| Provider Name | Erin Kathleen Buckley |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1417261041 PECOS PAC ID: 5597909424 Enrollment ID: I20180626000890 |
| Provider Name | Marie Alexandra Muia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669966081 PECOS PAC ID: 5092061622 Enrollment ID: I20180711002988 |
| Provider Name | Steve Biko Onyambu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1295115608 PECOS PAC ID: 7113274291 Enrollment ID: I20180719004038 |
| Provider Name | Kevin Thomas Bauerle |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1861757346 PECOS PAC ID: 8527289685 Enrollment ID: I20180723001325 |
| Provider Name | Ramya Chinnasamy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063708238 PECOS PAC ID: 6709009053 Enrollment ID: I20180724003131 |
| Provider Name | Catherine Ash |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861874059 PECOS PAC ID: 4284942806 Enrollment ID: I20180807003033 |
| Provider Name | Jonathan Yoon |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1639518673 PECOS PAC ID: 2668720665 Enrollment ID: I20180808000932 |
| Provider Name | Kayci Renee Huff-hardy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1720346729 PECOS PAC ID: 0345483400 Enrollment ID: I20180820001889 |
| Provider Name | Asal Fathian |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629202270 PECOS PAC ID: 7719113000 Enrollment ID: I20180905001921 |
| Provider Name | Stephanie A Windish |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912313883 PECOS PAC ID: 8022394519 Enrollment ID: I20180921001827 |
| Provider Name | Zahra Fatimah Hassan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912388695 PECOS PAC ID: 5799036901 Enrollment ID: I20180927002160 |
| Provider Name | Mary K Higgs |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1619053188 PECOS PAC ID: 5092734657 Enrollment ID: I20181016002157 |
| Provider Name | Tamara K Young |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1740317510 PECOS PAC ID: 3274586607 Enrollment ID: I20181113000444 |
| Provider Name | Terrence Fletcher Holekamp |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1134375249 PECOS PAC ID: 1254561699 Enrollment ID: I20181114000694 |
| Provider Name | Kathleen E Koenen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841781473 PECOS PAC ID: 2769727791 Enrollment ID: I20181220000333 |
| Provider Name | Maryna Popp |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1326486515 PECOS PAC ID: 9335436583 Enrollment ID: I20190206000642 |
| Provider Name | Preetham Reddy Muskula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003104605 PECOS PAC ID: 6901129394 Enrollment ID: I20190325001870 |
| Provider Name | Yuree J Lin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407273386 PECOS PAC ID: 6406147552 Enrollment ID: I20190327000177 |
| Provider Name | Lamia K Atasi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811139330 PECOS PAC ID: 1355508870 Enrollment ID: I20190410002503 |
| Provider Name | Collin L Chen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1194139113 PECOS PAC ID: 6507086998 Enrollment ID: I20190611002242 |
| Provider Name | Edmond Nelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912285446 PECOS PAC ID: 1951541754 Enrollment ID: I20190613000446 |
| Provider Name | Abdul Rishi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104269703 PECOS PAC ID: 3678866423 Enrollment ID: I20190618001126 |
| Provider Name | Vedica Sharma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104277458 PECOS PAC ID: 2365735552 Enrollment ID: I20190709003078 |
| Provider Name | Andrew C Zuckerman |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1366403644 PECOS PAC ID: 6305167412 Enrollment ID: I20190712001027 |
| Provider Name | Mohamed M Alwan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538542634 PECOS PAC ID: 8820390297 Enrollment ID: I20190731002227 |
| Provider Name | Sana Habib |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629431747 PECOS PAC ID: 3678866746 Enrollment ID: I20190802000708 |
| Provider Name | Asm Iftiar Chowdhury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1053759142 PECOS PAC ID: 1355582396 Enrollment ID: I20190805002113 |
| Provider Name | Jeremiah Cox |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1669854840 PECOS PAC ID: 5395053813 Enrollment ID: I20190807001049 |
| Provider Name | Christopher T Boyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205109675 PECOS PAC ID: 0244518785 Enrollment ID: I20190807001555 |
| Provider Name | Carrie Elise Johans |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1669734968 PECOS PAC ID: 4486898210 Enrollment ID: I20190808000780 |
| Provider Name | Tiffany M Krimminger |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1699205062 PECOS PAC ID: 3072840404 Enrollment ID: I20190808000970 |
| Provider Name | Johnson Wong |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861846909 PECOS PAC ID: 2466780770 Enrollment ID: I20190824000654 |
| Provider Name | Jessica Leigh Upchurch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457766974 PECOS PAC ID: 0648564914 Enrollment ID: I20190826000184 |
| Provider Name | Laura Ulmer |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1548600083 PECOS PAC ID: 0042453243 Enrollment ID: I20190827003601 |
| Provider Name | Phan Thuc Hang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346894144 PECOS PAC ID: 6305174467 Enrollment ID: I20190827003683 |
| Provider Name | Loren Nathan Bach |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205279650 PECOS PAC ID: 7618272865 Enrollment ID: I20190906002664 |
| Provider Name | William Joseph Goldkamp |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1831458652 PECOS PAC ID: 7113165846 Enrollment ID: I20190910001927 |
| Provider Name | Aman Ullah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407207624 PECOS PAC ID: 6103103890 Enrollment ID: I20190926003341 |
| Provider Name | Cristian Popu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790148500 PECOS PAC ID: 0345538609 Enrollment ID: I20191018001209 |
| Provider Name | Schuyler Halverson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1154764116 PECOS PAC ID: 2062715337 Enrollment ID: I20191023003270 |
| Provider Name | Shanna D Finney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376073536 PECOS PAC ID: 9638501851 Enrollment ID: I20191108001914 |
| Provider Name | Hailey Noelle Schlesinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003479122 PECOS PAC ID: 8921341652 Enrollment ID: I20191118000512 |
| Provider Name | Soumil Lele |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1972967602 PECOS PAC ID: 0244666873 Enrollment ID: I20200130001151 |
| Provider Name | Brittany Nicole Mora |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336780493 PECOS PAC ID: 1759719990 Enrollment ID: I20200321000087 |
| Provider Name | Alexandra L Mcdonald |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518501600 PECOS PAC ID: 3375965684 Enrollment ID: I20200615001666 |
| Provider Name | Melissa A Hager |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1033590732 PECOS PAC ID: 7719294602 Enrollment ID: I20200709003423 |
| Provider Name | Felix Nau Jr |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1932632544 PECOS PAC ID: 5294005351 Enrollment ID: I20200721001367 |
| Provider Name | Jennifer Bockerstett |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801316070 PECOS PAC ID: 4688940794 Enrollment ID: I20200803001450 |
| Provider Name | Jeffrey S Calvin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750764866 PECOS PAC ID: 3173825551 Enrollment ID: I20200804002733 |
| Provider Name | Charles Ma |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205377579 PECOS PAC ID: 0143598037 Enrollment ID: I20200806002658 |
| Provider Name | Talat Syed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588011605 PECOS PAC ID: 4587903414 Enrollment ID: I20200813001825 |
| Provider Name | Lindsey Marie Bushmann |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417498601 PECOS PAC ID: 5193094985 Enrollment ID: I20200814000483 |
| Provider Name | Anne Longtine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134516701 PECOS PAC ID: 2961716584 Enrollment ID: I20200814001935 |
| Provider Name | Maria Stunkel |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1588042709 PECOS PAC ID: 9436464096 Enrollment ID: I20200817002315 |
| Provider Name | Emily W Zantow |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184003410 PECOS PAC ID: 2365741378 Enrollment ID: I20200825002945 |
| Provider Name | Venkataramana Somisetty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215459375 PECOS PAC ID: 0547531345 Enrollment ID: I20200827000455 |
| Provider Name | Alexander Richard Vaynman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275065435 PECOS PAC ID: 0143647701 Enrollment ID: I20200827000474 |
| Provider Name | Michelle Silasi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316122476 PECOS PAC ID: 4486790391 Enrollment ID: I20200831001761 |
| Provider Name | Tiago Araujo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730600156 PECOS PAC ID: 2466726153 Enrollment ID: I20200901000423 |
| Provider Name | Fang Bai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639564776 PECOS PAC ID: 3577872878 Enrollment ID: I20200909000395 |
| Provider Name | Vadim Vasilevski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831629823 PECOS PAC ID: 4082032255 Enrollment ID: I20200921001461 |
| Provider Name | Ramza Haque |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619406410 PECOS PAC ID: 8022437151 Enrollment ID: I20200923001259 |
| Provider Name | Pearce W Mundhenke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679003388 PECOS PAC ID: 5496021057 Enrollment ID: I20201006001246 |
| Provider Name | James Hollis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710092721 PECOS PAC ID: 9032387196 Enrollment ID: I20201104002909 |
| Provider Name | Chisom Eze |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821527649 PECOS PAC ID: 6002187333 Enrollment ID: I20201130002054 |
| Provider Name | Fowad Shahzad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568708428 PECOS PAC ID: 1850532532 Enrollment ID: I20201217002009 |
| Provider Name | Carolyn Hilliard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1922488261 PECOS PAC ID: 1153634530 Enrollment ID: I20210201002777 |
| Provider Name | Kallie Harrison |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1104118249 PECOS PAC ID: 0345553160 Enrollment ID: I20210602003085 |
| Provider Name | Andrew Dean Mayo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598150393 PECOS PAC ID: 8224398490 Enrollment ID: I20210607001254 |
| Provider Name | Derrick Clunis |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1407832579 PECOS PAC ID: 8527058015 Enrollment ID: I20210712003291 |
| Provider Name | Rachel Yoon Kmetz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043528540 PECOS PAC ID: 1052646148 Enrollment ID: I20210719000545 |
| Provider Name | Yasser Kabbani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982050142 PECOS PAC ID: 5698066736 Enrollment ID: I20210721003110 |
| Provider Name | Kathryn Emily Harvey-feldewerth |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700370996 PECOS PAC ID: 2668722547 Enrollment ID: I20210726002126 |
| Provider Name | Andrew Park |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427113729 PECOS PAC ID: 9931248366 Enrollment ID: I20210726003497 |
| Provider Name | Trevor Cabrera |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1780116392 PECOS PAC ID: 0840609038 Enrollment ID: I20210803001726 |
| Provider Name | William Frick |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396236402 PECOS PAC ID: 6800151481 Enrollment ID: I20210806001585 |
| Provider Name | Tariq Halasa |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043754039 PECOS PAC ID: 8729482757 Enrollment ID: I20210812000854 |
| Provider Name | Nathaniel Wachter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922492123 PECOS PAC ID: 8224336946 Enrollment ID: I20210816000788 |
| Provider Name | Neil Backer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962933911 PECOS PAC ID: 2769732015 Enrollment ID: I20210820000412 |
| Provider Name | Nicole F Hawatmeh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497248801 PECOS PAC ID: 3971908336 Enrollment ID: I20210823002505 |
| Provider Name | Andre Robert Theuerkauf |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932693181 PECOS PAC ID: 6709281744 Enrollment ID: I20210830000570 |
| Provider Name | Dorian G Shimotani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407344393 PECOS PAC ID: 5496001042 Enrollment ID: I20210914001756 |
| Provider Name | Mohit Harsh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1528553799 PECOS PAC ID: 4587061338 Enrollment ID: I20210922000988 |
| Provider Name | Archana Machavarapu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063866374 PECOS PAC ID: 4486984440 Enrollment ID: I20210927002285 |
| Provider Name | Aref Qureini |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437681251 PECOS PAC ID: 8729359526 Enrollment ID: I20210928000370 |
| Provider Name | Andrew Dawson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912353533 PECOS PAC ID: 0042502478 Enrollment ID: I20211008002688 |
| Provider Name | Vanaja Yedla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710483193 PECOS PAC ID: 4082002084 Enrollment ID: I20211025001346 |
| Provider Name | Divya Sivakumar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528419587 PECOS PAC ID: 5092000851 Enrollment ID: I20211210002430 |
| Provider Name | Adriena Beatty |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043260979 PECOS PAC ID: 7719127406 Enrollment ID: I20211215001014 |
| Provider Name | Casey Cordts |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1245404656 PECOS PAC ID: 0042480915 Enrollment ID: I20211217001536 |
| Provider Name | Milos Ivanovic |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063901270 PECOS PAC ID: 1254723786 Enrollment ID: I20220113001244 |
| Provider Name | Kortny Dusek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770234734 PECOS PAC ID: 7618360975 Enrollment ID: I20220209000364 |
| Provider Name | Samuel Abebe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1003256421 PECOS PAC ID: 6608163548 Enrollment ID: I20220301001775 |
| Provider Name | Meghan Marie Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003577925 PECOS PAC ID: 3779978705 Enrollment ID: I20220309002877 |
| Provider Name | Daniel Hernandez Gonzalez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427602176 PECOS PAC ID: 4587096185 Enrollment ID: I20220630000428 |
| Provider Name | Praveen Nandamuru |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1396242954 PECOS PAC ID: 2668727470 Enrollment ID: I20220630000522 |
| Provider Name | Akhi Mustari |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356901110 PECOS PAC ID: 3274914783 Enrollment ID: I20220714003157 |
| Provider Name | Taimoor Haider |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1659924017 PECOS PAC ID: 7214361492 Enrollment ID: I20220714003443 |
| Provider Name | Alison Odineal |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1497218432 PECOS PAC ID: 5092049239 Enrollment ID: I20220721000867 |
| Provider Name | John Pocholo Whitaker Tuason |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891347498 PECOS PAC ID: 2769863711 Enrollment ID: I20220721002591 |
| Provider Name | Kara Elise Nuspl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932760972 PECOS PAC ID: 3577899640 Enrollment ID: I20220726002431 |
| Provider Name | Basil I Shahin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851951982 PECOS PAC ID: 0446648802 Enrollment ID: I20220802000672 |
| Provider Name | Osarenren Idemudia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1467013094 PECOS PAC ID: 0547592370 Enrollment ID: I20220803002477 |
| Provider Name | Ghislain B.k. Tchomobe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720548290 PECOS PAC ID: 7012390479 Enrollment ID: I20220817002166 |
| Provider Name | Anam Aqeel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073178315 PECOS PAC ID: 5799017356 Enrollment ID: I20220817003496 |
| Provider Name | Winnie M Hua |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851850846 PECOS PAC ID: 8527393370 Enrollment ID: I20220822002944 |
| Provider Name | Birju V Amin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821658402 PECOS PAC ID: 0042694069 Enrollment ID: I20220825000360 |
| Provider Name | Tejas N Sangoi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1417416256 PECOS PAC ID: 8820322076 Enrollment ID: I20220908000830 |
| Provider Name | Iqra Iqbal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104353614 PECOS PAC ID: 4183994015 Enrollment ID: I20220908001957 |
| Provider Name | Mark Bigg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750941571 PECOS PAC ID: 6901132190 Enrollment ID: I20220909000891 |
| Provider Name | Alexander Heese |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871056333 PECOS PAC ID: 3577897321 Enrollment ID: I20220910000404 |
| Provider Name | Danni Habtu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508421777 PECOS PAC ID: 8820322704 Enrollment ID: I20220912000316 |
| Provider Name | Matthew Frederic Burke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457811481 PECOS PAC ID: 4082099791 Enrollment ID: I20220916000674 |
| Provider Name | Paulina G Rue |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871055046 PECOS PAC ID: 7315271418 Enrollment ID: I20220921003519 |
| Provider Name | Charu Kolekar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811320856 PECOS PAC ID: 8729336565 Enrollment ID: I20221013002976 |
| Provider Name | Mytri Pokal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811250962 PECOS PAC ID: 0547483893 Enrollment ID: I20221013003227 |
| Provider Name | Amanda Marie Wood |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952887333 PECOS PAC ID: 2163753419 Enrollment ID: I20221014001343 |
| Provider Name | Vikram Sangani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821438995 PECOS PAC ID: 1052695673 Enrollment ID: I20221017002986 |
| Provider Name | Christine Walters |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1134783798 PECOS PAC ID: 2365779659 Enrollment ID: I20221017003106 |
| Provider Name | Megan Collins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972039881 PECOS PAC ID: 1557783511 Enrollment ID: I20221020002458 |
| Provider Name | Sabat Sardar Ameen |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1811549710 PECOS PAC ID: 0446639447 Enrollment ID: I20221128001498 |
| Provider Name | Delee Har |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972703213 PECOS PAC ID: 5092939272 Enrollment ID: I20221228000293 |
| Provider Name | Miquia Sherree Henderson |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1457871394 PECOS PAC ID: 2668843970 Enrollment ID: I20230125000407 |
| Provider Name | Adnan Shahid Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558865097 PECOS PAC ID: 8628324852 Enrollment ID: I20230330002322 |
| Provider Name | Jennifer Buehler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1174919591 PECOS PAC ID: 3678876455 Enrollment ID: I20230414000980 |
| Provider Name | Aditi Lele |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356803548 PECOS PAC ID: 5092042390 Enrollment ID: I20230524000536 |
| Provider Name | Chizor Odibi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477702462 PECOS PAC ID: 9931389772 Enrollment ID: I20230525002831 |
| Provider Name | Bijoy Kar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407207699 PECOS PAC ID: 5193050599 Enrollment ID: I20230628003444 |
| Provider Name | Trevor D Beardsley |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861851404 PECOS PAC ID: 9335508696 Enrollment ID: I20230705000434 |
| Provider Name | Ram Sanjeev Alur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386808798 PECOS PAC ID: 5193185270 Enrollment ID: I20230720003309 |
| Provider Name | Chase Meyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154958908 PECOS PAC ID: 0941624001 Enrollment ID: I20230720004003 |
| Provider Name | Cody D Novack |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689290181 PECOS PAC ID: 8022434109 Enrollment ID: I20230728000619 |
| Provider Name | Quang Trong Trung Le |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1598285959 PECOS PAC ID: 1658640289 Enrollment ID: I20230803003097 |
| Provider Name | Akash Mandhan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194337428 PECOS PAC ID: 1850752049 Enrollment ID: I20230803004066 |
| Provider Name | Edward Wang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386131423 PECOS PAC ID: 0042565160 Enrollment ID: I20230818000570 |
| Provider Name | Collin James Hill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821614439 PECOS PAC ID: 9133542939 Enrollment ID: I20230824001900 |
| Provider Name | Preston Ernest Mundhenke |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1407472053 PECOS PAC ID: 7416371836 Enrollment ID: I20230824003166 |
| Provider Name | Abigail Wheeler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720608268 PECOS PAC ID: 4880071869 Enrollment ID: I20230829001188 |
| Provider Name | Ibipo Abdurraheem-salami |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962024323 PECOS PAC ID: 9234504812 Enrollment ID: I20230830001824 |
| Provider Name | Amy E Miller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144752445 PECOS PAC ID: 1658643036 Enrollment ID: I20230907001780 |
| Provider Name | Elizabeth Houston |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225653942 PECOS PAC ID: 4284051905 Enrollment ID: I20230919000457 |
| Provider Name | Samantha Jane Collins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114555927 PECOS PAC ID: 3072937580 Enrollment ID: I20230928002009 |
| Provider Name | Kenneth James Shortt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649767294 PECOS PAC ID: 0244564862 Enrollment ID: I20231006000330 |
| Provider Name | Mafaza Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275161796 PECOS PAC ID: 9931523321 Enrollment ID: I20231010001650 |
| Provider Name | Muhaddis Ejaz Ahmad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417576984 PECOS PAC ID: 9436504321 Enrollment ID: I20231012002308 |
| Provider Name | Nedaa M. Husainat |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558980037 PECOS PAC ID: 9830544675 Enrollment ID: I20231013000913 |
| Provider Name | Hamza Bajwa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326668401 PECOS PAC ID: 6103273727 Enrollment ID: I20231103000570 |
St. Louis Center For Preventive And Longevity Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 777 S New Ballas Rd, Suite 200 E, Saint Louis, MO 63141 Phone: 314-994-1536 Fax: 314-692-0241 | |
Town And Country Primary Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3009 N Ballas Rd, Suite 300a, Saint Louis, MO 63131 Phone: 314-872-8999 | |
Family Care Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Lynch St, Saint Louis, MO 63118 Phone: 314-531-5444 Fax: 314-531-0063 | |
Wusm Bjc Aco Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Campus Box 8081, Saint Louis, MO 63110 Phone: 314-273-0770 | |
Victus Physician Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12607 Olive Blvd, Saint Louis, MO 63141 Phone: 314-327-8070 | |
Salvation Army Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2900 Washington Ave, Saint Louis, MO 63103 Phone: 314-898-1700 Fax: 314-814-8542 | |
Dtg Ii Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3819 Tesson Ct, Saint Louis, MO 63123 Phone: 800-268-7713 Fax: 415-704-3294 |