| Nantucket Physicians Organization | |
|
57 Prospect St Room 101 Nantucket MA 02554-2799 | |
| (508) 776-7428 | |
| (508) 693-5942 |
| Full Name | Nantucket Physicians Organization |
|---|---|
| Speciality | Orthopaedic Surgery |
| Location | 57 Prospect St, Nantucket, Massachusetts |
| Authorized Official Name and Position | Jennifer Malloy Monto (MANAGER) |
| Authorized Official Contact | 5088251327 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nantucket Physicians Organization 57 Prospect St Room 122 Nantucket MA 02554-2799 Ph: (508) 825-1327 | Nantucket Physicians Organization 57 Prospect St Room 101 Nantucket MA 02554-2799 Ph: (508) 776-7428 |
| NPI Number | 1568798510 |
|---|---|
| Provider Enumeration Date | 10/27/2009 |
| Last Update Date | 08/16/2017 |
| Medicare PECOS PAC ID | 6608065438 |
|---|---|
| Medicare Enrollment ID | O20110111000016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568798510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 242762 (Massachusetts) | Secondary |
| 207X00000X | Orthopaedic Surgery | 150697 (Massachusetts) | Primary |
| Provider Name | Gary J Brenner |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1447240627 PECOS PAC ID: 3375449598 Enrollment ID: I20031209000777 |
| Provider Name | Salma Batool Anwar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1285624916 PECOS PAC ID: 1254230840 Enrollment ID: I20040102000428 |
| Provider Name | Nancy Lucchini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689697492 PECOS PAC ID: 8224931555 Enrollment ID: I20040202000585 |
| Provider Name | Richard H Ma |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013995398 PECOS PAC ID: 0547153611 Enrollment ID: I20040203000820 |
| Provider Name | Caroline Kuhlman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215093133 PECOS PAC ID: 7517851223 Enrollment ID: I20040212000514 |
| Provider Name | Jeanne Griffin Vaughn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710042346 PECOS PAC ID: 6002800059 Enrollment ID: I20040413000114 |
| Provider Name | Matthew Tierney |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134105646 PECOS PAC ID: 1052308558 Enrollment ID: I20040427001304 |
| Provider Name | Nandita Srividya Scott |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1316051212 PECOS PAC ID: 0840289369 Enrollment ID: I20040510001305 |
| Provider Name | Cherylyn Black |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689697245 PECOS PAC ID: 4981694072 Enrollment ID: I20040512000870 |
| Provider Name | Gregg S Meyer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811997927 PECOS PAC ID: 1456264829 Enrollment ID: I20040617000188 |
| Provider Name | Paul I Geraldez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457342958 PECOS PAC ID: 4981684958 Enrollment ID: I20040721000564 |
| Provider Name | Shihab Ahmed |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1821088451 PECOS PAC ID: 7214900901 Enrollment ID: I20040819000929 |
| Provider Name | Joseph Michael Garasic |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154303808 PECOS PAC ID: 9436123502 Enrollment ID: I20040824000772 |
| Provider Name | John F Hanlon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417994153 PECOS PAC ID: 1153381033 Enrollment ID: I20041014000941 |
| Provider Name | Richard H. Koehler |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1831146414 PECOS PAC ID: 2668462706 Enrollment ID: I20041104000928 |
| Provider Name | Donald S Marks |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982680740 PECOS PAC ID: 4789630252 Enrollment ID: I20050328000853 |
| Provider Name | Diane R Pearl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427062959 PECOS PAC ID: 4183671761 Enrollment ID: I20050406000022 |
| Provider Name | Robert A Partridge |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1003836958 PECOS PAC ID: 5092753079 Enrollment ID: I20050420000674 |
| Provider Name | Mari Kim Bunnell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1205892361 PECOS PAC ID: 8820037294 Enrollment ID: I20050426001121 |
| Provider Name | Dana K Fugelso |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1518925585 PECOS PAC ID: 9133165376 Enrollment ID: I20050628001266 |
| Provider Name | Duraisamy Balaguru |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1154382703 PECOS PAC ID: 0244267615 Enrollment ID: I20050719000027 |
| Provider Name | Timothy J Lepore |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720041023 PECOS PAC ID: 1850323114 Enrollment ID: I20050926001037 |
| Provider Name | Phillip D Mccrary |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861488967 PECOS PAC ID: 6103860952 Enrollment ID: I20051029000161 |
| Provider Name | Jennifer N Skolnick |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1114975380 PECOS PAC ID: 7012935257 Enrollment ID: I20051107000669 |
| Provider Name | Katayoon Goodarzi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518073345 PECOS PAC ID: 2668499880 Enrollment ID: I20051114000603 |
| Provider Name | Alfred J Phillips |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1982727129 PECOS PAC ID: 7315967684 Enrollment ID: I20051201000223 |
| Provider Name | Steven A Kohler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1134170194 PECOS PAC ID: 7113947433 Enrollment ID: I20051201000650 |
| Provider Name | Jon S Dubois |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1922080241 PECOS PAC ID: 1153337290 Enrollment ID: I20060228000235 |
| Provider Name | Dale K Weldon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316004989 PECOS PAC ID: 8628086527 Enrollment ID: I20060404000675 |
| Provider Name | Regina M Mostone |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528049772 PECOS PAC ID: 9931117736 Enrollment ID: I20060404000745 |
| Provider Name | Pieter M Pil |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1396743209 PECOS PAC ID: 1052323599 Enrollment ID: I20060626000268 |
| Provider Name | Elene T Viscosi-spieler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033214978 PECOS PAC ID: 7012913072 Enrollment ID: I20061013000460 |
| Provider Name | Michelle F Costa |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1962548941 PECOS PAC ID: 3274625157 Enrollment ID: I20070823000166 |
| Provider Name | Kimberlyn C Grams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841476207 PECOS PAC ID: 3072696590 Enrollment ID: I20080207000065 |
| Provider Name | Jennifer M Viano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104007905 PECOS PAC ID: 1759466899 Enrollment ID: I20080313000073 |
| Provider Name | Leslie S Kerzner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1932188034 PECOS PAC ID: 1456438670 Enrollment ID: I20080411000162 |
| Provider Name | Christopher H Hashikawa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770688160 PECOS PAC ID: 7214008291 Enrollment ID: I20080618000746 |
| Provider Name | Elizabeth Holby |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1891795720 PECOS PAC ID: 6507866282 Enrollment ID: I20080917000748 |
| Provider Name | Brian Ghoshhajra |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558539080 PECOS PAC ID: 1557438710 Enrollment ID: I20080930000449 |
| Provider Name | Elton Fennell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497705891 PECOS PAC ID: 7012950926 Enrollment ID: I20081010000243 |
| Provider Name | Raymond R. Monto |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689634545 PECOS PAC ID: 2668414673 Enrollment ID: I20090310000037 |
| Provider Name | Faith Holden Frable |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063526697 PECOS PAC ID: 7517962681 Enrollment ID: I20090421000482 |
| Provider Name | Ami B. Bhatt |
|---|---|
| Provider Type | Practitioner - Adult Congenital Heart Disease (achd) |
| Provider Identifiers | NPI Number: 1285600155 PECOS PAC ID: 1759431489 Enrollment ID: I20090618000083 |
| Provider Name | Margaret M Koehm |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255315545 PECOS PAC ID: 1557446416 Enrollment ID: I20090901000011 |
| Provider Name | Joel J Hass |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396741963 PECOS PAC ID: 5294715850 Enrollment ID: I20100602000061 |
| Provider Name | Jeffrey A Barnes |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1326238411 PECOS PAC ID: 4981738176 Enrollment ID: I20100810000140 |
| Provider Name | Scot A Millay |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1518176965 PECOS PAC ID: 7214061100 Enrollment ID: I20100813000675 |
| Provider Name | Brittany Weber |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1720200819 PECOS PAC ID: 0648395004 Enrollment ID: I20100909000340 |
| Provider Name | Emmanuel Kanyi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467773382 PECOS PAC ID: 6002008976 Enrollment ID: I20101011000444 |
| Provider Name | Glenn Michael Colassi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891019907 PECOS PAC ID: 7113041203 Enrollment ID: I20101110000423 |
| Provider Name | Michael J Gray |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316033871 PECOS PAC ID: 3274711668 Enrollment ID: I20110708000006 |
| Provider Name | Richard E Heywood |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1336118066 PECOS PAC ID: 7012196819 Enrollment ID: I20110826000489 |
| Provider Name | Stephen Kelly |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558504258 PECOS PAC ID: 7113185117 Enrollment ID: I20120222000466 |
| Provider Name | Tiffany L Blake Lamb |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043473622 PECOS PAC ID: 4486812856 Enrollment ID: I20120813000219 |
| Provider Name | Penne Traci Greer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487991725 PECOS PAC ID: 1254576176 Enrollment ID: I20130418000163 |
| Provider Name | Michael C Lee |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1447442009 PECOS PAC ID: 6901061522 Enrollment ID: I20130730000786 |
| Provider Name | Lisa M Vieira-salvatore |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1437175106 PECOS PAC ID: 0042394835 Enrollment ID: I20130923000020 |
| Provider Name | William M Perry |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306847520 PECOS PAC ID: 2567447535 Enrollment ID: I20140114001157 |
| Provider Name | Joy N Tsai |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1710134929 PECOS PAC ID: 6406041599 Enrollment ID: I20140620000032 |
| Provider Name | Leo L Tsai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720250228 PECOS PAC ID: 6800011974 Enrollment ID: I20140703000066 |
| Provider Name | Michael P Bowley |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861620247 PECOS PAC ID: 2466628375 Enrollment ID: I20140714002361 |
| Provider Name | Janine C Albert |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629395991 PECOS PAC ID: 1658514583 Enrollment ID: I20140715000600 |
| Provider Name | Steven E Feder |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1952397572 PECOS PAC ID: 5890717565 Enrollment ID: I20150123000719 |
| Provider Name | Kassem Safa |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1336397231 PECOS PAC ID: 1557524675 Enrollment ID: I20150616002250 |
| Provider Name | Gillian L Mccafferty |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629335914 PECOS PAC ID: 5294969200 Enrollment ID: I20150625001165 |
| Provider Name | Tara J Chute |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1023303997 PECOS PAC ID: 0345472114 Enrollment ID: I20150814014294 |
| Provider Name | Kenya Hanspard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932170305 PECOS PAC ID: 9739072984 Enrollment ID: I20160318000840 |
| Provider Name | Annette M Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164877635 PECOS PAC ID: 6901192525 Enrollment ID: I20160908001092 |
| Provider Name | Colleen M Harrington |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1952577025 PECOS PAC ID: 8224224902 Enrollment ID: I20160926000071 |
| Provider Name | Kaavya Paruchuri |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1073952792 PECOS PAC ID: 9133418023 Enrollment ID: I20170119002004 |
| Provider Name | Seth A Wander |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1790123792 PECOS PAC ID: 0648408526 Enrollment ID: I20170306001604 |
| Provider Name | Nicole Nadeau |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1184915233 PECOS PAC ID: 5597981670 Enrollment ID: I20170621002059 |
| Provider Name | Jonathan A Casey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639139819 PECOS PAC ID: 0547361222 Enrollment ID: I20170918000990 |
| Provider Name | Evin Yucel |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942436712 PECOS PAC ID: 3577870328 Enrollment ID: I20170922003120 |
| Provider Name | John F D Avella |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225137243 PECOS PAC ID: 8628159886 Enrollment ID: I20171031000745 |
| Provider Name | Andrew Robert Branagan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1679707053 PECOS PAC ID: 0042531527 Enrollment ID: I20171207000592 |
| Provider Name | Francis X O Connor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306819867 PECOS PAC ID: 7618158742 Enrollment ID: I20171214002577 |
| Provider Name | Derek A Andelloux |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013145275 PECOS PAC ID: 0244488823 Enrollment ID: I20180418001055 |
| Provider Name | Candy Bernier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376020099 PECOS PAC ID: 2961747365 Enrollment ID: I20181212002679 |
| Provider Name | Meredith H Lepore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770772881 PECOS PAC ID: 9537346697 Enrollment ID: I20190604000399 |
| Provider Name | Sara Bouberhan |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1487929634 PECOS PAC ID: 0547572380 Enrollment ID: I20190611001589 |
| Provider Name | Adam J Kaye |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1942658190 PECOS PAC ID: 7214261338 Enrollment ID: I20190624002731 |
| Provider Name | Vincent A Marino |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093791691 PECOS PAC ID: 1850314857 Enrollment ID: I20190723001500 |
| Provider Name | Gayatri V Jayaraman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1942439690 PECOS PAC ID: 0941450613 Enrollment ID: I20190820000269 |
| Provider Name | Joanne S Chiu |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1659515344 PECOS PAC ID: 8224317771 Enrollment ID: I20190910000185 |
| Provider Name | James Mullen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770663312 PECOS PAC ID: 5294728093 Enrollment ID: I20200109001185 |
| Provider Name | Guy Nuki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346209582 PECOS PAC ID: 3971577487 Enrollment ID: I20200109001682 |
| Provider Name | Tari A Advani |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669443081 PECOS PAC ID: 2668409665 Enrollment ID: I20200226002287 |
| Provider Name | Molly Harding |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679126494 PECOS PAC ID: 7810326899 Enrollment ID: I20200327000501 |
| Provider Name | Brandon E Giberson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265886956 PECOS PAC ID: 6800129545 Enrollment ID: I20200514001545 |
| Provider Name | Mary E Meinke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780117168 PECOS PAC ID: 8123442381 Enrollment ID: I20200721001668 |
| Provider Name | Sergi Martinez Ramirez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1396125217 PECOS PAC ID: 8729395777 Enrollment ID: I20200730002757 |
| Provider Name | Matthew D Dalke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861842726 PECOS PAC ID: 2668721671 Enrollment ID: I20200806001436 |
| Provider Name | Katherine Helen Albutt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1952749509 PECOS PAC ID: 0244468247 Enrollment ID: I20200910001803 |
| Provider Name | Barbara N Malone |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1831135193 PECOS PAC ID: 7113976127 Enrollment ID: I20200923003263 |
| Provider Name | Michael A Bell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316967375 PECOS PAC ID: 9436063971 Enrollment ID: I20201020001353 |
| Provider Name | Katherine M Nichols |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396158143 PECOS PAC ID: 5395037980 Enrollment ID: I20201120001990 |
| Provider Name | Michele L Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184238438 PECOS PAC ID: 4183023948 Enrollment ID: I20210621000632 |
| Provider Name | Janice Thai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568691392 PECOS PAC ID: 1759626294 Enrollment ID: I20210823000362 |
| Provider Name | Anna E Goodheart |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235510645 PECOS PAC ID: 6204144991 Enrollment ID: I20210823000474 |
| Provider Name | Alexandra Marie Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609300888 PECOS PAC ID: 6103195169 Enrollment ID: I20211102002992 |
| Provider Name | Nadeem S Ali |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053351528 PECOS PAC ID: 3870568686 Enrollment ID: I20211209000505 |
| Provider Name | Alexinna Johns |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1073731006 PECOS PAC ID: 0042381410 Enrollment ID: I20211230001806 |
| Provider Name | Deborah Moss-gail |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184947947 PECOS PAC ID: 1254523251 Enrollment ID: I20220308002637 |
| Provider Name | Ranjiv Advani |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1396716742 PECOS PAC ID: 5496746331 Enrollment ID: I20220506000305 |
| Provider Name | John Hower |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871734194 PECOS PAC ID: 9133273758 Enrollment ID: I20220506000417 |
| Provider Name | Claire Conklin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790268753 PECOS PAC ID: 9537590294 Enrollment ID: I20220506000558 |
| Provider Name | Anders Knutzen |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912985037 PECOS PAC ID: 0648184333 Enrollment ID: I20220607002127 |
| Provider Name | Jonathan Rose |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1033566682 PECOS PAC ID: 5092009951 Enrollment ID: I20220630002745 |
| Provider Name | Joy Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457738510 PECOS PAC ID: 3274833728 Enrollment ID: I20220909000681 |
| Provider Name | Erica Lee Ditkoff |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1285165589 PECOS PAC ID: 5092190017 Enrollment ID: I20220912002489 |
| Provider Name | Sonal Bhavesh Patel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184233066 PECOS PAC ID: 5193192979 Enrollment ID: I20221108001403 |
| Provider Name | Douglas Campbell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093100646 PECOS PAC ID: 7719295062 Enrollment ID: I20221110002013 |
| Provider Name | H Brandon Ayre |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548206428 PECOS PAC ID: 0345275004 Enrollment ID: I20221115001660 |
| Provider Name | Katie L Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346609682 PECOS PAC ID: 1658663950 Enrollment ID: I20221115001996 |
| Provider Name | Allison Marie Ebrahimi Gold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225689763 PECOS PAC ID: 3072945252 Enrollment ID: I20230313001649 |
| Provider Name | Daniel Tran |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1427080647 PECOS PAC ID: 1850499732 Enrollment ID: I20230508001209 |
| Provider Name | Bita Zahedi |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1821520859 PECOS PAC ID: 2769755750 Enrollment ID: I20230511000247 |
| Provider Name | Stephen Skinner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1790128155 PECOS PAC ID: 7214237684 Enrollment ID: I20230607003019 |
| Provider Name | Shawne Broderick |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1215183363 PECOS PAC ID: 6406916782 Enrollment ID: I20230703001635 |
| Provider Name | Francine Hughes |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235219718 PECOS PAC ID: 0345145959 Enrollment ID: I20230815000319 |
| Provider Name | Ashlee Taylor Belliveau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215452792 PECOS PAC ID: 7416349709 Enrollment ID: I20240124002754 |
| Provider Name | Robert C Kelly |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1336402452 PECOS PAC ID: 0749419620 Enrollment ID: I20240131001861 |
| Provider Name | Tamara R Dildy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306804000 PECOS PAC ID: 9931195088 Enrollment ID: I20240319002477 |
Nantucket Cottage Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 57 Prospect St, Nantucket, MA 02554 Phone: 508-825-8100 |