| Norcal Healthconnect Llc | |
|
1375 University Ave Healdsburg CA 95448-3382 | |
| (707) 431-6500 | |
| Not Available |
| Full Name | Norcal Healthconnect Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1375 University Ave, Healdsburg, California |
| Authorized Official Name and Position | Donald W Anderson (ASSISTANT SECRETARY FOR ENROLLMENT) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Norcal Healthconnect Llc 1111 Sonoma Ave Santa Rosa CA 95405-4819 Ph: () - | Norcal Healthconnect Llc 1375 University Ave Healdsburg CA 95448-3382 Ph: (707) 431-6500 |
| NPI Number | 1720695547 |
|---|---|
| Provider Enumeration Date | 09/25/2020 |
| Last Update Date | 12/18/2023 |
| Medicare PECOS PAC ID | 2466864038 |
|---|---|
| Medicare Enrollment ID | O20210308001127 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720695547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Bruce D Deas |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639189715 PECOS PAC ID: 4082503586 Enrollment ID: I20040317000899 |
| Provider Name | Steven Maron |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821026063 PECOS PAC ID: 7810806734 Enrollment ID: I20040317000955 |
| Provider Name | Judy A Widger |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821062027 PECOS PAC ID: 1759363831 Enrollment ID: I20040602001466 |
| Provider Name | Gerry Vasco Lazzareschi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780768762 PECOS PAC ID: 4385627058 Enrollment ID: I20040611001394 |
| Provider Name | Edward S J Wang |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1689626277 PECOS PAC ID: 8527031806 Enrollment ID: I20040816000392 |
| Provider Name | Gary J Mishkin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912981382 PECOS PAC ID: 7810954708 Enrollment ID: I20041213000365 |
| Provider Name | Alanna Lee Wargula |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1336277730 PECOS PAC ID: 4183710650 Enrollment ID: I20071012000731 |
| Provider Name | Claudia Alexandra Santucci |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1275734154 PECOS PAC ID: 9830286863 Enrollment ID: I20071107000380 |
| Provider Name | Nathan A Teismann |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548459282 PECOS PAC ID: 7719061787 Enrollment ID: I20080228000768 |
| Provider Name | Richard M Auld |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1144284290 PECOS PAC ID: 0143392126 Enrollment ID: I20080708000689 |
| Provider Name | Michael T Bollinger |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417941642 PECOS PAC ID: 0244398162 Enrollment ID: I20081022000269 |
| Provider Name | Gary M Lekander |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174697783 PECOS PAC ID: 1658433644 Enrollment ID: I20081230000139 |
| Provider Name | Joseph Matel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871792382 PECOS PAC ID: 9638236573 Enrollment ID: I20090320000499 |
| Provider Name | K Daniel Rose |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790704518 PECOS PAC ID: 3870638646 Enrollment ID: I20100304000187 |
| Provider Name | Dilip Suryavanshi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104015387 PECOS PAC ID: 1850586744 Enrollment ID: I20101117001219 |
| Provider Name | Barbara A Boylan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013091081 PECOS PAC ID: 2466649579 Enrollment ID: I20101214001328 |
| Provider Name | Thomas J Kaiser |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1104882653 PECOS PAC ID: 7911195532 Enrollment ID: I20101227000502 |
| Provider Name | Neema M Patel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1598994121 PECOS PAC ID: 2062678485 Enrollment ID: I20120730000141 |
| Provider Name | Peri Life Penman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639480064 PECOS PAC ID: 1052554094 Enrollment ID: I20130823000720 |
| Provider Name | Shazah Khawaja |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083636450 PECOS PAC ID: 6608975230 Enrollment ID: I20131114000553 |
| Provider Name | Anusuya Mokashi |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720373376 PECOS PAC ID: 1355589920 Enrollment ID: I20140827003022 |
| Provider Name | Harvey R Langee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1801818042 PECOS PAC ID: 8820040546 Enrollment ID: I20150807014248 |
| Provider Name | Joseph M Tito |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1073570131 PECOS PAC ID: 1951333962 Enrollment ID: I20170710001298 |
| Provider Name | Tiny Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417029133 PECOS PAC ID: 2668609322 Enrollment ID: I20190109002833 |
| Provider Name | Shannon Lyn Manley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780149153 PECOS PAC ID: 1951642743 Enrollment ID: I20190403003276 |
| Provider Name | Graeme Stuart Mchenry |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1861809683 PECOS PAC ID: 3678874534 Enrollment ID: I20200224002161 |
| Provider Name | Dennis A Fito |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346477585 PECOS PAC ID: 7315102761 Enrollment ID: I20200326002127 |
| Provider Name | Arun Jain |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588691489 PECOS PAC ID: 4587653027 Enrollment ID: I20210112001950 |
| Provider Name | Vytas Petras Karalius |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1699279372 PECOS PAC ID: 7416292685 Enrollment ID: I20220718003155 |
| Provider Name | Stacy Nicolle Fekkers |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1629745120 PECOS PAC ID: 9638516636 Enrollment ID: I20240326003888 |
Northern California Medical Associates, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 Healdsburg Ave, Healdsburg, CA 95448 Phone: 707-358-0222 Fax: 707-385-0109 | |
Attila Mady Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1375 University St, Healdsburg, CA 95448 Phone: 707-431-6500 | |
Dr Rachel Mayorga Md Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 421 March Ave Ste D, Healdsburg, CA 95448 Phone: 707-385-0222 Fax: 707-629-4849 | |
Alliance Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1381 University St, Healdsburg, CA 95448 Phone: 707-433-5494 Fax: 707-385-2157 | |
Tehco Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1375 University St, Healdsburg, CA 95448 Phone: 702-453-3799 Fax: 702-453-5741 | |
Dr Ghazaleh Bahrami Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1375 University St, Healdsburg, CA 95448 Phone: 702-453-3799 Fax: 702-453-5741 | |
Alliance Medical Center, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1557 Healdsburg Ave Ste 15&16, Healdsburg, CA 95448 Phone: 707-433-5494 |