| Parkview Ancillary Services Corporation | |
|
1619 N. Greenwood Ave. Ste. 106 Pueblo CO 81003-2655 | |
| (719) 584-4045 | |
| (719) 542-0809 |
| Full Name | Parkview Ancillary Services Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 1619 N. Greenwood Ave., Pueblo, Colorado |
| Authorized Official Name and Position | Leslie Barnes (PRESIDENT/CEO) |
| Authorized Official Contact | 7195844573 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Parkview Ancillary Services Corporation 58 Club Manor Dr. Pueblo CO 81008-1601 Ph: (719) 584-4045 | Parkview Ancillary Services Corporation 1619 N. Greenwood Ave. Ste. 106 Pueblo CO 81003-2655 Ph: (719) 584-4045 |
| NPI Number | 1982878765 |
|---|---|
| Provider Enumeration Date | 04/14/2008 |
| Last Update Date | 05/23/2022 |
| Medicare PECOS PAC ID | 4385722511 |
|---|---|
| Medicare Enrollment ID | O20080429000248 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982878765 | NPI | - | NPPES |
| 16177754 | Medicaid | CO | |
| 12701378 | Medicaid | CO | |
| 24539716 | Medicaid | CO | |
| 29734860 | Medicaid | CO | |
| 81531869 | Medicaid | CO | |
| 95682872 | Medicaid | CO | |
| 26834774 | Medicaid | CO | |
| 63027348 | Medicaid | CO | |
| 74808583 | Medicaid | CO | |
| 96470259 | Medicaid | CO | |
| 99437767 | Medicaid | CO | |
| 07725779 | Medicaid | CO | |
| 14589265 | Medicaid | CO | |
| 26973898 | Medicaid | CO | |
| 27728757 | Medicaid | CO | |
| 49478541 | Medicaid | CO | |
| 36083372 | Medicaid | CO | |
| 38829584 | Medicaid | CO | |
| 56139071 | Medicaid | CO | |
| 59270748 | Medicaid | CO | |
| 89236751 | Medicaid | CO | |
| 67720587 | Medicaid | CO | |
| 20875576 | Medicaid | CO | |
| 23073055 | Medicaid | CO | |
| 29588855 | Medicaid | CO | |
| 22584226 | Medicaid | CO |
| Provider Name | Thomas A Herzog |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366466526 PECOS PAC ID: 7416857149 Enrollment ID: I20040109000960 |
| Provider Name | Craig S Shapiro |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1386638799 PECOS PAC ID: 1456241082 Enrollment ID: I20040419001817 |
| Provider Name | George Joseph Mattione |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1366426165 PECOS PAC ID: 4981693124 Enrollment ID: I20040511001461 |
| Provider Name | Christopher A Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295797413 PECOS PAC ID: 1355330507 Enrollment ID: I20040511001526 |
| Provider Name | Shari A Blackmon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1134280662 PECOS PAC ID: 0749264992 Enrollment ID: I20040615001279 |
| Provider Name | Musharraf A Nizami |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144317785 PECOS PAC ID: 5799683009 Enrollment ID: I20040727001572 |
| Provider Name | Bryan Michael Mahan |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1134159023 PECOS PAC ID: 3678522737 Enrollment ID: I20050114000647 |
| Provider Name | John Stephan Nichols |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1306856752 PECOS PAC ID: 6901851567 Enrollment ID: I20050316000456 |
| Provider Name | Lee M Fonseca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831258367 PECOS PAC ID: 8527015908 Enrollment ID: I20050407000520 |
| Provider Name | Roman Langston |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356316913 PECOS PAC ID: 0840261194 Enrollment ID: I20050805000101 |
| Provider Name | Dan Miller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104857580 PECOS PAC ID: 3870526536 Enrollment ID: I20050919000074 |
| Provider Name | Gregory Szych |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841268521 PECOS PAC ID: 4688655467 Enrollment ID: I20050922000436 |
| Provider Name | Jonathan L Hughes |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1528048865 PECOS PAC ID: 5395779870 Enrollment ID: I20050923000444 |
| Provider Name | Philip M Rickman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295730851 PECOS PAC ID: 1759280571 Enrollment ID: I20051011000995 |
| Provider Name | Douglas F Duffee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851372320 PECOS PAC ID: 9335164391 Enrollment ID: I20051027000789 |
| Provider Name | Cheryl L Wegelin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124150883 PECOS PAC ID: 2163431909 Enrollment ID: I20060406000292 |
| Provider Name | Charlene J Hickson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1417909938 PECOS PAC ID: 8123095544 Enrollment ID: I20060612000083 |
| Provider Name | Peter Lochow |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1033163258 PECOS PAC ID: 6800809997 Enrollment ID: I20060712000179 |
| Provider Name | Andrea B Kaiser |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447296710 PECOS PAC ID: 4981517364 Enrollment ID: I20060815000315 |
| Provider Name | Lee T Wolfe |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1003868449 PECOS PAC ID: 2163480492 Enrollment ID: I20070206000663 |
| Provider Name | Carl E Bartecchi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1457335705 PECOS PAC ID: 4082619713 Enrollment ID: I20070917000528 |
| Provider Name | Chike Onyejekwe |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1891775565 PECOS PAC ID: 6103914429 Enrollment ID: I20071120000040 |
| Provider Name | Kelly J Colbert |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487838207 PECOS PAC ID: 8022191105 Enrollment ID: I20080213000024 |
| Provider Name | Brent A Brumfield |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801891502 PECOS PAC ID: 9931008760 Enrollment ID: I20080423000185 |
| Provider Name | Candace S Glazier |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902825227 PECOS PAC ID: 3870495922 Enrollment ID: I20080612000203 |
| Provider Name | Amy L Tomlinson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1194819565 PECOS PAC ID: 6800835117 Enrollment ID: I20080715000898 |
| Provider Name | Rickland L Likes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346420189 PECOS PAC ID: 9739257270 Enrollment ID: I20081009000830 |
| Provider Name | Andrae Lucas |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1760559561 PECOS PAC ID: 9133289978 Enrollment ID: I20081124000297 |
| Provider Name | Michael O Growney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851437636 PECOS PAC ID: 2860453321 Enrollment ID: I20090127000452 |
| Provider Name | Grazyna Tycner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710181300 PECOS PAC ID: 9739245770 Enrollment ID: I20090227000134 |
| Provider Name | Neil A Banga |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306081237 PECOS PAC ID: 3779649496 Enrollment ID: I20090304000793 |
| Provider Name | Charles R Dygert |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1245391648 PECOS PAC ID: 0446316954 Enrollment ID: I20090309000471 |
| Provider Name | Eric R Richter |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1013117092 PECOS PAC ID: 9830248913 Enrollment ID: I20090520000113 |
| Provider Name | Lev Asherov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164685228 PECOS PAC ID: 9335292648 Enrollment ID: I20090804000731 |
| Provider Name | Teresa K Braden |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073522595 PECOS PAC ID: 1658350293 Enrollment ID: I20090804000734 |
| Provider Name | Paula M Dionisio |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669457263 PECOS PAC ID: 6305990615 Enrollment ID: I20090821000081 |
| Provider Name | Michael A Glass |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1164425047 PECOS PAC ID: 9234296989 Enrollment ID: I20090908000137 |
| Provider Name | Joseph W Castelli |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1689646812 PECOS PAC ID: 1355422916 Enrollment ID: I20090915000514 |
| Provider Name | Hisman H Percival |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457354763 PECOS PAC ID: 4688617947 Enrollment ID: I20091216000234 |
| Provider Name | Lynn M Shields |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023240645 PECOS PAC ID: 6305986423 Enrollment ID: I20091222000406 |
| Provider Name | Erin P Beatty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891918371 PECOS PAC ID: 7315088747 Enrollment ID: I20100107000644 |
| Provider Name | Sonja Sutton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740326974 PECOS PAC ID: 9234120296 Enrollment ID: I20100112000448 |
| Provider Name | Kairi A Vaher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790010395 PECOS PAC ID: 7315073970 Enrollment ID: I20100407000597 |
| Provider Name | Kristin L Kruse |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861487563 PECOS PAC ID: 5698862316 Enrollment ID: I20100526000531 |
| Provider Name | Dennard W Ellison |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1285728659 PECOS PAC ID: 0244371128 Enrollment ID: I20100614000085 |
| Provider Name | Brian P Sandoval |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467457028 PECOS PAC ID: 7012816846 Enrollment ID: I20100810001118 |
| Provider Name | Martin L Beggs |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1629072228 PECOS PAC ID: 0345136271 Enrollment ID: I20100817000245 |
| Provider Name | Christopher W Harper |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023221041 PECOS PAC ID: 0446374755 Enrollment ID: I20100824000081 |
| Provider Name | Kevin M Bolton |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1558522276 PECOS PAC ID: 5496879728 Enrollment ID: I20100824000431 |
| Provider Name | James E Caldwell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992700694 PECOS PAC ID: 2668371493 Enrollment ID: I20100824000628 |
| Provider Name | Charles W Stout |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1497756597 PECOS PAC ID: 4284696303 Enrollment ID: I20100914000218 |
| Provider Name | George D Gibson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1205880960 PECOS PAC ID: 9830382274 Enrollment ID: I20101019000247 |
| Provider Name | Jennifer L Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1154460186 PECOS PAC ID: 2365635653 Enrollment ID: I20101019000951 |
| Provider Name | Fernando Ariel Mahmoud |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245542471 PECOS PAC ID: 7719176841 Enrollment ID: I20110105000736 |
| Provider Name | Michelle A Ridnour |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043217607 PECOS PAC ID: 0749264562 Enrollment ID: I20110114000533 |
| Provider Name | Jenny K Lee |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225184906 PECOS PAC ID: 1557542099 Enrollment ID: I20110216001049 |
| Provider Name | Lirio S Polintan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437115409 PECOS PAC ID: 3870773542 Enrollment ID: I20110217000628 |
| Provider Name | Ann C Vanvalkenburg |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1164420543 PECOS PAC ID: 4284816380 Enrollment ID: I20110310000729 |
| Provider Name | Jessica L Cummings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366672719 PECOS PAC ID: 5890978068 Enrollment ID: I20110324000992 |
| Provider Name | David M Goodrich |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902989544 PECOS PAC ID: 5395848071 Enrollment ID: I20110421000879 |
| Provider Name | Robert N Alsever |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1780667972 PECOS PAC ID: 0143408245 Enrollment ID: I20110620000357 |
| Provider Name | Tisha K Fujii |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720092596 PECOS PAC ID: 4880675339 Enrollment ID: I20110725000663 |
| Provider Name | Michael W Hanson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437166923 PECOS PAC ID: 8426228453 Enrollment ID: I20110831000381 |
| Provider Name | Eric A Bernauer |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053370429 PECOS PAC ID: 8729258652 Enrollment ID: I20110831000577 |
| Provider Name | Thomas L Harris |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699961029 PECOS PAC ID: 2860662525 Enrollment ID: I20110907001239 |
| Provider Name | Gregory A Hosler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679714745 PECOS PAC ID: 2365634391 Enrollment ID: I20110908002074 |
| Provider Name | Brian W Bell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467543207 PECOS PAC ID: 5496926024 Enrollment ID: I20110912000552 |
| Provider Name | Ali K Murad |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1811103831 PECOS PAC ID: 5092987024 Enrollment ID: I20111017000198 |
| Provider Name | Rajeev C Kandukuri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1770704025 PECOS PAC ID: 0345413530 Enrollment ID: I20111103000616 |
| Provider Name | Jeffrey P Johnson |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1316978976 PECOS PAC ID: 4385818020 Enrollment ID: I20111115000799 |
| Provider Name | Joshiah Gordon |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1952454290 PECOS PAC ID: 0941308555 Enrollment ID: I20111209000133 |
| Provider Name | Sandra K Nebl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144342106 PECOS PAC ID: 8820259542 Enrollment ID: I20120405000283 |
| Provider Name | Michael A Ramos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699743724 PECOS PAC ID: 2062673197 Enrollment ID: I20120416000814 |
| Provider Name | Brittany L Hucko |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225301047 PECOS PAC ID: 5092977272 Enrollment ID: I20120504000209 |
| Provider Name | Kimberly Kristine James |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467723791 PECOS PAC ID: 8022271923 Enrollment ID: I20120511000249 |
| Provider Name | Adam O Strunk |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1487791745 PECOS PAC ID: 3274703780 Enrollment ID: I20120525000452 |
| Provider Name | Mark E Maurer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1891923033 PECOS PAC ID: 3274796248 Enrollment ID: I20120601000019 |
| Provider Name | Marcel J Junqueira |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1831353705 PECOS PAC ID: 1850557372 Enrollment ID: I20120726000612 |
| Provider Name | Laurence A Berarducci |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669478541 PECOS PAC ID: 6507768017 Enrollment ID: I20120821000120 |
| Provider Name | Michael Patrick Borbely |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1770718512 PECOS PAC ID: 7113175605 Enrollment ID: I20120906000658 |
| Provider Name | Emma I Stout |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1639308828 PECOS PAC ID: 3375794050 Enrollment ID: I20121105000618 |
| Provider Name | Kathryn R Mccaffrey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538484696 PECOS PAC ID: 9638310782 Enrollment ID: I20130801000222 |
| Provider Name | Andrew A Loptien |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255670386 PECOS PAC ID: 2567603509 Enrollment ID: I20130802000257 |
| Provider Name | Dallen D Mill |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487817326 PECOS PAC ID: 5193969871 Enrollment ID: I20130919000129 |
| Provider Name | Richard John Russell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861471443 PECOS PAC ID: 1052352846 Enrollment ID: I20130920000706 |
| Provider Name | Jacqueline M Hooper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225323405 PECOS PAC ID: 9931343456 Enrollment ID: I20130923000476 |
| Provider Name | Theresa Elizabeth Kuhn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497178172 PECOS PAC ID: 1456581040 Enrollment ID: I20140227000075 |
| Provider Name | Stephen E Paquelet |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1669696167 PECOS PAC ID: 7517068836 Enrollment ID: I20140430000836 |
| Provider Name | David S Feuer |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1447251897 PECOS PAC ID: 4789586124 Enrollment ID: I20140514001883 |
| Provider Name | William C Wilbur |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154626703 PECOS PAC ID: 2567645732 Enrollment ID: I20140605000470 |
| Provider Name | Bernard-dean Marucci |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1255453924 PECOS PAC ID: 1456313725 Enrollment ID: I20140724001923 |
| Provider Name | Virginia C Gillispie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730216771 PECOS PAC ID: 3971720392 Enrollment ID: I20140808000721 |
| Provider Name | Jatinbhai J Patel |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1649504085 PECOS PAC ID: 5496973380 Enrollment ID: I20140908000867 |
| Provider Name | Rachel C Niemet |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1326366105 PECOS PAC ID: 4587803325 Enrollment ID: I20140912001102 |
| Provider Name | Esperanza F Salazar |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1205167871 PECOS PAC ID: 6002035615 Enrollment ID: I20140915000081 |
| Provider Name | Steven Steinberg |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1225037062 PECOS PAC ID: 0345231023 Enrollment ID: I20141112000464 |
| Provider Name | Kenneth Madsen |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1164412862 PECOS PAC ID: 2769402403 Enrollment ID: I20141222000409 |
| Provider Name | Kati J Foechterle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124423116 PECOS PAC ID: 1052639705 Enrollment ID: I20150409001783 |
| Provider Name | Emily Jarmon Hodges |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295171460 PECOS PAC ID: 6406084631 Enrollment ID: I20150615002017 |
| Provider Name | Eric A Elliott |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750642914 PECOS PAC ID: 1355580168 Enrollment ID: I20150617001586 |
| Provider Name | Pantelis Hadjizacharia |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1043472400 PECOS PAC ID: 5890008973 Enrollment ID: I20150717002306 |
| Provider Name | Meghan M Timmerman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1326309576 PECOS PAC ID: 1951540749 Enrollment ID: I20150722006118 |
| Provider Name | Michelle R Kowalis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932460185 PECOS PAC ID: 4880834423 Enrollment ID: I20150812007414 |
| Provider Name | Natalie Marie Mosley |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1639496987 PECOS PAC ID: 3072760958 Enrollment ID: I20150821014587 |
| Provider Name | Mandy Glasmeyer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245612571 PECOS PAC ID: 8729396262 Enrollment ID: I20151001002387 |
| Provider Name | Artin Terhakopian |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1962466110 PECOS PAC ID: 7315247509 Enrollment ID: I20151119000875 |
| Provider Name | George R Reiss |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1164510871 PECOS PAC ID: 0547384679 Enrollment ID: I20151130000738 |
| Provider Name | Patricia Gorman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1093805962 PECOS PAC ID: 2668666157 Enrollment ID: I20160203002251 |
| Provider Name | Thomas Herbert Wagner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1740251230 PECOS PAC ID: 3971688672 Enrollment ID: I20160309002723 |
| Provider Name | Jennifer R Roberts |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1710282561 PECOS PAC ID: 1456642701 Enrollment ID: I20160617000128 |
| Provider Name | Benjamin C Kam |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1598755209 PECOS PAC ID: 4486733482 Enrollment ID: I20160706000961 |
| Provider Name | Kayleigh A Zerr |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932547130 PECOS PAC ID: 9335381110 Enrollment ID: I20160803000198 |
| Provider Name | Aparna Seetharama |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1134484660 PECOS PAC ID: 6800036740 Enrollment ID: I20160810000377 |
| Provider Name | Elizabeth May Wasson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063775617 PECOS PAC ID: 0941596738 Enrollment ID: I20160902000863 |
| Provider Name | Wallacy S Garcia |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982982864 PECOS PAC ID: 0749422210 Enrollment ID: I20160922002826 |
| Provider Name | Rupal N Chavda |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1760799894 PECOS PAC ID: 3971803768 Enrollment ID: I20160923001321 |
| Provider Name | Kyle Tipton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336507847 PECOS PAC ID: 6406143049 Enrollment ID: I20160924000122 |
| Provider Name | Raj Vashistha |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1033436977 PECOS PAC ID: 5890977888 Enrollment ID: I20161004002887 |
| Provider Name | Kathleen M H Brown |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1881821312 PECOS PAC ID: 9931340288 Enrollment ID: I20161012002262 |
| Provider Name | Michael F Fechko |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1952853749 PECOS PAC ID: 6002196953 Enrollment ID: I20161209001825 |
| Provider Name | Mikayla R Jarratt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962944298 PECOS PAC ID: 7517243983 Enrollment ID: I20170419002117 |
| Provider Name | Jeffrey L Burks |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710422530 PECOS PAC ID: 6901183524 Enrollment ID: I20170509002768 |
| Provider Name | Erin L Ashby |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1295021525 PECOS PAC ID: 9638492580 Enrollment ID: I20170613000678 |
| Provider Name | Tana L Trujillo |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1811300072 PECOS PAC ID: 7214205004 Enrollment ID: I20170620001897 |
| Provider Name | Kerry M Zeigler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316369499 PECOS PAC ID: 6305077371 Enrollment ID: I20170623002100 |
| Provider Name | Christopher J Stark |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013936764 PECOS PAC ID: 5991703381 Enrollment ID: I20170706002288 |
| Provider Name | Kiely M Schultz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346654761 PECOS PAC ID: 7618196445 Enrollment ID: I20170717003301 |
| Provider Name | Kari A Coffey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1871907089 PECOS PAC ID: 4082833892 Enrollment ID: I20170719000714 |
| Provider Name | Stephanie R Murphy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558775049 PECOS PAC ID: 6002035805 Enrollment ID: I20170719003110 |
| Provider Name | Vickie L Stuart |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548374341 PECOS PAC ID: 5698856912 Enrollment ID: I20170810001538 |
| Provider Name | Jameson D Way |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245248293 PECOS PAC ID: 4082756317 Enrollment ID: I20170922000288 |
| Provider Name | Soyeun Chu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144453473 PECOS PAC ID: 0941575831 Enrollment ID: I20171003004944 |
| Provider Name | Kaitlin E Booth |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1225553563 PECOS PAC ID: 2668748872 Enrollment ID: I20171016001926 |
| Provider Name | Elizabeth G Wentling |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790979219 PECOS PAC ID: 2961480512 Enrollment ID: I20171031003223 |
| Provider Name | Anthony Harper |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992214233 PECOS PAC ID: 9931465192 Enrollment ID: I20171106000201 |
| Provider Name | Peter Sykora |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1366795080 PECOS PAC ID: 8527290881 Enrollment ID: I20171107002336 |
| Provider Name | Bobbi M Hall |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740790708 PECOS PAC ID: 2163789579 Enrollment ID: I20171120001347 |
| Provider Name | Timothy Raymond Farris |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508157157 PECOS PAC ID: 3072827641 Enrollment ID: I20171229002235 |
| Provider Name | Nathaniel P Hasbrouck |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407354038 PECOS PAC ID: 8921368820 Enrollment ID: I20180215000377 |
| Provider Name | Alexandra A Watson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528568946 PECOS PAC ID: 1456613140 Enrollment ID: I20180316000160 |
| Provider Name | Jordan Alexandra Dyer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578062444 PECOS PAC ID: 7810259561 Enrollment ID: I20180319000377 |
| Provider Name | Erin Connor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1710919204 PECOS PAC ID: 9335124205 Enrollment ID: I20180601000497 |
| Provider Name | Shreya J Shetty |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1215168190 PECOS PAC ID: 7719264274 Enrollment ID: I20180618002285 |
| Provider Name | Sarah Starr Covell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1861641235 PECOS PAC ID: 7416938881 Enrollment ID: I20180626000164 |
| Provider Name | William Brian Harrison |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558854422 PECOS PAC ID: 0042566911 Enrollment ID: I20180706001637 |
| Provider Name | Daniel Lee |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639550189 PECOS PAC ID: 7810204229 Enrollment ID: I20180718000305 |
| Provider Name | Lindsey R Longfellow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1336521780 PECOS PAC ID: 4789991373 Enrollment ID: I20180719001183 |
| Provider Name | Fadi T Alattar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1255585329 PECOS PAC ID: 9638483746 Enrollment ID: I20180723000153 |
| Provider Name | Babafemi Pratt |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1174773873 PECOS PAC ID: 2365695509 Enrollment ID: I20180723001787 |
| Provider Name | Derar Albashaireh |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1083902431 PECOS PAC ID: 2264665413 Enrollment ID: I20180726001360 |
| Provider Name | Bhavith Aruni Babu |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1841587938 PECOS PAC ID: 6002113529 Enrollment ID: I20180730000083 |
| Provider Name | Jamie Jinyoung Yi |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043745318 PECOS PAC ID: 9638427313 Enrollment ID: I20180813002721 |
| Provider Name | Susan M Czelusta |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1831646678 PECOS PAC ID: 5395094452 Enrollment ID: I20180822002597 |
| Provider Name | Stephanie Katherine Lucas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548647795 PECOS PAC ID: 4385935949 Enrollment ID: I20180904002225 |
| Provider Name | Steven D Pettypool |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962735308 PECOS PAC ID: 3870639644 Enrollment ID: I20180927002426 |
| Provider Name | Parul Maheshwari |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1093062234 PECOS PAC ID: 9032339916 Enrollment ID: I20181019000615 |
| Provider Name | Praveen Maheshwari |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1053549352 PECOS PAC ID: 5496980336 Enrollment ID: I20181211000970 |
| Provider Name | Lindsey R Bollinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447727367 PECOS PAC ID: 9032453402 Enrollment ID: I20181212001079 |
| Provider Name | Amber R Doss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790253128 PECOS PAC ID: 9234474529 Enrollment ID: I20181213003011 |
| Provider Name | Jamison R Lester |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346718855 PECOS PAC ID: 6204171564 Enrollment ID: I20181214002453 |
| Provider Name | Coral B Martinez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013486299 PECOS PAC ID: 3870838444 Enrollment ID: I20181231001464 |
| Provider Name | Lisa L Laginess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245704667 PECOS PAC ID: 9830437896 Enrollment ID: I20190218000245 |
| Provider Name | Barbara Lynn Pearse |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1851533814 PECOS PAC ID: 2466503248 Enrollment ID: I20190404002376 |
| Provider Name | Sung K Yang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1275631285 PECOS PAC ID: 6204889827 Enrollment ID: I20190408002199 |
| Provider Name | Srikant Sivaraman |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1881959005 PECOS PAC ID: 6103125273 Enrollment ID: I20190618002219 |
| Provider Name | Christopher J Calcagno |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1013178508 PECOS PAC ID: 2264696350 Enrollment ID: I20190710000258 |
| Provider Name | Megan C Reichmuth |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1932544855 PECOS PAC ID: 1850694696 Enrollment ID: I20190724001575 |
| Provider Name | Abner Fernandez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063868578 PECOS PAC ID: 1355688342 Enrollment ID: I20190816000677 |
| Provider Name | Mohammed M Nayeem |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649625229 PECOS PAC ID: 0345578837 Enrollment ID: I20190821003863 |
| Provider Name | Patrick Curtis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801308671 PECOS PAC ID: 9638430218 Enrollment ID: I20190913000173 |
| Provider Name | Briana Curtis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487166252 PECOS PAC ID: 1557622339 Enrollment ID: I20190927001169 |
| Provider Name | Rene Powell |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578903563 PECOS PAC ID: 5092032409 Enrollment ID: I20191004002387 |
| Provider Name | Jayme L Schaaf |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124504634 PECOS PAC ID: 5092147967 Enrollment ID: I20191114000738 |
| Provider Name | Carl Lagrimas |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447797899 PECOS PAC ID: 5698059301 Enrollment ID: I20191214000038 |
| Provider Name | Katelyn P Jones |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154794576 PECOS PAC ID: 7012211477 Enrollment ID: I20191218002232 |
| Provider Name | Caitlin E O Connor |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295374379 PECOS PAC ID: 8224465158 Enrollment ID: I20200305000755 |
| Provider Name | Erik Matthews Wickstrum |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467083881 PECOS PAC ID: 6002244555 Enrollment ID: I20200316000866 |
| Provider Name | Mitzi Willhoite |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205202637 PECOS PAC ID: 8325355704 Enrollment ID: I20200327000885 |
| Provider Name | Jessica L Parr |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1962856781 PECOS PAC ID: 4183916802 Enrollment ID: I20200420001191 |
| Provider Name | Paul Andrew Valentine |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184262123 PECOS PAC ID: 3274963426 Enrollment ID: I20200430002390 |
| Provider Name | Tran My Dao |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1487292520 PECOS PAC ID: 1557790813 Enrollment ID: I20200507001674 |
| Provider Name | Nathan S Shapiro-shellaby |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376998823 PECOS PAC ID: 9931495488 Enrollment ID: I20200511002862 |
| Provider Name | Kourtney K Aylor-lee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396286159 PECOS PAC ID: 0042557993 Enrollment ID: I20200513000942 |
| Provider Name | Dustin P Fulton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700283736 PECOS PAC ID: 8325363229 Enrollment ID: I20200522000719 |
| Provider Name | Shannon J Woznick |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912187568 PECOS PAC ID: 6305927104 Enrollment ID: I20200610002628 |
| Provider Name | Daniel Menendez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548435084 PECOS PAC ID: 4880753490 Enrollment ID: I20200610002965 |
| Provider Name | Priscilla F Nobecourt |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1205220530 PECOS PAC ID: 7911286117 Enrollment ID: I20200706002066 |
| Provider Name | Gina Springer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619203528 PECOS PAC ID: 1355482050 Enrollment ID: I20200708002024 |
| Provider Name | Dianna Graber |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447341458 PECOS PAC ID: 0244264562 Enrollment ID: I20200715000131 |
| Provider Name | Lena Pasternak |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811438393 PECOS PAC ID: 9537406566 Enrollment ID: I20200716001821 |
| Provider Name | Matthew E Grayson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700214954 PECOS PAC ID: 0143449298 Enrollment ID: I20200722003842 |
| Provider Name | Suraj Singh |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1962504704 PECOS PAC ID: 9931108586 Enrollment ID: I20200723000176 |
| Provider Name | Vincent J Vaughn |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134660400 PECOS PAC ID: 5092052159 Enrollment ID: I20200723003705 |
| Provider Name | Andrew C Boulos |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1689010100 PECOS PAC ID: 0446548275 Enrollment ID: I20200724000701 |
| Provider Name | Joelynn Marie Cartmell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649757485 PECOS PAC ID: 6709200546 Enrollment ID: I20200727000826 |
| Provider Name | Symran Gill |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235669342 PECOS PAC ID: 6002231594 Enrollment ID: I20200730002679 |
| Provider Name | Joshua J Ruiz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1124412440 PECOS PAC ID: 4183916380 Enrollment ID: I20200806001950 |
| Provider Name | Bilal A Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821525106 PECOS PAC ID: 4880966043 Enrollment ID: I20200814000420 |
| Provider Name | Nida Firdous |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699200535 PECOS PAC ID: 0244656213 Enrollment ID: I20200820003201 |
| Provider Name | Nabila Naser |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275068280 PECOS PAC ID: 3779853171 Enrollment ID: I20200821001393 |
| Provider Name | Brandon G Dmytruk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235651514 PECOS PAC ID: 2860766037 Enrollment ID: I20200903002061 |
| Provider Name | Dongkwan Jin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1508310111 PECOS PAC ID: 5698061315 Enrollment ID: I20200904000400 |
| Provider Name | Melissa M Lesavoy |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750775102 PECOS PAC ID: 8123446432 Enrollment ID: I20200918001425 |
| Provider Name | Jamie L Engel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669714671 PECOS PAC ID: 8022246479 Enrollment ID: I20200918002406 |
| Provider Name | Diana P Levy |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083248991 PECOS PAC ID: 4284059650 Enrollment ID: I20201014000053 |
| Provider Name | Rochelle Nieblas Davis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1184182693 PECOS PAC ID: 7911327978 Enrollment ID: I20201014000688 |
| Provider Name | Piotr H Tabaczewski |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568657450 PECOS PAC ID: 3375699358 Enrollment ID: I20201116002195 |
| Provider Name | Lisa Carter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821607938 PECOS PAC ID: 1153733746 Enrollment ID: I20201228000248 |
| Provider Name | Nathan R Klein |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831785831 PECOS PAC ID: 1658786793 Enrollment ID: I20210223001002 |
| Provider Name | Wendy V Gerhardt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1700269420 PECOS PAC ID: 9436465812 Enrollment ID: I20210303001521 |
| Provider Name | James Edward Miller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336177716 PECOS PAC ID: 8729185269 Enrollment ID: I20210304001674 |
| Provider Name | Phebe M Golden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023605706 PECOS PAC ID: 1951717925 Enrollment ID: I20210317001513 |
| Provider Name | Shaileen A Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689265571 PECOS PAC ID: 3274942305 Enrollment ID: I20210503000124 |
| Provider Name | Jarrod Cifra |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669989877 PECOS PAC ID: 7012278914 Enrollment ID: I20210603002116 |
| Provider Name | Madeline M Syzek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710515523 PECOS PAC ID: 9830590629 Enrollment ID: I20210630003290 |
| Provider Name | Elizabeth D Morphis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083280333 PECOS PAC ID: 9638572910 Enrollment ID: I20210723001818 |
| Provider Name | Michael Ramos |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508355421 PECOS PAC ID: 5890199947 Enrollment ID: I20210811001909 |
| Provider Name | Madeera Kathpal |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1114150612 PECOS PAC ID: 7719274240 Enrollment ID: I20210811001951 |
| Provider Name | Bethwel Raore |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1215114475 PECOS PAC ID: 8921263872 Enrollment ID: I20210811002810 |
| Provider Name | Patrick T Pamintuan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801384656 PECOS PAC ID: 1052658481 Enrollment ID: I20210812000903 |
| Provider Name | Dave Seecharan |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1174789416 PECOS PAC ID: 0042435406 Enrollment ID: I20210818000547 |
| Provider Name | Ashley M Allemon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265969026 PECOS PAC ID: 4789921453 Enrollment ID: I20210824002432 |
| Provider Name | Shane D Rothermel |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083000541 PECOS PAC ID: 0648550285 Enrollment ID: I20210824002774 |
| Provider Name | Sarah L Bowers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497340855 PECOS PAC ID: 4789080755 Enrollment ID: I20210831002314 |
| Provider Name | Janice C Rodgers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760969802 PECOS PAC ID: 5991047839 Enrollment ID: I20210903000687 |
| Provider Name | Juliana Bertha D Gomez Abanto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770036881 PECOS PAC ID: 6800180373 Enrollment ID: I20210909000954 |
| Provider Name | Robert E Ayer |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1891902714 PECOS PAC ID: 5193965036 Enrollment ID: I20210917001417 |
| Provider Name | Mairaj T Sami |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1396181434 PECOS PAC ID: 1951629401 Enrollment ID: I20210922001860 |
| Provider Name | Chad B. Moore |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790089951 PECOS PAC ID: 8820495039 Enrollment ID: I20210930000158 |
| Provider Name | Rosalyn M Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366112880 PECOS PAC ID: 2264830215 Enrollment ID: I20211006001571 |
| Provider Name | Abigail L Meyer |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1619646080 PECOS PAC ID: 2163820689 Enrollment ID: I20211013000997 |
| Provider Name | Andrea Frances Ball |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528339991 PECOS PAC ID: 2264697408 Enrollment ID: I20211112000569 |
| Provider Name | Meghan R Cole |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477184885 PECOS PAC ID: 0042649287 Enrollment ID: I20211122001226 |
| Provider Name | Jenifer L Haynes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518256205 PECOS PAC ID: 2062682321 Enrollment ID: I20220104002784 |
| Provider Name | Matthew J Deluca |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689339376 PECOS PAC ID: 9335531094 Enrollment ID: I20220110002107 |
| Provider Name | Cynthia A Moses |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1396405734 PECOS PAC ID: 5395137160 Enrollment ID: I20220128000788 |
| Provider Name | Lindsey A Tallakson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1467023903 PECOS PAC ID: 7214320050 Enrollment ID: I20220131001473 |
| Provider Name | Kristina J Reavis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992327217 PECOS PAC ID: 0547654261 Enrollment ID: I20220223001124 |
| Provider Name | David A Cooley |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1528134582 PECOS PAC ID: 8921266495 Enrollment ID: I20220309001511 |
| Provider Name | Logan D Hirsch |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346897303 PECOS PAC ID: 8628463411 Enrollment ID: I20220314001007 |
| Provider Name | Diana S Pacheco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316695059 PECOS PAC ID: 7618362849 Enrollment ID: I20220324001583 |
| Provider Name | Carl John Boyd |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487642971 PECOS PAC ID: 8325035561 Enrollment ID: I20220404002069 |
| Provider Name | Heather H Palm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376292961 PECOS PAC ID: 5395131627 Enrollment ID: I20220413002116 |
| Provider Name | Timothy Jardeleza |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1871619361 PECOS PAC ID: 9830322395 Enrollment ID: I20220426001872 |
| Provider Name | Cody Wallace Aucoin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1245727080 PECOS PAC ID: 5698026342 Enrollment ID: I20220505000481 |
| Provider Name | Manuel J Lozada |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306283205 PECOS PAC ID: 4981953957 Enrollment ID: I20220511001170 |
| Provider Name | Michael Ray Falk |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1447367438 PECOS PAC ID: 6204908445 Enrollment ID: I20220520000308 |
| Provider Name | Tiffany D Bartoles |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326683533 PECOS PAC ID: 2567898810 Enrollment ID: I20220617001305 |
| Provider Name | Alizeh Rizvi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740846047 PECOS PAC ID: 8022345677 Enrollment ID: I20220705000260 |
| Provider Name | Suhitha Madhavaram |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1609230705 PECOS PAC ID: 4486072923 Enrollment ID: I20220706000348 |
| Provider Name | Nadia Orr |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346703733 PECOS PAC ID: 7517347727 Enrollment ID: I20220706002058 |
| Provider Name | Nishedh Gyawali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366096737 PECOS PAC ID: 9638559560 Enrollment ID: I20220708001827 |
| Provider Name | Avinash R Sagi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932552130 PECOS PAC ID: 8022374099 Enrollment ID: I20220713000647 |
| Provider Name | Kristin L Hull |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962938779 PECOS PAC ID: 5991074585 Enrollment ID: I20220725000331 |
| Provider Name | Sara L Timko |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508500158 PECOS PAC ID: 1254712144 Enrollment ID: I20220725000955 |
| Provider Name | Andrew C Dimmen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467196469 PECOS PAC ID: 2264814094 Enrollment ID: I20220726003646 |
| Provider Name | Dharmista R Chaudhary |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437612637 PECOS PAC ID: 2769719319 Enrollment ID: I20220819000437 |
| Provider Name | Emily L Price |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902536014 PECOS PAC ID: 8224412499 Enrollment ID: I20220907002585 |
| Provider Name | Gregory J Barton |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1992168546 PECOS PAC ID: 4486946316 Enrollment ID: I20220915003546 |
| Provider Name | Nayeli Zarate |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346700523 PECOS PAC ID: 6406231190 Enrollment ID: I20220915004005 |
| Provider Name | Emem L Umoh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962875039 PECOS PAC ID: 9537441803 Enrollment ID: I20220916002025 |
| Provider Name | Jeremy Jackson Renz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285121285 PECOS PAC ID: 0345597605 Enrollment ID: I20220920002050 |
| Provider Name | Tracy L Scott |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992297683 PECOS PAC ID: 8426434473 Enrollment ID: I20220929000243 |
| Provider Name | Christopher Charles Hollinger |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295855617 PECOS PAC ID: 1254477300 Enrollment ID: I20221013002521 |
| Provider Name | Mark Liu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1952539470 PECOS PAC ID: 0749613024 Enrollment ID: I20221021001751 |
| Provider Name | Jacquelyn L Eleson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174247258 PECOS PAC ID: 1456728393 Enrollment ID: I20221104001823 |
| Provider Name | Chalanne Lynn Stockman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871200451 PECOS PAC ID: 5092183152 Enrollment ID: I20221121001344 |
| Provider Name | Sefi C Khamo |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1306075585 PECOS PAC ID: 7618118712 Enrollment ID: I20221220000966 |
| Provider Name | Jenny L Rasmussen |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1366756397 PECOS PAC ID: 7315062965 Enrollment ID: I20230128000201 |
| Provider Name | Carlton S Pearse |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457358582 PECOS PAC ID: 3971508623 Enrollment ID: I20230213001243 |
| Provider Name | Barbara G Bielska |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1801864251 PECOS PAC ID: 0345383931 Enrollment ID: I20230228003303 |
| Provider Name | Oliver Dimitrijevic |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003055252 PECOS PAC ID: 0547418766 Enrollment ID: I20230301002608 |
| Provider Name | Antonio A Graham |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1619255148 PECOS PAC ID: 2769625334 Enrollment ID: I20230323000860 |
| Provider Name | Carolyn M Cordova |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1649450941 PECOS PAC ID: 2961876479 Enrollment ID: I20230324000583 |
| Provider Name | Josephine C Erickson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922708536 PECOS PAC ID: 2961876487 Enrollment ID: I20230324001070 |
| Provider Name | William W Nelson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851372536 PECOS PAC ID: 8628044195 Enrollment ID: I20230328000234 |
| Provider Name | Jacob M Arthur |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649711516 PECOS PAC ID: 9739554163 Enrollment ID: I20230417000983 |
| Provider Name | Laura L Rodriguez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821406067 PECOS PAC ID: 7517287386 Enrollment ID: I20230510000050 |
| Provider Name | Chelsey Rae Cortese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801584008 PECOS PAC ID: 9739545385 Enrollment ID: I20230524000406 |
| Provider Name | Ping Pan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508155540 PECOS PAC ID: 9133367238 Enrollment ID: I20230605002430 |
| Provider Name | Kathleen M Feeley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295735777 PECOS PAC ID: 2961445762 Enrollment ID: I20230606000562 |
| Provider Name | John A Schultz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1598276552 PECOS PAC ID: 3779840186 Enrollment ID: I20230626002341 |
| Provider Name | Noah Palmer Prebish |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558065540 PECOS PAC ID: 1254799059 Enrollment ID: I20230627001799 |
| Provider Name | Danyel R Baker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588222020 PECOS PAC ID: 4981930310 Enrollment ID: I20230705001462 |
| Provider Name | Nathan S Grigg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1881214567 PECOS PAC ID: 2365853454 Enrollment ID: I20230705003515 |
| Provider Name | Krishna C Mahat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548884414 PECOS PAC ID: 6608293832 Enrollment ID: I20230724000169 |
| Provider Name | Samantha J Tylka |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811663529 PECOS PAC ID: 9436519352 Enrollment ID: I20230724001644 |
| Provider Name | Gilbert Reynolds Schorlemmer |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1629060553 PECOS PAC ID: 6103814736 Enrollment ID: I20230808001134 |
| Provider Name | Marshall D Sklar |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1225042351 PECOS PAC ID: 1658264205 Enrollment ID: I20230809001315 |
| Provider Name | Robert Frederick Chamberlain |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467815878 PECOS PAC ID: 1759786205 Enrollment ID: I20230818000204 |
| Provider Name | Daniel K Oraham |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235753369 PECOS PAC ID: 3173947660 Enrollment ID: I20230818001553 |
| Provider Name | Jayda L Haley |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1912682956 PECOS PAC ID: 5597128694 Enrollment ID: I20230822003242 |
| Provider Name | Ali Raja |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1871150789 PECOS PAC ID: 1355705484 Enrollment ID: I20230907004259 |
| Provider Name | Zachary J Kufahl |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1912420654 PECOS PAC ID: 9133583115 Enrollment ID: I20230908002103 |
| Provider Name | Julieanne M Zenz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154434371 PECOS PAC ID: 2860487394 Enrollment ID: I20230908002678 |
| Provider Name | Ilan D Bornstein |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083647747 PECOS PAC ID: 6103849328 Enrollment ID: I20230908002975 |
| Provider Name | Jennifer C John |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942761978 PECOS PAC ID: 7214381482 Enrollment ID: I20230922000530 |
| Provider Name | Bryan S Ferrara |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1114303237 PECOS PAC ID: 7214212281 Enrollment ID: I20230926001987 |
| Provider Name | Amira Bakkar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811598907 PECOS PAC ID: 2062823883 Enrollment ID: I20231004000595 |
| Provider Name | Stephen N Deturk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639795875 PECOS PAC ID: 8022463215 Enrollment ID: I20231008000064 |
| Provider Name | Spencer Trooboff |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588041073 PECOS PAC ID: 3476851882 Enrollment ID: I20231012003179 |
| Provider Name | Elinor A Enderle |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1154109742 PECOS PAC ID: 8921453705 Enrollment ID: I20231013002457 |
| Provider Name | Lauren Barousse |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1841077617 PECOS PAC ID: 1153776935 Enrollment ID: I20231013002719 |
| Provider Name | Colton Mcnichols |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1396162624 PECOS PAC ID: 2769607696 Enrollment ID: I20231013002926 |
| Provider Name | Tessa E Newman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679992507 PECOS PAC ID: 3678797958 Enrollment ID: I20231101002888 |
| Provider Name | Randy Metcalf |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1073506648 PECOS PAC ID: 4486685765 Enrollment ID: I20231130001398 |
| Provider Name | Shane Hamacher |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1619460144 PECOS PAC ID: 0143578419 Enrollment ID: I20231130001734 |
| Provider Name | Kevin A Shapiro |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1861953556 PECOS PAC ID: 9931434776 Enrollment ID: I20231205001113 |
| Provider Name | Sohaib A Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1154949584 PECOS PAC ID: 4284050139 Enrollment ID: I20231213001501 |
| Provider Name | John Saur |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1013253665 PECOS PAC ID: 3577795392 Enrollment ID: I20240106000488 |
| Provider Name | Sai Prasad Gadapa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1801296397 PECOS PAC ID: 1658643408 Enrollment ID: I20240116001901 |
| Provider Name | Timothy S Lyda |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1952347106 PECOS PAC ID: 5092841437 Enrollment ID: I20240131001043 |
| Provider Name | Gina T Baaklini |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1912404567 PECOS PAC ID: 6406181049 Enrollment ID: I20240210000016 |
| Provider Name | Mena Tawfik |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1992325104 PECOS PAC ID: 1759707755 Enrollment ID: I20240213001462 |
| Provider Name | Subodh Adhikari |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457731861 PECOS PAC ID: 2961709241 Enrollment ID: I20240219002931 |
| Provider Name | Jennifer A Tennant |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1396179651 PECOS PAC ID: 4385878651 Enrollment ID: I20240221003206 |
| Provider Name | Howard Kotler |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1609805985 PECOS PAC ID: 9234298712 Enrollment ID: I20240319002767 |
| Provider Name | Olivia Cisneros |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386401800 PECOS PAC ID: 5799122818 Enrollment ID: I20240326000458 |
| Provider Name | Clay E Lyddane |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1760641476 PECOS PAC ID: 6901074459 Enrollment ID: I20240425000698 |
| Provider Name | Hasan Aoun |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740803154 PECOS PAC ID: 2668893389 Enrollment ID: I20240502003487 |
Lake Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2001 Lake Ave, Pueblo, CO 81004 Phone: 719-564-0300 Fax: 719-564-0303 | |
Risley School Based Wellness Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 625 N Monument Ave, Pueblo, CO 81001 Phone: 719-543-8711 Fax: 719-543-5340 | |
Digestive Diseases Specialists Of Colorado,llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1600 N Grand Ave, Suite 440, Pueblo, CO 81003 Phone: 719-543-3500 Fax: 719-543-3504 | |
Aleracare Of Colorado, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1303 Fortino Blvd, Pueblo, CO 81008 Phone: 888-209-8874 | |
Parkview Ancillary Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 525 West 15th Street, Ste. 300, Pueblo, CO 81003 Phone: 719-542-1696 Fax: 719-542-1698 | |
Concentra Urgent Care Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4117 N Elizabeth St, Pueblo, CO 81008 Phone: 719-545-0788 | |
Front Range Clinic Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1249 E Routt Ave, Pueblo, CO 81004 Phone: 720-808-0051 |