| Providence Health & Services Oregon | |
|
965 Ellendale Dr Medford OR 97504-8215 | |
| (541) 732-6000 | |
| (541) 732-6005 |
| Full Name | Providence Health & Services Oregon |
|---|---|
| Speciality | Clinic/Center |
| Location | 965 Ellendale Dr, Medford, Oregon |
| Authorized Official Name and Position | Donald Wayne 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 |
|---|---|
| Providence Health & Services Oregon Po Box 3158 Portland OR 97208-3158 Ph: (503) 215-6494 | Providence Health & Services Oregon 965 Ellendale Dr Medford OR 97504-8215 Ph: (541) 732-6000 |
| NPI Number | 1568547503 |
|---|---|
| Provider Enumeration Date | 10/26/2006 |
| Last Update Date | 02/14/2022 |
| Medicare PECOS PAC ID | 5294623245 |
|---|---|
| Medicare Enrollment ID | O20040310000315 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568547503 | NPI | - | NPPES |
| 288515 | Medicaid | OR | |
| CG6801 | Other | OR | RAILROAD MEDICARE |
| Provider Name | Kay E Case |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1952372831 PECOS PAC ID: 4486567773 Enrollment ID: I20040102000152 |
| Provider Name | Brian E Winkler |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265432256 PECOS PAC ID: 7315839628 Enrollment ID: I20040329001733 |
| Provider Name | Brandan A Hull |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184719882 PECOS PAC ID: 3274523352 Enrollment ID: I20040512001540 |
| Provider Name | Travis Alan Mcneal |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1356437230 PECOS PAC ID: 1052301033 Enrollment ID: I20040512001575 |
| Provider Name | Amy E Schmitt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942271986 PECOS PAC ID: 9133101512 Enrollment ID: I20040601001404 |
| Provider Name | Richard H Sohn |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1609818939 PECOS PAC ID: 0143202499 Enrollment ID: I20040602000390 |
| Provider Name | Michael A Davis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1629150420 PECOS PAC ID: 9931187960 Enrollment ID: I20040707001436 |
| Provider Name | Michael L Potter |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1457388191 PECOS PAC ID: 7618955642 Enrollment ID: I20040707001469 |
| Provider Name | Stephan W Coffman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649235300 PECOS PAC ID: 3870571656 Enrollment ID: I20040708001178 |
| Provider Name | Daniel R Brandenburg |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255427290 PECOS PAC ID: 4880674001 Enrollment ID: I20040720001106 |
| Provider Name | Nancy Hagloch |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184711749 PECOS PAC ID: 3870565476 Enrollment ID: I20040812000469 |
| Provider Name | Matthew J Gadbaw |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1558392969 PECOS PAC ID: 8224001599 Enrollment ID: I20040816000337 |
| Provider Name | Deborah R Wolfson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285666594 PECOS PAC ID: 9537137153 Enrollment ID: I20040922000132 |
| Provider Name | Kimya-anhcina Lan Nguyen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073596243 PECOS PAC ID: 0749265478 Enrollment ID: I20041215000633 |
| Provider Name | Tracy L Haley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1407943889 PECOS PAC ID: 1850349010 Enrollment ID: I20050105000318 |
| Provider Name | Carmen G Kendall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780639575 PECOS PAC ID: 3577515261 Enrollment ID: I20050210000379 |
| Provider Name | William B Craft |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1689760506 PECOS PAC ID: 1456392489 Enrollment ID: I20050519000394 |
| Provider Name | Jonathan Lindgren |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861615668 PECOS PAC ID: 6406880152 Enrollment ID: I20050921001091 |
| Provider Name | Carolyn A Sites |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790718310 PECOS PAC ID: 6103843297 Enrollment ID: I20051027001077 |
| Provider Name | Amy D Carolan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295762946 PECOS PAC ID: 0749208668 Enrollment ID: I20051109000086 |
| Provider Name | Stephen Christensen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1043271869 PECOS PAC ID: 9537187414 Enrollment ID: I20051109000563 |
| Provider Name | Michael A Wilson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1871539973 PECOS PAC ID: 8325948235 Enrollment ID: I20051116000893 |
| Provider Name | Todd A Caulfield |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1710921085 PECOS PAC ID: 4284661158 Enrollment ID: I20051205000112 |
| Provider Name | Geoffrey M Wilson |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1336185438 PECOS PAC ID: 3870493786 Enrollment ID: I20051219000124 |
| Provider Name | Jason R Wollmuth |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164498499 PECOS PAC ID: 1951312255 Enrollment ID: I20060530000217 |
| Provider Name | James G Beckerman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487697488 PECOS PAC ID: 4789630385 Enrollment ID: I20060807000363 |
| Provider Name | Shannon C Fife |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639282148 PECOS PAC ID: 3274539085 Enrollment ID: I20061018000100 |
| Provider Name | Laurie Leigh Callahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194821751 PECOS PAC ID: 0042210049 Enrollment ID: I20061221000335 |
| Provider Name | Nicole L Bishop-perdue |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1275641060 PECOS PAC ID: 5496857245 Enrollment ID: I20070225000002 |
| Provider Name | Shannon E Jackson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558301168 PECOS PAC ID: 0446352827 Enrollment ID: I20070305000236 |
| Provider Name | Lisa Kay Keller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497780795 PECOS PAC ID: 6709782592 Enrollment ID: I20070404000082 |
| Provider Name | Emilia Arden |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1114123684 PECOS PAC ID: 8123110285 Enrollment ID: I20070821000009 |
| Provider Name | Jason M Kuhl |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659449296 PECOS PAC ID: 3072605799 Enrollment ID: I20070824000595 |
| Provider Name | Karin E Kuhl |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689722795 PECOS PAC ID: 7911091558 Enrollment ID: I20070913000463 |
| Provider Name | Ee Lin Wan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558532317 PECOS PAC ID: 5395815641 Enrollment ID: I20080529000633 |
| Provider Name | Curtis Oddo |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356400618 PECOS PAC ID: 8224100425 Enrollment ID: I20080703000263 |
| Provider Name | Tanja B Pejovic |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1770598278 PECOS PAC ID: 7315010840 Enrollment ID: I20080716000835 |
| Provider Name | Jeffrey Martin Bluhm |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1730125022 PECOS PAC ID: 9133151525 Enrollment ID: I20080813000445 |
| Provider Name | Sheila S Zia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811151368 PECOS PAC ID: 1557436839 Enrollment ID: I20080821000065 |
| Provider Name | Julian W Bell |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1497840813 PECOS PAC ID: 3173557493 Enrollment ID: I20080827000167 |
| Provider Name | Richard L Julyan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518048438 PECOS PAC ID: 1850468745 Enrollment ID: I20080918000200 |
| Provider Name | Cynthia L Mosser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790940088 PECOS PAC ID: 4789751355 Enrollment ID: I20080923000742 |
| Provider Name | Gregory Robert Flick |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1417991969 PECOS PAC ID: 3870525264 Enrollment ID: I20081113000712 |
| Provider Name | Brett M Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053561241 PECOS PAC ID: 3375603061 Enrollment ID: I20090702000653 |
| Provider Name | Walter G Carlini |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770583338 PECOS PAC ID: 2860440617 Enrollment ID: I20090714000596 |
| Provider Name | Amit A Barve |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760667059 PECOS PAC ID: 2567510787 Enrollment ID: I20090729000503 |
| Provider Name | Ethan Korngold |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1568452738 PECOS PAC ID: 0345248464 Enrollment ID: I20090826000937 |
| Provider Name | Jay B Ham |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1760659627 PECOS PAC ID: 7113072943 Enrollment ID: I20090831000689 |
| Provider Name | Fareha A Nawaz |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1770702839 PECOS PAC ID: 8628114717 Enrollment ID: I20091002000313 |
| Provider Name | Sophana Karnchanasorn |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710165303 PECOS PAC ID: 6800933276 Enrollment ID: I20091019000102 |
| Provider Name | Andrew D Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376639245 PECOS PAC ID: 6709929540 Enrollment ID: I20100202000862 |
| Provider Name | Neil M Olsen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1942396676 PECOS PAC ID: 1557404662 Enrollment ID: I20100211000158 |
| Provider Name | Eric Webb |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306920087 PECOS PAC ID: 1850434937 Enrollment ID: I20100211000696 |
| Provider Name | Annemarie Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972639276 PECOS PAC ID: 2365578473 Enrollment ID: I20100329000295 |
| Provider Name | Shirley A Malcolm |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1316951510 PECOS PAC ID: 2062542665 Enrollment ID: I20100608000681 |
| Provider Name | Aaron W Partsafas |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1578772935 PECOS PAC ID: 1658496682 Enrollment ID: I20100915000181 |
| Provider Name | Lisa J Michelbrink |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912989799 PECOS PAC ID: 1759338270 Enrollment ID: I20101007000947 |
| Provider Name | Minette C Lukban |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518287739 PECOS PAC ID: 7315139029 Enrollment ID: I20101012001259 |
| Provider Name | Andrean Andreev Gurov |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972551703 PECOS PAC ID: 2961405337 Enrollment ID: I20101019000741 |
| Provider Name | Mohamed Siyad |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780862391 PECOS PAC ID: 1254525066 Enrollment ID: I20101104001356 |
| Provider Name | Paul Fritz Schleinitz |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437129087 PECOS PAC ID: 5092784090 Enrollment ID: I20101118000653 |
| Provider Name | Todd A Winter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1184621559 PECOS PAC ID: 7911193016 Enrollment ID: I20101201001011 |
| Provider Name | Garrett H Peard |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124025580 PECOS PAC ID: 2365638368 Enrollment ID: I20101201001144 |
| Provider Name | Jeremy R Krueger |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750543195 PECOS PAC ID: 3870761489 Enrollment ID: I20110727000049 |
| Provider Name | Jared A Shipley |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1194933770 PECOS PAC ID: 4284820275 Enrollment ID: I20110906000167 |
| Provider Name | Timothy Hutchings |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1144345455 PECOS PAC ID: 9931206208 Enrollment ID: I20110908001846 |
| Provider Name | Marjorie N Harvill-brooks |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1831148196 PECOS PAC ID: 8224040290 Enrollment ID: I20110913000278 |
| Provider Name | Lian R Shaw |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1154379576 PECOS PAC ID: 6002807724 Enrollment ID: I20110921000884 |
| Provider Name | Shaik I Basha |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578712378 PECOS PAC ID: 0244403723 Enrollment ID: I20111027000862 |
| Provider Name | Deborah J Kerneen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588931372 PECOS PAC ID: 0547429649 Enrollment ID: I20120308000841 |
| Provider Name | Puneet Bandi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801030382 PECOS PAC ID: 2466608062 Enrollment ID: I20120815000194 |
| Provider Name | Scott C Brancato |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1184849762 PECOS PAC ID: 9931358629 Enrollment ID: I20121015000084 |
| Provider Name | Karen Harris |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780778225 PECOS PAC ID: 3375697501 Enrollment ID: I20121025000482 |
| Provider Name | Kathrine L Lohrfink |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285996405 PECOS PAC ID: 1759534506 Enrollment ID: I20130104000106 |
| Provider Name | Mark C Mason |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1336124510 PECOS PAC ID: 1355363391 Enrollment ID: I20130104000266 |
| Provider Name | Deborah Ann Volk |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1174574081 PECOS PAC ID: 4880596311 Enrollment ID: I20130606000594 |
| Provider Name | Minal B Jaju |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1427491620 PECOS PAC ID: 1052551421 Enrollment ID: I20130708000402 |
| Provider Name | Piotr H Tabaczewski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568657450 PECOS PAC ID: 3375699358 Enrollment ID: I20130725000481 |
| Provider Name | Erika Maria Moseson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1790010387 PECOS PAC ID: 9133305337 Enrollment ID: I20130801000886 |
| Provider Name | Jennifer Veit Hall Jackson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174784367 PECOS PAC ID: 1052567674 Enrollment ID: I20130904000797 |
| Provider Name | Morris Maizels |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356499305 PECOS PAC ID: 9638218233 Enrollment ID: I20131004000132 |
| Provider Name | Jessica L Luckman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750703559 PECOS PAC ID: 1951533561 Enrollment ID: I20140414001962 |
| Provider Name | William L Boyan |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1124119144 PECOS PAC ID: 7012947377 Enrollment ID: I20140611000902 |
| Provider Name | Cihan Cevik |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1619169596 PECOS PAC ID: 4082839139 Enrollment ID: I20140702002120 |
| Provider Name | Jason Kephart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699033597 PECOS PAC ID: 4284853466 Enrollment ID: I20140922000153 |
| Provider Name | Joana Silva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538583471 PECOS PAC ID: 8527288109 Enrollment ID: I20141002000549 |
| Provider Name | Eric Lynn Wickard |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730432378 PECOS PAC ID: 7315198553 Enrollment ID: I20141021002065 |
| Provider Name | Wesley T Ramoso |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649591223 PECOS PAC ID: 4385873322 Enrollment ID: I20150209002206 |
| Provider Name | Stefanie T Ogawa |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1538435417 PECOS PAC ID: 7113244641 Enrollment ID: I20150323000685 |
| Provider Name | Christine Y Huang |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1457514903 PECOS PAC ID: 7416112420 Enrollment ID: I20150417001893 |
| Provider Name | Hannah I Rose |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174880470 PECOS PAC ID: 4789829631 Enrollment ID: I20150602001426 |
| Provider Name | Aaron D Williams |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1578541710 PECOS PAC ID: 0840518023 Enrollment ID: I20150720001831 |
| Provider Name | Jennifer L Deltour |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265813729 PECOS PAC ID: 8527372622 Enrollment ID: I20150803002542 |
| Provider Name | Subhechchha Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245595206 PECOS PAC ID: 4082848882 Enrollment ID: I20150805006708 |
| Provider Name | Alireza Shabani Ardali |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1083862403 PECOS PAC ID: 4789730508 Enrollment ID: I20150811006094 |
| Provider Name | Jayrus Francis S Soliman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245598416 PECOS PAC ID: 5496905713 Enrollment ID: I20150827001052 |
| Provider Name | Charisse N Siapno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720219520 PECOS PAC ID: 2668622846 Enrollment ID: I20150910001274 |
| Provider Name | Carla N Overstreet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154795508 PECOS PAC ID: 5496056798 Enrollment ID: I20151210000788 |
| Provider Name | Ramon Anel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1467547711 PECOS PAC ID: 2769377423 Enrollment ID: I20160315001951 |
| Provider Name | Nathaniel S Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740538156 PECOS PAC ID: 1557668936 Enrollment ID: I20160330000982 |
| Provider Name | Michelle D Pies |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1700224516 PECOS PAC ID: 2769772664 Enrollment ID: I20160606001427 |
| Provider Name | Sara E Walz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154687259 PECOS PAC ID: 9739311721 Enrollment ID: I20160615001455 |
| Provider Name | Vipul Mahajan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1467795864 PECOS PAC ID: 9436450210 Enrollment ID: I20160811000828 |
| Provider Name | Rebecca M Mueller |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1902048580 PECOS PAC ID: 9133398571 Enrollment ID: I20160822002101 |
| Provider Name | Sivajothi Kanagalingam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1952616369 PECOS PAC ID: 1254633019 Enrollment ID: I20160825000046 |
| Provider Name | Gabrielle M Fey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578918546 PECOS PAC ID: 5294021721 Enrollment ID: I20160909001851 |
| Provider Name | Angela H Marcucilli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942655931 PECOS PAC ID: 9830486851 Enrollment ID: I20160919002707 |
| Provider Name | Elisabeth Anacius |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003109828 PECOS PAC ID: 7810155090 Enrollment ID: I20161109001708 |
| Provider Name | Whitney A Serafini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770033474 PECOS PAC ID: 2567741754 Enrollment ID: I20161110001448 |
| Provider Name | Pawani Sachar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689955536 PECOS PAC ID: 9234421413 Enrollment ID: I20161121000373 |
| Provider Name | Lindsey R Mckinley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265845754 PECOS PAC ID: 8022233279 Enrollment ID: I20170502002710 |
| Provider Name | Mathias L Stoenescu |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1245232776 PECOS PAC ID: 0749214450 Enrollment ID: I20170503001914 |
| Provider Name | Siva Rama Krishna Marri |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1366755126 PECOS PAC ID: 5294030300 Enrollment ID: I20170517001848 |
| Provider Name | Jodi R Moon |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1679891501 PECOS PAC ID: 3971873589 Enrollment ID: I20170713003674 |
| Provider Name | Vadim Leyenson |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1427052851 PECOS PAC ID: 7214830298 Enrollment ID: I20170830003768 |
| Provider Name | Mohamed Refaat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1053607457 PECOS PAC ID: 1557591625 Enrollment ID: I20171129000688 |
| Provider Name | Jennifer M Foltz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578089108 PECOS PAC ID: 3173880085 Enrollment ID: I20171201000829 |
| Provider Name | Vashti A Ivey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497159933 PECOS PAC ID: 5890019004 Enrollment ID: I20171227001754 |
| Provider Name | Aravind Chandra |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1255742466 PECOS PAC ID: 3375809080 Enrollment ID: I20180118001601 |
| Provider Name | Donita J Jensen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740778679 PECOS PAC ID: 7214291830 Enrollment ID: I20180508001288 |
| Provider Name | Andrew S Tang |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1356769798 PECOS PAC ID: 7810292638 Enrollment ID: I20180615001716 |
| Provider Name | Travis Adam Day |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912333451 PECOS PAC ID: 5890924252 Enrollment ID: I20180626001391 |
| Provider Name | Daniel M Coontz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063901007 PECOS PAC ID: 1850647959 Enrollment ID: I20180703001197 |
| Provider Name | Timothy James Muhonen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780752469 PECOS PAC ID: 3971586512 Enrollment ID: I20180712002517 |
| Provider Name | Lindsey Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629588504 PECOS PAC ID: 0941567721 Enrollment ID: I20180802001724 |
| Provider Name | Tracie Lynn Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093292971 PECOS PAC ID: 2365795309 Enrollment ID: I20181022001962 |
| Provider Name | Rupinder K Sandhu |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962498741 PECOS PAC ID: 3173557881 Enrollment ID: I20181030001831 |
| Provider Name | Ted Hideki Yamamoto |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689012015 PECOS PAC ID: 2466737960 Enrollment ID: I20181130000136 |
| Provider Name | Fabian A Lopez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518041029 PECOS PAC ID: 2466559208 Enrollment ID: I20181211003221 |
| Provider Name | Ayodeji A Oduola |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942530266 PECOS PAC ID: 6305009077 Enrollment ID: I20190110000750 |
| Provider Name | Carissa D Bravo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538562749 PECOS PAC ID: 6406194141 Enrollment ID: I20190205002211 |
| Provider Name | Uzomechine Thabiso Chiedozi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699160903 PECOS PAC ID: 1759680721 Enrollment ID: I20190212001243 |
| Provider Name | Gritz Pierre |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1215319140 PECOS PAC ID: 2961718259 Enrollment ID: I20190311000280 |
| Provider Name | Andrea L Purtzer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447702428 PECOS PAC ID: 6204116866 Enrollment ID: I20190401002237 |
| Provider Name | Jesse Akaki Hodson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518435585 PECOS PAC ID: 7911248174 Enrollment ID: I20190416002457 |
| Provider Name | Dana A Teszler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124582820 PECOS PAC ID: 9537401443 Enrollment ID: I20190424003047 |
| Provider Name | Toni A Baca |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780162032 PECOS PAC ID: 5092057919 Enrollment ID: I20190425000274 |
| Provider Name | Arezoo Taheri |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1215917992 PECOS PAC ID: 3971531690 Enrollment ID: I20190513002592 |
| Provider Name | Arnold Cha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811320179 PECOS PAC ID: 0749505998 Enrollment ID: I20190522000408 |
| Provider Name | Isaac Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801243530 PECOS PAC ID: 9335431824 Enrollment ID: I20190607000492 |
| Provider Name | Matthew Williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1154776359 PECOS PAC ID: 4082961941 Enrollment ID: I20190610001060 |
| Provider Name | Kamika Gower-allum |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1790238657 PECOS PAC ID: 3072849967 Enrollment ID: I20190730004729 |
| Provider Name | Sanjog Bastola |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1922459064 PECOS PAC ID: 4981996253 Enrollment ID: I20190731004037 |
| Provider Name | Anu Sharma |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689228231 PECOS PAC ID: 2264761022 Enrollment ID: I20190904003025 |
| Provider Name | Greg D Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194255950 PECOS PAC ID: 1456621325 Enrollment ID: I20190913001684 |
| Provider Name | Rajpreet Singh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316391956 PECOS PAC ID: 8022305473 Enrollment ID: I20191001001964 |
| Provider Name | Lindsey A Patterson |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1548818180 PECOS PAC ID: 4486985819 Enrollment ID: I20191015003588 |
| Provider Name | Grant A Jolliffe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699325092 PECOS PAC ID: 9739411133 Enrollment ID: I20191105001565 |
| Provider Name | Maria Elena Rivera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356977144 PECOS PAC ID: 5496184566 Enrollment ID: I20200413000070 |
| Provider Name | Erica N Dickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881166627 PECOS PAC ID: 2961833132 Enrollment ID: I20200504002304 |
| Provider Name | Kendra M Bloomfield |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609118900 PECOS PAC ID: 0648586297 Enrollment ID: I20200505000310 |
| Provider Name | Rebecca E Elliott |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1942697669 PECOS PAC ID: 7517261670 Enrollment ID: I20200519001927 |
| Provider Name | Jason A Primus |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1649684309 PECOS PAC ID: 6709005549 Enrollment ID: I20200604001070 |
| Provider Name | Julie Ann Mondz-kleinman |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1598244402 PECOS PAC ID: 1658793526 Enrollment ID: I20200623000322 |
| Provider Name | Christelle Serra-van Brunt |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922492586 PECOS PAC ID: 6204105281 Enrollment ID: I20200626001952 |
| Provider Name | Neha Garg |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629590419 PECOS PAC ID: 2163845934 Enrollment ID: I20200713001373 |
| Provider Name | Humza Saleem Maqbool |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003334368 PECOS PAC ID: 0244654986 Enrollment ID: I20200728001169 |
| Provider Name | Aaron D Dam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851826937 PECOS PAC ID: 8426473455 Enrollment ID: I20200806003637 |
| Provider Name | Kristi A Taylor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083156277 PECOS PAC ID: 5092070649 Enrollment ID: I20201019000742 |
| Provider Name | Annabel M Walker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447865464 PECOS PAC ID: 4183044431 Enrollment ID: I20201026002685 |
| Provider Name | Shasta M Stephens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417312315 PECOS PAC ID: 1254638828 Enrollment ID: I20201203001261 |
| Provider Name | Leah Burke Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487251773 PECOS PAC ID: 6305258476 Enrollment ID: I20201214002308 |
| Provider Name | Tracy R Drahota |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1134425929 PECOS PAC ID: 1557542941 Enrollment ID: I20210119001273 |
| Provider Name | Dale S Janik |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376573881 PECOS PAC ID: 9335156694 Enrollment ID: I20210314000011 |
| Provider Name | Sandeep S Jhajj |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1174962369 PECOS PAC ID: 8022369941 Enrollment ID: I20210520003155 |
| Provider Name | Claire Christina Ford |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366948622 PECOS PAC ID: 3779834361 Enrollment ID: I20210524000399 |
| Provider Name | Joshua Genstler |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669963716 PECOS PAC ID: 5294081949 Enrollment ID: I20210623001518 |
| Provider Name | Matthew W Haley |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154813889 PECOS PAC ID: 0244583680 Enrollment ID: I20210728002344 |
| Provider Name | Sarah K Min |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1083091466 PECOS PAC ID: 4880943794 Enrollment ID: I20210730002590 |
| Provider Name | Jenae M Hawkins |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1093004822 PECOS PAC ID: 0345419297 Enrollment ID: I20210910001768 |
| Provider Name | Elisa F Akagi Fukushima |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1730568080 PECOS PAC ID: 9537462460 Enrollment ID: I20210924001735 |
| Provider Name | Gregory Glenn Kautz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518458926 PECOS PAC ID: 4284022310 Enrollment ID: I20211022000868 |
| Provider Name | Dipal Dilipbhai Patel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780981563 PECOS PAC ID: 8022338268 Enrollment ID: I20211102001970 |
| Provider Name | Shruti Vakil |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720391493 PECOS PAC ID: 1951531904 Enrollment ID: I20211202002453 |
| Provider Name | Aaron J Kramer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1861843625 PECOS PAC ID: 9931494473 Enrollment ID: I20211215002444 |
| Provider Name | Patrick W Young |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164879649 PECOS PAC ID: 7113218058 Enrollment ID: I20220404002101 |
| Provider Name | Ashley Marie Twyman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1003311291 PECOS PAC ID: 2567799398 Enrollment ID: I20220407000279 |
| Provider Name | Matthew C Fischer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811382922 PECOS PAC ID: 5698068195 Enrollment ID: I20220411001580 |
| Provider Name | Courtney J Van Valkenburg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891249637 PECOS PAC ID: 7911286729 Enrollment ID: I20220421001741 |
| Provider Name | Ahern O Geilenfeldt |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1316384068 PECOS PAC ID: 1153637913 Enrollment ID: I20220429001572 |
| Provider Name | Sujan Jamarkattel |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255852521 PECOS PAC ID: 7810384336 Enrollment ID: I20220429002018 |
| Provider Name | Alexis A Tracy |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1689870750 PECOS PAC ID: 5294906103 Enrollment ID: I20220510000336 |
| Provider Name | Penny J Williams |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1588649453 PECOS PAC ID: 6305832452 Enrollment ID: I20220516000179 |
| Provider Name | Michael A Bressler |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1316507171 PECOS PAC ID: 3375878903 Enrollment ID: I20220606001464 |
| Provider Name | Sophie A Westrud |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396485371 PECOS PAC ID: 4981083136 Enrollment ID: I20220620000582 |
| Provider Name | David B Trowbridge |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1356367007 PECOS PAC ID: 9335338706 Enrollment ID: I20220620001376 |
| Provider Name | Chella Bhagyam |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1255836128 PECOS PAC ID: 7911335765 Enrollment ID: I20220627002270 |
| Provider Name | Alexandra Julienne Wiggins |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376004077 PECOS PAC ID: 6507109493 Enrollment ID: I20220628003472 |
| Provider Name | Caleb B Nyone |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1346731874 PECOS PAC ID: 3375975733 Enrollment ID: I20220805001788 |
| Provider Name | Najia Sayedy |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1174978217 PECOS PAC ID: 8921345349 Enrollment ID: I20220812002563 |
| Provider Name | Douglas J Ammerman |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1740622604 PECOS PAC ID: 1153688825 Enrollment ID: I20220812002876 |
| Provider Name | Raagav Mohanakrishnan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750841193 PECOS PAC ID: 8022347236 Enrollment ID: I20220823002256 |
| Provider Name | Sylvia Shaykis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1659759421 PECOS PAC ID: 1850775826 Enrollment ID: I20220825002129 |
| Provider Name | Logan L Vincent |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1164764288 PECOS PAC ID: 4688991946 Enrollment ID: I20220829003393 |
| Provider Name | Karen D Banks |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083998371 PECOS PAC ID: 4587899570 Enrollment ID: I20220920001476 |
| Provider Name | Marcia E Hoffheimer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689946451 PECOS PAC ID: 8729375225 Enrollment ID: I20221003002427 |
| Provider Name | Stuart Jacobson |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1841327210 PECOS PAC ID: 5092812123 Enrollment ID: I20221014002054 |
| Provider Name | Yunus A Moosa |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1548280464 PECOS PAC ID: 3072591494 Enrollment ID: I20221104000864 |
| Provider Name | Angela G Duke |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841243169 PECOS PAC ID: 1557365079 Enrollment ID: I20221104002223 |
| Provider Name | Robert S Emerick |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1255315495 PECOS PAC ID: 1850332842 Enrollment ID: I20221114002549 |
| Provider Name | Rupinder Kaur Heer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1538837687 PECOS PAC ID: 3971971938 Enrollment ID: I20221122002390 |
| Provider Name | Asad Sattar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1578925863 PECOS PAC ID: 2466784582 Enrollment ID: I20221207002273 |
| Provider Name | Mary Ebueku-smith |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639514805 PECOS PAC ID: 8426329897 Enrollment ID: I20221219002373 |
| Provider Name | Amanda M Bujaucius |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1891205134 PECOS PAC ID: 4789940529 Enrollment ID: I20230215001079 |
| Provider Name | Kristina S Kezar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1669452348 PECOS PAC ID: 9436174828 Enrollment ID: I20230327001260 |
| Provider Name | Trung T Nguyen |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639631492 PECOS PAC ID: 8325377815 Enrollment ID: I20230417001438 |
| Provider Name | William W Rowe |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164414595 PECOS PAC ID: 6608763479 Enrollment ID: I20230419000307 |
| Provider Name | Dipesh K C Ghimire |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1295106169 PECOS PAC ID: 4880941848 Enrollment ID: I20230420000965 |
| Provider Name | Alexei Zhadkevich |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760642268 PECOS PAC ID: 5698078533 Enrollment ID: I20230424000058 |
| Provider Name | Amanda K Elsome |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346854759 PECOS PAC ID: 1456765668 Enrollment ID: I20230424002568 |
| Provider Name | Dipak B K C |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1013146422 PECOS PAC ID: 3577617406 Enrollment ID: I20230425000989 |
| Provider Name | Ahmar Jafary |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1881855377 PECOS PAC ID: 7214179175 Enrollment ID: I20230522002004 |
| Provider Name | Stephen A Avera |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174986293 PECOS PAC ID: 4789913971 Enrollment ID: I20230607000249 |
| Provider Name | Kuldeep Kc |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669814760 PECOS PAC ID: 4082071667 Enrollment ID: I20230613002944 |
| Provider Name | Candice M Dolbier |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1629333893 PECOS PAC ID: 8325271661 Enrollment ID: I20230614004018 |
| Provider Name | Sandra Louise Drager |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1205802097 PECOS PAC ID: 9436325354 Enrollment ID: I20230616001707 |
| Provider Name | Sirikarn Napan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1609005370 PECOS PAC ID: 4082879499 Enrollment ID: I20230621002315 |
| Provider Name | Mai Thuy Murphy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1962968503 PECOS PAC ID: 1951787894 Enrollment ID: I20230804003265 |
| Provider Name | Durga P Vedati |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1821288499 PECOS PAC ID: 4880731124 Enrollment ID: I20230818000711 |
| Provider Name | Jessica Visser |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1912249756 PECOS PAC ID: 6901185784 Enrollment ID: I20230818002523 |
| Provider Name | Pankhuri Malhotra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1518587187 PECOS PAC ID: 1254762867 Enrollment ID: I20230828001649 |
| Provider Name | Niba F Nchotu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366709792 PECOS PAC ID: 3274854153 Enrollment ID: I20230830001367 |
| Provider Name | Heather C Robinson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174154454 PECOS PAC ID: 7214390731 Enrollment ID: I20230831002152 |
| Provider Name | Jakob L Feeney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720609324 PECOS PAC ID: 7416379557 Enrollment ID: I20230905003550 |
| Provider Name | Bernadette A Tan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063919702 PECOS PAC ID: 5991136558 Enrollment ID: I20231023003550 |
| Provider Name | Melinda M Mantooth |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639708175 PECOS PAC ID: 3476972381 Enrollment ID: I20231101000583 |
| Provider Name | Vicky Sandhu |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1316407596 PECOS PAC ID: 4688093867 Enrollment ID: I20231104000531 |
| Provider Name | Jesse Sabiiti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932392693 PECOS PAC ID: 3678660008 Enrollment ID: I20231108001466 |
| Provider Name | Juan Weksler |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1316919723 PECOS PAC ID: 2365482759 Enrollment ID: I20231122002076 |
| Provider Name | Teja V Surapaneni |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1275875130 PECOS PAC ID: 2163717091 Enrollment ID: I20231127002587 |
| Provider Name | Stefanie A Colavito |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548282916 PECOS PAC ID: 1355393034 Enrollment ID: I20231129003133 |
| Provider Name | Tara R Thompson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710226204 PECOS PAC ID: 4082912753 Enrollment ID: I20240117002624 |
| Provider Name | Carrie Kelley Lucas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760259402 PECOS PAC ID: 3971940222 Enrollment ID: I20240321002359 |
| Provider Name | James Kuo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326452087 PECOS PAC ID: 2062704380 Enrollment ID: I20240410003357 |
| Provider Name | Harish Talla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588951339 PECOS PAC ID: 2567683881 Enrollment ID: I20240421000100 |
| Provider Name | Mahmut G Yucel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1104453091 PECOS PAC ID: 9638564974 Enrollment ID: I20240423004377 |
| Provider Name | Prithiv J Prasad |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1093191967 PECOS PAC ID: 4183958390 Enrollment ID: I20240604001034 |
Ups Medford (cdrc - Expansion) Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2825 E Barnett Rd, Medford, OR 97504 Phone: 503-494-9000 | |
Rogue Community Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 900 E Main St, Medford, OR 97504 Phone: 541-842-7705 Fax: 541-842-7640 | |
Columbiacare Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3200 Juanipero Way, Medford, OR 97504 Phone: 541-858-8170 Fax: 541-858-8167 | |
Pmg Medford Physiatry Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 920 Royal Ave, Medford, OR 97504 Phone: 541-732-8400 Fax: 541-732-8401 | |
Pmg South Heart Rhythm Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1698 E Mcandrews Rd, Ste 300, Medford, OR 97504 Phone: 541-732-7850 Fax: 541-732-7851 | |
Complete Integrative Care, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 3156 State St, Medford, OR 97504 Phone: 541-773-5772 Fax: 541-773-1113 | |
La Clinica Acute Care Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 638 Market St, Medford, OR 97504 Phone: 541-494-3840 Fax: 541-494-1789 |