| Sih Medical Group | |
|
1239 E Main St Carbondale IL 62901 | |
| (618) 457-5200 | |
| (618) 549-5128 |
| Full Name | Sih Medical Group |
|---|---|
| Speciality | Internal Medicine |
| Location | 1239 E Main St, Carbondale, Illinois |
| Authorized Official Name and Position | Warren P. Ladner (SR VP/CFO) |
| Authorized Official Contact | 6184575200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sih Medical Group 1239 E Main St Carbondale IL 62901-3175 Ph: (618) 457-5200 | Sih Medical Group 1239 E Main St Carbondale IL 62901 Ph: (618) 457-5200 |
| NPI Number | 1770656837 |
|---|---|
| Provider Enumeration Date | 11/16/2006 |
| Last Update Date | 09/04/2024 |
| Medicare PECOS PAC ID | 3678677390 |
|---|---|
| Medicare Enrollment ID | O20070404000595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770656837 | NPI | - | NPPES |
| 3932056 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Roger D Watters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356321343 PECOS PAC ID: 4587578513 Enrollment ID: I20031114000190 |
| Provider Name | Donna M Bell |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1609816453 PECOS PAC ID: 6901702034 Enrollment ID: I20031210000262 |
| Provider Name | Felipe Peren Enriquez |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1457305468 PECOS PAC ID: 8729985007 Enrollment ID: I20031216000364 |
| Provider Name | Pamela K Sparling |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1811989627 PECOS PAC ID: 8325946882 Enrollment ID: I20031222000750 |
| Provider Name | Lynn S Cook |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1508891219 PECOS PAC ID: 3971405804 Enrollment ID: I20040122000334 |
| Provider Name | Echo R Reardon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124041884 PECOS PAC ID: 6002718822 Enrollment ID: I20040122000910 |
| Provider Name | Naeem A Qureshi |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588618482 PECOS PAC ID: 4486547924 Enrollment ID: I20040207000396 |
| Provider Name | Dobroslawa T Reschke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639191992 PECOS PAC ID: 2860381407 Enrollment ID: I20040312000254 |
| Provider Name | Michael A Workman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184731267 PECOS PAC ID: 7012807464 Enrollment ID: I20040318000784 |
| Provider Name | Sam Stokes |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1558452144 PECOS PAC ID: 8022908573 Enrollment ID: I20040403000060 |
| Provider Name | Eldin E Karaikovic |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1033131024 PECOS PAC ID: 3870586308 Enrollment ID: I20040408000291 |
| Provider Name | Gerald W Mcclallen |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285686709 PECOS PAC ID: 2769477256 Enrollment ID: I20040415000359 |
| Provider Name | Jaswant S Sidhu |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1548228752 PECOS PAC ID: 1759372253 Enrollment ID: I20040522000290 |
| Provider Name | George Brodsky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417928714 PECOS PAC ID: 4284619784 Enrollment ID: I20040621000071 |
| Provider Name | Kathleen L Grove |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1912016064 PECOS PAC ID: 9032109517 Enrollment ID: I20040706000650 |
| Provider Name | Chante T Trinh |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093827727 PECOS PAC ID: 5698753465 Enrollment ID: I20040709000122 |
| Provider Name | Jeffrey Jacobs |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174524136 PECOS PAC ID: 0143290098 Enrollment ID: I20040730000597 |
| Provider Name | Gardner T Kenny |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1851383947 PECOS PAC ID: 0648263871 Enrollment ID: I20040810000382 |
| Provider Name | Abdul R Majid |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508858424 PECOS PAC ID: 6800868266 Enrollment ID: I20040810000425 |
| Provider Name | Bradley J Blakey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1285621151 PECOS PAC ID: 1557333689 Enrollment ID: I20040810000528 |
| Provider Name | Alan D Wagner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881686244 PECOS PAC ID: 8820060874 Enrollment ID: I20040810000793 |
| Provider Name | Allan J Schwartz |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013946433 PECOS PAC ID: 6709850308 Enrollment ID: I20040820000190 |
| Provider Name | Zheng G Liu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1841210952 PECOS PAC ID: 7416917471 Enrollment ID: I20041013001317 |
| Provider Name | Mark J Garwin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326030396 PECOS PAC ID: 0547253775 Enrollment ID: I20041014000441 |
| Provider Name | Brian C Harrison |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518920073 PECOS PAC ID: 5294797478 Enrollment ID: I20041029000890 |
| Provider Name | Cynthia A Epplin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578555348 PECOS PAC ID: 5294798708 Enrollment ID: I20041111000430 |
| Provider Name | Richard Dilorenzo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1528090164 PECOS PAC ID: 4789633900 Enrollment ID: I20050114000328 |
| Provider Name | Kent A Arnold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982684445 PECOS PAC ID: 5597718148 Enrollment ID: I20050223000951 |
| Provider Name | Mark G Busby |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679510739 PECOS PAC ID: 2567368780 Enrollment ID: I20050310000358 |
| Provider Name | Nyambi Ebie |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1548234883 PECOS PAC ID: 5294787677 Enrollment ID: I20050324000490 |
| Provider Name | Brenda L Carter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1598790180 PECOS PAC ID: 4880633825 Enrollment ID: I20050428000553 |
| Provider Name | Son Phong Le |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1902988009 PECOS PAC ID: 4981645173 Enrollment ID: I20050518000476 |
| Provider Name | Aruna K Mittapalli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588637839 PECOS PAC ID: 2365483203 Enrollment ID: I20050520000226 |
| Provider Name | Cesar E Coello |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1003997560 PECOS PAC ID: 5698716488 Enrollment ID: I20050523000328 |
| Provider Name | John T Girardi |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346248143 PECOS PAC ID: 1254328560 Enrollment ID: I20050630000077 |
| Provider Name | Ida Kay Hess |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831264639 PECOS PAC ID: 6406883180 Enrollment ID: I20050725000658 |
| Provider Name | Refat D Khader |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1073505988 PECOS PAC ID: 1456242601 Enrollment ID: I20050801000124 |
| Provider Name | Eric A Ruebke |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1467402065 PECOS PAC ID: 7810927514 Enrollment ID: I20050812000422 |
| Provider Name | Matthew C Winkleman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225018153 PECOS PAC ID: 9335118249 Enrollment ID: I20050817000120 |
| Provider Name | Laura M Winkleman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558331207 PECOS PAC ID: 6901865450 Enrollment ID: I20050818000535 |
| Provider Name | Dacia Renee Gerst |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104874338 PECOS PAC ID: 5799700878 Enrollment ID: I20051007000382 |
| Provider Name | Mary M Lynda Damery |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528056504 PECOS PAC ID: 8628095593 Enrollment ID: I20051031000080 |
| Provider Name | Richard E Boren |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346353117 PECOS PAC ID: 1254359888 Enrollment ID: I20051102000895 |
| Provider Name | Charlene G Shallow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295819688 PECOS PAC ID: 7315967833 Enrollment ID: I20051129000904 |
| Provider Name | Kurt R Martin |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1164535365 PECOS PAC ID: 1658284773 Enrollment ID: I20060201000464 |
| Provider Name | Ana Migone |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790753341 PECOS PAC ID: 5294648309 Enrollment ID: I20060202000322 |
| Provider Name | Jai Singh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1255333118 PECOS PAC ID: 3870488331 Enrollment ID: I20060315000183 |
| Provider Name | Craig Thomas Davis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134201213 PECOS PAC ID: 5193734861 Enrollment ID: I20060410000124 |
| Provider Name | Mark Thomas Donvito |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073564175 PECOS PAC ID: 7618988478 Enrollment ID: I20060509000324 |
| Provider Name | Osama R Aaflaq |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083663520 PECOS PAC ID: 8527079383 Enrollment ID: I20060509000326 |
| Provider Name | Donna P Carney |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164473260 PECOS PAC ID: 6406867266 Enrollment ID: I20060509000348 |
| Provider Name | Anad K Salem |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659366839 PECOS PAC ID: 9032120704 Enrollment ID: I20060509000558 |
| Provider Name | Valerie Ann Kupferer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003869280 PECOS PAC ID: 5395757397 Enrollment ID: I20060612000037 |
| Provider Name | Javier Muniz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548263668 PECOS PAC ID: 0143223297 Enrollment ID: I20060810000429 |
| Provider Name | Dana I Tarandy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629001623 PECOS PAC ID: 7012911142 Enrollment ID: I20060905000060 |
| Provider Name | Hossam Hamdi Mohamed Abdelsalam |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1972543080 PECOS PAC ID: 5698782175 Enrollment ID: I20060914000435 |
| Provider Name | Abdel M Anwar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639128432 PECOS PAC ID: 7214926617 Enrollment ID: I20060927000256 |
| Provider Name | John Ward Watson |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1871596726 PECOS PAC ID: 6608820675 Enrollment ID: I20061130000020 |
| Provider Name | Adrian P Martin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1568531010 PECOS PAC ID: 9133128697 Enrollment ID: I20061211000157 |
| Provider Name | Alberto D Cuartas |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1740381169 PECOS PAC ID: 2264403823 Enrollment ID: I20061219000459 |
| Provider Name | David A Mann |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1386739670 PECOS PAC ID: 2961499207 Enrollment ID: I20061228000275 |
| Provider Name | Raed Al-dallow |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1164572095 PECOS PAC ID: 4688675903 Enrollment ID: I20070129000474 |
| Provider Name | Dale W Blaise |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770557472 PECOS PAC ID: 0941106660 Enrollment ID: I20070329000493 |
| Provider Name | Eduardo Smith Singares |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477554756 PECOS PAC ID: 6507898368 Enrollment ID: I20070621000193 |
| Provider Name | John E Williamson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629017108 PECOS PAC ID: 7719950658 Enrollment ID: I20070713000171 |
| Provider Name | James D Wade |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639223464 PECOS PAC ID: 7214037647 Enrollment ID: I20070713000303 |
| Provider Name | Sajjad Mueed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1124182860 PECOS PAC ID: 4183691884 Enrollment ID: I20070808000770 |
| Provider Name | Steve A Rhyne |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255396495 PECOS PAC ID: 0547241895 Enrollment ID: I20070824000837 |
| Provider Name | Adam M Vargo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861683187 PECOS PAC ID: 6305939315 Enrollment ID: I20070907000228 |
| Provider Name | Paula R Lindner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1730151499 PECOS PAC ID: 9931187713 Enrollment ID: I20071012000029 |
| Provider Name | Tanatip Korte |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1376656439 PECOS PAC ID: 5597852582 Enrollment ID: I20071108000093 |
| Provider Name | Loni J Banks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508056953 PECOS PAC ID: 8022106285 Enrollment ID: I20071121000503 |
| Provider Name | Jeffrey Lehman |
|---|---|
| Provider Type | Practitioner - Allergy/immunology |
| Provider Identifiers | NPI Number: 1548261399 PECOS PAC ID: 8921072679 Enrollment ID: I20071128000076 |
| Provider Name | Andrew L Makowski |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770514861 PECOS PAC ID: 4385648021 Enrollment ID: I20071227000250 |
| Provider Name | Gordon K Chu |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1235310756 PECOS PAC ID: 9335225499 Enrollment ID: I20080328000790 |
| Provider Name | L Royce Larsen |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093734774 PECOS PAC ID: 4486732484 Enrollment ID: I20080416000257 |
| Provider Name | Joshua K Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326222563 PECOS PAC ID: 6608954193 Enrollment ID: I20080424000193 |
| Provider Name | Obaid Shafiq |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1144418401 PECOS PAC ID: 8022197532 Enrollment ID: I20080509000062 |
| Provider Name | Sahar Halabi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1003937350 PECOS PAC ID: 9931271764 Enrollment ID: I20080710000424 |
| Provider Name | Dongwoo John Chang |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1962485037 PECOS PAC ID: 6709779853 Enrollment ID: I20080819000941 |
| Provider Name | Archana K Reddy |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629236047 PECOS PAC ID: 2264509579 Enrollment ID: I20080927000114 |
| Provider Name | Christopher Hogg |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1518998202 PECOS PAC ID: 9537190988 Enrollment ID: I20081007000219 |
| Provider Name | Gowda Sharath |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043466576 PECOS PAC ID: 4688732415 Enrollment ID: I20081023000487 |
| Provider Name | Jeffery Michael Jones |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295998011 PECOS PAC ID: 1951460997 Enrollment ID: I20081106000175 |
| Provider Name | Aaron B Greenspan |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1558382911 PECOS PAC ID: 5597757468 Enrollment ID: I20090108000568 |
| Provider Name | Donnie E Shelton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1346301025 PECOS PAC ID: 2668536913 Enrollment ID: I20090130000504 |
| Provider Name | Jeffrey D Parks |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215044367 PECOS PAC ID: 1153210596 Enrollment ID: I20090324000319 |
| Provider Name | Agnieszka Anna Ardelt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568426427 PECOS PAC ID: 6002711769 Enrollment ID: I20090519000284 |
| Provider Name | Sandra Lynn Rose |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487889317 PECOS PAC ID: 0749333029 Enrollment ID: I20090804000429 |
| Provider Name | Mack E Mccain |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1558321190 PECOS PAC ID: 4284667379 Enrollment ID: I20090828000494 |
| Provider Name | Eric Kivisto |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447257316 PECOS PAC ID: 8820155963 Enrollment ID: I20090917000544 |
| Provider Name | Kevin D Oestmann |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902913908 PECOS PAC ID: 6507755949 Enrollment ID: I20100130000098 |
| Provider Name | Emily D Hanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023083748 PECOS PAC ID: 2668515834 Enrollment ID: I20100210000431 |
| Provider Name | Linda C Sharpless |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669458543 PECOS PAC ID: 9931092624 Enrollment ID: I20100312000575 |
| Provider Name | Dana L Rix-crouse |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407187784 PECOS PAC ID: 9335275544 Enrollment ID: I20100326000763 |
| Provider Name | Allison B Campos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962731919 PECOS PAC ID: 9133256209 Enrollment ID: I20100421000443 |
| Provider Name | Mark J Korte |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821102849 PECOS PAC ID: 7911981089 Enrollment ID: I20100520000743 |
| Provider Name | Dennon W Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689788630 PECOS PAC ID: 3072597350 Enrollment ID: I20100526001006 |
| Provider Name | Sherry Michele Williams |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1104137140 PECOS PAC ID: 5799818068 Enrollment ID: I20100806000596 |
| Provider Name | Lynn Ann Suppan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1780916569 PECOS PAC ID: 3971627167 Enrollment ID: I20100824001239 |
| Provider Name | Cora E Musial |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1609889450 PECOS PAC ID: 6406970615 Enrollment ID: I20100825000221 |
| Provider Name | Mary K Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386960151 PECOS PAC ID: 5395860993 Enrollment ID: I20100920001064 |
| Provider Name | Uday R Shankar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992901185 PECOS PAC ID: 9133213077 Enrollment ID: I20101007000481 |
| Provider Name | Bhanu Vakkalanka |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1578766796 PECOS PAC ID: 3072705789 Enrollment ID: I20101012001232 |
| Provider Name | Gerson A Criste |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1265698260 PECOS PAC ID: 8426103524 Enrollment ID: I20101015000489 |
| Provider Name | Erin E Stock |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326165846 PECOS PAC ID: 2062606528 Enrollment ID: I20101029000113 |
| Provider Name | Amanda J Bleichner |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1639339419 PECOS PAC ID: 7315131638 Enrollment ID: I20101101000702 |
| Provider Name | Ahmed H Jafri |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1376597815 PECOS PAC ID: 4587743232 Enrollment ID: I20101111001461 |
| Provider Name | Raymund O Pineda |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841262789 PECOS PAC ID: 5698867034 Enrollment ID: I20101213000711 |
| Provider Name | Donald P Prentiss |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1275617839 PECOS PAC ID: 9436130507 Enrollment ID: I20110104001195 |
| Provider Name | James X Tao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1174674154 PECOS PAC ID: 2668661570 Enrollment ID: I20110107000466 |
| Provider Name | Joseph R Haake |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1982805503 PECOS PAC ID: 9830378140 Enrollment ID: I20110119000437 |
| Provider Name | Shannon B Rider |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508846429 PECOS PAC ID: 4981883543 Enrollment ID: I20110127001131 |
| Provider Name | Chizor Odibi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477702462 PECOS PAC ID: 9931389772 Enrollment ID: I20110210000626 |
| Provider Name | Conway Chin |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1326001827 PECOS PAC ID: 9436124104 Enrollment ID: I20110216000465 |
| Provider Name | Casey L Gustavison |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508004706 PECOS PAC ID: 2567529811 Enrollment ID: I20110325000726 |
| Provider Name | Jamie G Hall |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1801193206 PECOS PAC ID: 0547443327 Enrollment ID: I20110401000146 |
| Provider Name | Aileen Galan |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1679775647 PECOS PAC ID: 3577639822 Enrollment ID: I20110531000578 |
| Provider Name | Labib Elkahwaji |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114172186 PECOS PAC ID: 4284812371 Enrollment ID: I20110620000283 |
| Provider Name | William Geittmann |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467496455 PECOS PAC ID: 6608859053 Enrollment ID: I20110621000729 |
| Provider Name | Joshua J Miksanek |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760644439 PECOS PAC ID: 2365610771 Enrollment ID: I20110728000599 |
| Provider Name | Isha Tyagi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487816161 PECOS PAC ID: 7214106491 Enrollment ID: I20110803000895 |
| Provider Name | Adrian D Reed |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255593919 PECOS PAC ID: 0840469953 Enrollment ID: I20110805000750 |
| Provider Name | Srinivas Rajamahanty |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1124339403 PECOS PAC ID: 2365575057 Enrollment ID: I20110824000509 |
| Provider Name | Ashwin Narasimhan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548241912 PECOS PAC ID: 8426088659 Enrollment ID: I20110908001818 |
| Provider Name | Ronald A Zimmermann |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1346404985 PECOS PAC ID: 5991976300 Enrollment ID: I20110915000247 |
| Provider Name | Deana Lynn Hale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134373129 PECOS PAC ID: 3375715980 Enrollment ID: I20111004000106 |
| Provider Name | Bhanu Kiran Pisini |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1417262320 PECOS PAC ID: 8224201066 Enrollment ID: I20111024000337 |
| Provider Name | Brahm Jyot |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174772966 PECOS PAC ID: 3779756838 Enrollment ID: I20111104000672 |
| Provider Name | Megan M Hoffman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386931590 PECOS PAC ID: 4284809781 Enrollment ID: I20111212000818 |
| Provider Name | Ruthann Coale |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942425889 PECOS PAC ID: 2567639933 Enrollment ID: I20120125000909 |
| Provider Name | Stephanie A Osborne |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1942573944 PECOS PAC ID: 4789847930 Enrollment ID: I20120525000221 |
| Provider Name | Thomas M Pinski |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831461607 PECOS PAC ID: 5597929620 Enrollment ID: I20120621000018 |
| Provider Name | Nastane Le Bec |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518123843 PECOS PAC ID: 0042475915 Enrollment ID: I20120626000642 |
| Provider Name | Wilson Cueva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366608713 PECOS PAC ID: 4486839008 Enrollment ID: I20120920000747 |
| Provider Name | Sharon Kippenbrock |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1649431396 PECOS PAC ID: 2961650569 Enrollment ID: I20120924000028 |
| Provider Name | Matthew B Eubanks |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679717425 PECOS PAC ID: 5890943435 Enrollment ID: I20120924000546 |
| Provider Name | Shawn S Wallery |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881851780 PECOS PAC ID: 0749430445 Enrollment ID: I20121015000364 |
| Provider Name | Brett Dempsey |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1659599538 PECOS PAC ID: 7810062569 Enrollment ID: I20121102000444 |
| Provider Name | Mark Stephen Fleming |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1508807181 PECOS PAC ID: 4880507664 Enrollment ID: I20121105000096 |
| Provider Name | Christina H Kraus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750504023 PECOS PAC ID: 3577664135 Enrollment ID: I20121114000487 |
| Provider Name | Karthik Koduru |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1720241565 PECOS PAC ID: 0244308732 Enrollment ID: I20121116000547 |
| Provider Name | Shasha Wu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083833412 PECOS PAC ID: 5597919654 Enrollment ID: I20130126000024 |
| Provider Name | Jimmy Morrison |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1881782654 PECOS PAC ID: 5193637742 Enrollment ID: I20130219000419 |
| Provider Name | Angela P Buss |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1568791408 PECOS PAC ID: 7416086699 Enrollment ID: I20130308000224 |
| Provider Name | Kristin R Betz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588909519 PECOS PAC ID: 2163677402 Enrollment ID: I20130312000505 |
| Provider Name | Nader Jacob Dababneh |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1821065392 PECOS PAC ID: 0547236101 Enrollment ID: I20130313000541 |
| Provider Name | Ella Caitlin Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821348988 PECOS PAC ID: 1850536178 Enrollment ID: I20130314000243 |
| Provider Name | Antonio A Cummings |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1427369313 PECOS PAC ID: 9234374083 Enrollment ID: I20130326000519 |
| Provider Name | Ashley E Juhl |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1578804001 PECOS PAC ID: 0749426120 Enrollment ID: I20130410000360 |
| Provider Name | Adrienne N Kovalsky |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356573968 PECOS PAC ID: 4385897263 Enrollment ID: I20130429000250 |
| Provider Name | Joseph Reses |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1356526255 PECOS PAC ID: 6507997913 Enrollment ID: I20130712000415 |
| Provider Name | Elizabeth R Eggemeyer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528401809 PECOS PAC ID: 2668612698 Enrollment ID: I20130715000713 |
| Provider Name | Harshavardhan Tathireddy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366670994 PECOS PAC ID: 4587805080 Enrollment ID: I20130725000675 |
| Provider Name | Muhammad J Popalzai |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1003051871 PECOS PAC ID: 1052562535 Enrollment ID: I20130731000752 |
| Provider Name | Don C Arnold |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1457501926 PECOS PAC ID: 7517137995 Enrollment ID: I20130807000388 |
| Provider Name | Michael A Chipman |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760693899 PECOS PAC ID: 5991820482 Enrollment ID: I20130808000135 |
| Provider Name | Suven Shankar |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1760605372 PECOS PAC ID: 0941443998 Enrollment ID: I20130823000753 |
| Provider Name | Swarna Matsa |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1245548536 PECOS PAC ID: 2961646328 Enrollment ID: I20130925000334 |
| Provider Name | Satyadeep Bhattacharya |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1477726875 PECOS PAC ID: 8325272586 Enrollment ID: I20131002000242 |
| Provider Name | Lisa Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376847301 PECOS PAC ID: 7618103151 Enrollment ID: I20131112000279 |
| Provider Name | Jill B Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326314634 PECOS PAC ID: 2062642572 Enrollment ID: I20140303000569 |
| Provider Name | Beth J Stewart |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235553470 PECOS PAC ID: 9537391339 Enrollment ID: I20140409001954 |
| Provider Name | Constance E Kirby |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1831514470 PECOS PAC ID: 3870725344 Enrollment ID: I20140416000001 |
| Provider Name | Clayton Thomas Ford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689960650 PECOS PAC ID: 8224283452 Enrollment ID: I20140625001397 |
| Provider Name | Brent M Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063708550 PECOS PAC ID: 6800041039 Enrollment ID: I20140709002262 |
| Provider Name | Kelli Nicole Webb |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1518129600 PECOS PAC ID: 8921247768 Enrollment ID: I20140711001319 |
| Provider Name | Mitchell A Cook |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1285920835 PECOS PAC ID: 6305061037 Enrollment ID: I20140714000036 |
| Provider Name | Gurpreet Singh Bambra |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649428475 PECOS PAC ID: 7911123534 Enrollment ID: I20140716002377 |
| Provider Name | Narayan Deshmukh |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1124093307 PECOS PAC ID: 6204878077 Enrollment ID: I20140722001905 |
| Provider Name | Alejandro Hornik |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134384977 PECOS PAC ID: 0345466579 Enrollment ID: I20140724001871 |
| Provider Name | Nitin C Patel |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1144267865 PECOS PAC ID: 7113816752 Enrollment ID: I20140730001685 |
| Provider Name | Shrutee Baniya |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1699088203 PECOS PAC ID: 0840417572 Enrollment ID: I20140804001429 |
| Provider Name | Stacie Griffis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881980092 PECOS PAC ID: 3678790144 Enrollment ID: I20140806001310 |
| Provider Name | Heather Lynn Barrett |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1619105897 PECOS PAC ID: 7416196878 Enrollment ID: I20140825000981 |
| Provider Name | Richard Kyle Buchman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639457807 PECOS PAC ID: 0941428205 Enrollment ID: I20140827002918 |
| Provider Name | Muhammad Adnan Malik |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1609014026 PECOS PAC ID: 4789803180 Enrollment ID: I20140917001881 |
| Provider Name | Crystal Adel Honold |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1609171206 PECOS PAC ID: 3678895869 Enrollment ID: I20141125000125 |
| Provider Name | Holly A Wilke |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386064996 PECOS PAC ID: 3173845302 Enrollment ID: I20141125001472 |
| Provider Name | Asim M Saeed |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1033421953 PECOS PAC ID: 6901029222 Enrollment ID: I20150112000402 |
| Provider Name | Yousef Al-shraideh |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1184989915 PECOS PAC ID: 8325296874 Enrollment ID: I20150219002433 |
| Provider Name | Steven Bruce Wehmeyer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780874255 PECOS PAC ID: 1759577844 Enrollment ID: I20150304001757 |
| Provider Name | Kyle W Higdon |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235527854 PECOS PAC ID: 6709102783 Enrollment ID: I20150310002199 |
| Provider Name | Joseph J Miller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720476914 PECOS PAC ID: 8325364193 Enrollment ID: I20150313001587 |
| Provider Name | Christopher James Hanson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447514971 PECOS PAC ID: 3072751734 Enrollment ID: I20150327002475 |
| Provider Name | Tamara Lynn Buckles |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1821145715 PECOS PAC ID: 5890848832 Enrollment ID: I20150407000499 |
| Provider Name | Jeffrey Frakes |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407858806 PECOS PAC ID: 2567355373 Enrollment ID: I20150605000703 |
| Provider Name | Andrea Rhea Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093193773 PECOS PAC ID: 1658682976 Enrollment ID: I20150612000787 |
| Provider Name | John Field |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1578906624 PECOS PAC ID: 7416268487 Enrollment ID: I20150617000802 |
| Provider Name | Bachir Farah |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1336370915 PECOS PAC ID: 9638480684 Enrollment ID: I20150618000388 |
| Provider Name | Lukasz Dabrowski |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1467711796 PECOS PAC ID: 6002127529 Enrollment ID: I20150624001342 |
| Provider Name | Esteban Golombievski |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023339033 PECOS PAC ID: 7719299171 Enrollment ID: I20150629000989 |
| Provider Name | Joe Varghese Yohannan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003163148 PECOS PAC ID: 4688813371 Enrollment ID: I20150707000523 |
| Provider Name | Thomas J. Cartolano |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366688632 PECOS PAC ID: 9335452846 Enrollment ID: I20150713001954 |
| Provider Name | Olufenwa Milhouse |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1225353717 PECOS PAC ID: 1850515958 Enrollment ID: I20150716002243 |
| Provider Name | Muhammad Ali Khan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1144412859 PECOS PAC ID: 0446480354 Enrollment ID: I20150716003268 |
| Provider Name | Eugenio Fortunato Vargas |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1396734414 PECOS PAC ID: 9739399932 Enrollment ID: I20150717000400 |
| Provider Name | Kevin Ml Martin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1093007171 PECOS PAC ID: 6507082047 Enrollment ID: I20150717000523 |
| Provider Name | Adam J Henson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154684975 PECOS PAC ID: 4385860493 Enrollment ID: I20150721002147 |
| Provider Name | Nicholas A Pasteur |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1104180173 PECOS PAC ID: 6800116682 Enrollment ID: I20150727001109 |
| Provider Name | Sarah Nicole Kries |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063897908 PECOS PAC ID: 0042525073 Enrollment ID: I20150819008178 |
| Provider Name | Ryan Stock |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1134414618 PECOS PAC ID: 4880909712 Enrollment ID: I20150820011352 |
| Provider Name | Guo Phoenix |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1396901062 PECOS PAC ID: 5597935643 Enrollment ID: I20150827003008 |
| Provider Name | Carlos Mario Rivera Serrano |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1497910905 PECOS PAC ID: 9537303516 Enrollment ID: I20151022001996 |
| Provider Name | Vivian L Marks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225467806 PECOS PAC ID: 4688805260 Enrollment ID: I20151023001009 |
| Provider Name | Raja Kumari Vaidadi |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588918395 PECOS PAC ID: 4587974738 Enrollment ID: I20151030001293 |
| Provider Name | Sorel Lira |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1639445331 PECOS PAC ID: 9133429343 Enrollment ID: I20151119001684 |
| Provider Name | Cori Ann Starkweather |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932578895 PECOS PAC ID: 6709186943 Enrollment ID: I20151119002890 |
| Provider Name | Melissa Andrea Martinez Mateo |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1003124280 PECOS PAC ID: 1254570799 Enrollment ID: I20151120001752 |
| Provider Name | Mark T Hemming |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407110174 PECOS PAC ID: 0143534776 Enrollment ID: I20151229002246 |
| Provider Name | Kara Nan Ferrell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982075396 PECOS PAC ID: 4082915194 Enrollment ID: I20160105002267 |
| Provider Name | Matheau Julien |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1619189933 PECOS PAC ID: 6002118254 Enrollment ID: I20160106000390 |
| Provider Name | Laura Castillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275905374 PECOS PAC ID: 7517260177 Enrollment ID: I20160114002981 |
| Provider Name | Barak Bar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306085048 PECOS PAC ID: 4981848058 Enrollment ID: I20160324001843 |
| Provider Name | Celena M Lowes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841650736 PECOS PAC ID: 3678870003 Enrollment ID: I20160329002423 |
| Provider Name | Jessica Milburn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669833026 PECOS PAC ID: 7911204300 Enrollment ID: I20160330001300 |
| Provider Name | Amy Nichole Dinga |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285035436 PECOS PAC ID: 2668770645 Enrollment ID: I20160406002485 |
| Provider Name | Ashley Nicole Hornik |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225499825 PECOS PAC ID: 4981902988 Enrollment ID: I20160407000441 |
| Provider Name | Joseph Specker |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1255706818 PECOS PAC ID: 3870892961 Enrollment ID: I20160425000002 |
| Provider Name | Ashley Lauren Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689029993 PECOS PAC ID: 0143519397 Enrollment ID: I20160511002407 |
| Provider Name | Michael L Heaney |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1407858012 PECOS PAC ID: 6002729290 Enrollment ID: I20160614000992 |
| Provider Name | Tommy J Kwak |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1235472820 PECOS PAC ID: 6608172291 Enrollment ID: I20160623002184 |
| Provider Name | Charli Walter Leroy Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649611252 PECOS PAC ID: 4880836204 Enrollment ID: I20160628000691 |
| Provider Name | Mohammad A Ishaq |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1336585140 PECOS PAC ID: 6406157684 Enrollment ID: I20160718000381 |
| Provider Name | Benjamin J Wagner |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497047567 PECOS PAC ID: 5799914495 Enrollment ID: I20160719000295 |
| Provider Name | Kevin Neill |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1972821734 PECOS PAC ID: 5294028601 Enrollment ID: I20160722000936 |
| Provider Name | Arturo Jose Lara Llerena |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538501721 PECOS PAC ID: 1052611373 Enrollment ID: I20160727001430 |
| Provider Name | Naoum P Issa |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902184591 PECOS PAC ID: 9739481474 Enrollment ID: I20160728002093 |
| Provider Name | Tiffany B Ward |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1619186269 PECOS PAC ID: 9335320704 Enrollment ID: I20160808000026 |
| Provider Name | Vineet Kumar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1285074385 PECOS PAC ID: 3870890882 Enrollment ID: I20160809003026 |
| Provider Name | Danielle L Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417305293 PECOS PAC ID: 7113211004 Enrollment ID: I20160816002001 |
| Provider Name | Sahithi Jarugula |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1215228655 PECOS PAC ID: 9335371079 Enrollment ID: I20160819000412 |
| Provider Name | William P Sage |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1437140118 PECOS PAC ID: 2769427996 Enrollment ID: I20160824003159 |
| Provider Name | Anne Marie Rose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942754767 PECOS PAC ID: 8123314929 Enrollment ID: I20160902001283 |
| Provider Name | Uwais B Zaid |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1366777856 PECOS PAC ID: 8426280546 Enrollment ID: I20161007000746 |
| Provider Name | Drake Rothstein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1700800992 PECOS PAC ID: 7810994514 Enrollment ID: I20161011000107 |
| Provider Name | Jonya S Lockart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497108971 PECOS PAC ID: 6709174188 Enrollment ID: I20161018002202 |
| Provider Name | Shivaprasad Marulendra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1205810926 PECOS PAC ID: 1759326382 Enrollment ID: I20161117000540 |
| Provider Name | Zachary A Miksanek |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1316351315 PECOS PAC ID: 1153642889 Enrollment ID: I20161123000021 |
| Provider Name | Sonal Devendra Shah |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598170458 PECOS PAC ID: 2062637838 Enrollment ID: I20161206002574 |
| Provider Name | Jorel O Martinez |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1336553684 PECOS PAC ID: 7618271131 Enrollment ID: I20170105000543 |
| Provider Name | Subaila Zia |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1649479866 PECOS PAC ID: 3173795531 Enrollment ID: I20170210001455 |
| Provider Name | Sajid Mehmood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063749638 PECOS PAC ID: 2466622378 Enrollment ID: I20170306001468 |
| Provider Name | Gerald Steven Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770014748 PECOS PAC ID: 5799060158 Enrollment ID: I20170327001444 |
| Provider Name | Brian Ray Peterson |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1316978687 PECOS PAC ID: 8325149214 Enrollment ID: I20170405002432 |
| Provider Name | Diana L Tomlianovich |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497288492 PECOS PAC ID: 1850677352 Enrollment ID: I20170418001522 |
| Provider Name | Kristina Potanos |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134393267 PECOS PAC ID: 9830467778 Enrollment ID: I20170616001215 |
| Provider Name | Russell Leon Mcelveen |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1275714735 PECOS PAC ID: 1951540343 Enrollment ID: I20170616002432 |
| Provider Name | Abhish Koirala |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134474471 PECOS PAC ID: 6507186913 Enrollment ID: I20170623000188 |
| Provider Name | Hasan Al Janabi |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1255530119 PECOS PAC ID: 8426228008 Enrollment ID: I20170705001400 |
| Provider Name | Kati Rush |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1710241328 PECOS PAC ID: 2961713730 Enrollment ID: I20170731001547 |
| Provider Name | David Kosturakis |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952669277 PECOS PAC ID: 5496995953 Enrollment ID: I20170801002475 |
| Provider Name | Baqer A Haider |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1881009637 PECOS PAC ID: 5395016703 Enrollment ID: I20170803001280 |
| Provider Name | Syed Yamin Hashimi |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1689094948 PECOS PAC ID: 3678844024 Enrollment ID: I20170803002968 |
| Provider Name | Jason L Liang |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003235250 PECOS PAC ID: 2365713401 Enrollment ID: I20170808000113 |
| Provider Name | Jack Rostas |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1902063282 PECOS PAC ID: 9931365863 Enrollment ID: I20170816004512 |
| Provider Name | Robert Frankel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205880978 PECOS PAC ID: 0446262828 Enrollment ID: I20170821001920 |
| Provider Name | Breyanna Grays |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942560800 PECOS PAC ID: 3274825641 Enrollment ID: I20170913002785 |
| Provider Name | Yonatan N Yohannes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1780024232 PECOS PAC ID: 1951674928 Enrollment ID: I20170913003020 |
| Provider Name | Joshua Surowitz |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1700080678 PECOS PAC ID: 5698938272 Enrollment ID: I20170915002597 |
| Provider Name | Samantha Christopher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457745358 PECOS PAC ID: 2860766953 Enrollment ID: I20170928002004 |
| Provider Name | Whitney Celeste Mcguire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003334459 PECOS PAC ID: 4183999790 Enrollment ID: I20171009000591 |
| Provider Name | Sarah Shannon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902349863 PECOS PAC ID: 1557642675 Enrollment ID: I20171023000159 |
| Provider Name | Benjamin Dougherty Mason |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1760764153 PECOS PAC ID: 3870727092 Enrollment ID: I20171025000678 |
| Provider Name | Nathaniel C Crum |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1073031936 PECOS PAC ID: 4587930052 Enrollment ID: I20171027001545 |
| Provider Name | Tal Pollak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770831158 PECOS PAC ID: 9234370982 Enrollment ID: I20171102003619 |
| Provider Name | Abrar A Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1598182032 PECOS PAC ID: 0941566046 Enrollment ID: I20171106002216 |
| Provider Name | Nicholas John Scalzitti |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1689965790 PECOS PAC ID: 4587980545 Enrollment ID: I20171113003218 |
| Provider Name | Britley A White |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1205346483 PECOS PAC ID: 5597022871 Enrollment ID: I20171121001440 |
| Provider Name | Lenora Ann Levin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093227613 PECOS PAC ID: 0648537977 Enrollment ID: I20171122000060 |
| Provider Name | Ryan Neil Nankervis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124538475 PECOS PAC ID: 6002173549 Enrollment ID: I20171207003375 |
| Provider Name | Eric D Wagner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1306358445 PECOS PAC ID: 2961769435 Enrollment ID: I20171208001194 |
| Provider Name | Nicholas Jesse Strane |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1821257049 PECOS PAC ID: 1153492574 Enrollment ID: I20171212000653 |
| Provider Name | Andrew John Hossler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710392428 PECOS PAC ID: 6901021799 Enrollment ID: I20171212000827 |
| Provider Name | Joanne May Lee |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255431128 PECOS PAC ID: 6608874870 Enrollment ID: I20171219002396 |
| Provider Name | Susan Kay Selock |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649708926 PECOS PAC ID: 8426316290 Enrollment ID: I20171228000042 |
| Provider Name | Antoinette Marie Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053854729 PECOS PAC ID: 4082998836 Enrollment ID: I20180108000851 |
| Provider Name | Hope Elizabeth Merkley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689180978 PECOS PAC ID: 0547529992 Enrollment ID: I20180111000442 |
| Provider Name | Maria T Decastro |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558326470 PECOS PAC ID: 6305732587 Enrollment ID: I20180118001700 |
| Provider Name | Dabney Parker Stack |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1518903004 PECOS PAC ID: 1951379825 Enrollment ID: I20180201003169 |
| Provider Name | Christy R Holmes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508373770 PECOS PAC ID: 9931462181 Enrollment ID: I20180420002130 |
| Provider Name | Kristin Francis |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013362227 PECOS PAC ID: 5294027116 Enrollment ID: I20180426001079 |
| Provider Name | Kimberly Donn Hankins |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497255947 PECOS PAC ID: 6305100330 Enrollment ID: I20180427001702 |
| Provider Name | Kurt A Maddock |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1740253707 PECOS PAC ID: 0648184192 Enrollment ID: I20180515001899 |
| Provider Name | Clarke Morton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1497789515 PECOS PAC ID: 0345246443 Enrollment ID: I20180601000427 |
| Provider Name | Sahitya Settypalli |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1164838371 PECOS PAC ID: 5092036715 Enrollment ID: I20180606002606 |
| Provider Name | Shahabuddin Mohammad |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982983599 PECOS PAC ID: 1052617842 Enrollment ID: I20180612000970 |
| Provider Name | Aimee Michelle Belt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932698172 PECOS PAC ID: 3375898364 Enrollment ID: I20180614002404 |
| Provider Name | Rina Elizabeth Caslow |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609388545 PECOS PAC ID: 1658626171 Enrollment ID: I20180625000019 |
| Provider Name | Vadzim Chyzhyk |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093128720 PECOS PAC ID: 6002129962 Enrollment ID: I20180628000422 |
| Provider Name | Hammad Shafqat |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1093070302 PECOS PAC ID: 3870721939 Enrollment ID: I20180705000551 |
| Provider Name | Haitham Hassan Ahmed Hassane |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1487065546 PECOS PAC ID: 6406102979 Enrollment ID: I20180713001122 |
| Provider Name | Abraham El-sedfy |
|---|---|
| Provider Type | Practitioner - Colorectal Surgery (proctology) |
| Provider Identifiers | NPI Number: 1346506607 PECOS PAC ID: 6507113743 Enrollment ID: I20180719001756 |
| Provider Name | Asikhame Ahonkhai Oikeh |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1720444110 PECOS PAC ID: 2163779273 Enrollment ID: I20180720000949 |
| Provider Name | Nikita Chevalier |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1457613531 PECOS PAC ID: 7416267000 Enrollment ID: I20180720002411 |
| Provider Name | Roshan Bista |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1730564428 PECOS PAC ID: 8820345606 Enrollment ID: I20180725001320 |
| Provider Name | Kowsika Movva |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023490950 PECOS PAC ID: 2567775406 Enrollment ID: I20180727000169 |
| Provider Name | Punitha Shivaprasad |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609111699 PECOS PAC ID: 4385863505 Enrollment ID: I20180730000909 |
| Provider Name | Mohammed Lawan Gana Guba |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1003292624 PECOS PAC ID: 2567710973 Enrollment ID: I20180801001702 |
| Provider Name | Dan D Le |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1912214347 PECOS PAC ID: 3274790746 Enrollment ID: I20180802001173 |
| Provider Name | Motaz R Wraikat |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1073995684 PECOS PAC ID: 3072861996 Enrollment ID: I20180808002168 |
| Provider Name | Antonio Lozada |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1053677047 PECOS PAC ID: 6305143504 Enrollment ID: I20180809004229 |
| Provider Name | Charu Kolekar |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1811320856 PECOS PAC ID: 8729336565 Enrollment ID: I20180809005638 |
| Provider Name | Kasey D Harner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093206856 PECOS PAC ID: 2365791746 Enrollment ID: I20180817001210 |
| Provider Name | Megan E Sims |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134610587 PECOS PAC ID: 0345599528 Enrollment ID: I20180821003073 |
| Provider Name | Deborah R Tabachnick |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1790074912 PECOS PAC ID: 2567689607 Enrollment ID: I20180827001699 |
| Provider Name | Sunnan Moinuddin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497140727 PECOS PAC ID: 0143524199 Enrollment ID: I20180828003683 |
| Provider Name | Omar Latimer Dominique |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770996050 PECOS PAC ID: 0941524516 Enrollment ID: I20180904003276 |
| Provider Name | Andrew C Mcnally |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972099067 PECOS PAC ID: 1658621677 Enrollment ID: I20180912001014 |
| Provider Name | Mindy M Dudenbostel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447603246 PECOS PAC ID: 3274884937 Enrollment ID: I20180920000156 |
| Provider Name | Naeem Iqbal Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902287956 PECOS PAC ID: 8921311465 Enrollment ID: I20180920000467 |
| Provider Name | Maria D Linden |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316137490 PECOS PAC ID: 6002967536 Enrollment ID: I20180921002442 |
| Provider Name | Mohammed Ismail Al Hamati |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851779920 PECOS PAC ID: 3375845886 Enrollment ID: I20181002003280 |
| Provider Name | Lucas Craig Webb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447732953 PECOS PAC ID: 5597017210 Enrollment ID: I20181008003159 |
| Provider Name | Kara Danielle Flatt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295819381 PECOS PAC ID: 1850643594 Enrollment ID: I20181009000570 |
| Provider Name | Brittany Elizabeth Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457834178 PECOS PAC ID: 6406108059 Enrollment ID: I20181009001551 |
| Provider Name | Nicholas Kyle Shockley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649766288 PECOS PAC ID: 8123370509 Enrollment ID: I20181012000980 |
| Provider Name | Arsalan Salamat |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1669737243 PECOS PAC ID: 0345511481 Enrollment ID: I20181015002705 |
| Provider Name | Yasmin Farouk Tootla |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447544903 PECOS PAC ID: 5092099390 Enrollment ID: I20181101000664 |
| Provider Name | Katharine Johnson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306322110 PECOS PAC ID: 1254685126 Enrollment ID: I20181112001699 |
| Provider Name | Nicholas Anthony Kusnezov |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396185161 PECOS PAC ID: 3476803248 Enrollment ID: I20181130001792 |
| Provider Name | Cortney Dawn Meyer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1427461581 PECOS PAC ID: 1850635558 Enrollment ID: I20181206002905 |
| Provider Name | Kasey C Nelson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1205050416 PECOS PAC ID: 2769576719 Enrollment ID: I20190102000921 |
| Provider Name | Alan John Wilson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386774388 PECOS PAC ID: 8426125485 Enrollment ID: I20190103001057 |
| Provider Name | Imtiaz Alam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619064284 PECOS PAC ID: 7416932371 Enrollment ID: I20190124001002 |
| Provider Name | Michael E Branch |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1649246984 PECOS PAC ID: 5890885859 Enrollment ID: I20190221000207 |
| Provider Name | Leslie Ann Hickman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184196883 PECOS PAC ID: 1557601580 Enrollment ID: I20190328002317 |
| Provider Name | Jessica Morgan Hays |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194297879 PECOS PAC ID: 1759622822 Enrollment ID: I20190418001195 |
| Provider Name | Kathy S Devous |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538722202 PECOS PAC ID: 3173865680 Enrollment ID: I20190503000063 |
| Provider Name | Derek W Von Haag |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1073507026 PECOS PAC ID: 8224009980 Enrollment ID: I20190515001531 |
| Provider Name | Syed Saif Zahir |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649666900 PECOS PAC ID: 6406105782 Enrollment ID: I20190521001990 |
| Provider Name | Anne Margarette Bacal |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1992119176 PECOS PAC ID: 8123338233 Enrollment ID: I20190604000841 |
| Provider Name | Stephanie Nicole Whitlock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588222608 PECOS PAC ID: 1456684109 Enrollment ID: I20190611003298 |
| Provider Name | Basmah N Jilani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538519046 PECOS PAC ID: 4385981760 Enrollment ID: I20190613000861 |
| Provider Name | Ifeanyichukwu Anoka |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1639522998 PECOS PAC ID: 6305170747 Enrollment ID: I20190619000420 |
| Provider Name | Nishat Fatima |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1760898936 PECOS PAC ID: 6800191974 Enrollment ID: I20190626002503 |
| Provider Name | Ahmad Zafar Chaudhry |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1144304635 PECOS PAC ID: 0547386849 Enrollment ID: I20190703002396 |
| Provider Name | Tsahi Samra |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1255782082 PECOS PAC ID: 7416282884 Enrollment ID: I20190709000457 |
| Provider Name | Jason Everett West |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760831218 PECOS PAC ID: 2365733581 Enrollment ID: I20190709003055 |
| Provider Name | Victor Hugo Cepeda |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1033524715 PECOS PAC ID: 1355647314 Enrollment ID: I20190710000893 |
| Provider Name | Amar Rawal |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1538591268 PECOS PAC ID: 6901131168 Enrollment ID: I20190710001256 |
| Provider Name | Oluwatosin Beatrice Aluko-olokun |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1992168702 PECOS PAC ID: 6507148962 Enrollment ID: I20190711000135 |
| Provider Name | Sahil Gupta |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1972914869 PECOS PAC ID: 0446538730 Enrollment ID: I20190801001458 |
| Provider Name | William W Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801358163 PECOS PAC ID: 8123355542 Enrollment ID: I20190808000336 |
| Provider Name | Bachir Berbari |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1407288996 PECOS PAC ID: 6901133867 Enrollment ID: I20190815000257 |
| Provider Name | Salim Hosein |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1639427933 PECOS PAC ID: 5799007290 Enrollment ID: I20190816000585 |
| Provider Name | Vincent C Compton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1437719093 PECOS PAC ID: 9739417411 Enrollment ID: I20190819002983 |
| Provider Name | Long Ha Huynh |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013112283 PECOS PAC ID: 6800932468 Enrollment ID: I20190821002118 |
| Provider Name | Sarah K Basler |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447749841 PECOS PAC ID: 1850629379 Enrollment ID: I20190822000023 |
| Provider Name | Elliott Arnaud Lhospital |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1568880243 PECOS PAC ID: 6901134337 Enrollment ID: I20190823000577 |
| Provider Name | Mutaz Musa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1720432115 PECOS PAC ID: 8527396795 Enrollment ID: I20190826003076 |
| Provider Name | Numan Jahangir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1174985634 PECOS PAC ID: 8022303999 Enrollment ID: I20190905000022 |
| Provider Name | Stephen Otieno Awuor |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1790047736 PECOS PAC ID: 1759528854 Enrollment ID: I20190905002209 |
| Provider Name | Tiffany Ramseur Cowan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386876100 PECOS PAC ID: 1052466687 Enrollment ID: I20190909000996 |
| Provider Name | Ellie Marie Bentley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1093157315 PECOS PAC ID: 4587993019 Enrollment ID: I20190910000114 |
| Provider Name | Qianqian Xu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649618620 PECOS PAC ID: 6608158795 Enrollment ID: I20190910000135 |
| Provider Name | Allison Magnuson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1659751998 PECOS PAC ID: 6204187586 Enrollment ID: I20190912000197 |
| Provider Name | Anne Melinda Clayton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1447767603 PECOS PAC ID: 7911262506 Enrollment ID: I20190917003037 |
| Provider Name | Gregory S Clark |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1528627833 PECOS PAC ID: 8123358199 Enrollment ID: I20190918002030 |
| Provider Name | Alexis Korbar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609424399 PECOS PAC ID: 8022348978 Enrollment ID: I20190919002095 |
| Provider Name | William Ross Gray |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1114378882 PECOS PAC ID: 7911299300 Enrollment ID: I20190923000980 |
| Provider Name | Kaitlin Elizabeth Behnken |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720632508 PECOS PAC ID: 3375873946 Enrollment ID: I20190924002752 |
| Provider Name | Jessie Nicole Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033768577 PECOS PAC ID: 2860722402 Enrollment ID: I20190925001783 |
| Provider Name | Allison Frost |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528622644 PECOS PAC ID: 9032449178 Enrollment ID: I20191002003049 |
| Provider Name | Purnima Sharma |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265852644 PECOS PAC ID: 9830469261 Enrollment ID: I20191003000529 |
| Provider Name | Benjamin P Roose |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1609286509 PECOS PAC ID: 6800012253 Enrollment ID: I20191004001807 |
| Provider Name | Maryann Chrzaszcz |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1750777470 PECOS PAC ID: 3577857051 Enrollment ID: I20191008001698 |
| Provider Name | Brandi L Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427609775 PECOS PAC ID: 3173854718 Enrollment ID: I20191011000601 |
| Provider Name | Jodi Midiri |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528454170 PECOS PAC ID: 2769788207 Enrollment ID: I20191014000773 |
| Provider Name | Dawn Marie Stowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306490438 PECOS PAC ID: 0446581656 Enrollment ID: I20191018000751 |
| Provider Name | Jessica Oakley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194367318 PECOS PAC ID: 5890027999 Enrollment ID: I20191022002764 |
| Provider Name | Patricia Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306488127 PECOS PAC ID: 9133451263 Enrollment ID: I20191023000470 |
| Provider Name | Cassandra Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356995401 PECOS PAC ID: 9739411695 Enrollment ID: I20191025000054 |
| Provider Name | Ahmed U Sharif |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780034926 PECOS PAC ID: 3173816550 Enrollment ID: I20191030000349 |
| Provider Name | Gina Gladson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437699147 PECOS PAC ID: 2567794019 Enrollment ID: I20191101001048 |
| Provider Name | Jamal Jameel Mosabbeh |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861410771 PECOS PAC ID: 6608821632 Enrollment ID: I20191112000207 |
| Provider Name | Marc A Tressler |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1003903121 PECOS PAC ID: 2466498597 Enrollment ID: I20191112001255 |
| Provider Name | Jill Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770125817 PECOS PAC ID: 3678905692 Enrollment ID: I20191113001668 |
| Provider Name | Puja Mathur |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366709438 PECOS PAC ID: 0941596225 Enrollment ID: I20191121000567 |
| Provider Name | Heather Dawn Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053880781 PECOS PAC ID: 4981949948 Enrollment ID: I20191127001392 |
| Provider Name | Brooke A Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912549965 PECOS PAC ID: 8820421928 Enrollment ID: I20191203002845 |
| Provider Name | Barbara Joyce Gatton |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1659573749 PECOS PAC ID: 0042227308 Enrollment ID: I20191224000534 |
| Provider Name | Tara Lynn Hartley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639718612 PECOS PAC ID: 4981039377 Enrollment ID: I20200113001153 |
| Provider Name | Gregory Szych |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1841268521 PECOS PAC ID: 4688655467 Enrollment ID: I20200122000120 |
| Provider Name | Ganga Prabhakar |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1023109444 PECOS PAC ID: 6709860943 Enrollment ID: I20200130002235 |
| Provider Name | Bruce A Weiner |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1720084080 PECOS PAC ID: 6608947940 Enrollment ID: I20200205000266 |
| Provider Name | David Hak |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942290341 PECOS PAC ID: 0547272619 Enrollment ID: I20200207001644 |
| Provider Name | Jeffrey D Meier |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1427212091 PECOS PAC ID: 9739247958 Enrollment ID: I20200212000002 |
| Provider Name | Jamie M Hultgren |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114563368 PECOS PAC ID: 9032546429 Enrollment ID: I20200225000693 |
| Provider Name | Patrick Leonberger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063823763 PECOS PAC ID: 2163796566 Enrollment ID: I20200310002753 |
| Provider Name | Nichole Jean Boudet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942834742 PECOS PAC ID: 1355779745 Enrollment ID: I20200318001231 |
| Provider Name | Larry Zhao |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1700012689 PECOS PAC ID: 7416262621 Enrollment ID: I20200318001616 |
| Provider Name | John L Thurston |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1588959076 PECOS PAC ID: 9436440245 Enrollment ID: I20200319001668 |
| Provider Name | Tiffany Nicole Hines |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134605488 PECOS PAC ID: 1658611850 Enrollment ID: I20200320001722 |
| Provider Name | Pramodh K Wadera |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1417949553 PECOS PAC ID: 9436184512 Enrollment ID: I20200325000139 |
| Provider Name | Lindsay B Casolari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043846421 PECOS PAC ID: 3476982299 Enrollment ID: I20200330003768 |
| Provider Name | Ramakrishna Venkatesh |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1548286768 PECOS PAC ID: 1759446792 Enrollment ID: I20200413003782 |
| Provider Name | Grant Bochicchio |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255388906 PECOS PAC ID: 9133311509 Enrollment ID: I20200415000241 |
| Provider Name | Douglas Schuerer |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1922024140 PECOS PAC ID: 8820980204 Enrollment ID: I20200416002309 |
| Provider Name | Kelly Vallar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033403589 PECOS PAC ID: 0648572008 Enrollment ID: I20200421000354 |
| Provider Name | Piroska Kopar |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1760601116 PECOS PAC ID: 4183932817 Enrollment ID: I20200422002005 |
| Provider Name | Debra S Lumbley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1730146408 PECOS PAC ID: 1153313424 Enrollment ID: I20200518001154 |
| Provider Name | Jennifer Leonard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1619256641 PECOS PAC ID: 3678729696 Enrollment ID: I20200520000291 |
| Provider Name | Kelli Jo Kirkpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932722196 PECOS PAC ID: 2466873450 Enrollment ID: I20200529000597 |
| Provider Name | Shawn Pyle |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1104964519 PECOS PAC ID: 3779729207 Enrollment ID: I20200610000347 |
| Provider Name | Jason Snyder |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1447419320 PECOS PAC ID: 2860786852 Enrollment ID: I20200617003286 |
| Provider Name | Joanna E Gernsback |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1215252440 PECOS PAC ID: 3577891951 Enrollment ID: I20200622001126 |
| Provider Name | Michelle D Corzine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306465919 PECOS PAC ID: 8426470329 Enrollment ID: I20200623001763 |
| Provider Name | Gurveen Pal Singh Malhotra |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1154671741 PECOS PAC ID: 1850601758 Enrollment ID: I20200624001443 |
| Provider Name | Zohaib Akhtar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1760896633 PECOS PAC ID: 2668778556 Enrollment ID: I20200722003459 |
| Provider Name | Muhammad Amjad Hameed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326423823 PECOS PAC ID: 3971891722 Enrollment ID: I20200727000141 |
| Provider Name | Emily Jo Stickney |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134770175 PECOS PAC ID: 9234569369 Enrollment ID: I20200810000342 |
| Provider Name | Benjamin Collie |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689029654 PECOS PAC ID: 2860752789 Enrollment ID: I20200811001501 |
| Provider Name | Bethany Kelley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1417306838 PECOS PAC ID: 5890089668 Enrollment ID: I20200814000851 |
| Provider Name | Kavan G Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1437541406 PECOS PAC ID: 2769737337 Enrollment ID: I20200818001324 |
| Provider Name | Kirubel Herano |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1902333743 PECOS PAC ID: 8628340320 Enrollment ID: I20200820003358 |
| Provider Name | Prativa Pandey |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1871029280 PECOS PAC ID: 8729405436 Enrollment ID: I20200826002228 |
| Provider Name | Bethany Ann Butler |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1922342427 PECOS PAC ID: 2365697224 Enrollment ID: I20200826002531 |
| Provider Name | Anup Sud |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1316972631 PECOS PAC ID: 4486752649 Enrollment ID: I20200827002541 |
| Provider Name | Nida Junaid |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1053678755 PECOS PAC ID: 5597037986 Enrollment ID: I20200828000046 |
| Provider Name | Kali J Moe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790238160 PECOS PAC ID: 6103104534 Enrollment ID: I20200901002134 |
| Provider Name | Adam Waller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508476615 PECOS PAC ID: 9931527512 Enrollment ID: I20200914002215 |
| Provider Name | Krishna Chaitanya Cherukuri |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1487096962 PECOS PAC ID: 3173811718 Enrollment ID: I20200921002874 |
| Provider Name | Jessica Lohman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619412475 PECOS PAC ID: 7810261674 Enrollment ID: I20200922000332 |
| Provider Name | Elizabeth Bush |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1609217850 PECOS PAC ID: 2567606619 Enrollment ID: I20200929003603 |
| Provider Name | Alex Htun |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1326546201 PECOS PAC ID: 8527484633 Enrollment ID: I20201009001286 |
| Provider Name | Cynthia Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568071132 PECOS PAC ID: 8325458953 Enrollment ID: I20201110000628 |
| Provider Name | Patrick Kohlitz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962720482 PECOS PAC ID: 5395988620 Enrollment ID: I20201123000816 |
| Provider Name | Garri Priyampolskiy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1659760833 PECOS PAC ID: 6406129212 Enrollment ID: I20201224000209 |
| Provider Name | Candra D. Kronewitter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831788637 PECOS PAC ID: 1557776234 Enrollment ID: I20210210000432 |
| Provider Name | Brandon M Ufert |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1053932236 PECOS PAC ID: 3577978287 Enrollment ID: I20210210001881 |
| Provider Name | Vandra Harris |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1861828097 PECOS PAC ID: 2769606201 Enrollment ID: I20210215000012 |
| Provider Name | Kassandra L Magin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1760073340 PECOS PAC ID: 3577978881 Enrollment ID: I20210219000061 |
| Provider Name | Priyanka Baweja |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023322567 PECOS PAC ID: 4082863402 Enrollment ID: I20210226000017 |
| Provider Name | Ahmed A Khan |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1780017749 PECOS PAC ID: 9133424096 Enrollment ID: I20210302003145 |
| Provider Name | Anne Hardy-henry |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508276783 PECOS PAC ID: 6305124488 Enrollment ID: I20210303000869 |
| Provider Name | Charles Gerz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497993380 PECOS PAC ID: 8921318858 Enrollment ID: I20210323001602 |
| Provider Name | Muhammad Iqbal |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1548249931 PECOS PAC ID: 2062431547 Enrollment ID: I20210331002350 |
| Provider Name | David Vaccaro |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1548852437 PECOS PAC ID: 2961810122 Enrollment ID: I20210428001191 |
| Provider Name | Arslan Mirza |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073928776 PECOS PAC ID: 7113216169 Enrollment ID: I20210609001244 |
| Provider Name | Travis Petricek |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558546598 PECOS PAC ID: 2961553458 Enrollment ID: I20210616000361 |
| Provider Name | Taylor Rice |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992372817 PECOS PAC ID: 5496155152 Enrollment ID: I20210617000416 |
| Provider Name | Mitchell Reynolds |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1043603764 PECOS PAC ID: 7012220627 Enrollment ID: I20210618001115 |
| Provider Name | Sumeet Soni |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1962885293 PECOS PAC ID: 8022369172 Enrollment ID: I20210622001317 |
| Provider Name | Dominic Lee Phemister |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1306339189 PECOS PAC ID: 7214284538 Enrollment ID: I20210625001598 |
| Provider Name | Efstathios Karamanos |
|---|---|
| Provider Type | Practitioner - Plastic And Reconstructive Surgery |
| Provider Identifiers | NPI Number: 1861838260 PECOS PAC ID: 8820220619 Enrollment ID: I20210629000723 |
| Provider Name | Robert Sprague |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1255788022 PECOS PAC ID: 7315377256 Enrollment ID: I20210630001779 |
| Provider Name | Tramon C Hunnicutt |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1407425283 PECOS PAC ID: 9032511597 Enrollment ID: I20210707001894 |
| Provider Name | Jacob S Wolpers |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861062424 PECOS PAC ID: 2466854690 Enrollment ID: I20210712001187 |
| Provider Name | Kenechukwu Olufemi Chudy-onwugaje |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1861749780 PECOS PAC ID: 1355632233 Enrollment ID: I20210713000932 |
| Provider Name | Lakshmi Manogna Chintalacheruvu |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1417330283 PECOS PAC ID: 3971882242 Enrollment ID: I20210719003088 |
| Provider Name | Jonatan Hornik |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578941753 PECOS PAC ID: 9638472939 Enrollment ID: I20210720004027 |
| Provider Name | Andrea Loggini |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043695810 PECOS PAC ID: 1658663620 Enrollment ID: I20210721000137 |
| Provider Name | Hassan Pervaiz |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1710339817 PECOS PAC ID: 4789015934 Enrollment ID: I20210721000370 |
| Provider Name | Abdelhameed Nawwar |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1699218511 PECOS PAC ID: 4789087230 Enrollment ID: I20210721004192 |
| Provider Name | Kilali I Iyalla |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1811309214 PECOS PAC ID: 5890198832 Enrollment ID: I20210728001150 |
| Provider Name | Dennis Asamoah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518489889 PECOS PAC ID: 1951648096 Enrollment ID: I20210731000345 |
| Provider Name | Hal A Lewis |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1124554209 PECOS PAC ID: 5890067250 Enrollment ID: I20210810000875 |
| Provider Name | Jamie Josephine Compton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023680972 PECOS PAC ID: 8628472545 Enrollment ID: I20210813001270 |
| Provider Name | Donnell Carter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427238039 PECOS PAC ID: 7113005471 Enrollment ID: I20210816001548 |
| Provider Name | Alaa Ahmed |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144742230 PECOS PAC ID: 6800291311 Enrollment ID: I20210823000156 |
| Provider Name | Christina Etherton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629640594 PECOS PAC ID: 7517364433 Enrollment ID: I20210920003328 |
| Provider Name | Roy R Danks |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1306812029 PECOS PAC ID: 8224936729 Enrollment ID: I20210921002734 |
| Provider Name | Rachel M Fricker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558939207 PECOS PAC ID: 7911304464 Enrollment ID: I20210924003001 |
| Provider Name | Michael A Blasco |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1588082945 PECOS PAC ID: 3870896210 Enrollment ID: I20210927000831 |
| Provider Name | Katrina C Followell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417626979 PECOS PAC ID: 5496152613 Enrollment ID: I20210930000581 |
| Provider Name | Hiba A Haider |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558687939 PECOS PAC ID: 3476860438 Enrollment ID: I20211029001873 |
| Provider Name | Pamela J Clarida |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790391977 PECOS PAC ID: 5395135776 Enrollment ID: I20211129000157 |
| Provider Name | Catherine Eileen Oconnor |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1134189434 PECOS PAC ID: 0244219434 Enrollment ID: I20211202002013 |
| Provider Name | Jenna Whitehead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891452439 PECOS PAC ID: 1254721152 Enrollment ID: I20211208002957 |
| Provider Name | Dhananjay Deoskar |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1861696262 PECOS PAC ID: 9436222833 Enrollment ID: I20211220001098 |
| Provider Name | Emily L Martin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306504790 PECOS PAC ID: 7113318254 Enrollment ID: I20211227000942 |
| Provider Name | Trisha Lynn Phemister |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457017063 PECOS PAC ID: 4981095957 Enrollment ID: I20211230000063 |
| Provider Name | Stacey Elaine Oddera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558964080 PECOS PAC ID: 4082006804 Enrollment ID: I20220127001898 |
| Provider Name | Amy J Glasco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689241309 PECOS PAC ID: 0941692792 Enrollment ID: I20220127002982 |
| Provider Name | Megan Morriss |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1548642291 PECOS PAC ID: 8527372614 Enrollment ID: I20220201000603 |
| Provider Name | Garrett William Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821766973 PECOS PAC ID: 9537552609 Enrollment ID: I20220214000766 |
| Provider Name | Daniel Schuh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821551383 PECOS PAC ID: 4082007927 Enrollment ID: I20220217000134 |
| Provider Name | Claudia L Altmann |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1386691756 PECOS PAC ID: 7113008681 Enrollment ID: I20220305000028 |
| Provider Name | Kimberly Shani Forte |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1568782738 PECOS PAC ID: 4183852023 Enrollment ID: I20220309000322 |
| Provider Name | Paul Albert Tennant |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1245402353 PECOS PAC ID: 6406027408 Enrollment ID: I20220309002651 |
| Provider Name | Jordan M Kirsch |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1376920538 PECOS PAC ID: 3375853070 Enrollment ID: I20220330000691 |
| Provider Name | Harry H Hill |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1851316970 PECOS PAC ID: 6709771801 Enrollment ID: I20220331002894 |
| Provider Name | Lloyd Panjikaran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609372341 PECOS PAC ID: 6709134414 Enrollment ID: I20220405003039 |
| Provider Name | Lacie M Hitchens |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508512666 PECOS PAC ID: 9537555750 Enrollment ID: I20220414001994 |
| Provider Name | Nichole Justice |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376211151 PECOS PAC ID: 7911384912 Enrollment ID: I20220512001804 |
| Provider Name | Tiffany Colborn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982344214 PECOS PAC ID: 9537546254 Enrollment ID: I20220519000674 |
| Provider Name | Abbas Omais |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1699748046 PECOS PAC ID: 9133213226 Enrollment ID: I20220607000091 |
| Provider Name | Aaron King |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1538454426 PECOS PAC ID: 7214230606 Enrollment ID: I20220611000256 |
| Provider Name | Michael Mengarelli |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568022507 PECOS PAC ID: 5698001287 Enrollment ID: I20220707001977 |
| Provider Name | Ayesha Saeed |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801458245 PECOS PAC ID: 0345675427 Enrollment ID: I20220715000057 |
| Provider Name | Jacob Mark Burdett |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1104366574 PECOS PAC ID: 1557742947 Enrollment ID: I20220715002503 |
| Provider Name | Peter Filip |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1518493782 PECOS PAC ID: 9335485465 Enrollment ID: I20220718003662 |
| Provider Name | Poonam Thakore |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1447612148 PECOS PAC ID: 6305125790 Enrollment ID: I20220719001616 |
| Provider Name | Fadi Abou Obeid |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1811304751 PECOS PAC ID: 0547570855 Enrollment ID: I20220719001697 |
| Provider Name | Edgar Bello-martinez |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699201384 PECOS PAC ID: 5890044093 Enrollment ID: I20220719001965 |
| Provider Name | Eric Christopher Batory |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407410350 PECOS PAC ID: 0143601179 Enrollment ID: I20220721001626 |
| Provider Name | Rizwan Ahmad Khan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1902288855 PECOS PAC ID: 6800149949 Enrollment ID: I20220726002626 |
| Provider Name | Brent Hitchens |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1992438451 PECOS PAC ID: 1153703848 Enrollment ID: I20220727002355 |
| Provider Name | Jeffrey A Sorensen |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1578805651 PECOS PAC ID: 9335431873 Enrollment ID: I20220802001336 |
| Provider Name | Jessica Kathryn Staszak |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114360690 PECOS PAC ID: 9638316201 Enrollment ID: I20220812002085 |
| Provider Name | Javed S Iqbal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1649614462 PECOS PAC ID: 2769609957 Enrollment ID: I20220816002145 |
| Provider Name | Frederick Christiaan Venter |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1942860671 PECOS PAC ID: 7618350877 Enrollment ID: I20220821000075 |
| Provider Name | Hilda Watkins-williams |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1265994248 PECOS PAC ID: 1951630862 Enrollment ID: I20220821000080 |
| Provider Name | Mohammad Nimer |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1710440193 PECOS PAC ID: 1355676461 Enrollment ID: I20220823001150 |
| Provider Name | Attila Sandor Dobos |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1649765140 PECOS PAC ID: 7719360890 Enrollment ID: I20220823001751 |
| Provider Name | Ekanga Sunday Petters |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144751827 PECOS PAC ID: 8527331321 Enrollment ID: I20220907001693 |
| Provider Name | Awni D Shahait |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1871972422 PECOS PAC ID: 4284936154 Enrollment ID: I20220908002216 |
| Provider Name | Christopher Lewis |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578745493 PECOS PAC ID: 0648323147 Enrollment ID: I20220908002514 |
| Provider Name | Saad Habib |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063868818 PECOS PAC ID: 2365787876 Enrollment ID: I20220908003641 |
| Provider Name | Zahra Alsultan |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1952893778 PECOS PAC ID: 9436405651 Enrollment ID: I20220912003408 |
| Provider Name | David Hunt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982338877 PECOS PAC ID: 5092190439 Enrollment ID: I20220921000239 |
| Provider Name | Andrea K Hammer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841928967 PECOS PAC ID: 4587049812 Enrollment ID: I20220922000672 |
| Provider Name | Kenten Pey-kuen Wang |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1013998186 PECOS PAC ID: 7618162256 Enrollment ID: I20220927001330 |
| Provider Name | Daniel Elizondo |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1366002362 PECOS PAC ID: 1456687672 Enrollment ID: I20220927002210 |
| Provider Name | Brittany Kramer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619609328 PECOS PAC ID: 6608252259 Enrollment ID: I20221005000223 |
| Provider Name | Rebecca E Renfroe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093450728 PECOS PAC ID: 9032595335 Enrollment ID: I20221010001169 |
| Provider Name | Vishnu Raj Kumar Mani |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174964951 PECOS PAC ID: 3476956095 Enrollment ID: I20221016000028 |
| Provider Name | Michael S James |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659004430 PECOS PAC ID: 5597131524 Enrollment ID: I20221017002058 |
| Provider Name | Mariah Gloria Teriet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275267262 PECOS PAC ID: 5294101101 Enrollment ID: I20221018002156 |
| Provider Name | Justin Ross Whipple |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225629975 PECOS PAC ID: 3072989532 Enrollment ID: I20221025001471 |
| Provider Name | Pairote Jaroonwanichkul |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1801893979 PECOS PAC ID: 4183636533 Enrollment ID: I20221027000635 |
| Provider Name | Robert Willis |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1225033434 PECOS PAC ID: 5991705618 Enrollment ID: I20221123002019 |
| Provider Name | Ethan Mark Huckabee |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1043705395 PECOS PAC ID: 7810244217 Enrollment ID: I20221201003062 |
| Provider Name | Amy Leeann Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255973830 PECOS PAC ID: 0941635023 Enrollment ID: I20221212002132 |
| Provider Name | Anwar Cameron |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1548610595 PECOS PAC ID: 9335432715 Enrollment ID: I20221227001194 |
| Provider Name | Skylar Mccormick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780355016 PECOS PAC ID: 7416329073 Enrollment ID: I20230207002735 |
| Provider Name | Leah Rose Farley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114665866 PECOS PAC ID: 3173995628 Enrollment ID: I20230208003194 |
| Provider Name | Rachel L Michels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356059331 PECOS PAC ID: 0345612776 Enrollment ID: I20230214000419 |
| Provider Name | Jason Eng |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437513355 PECOS PAC ID: 2264729516 Enrollment ID: I20230310001085 |
| Provider Name | Halee B Essick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770295719 PECOS PAC ID: 8921473612 Enrollment ID: I20230411002085 |
| Provider Name | Samuel Laney |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1861590358 PECOS PAC ID: 3678679115 Enrollment ID: I20230418001269 |
| Provider Name | Marilyn Kline |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1629027586 PECOS PAC ID: 8325050933 Enrollment ID: I20230426001682 |
| Provider Name | Myranda Nicole Thomas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710676713 PECOS PAC ID: 9032575980 Enrollment ID: I20230518001220 |
| Provider Name | Hailee Elizabeth Basler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871123067 PECOS PAC ID: 3577929397 Enrollment ID: I20230522002031 |
| Provider Name | Danielle Jo Fisher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548800386 PECOS PAC ID: 7911364401 Enrollment ID: I20230526000595 |
| Provider Name | Anna Szyfer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134824790 PECOS PAC ID: 0244697621 Enrollment ID: I20230530001586 |
| Provider Name | Issa Pour Ghaz |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265962450 PECOS PAC ID: 2264702281 Enrollment ID: I20230612001382 |
| Provider Name | Anthony Guynes |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1285041137 PECOS PAC ID: 0446530810 Enrollment ID: I20230622001887 |
| Provider Name | Victoria Dare |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336830561 PECOS PAC ID: 7315305083 Enrollment ID: I20230628001350 |
| Provider Name | Ibraheem Javeed Mohammed |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1477047124 PECOS PAC ID: 9032578547 Enrollment ID: I20230630002195 |
| Provider Name | Is-haq Oladipo Malik |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1063998862 PECOS PAC ID: 9931502333 Enrollment ID: I20230703000471 |
| Provider Name | Eric Smith |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1073139051 PECOS PAC ID: 8022478791 Enrollment ID: I20230713002544 |
| Provider Name | Daniel A Kelver |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1194354456 PECOS PAC ID: 8628438744 Enrollment ID: I20230720000678 |
| Provider Name | Abbasali Badami |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1841641438 PECOS PAC ID: 7113388455 Enrollment ID: I20230802002219 |
| Provider Name | Jessica Serena Marie Belobraydic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699120055 PECOS PAC ID: 1658732938 Enrollment ID: I20230802003762 |
| Provider Name | Johnnatan Marin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1164059259 PECOS PAC ID: 3577923036 Enrollment ID: I20230803003244 |
| Provider Name | Luke Man Lin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932694452 PECOS PAC ID: 7214327873 Enrollment ID: I20230817001664 |
| Provider Name | Cyril Kamya |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1245783588 PECOS PAC ID: 4385932664 Enrollment ID: I20230817003460 |
| Provider Name | Brian Knight |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1952938193 PECOS PAC ID: 7719349901 Enrollment ID: I20230821001890 |
| Provider Name | Oleksii Iakymenko |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1598286353 PECOS PAC ID: 3870956733 Enrollment ID: I20230825001574 |
| Provider Name | Divyesh Nemakayala |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255781217 PECOS PAC ID: 3779812144 Enrollment ID: I20230908000386 |
| Provider Name | Janalyn Elwood |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346952728 PECOS PAC ID: 4587028535 Enrollment ID: I20230911001152 |
| Provider Name | Turenne M Metayer |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1124588892 PECOS PAC ID: 6103280755 Enrollment ID: I20230914002671 |
| Provider Name | Brianna Lee Darnell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144965245 PECOS PAC ID: 1658735220 Enrollment ID: I20230914003211 |
| Provider Name | Ashley Nicole Mitchell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003598269 PECOS PAC ID: 6204290646 Enrollment ID: I20230918003967 |
| Provider Name | Hannah Pellman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437832193 PECOS PAC ID: 8123482585 Enrollment ID: I20230919000090 |
| Provider Name | Ashley Rose Craig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194406777 PECOS PAC ID: 6800240029 Enrollment ID: I20230921002847 |
| Provider Name | Yasser Youssef |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1700308376 PECOS PAC ID: 2062766629 Enrollment ID: I20231011004076 |
| Provider Name | Angela Lea O'dell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831196120 PECOS PAC ID: 4688568769 Enrollment ID: I20231012000169 |
| Provider Name | Stefan Rozycki |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1538401146 PECOS PAC ID: 4789039298 Enrollment ID: I20231018000716 |
| Provider Name | Sonya Clark |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225810682 PECOS PAC ID: 5395191050 Enrollment ID: I20231101000699 |
| Provider Name | Morgan Rose Flamm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881472603 PECOS PAC ID: 3072961242 Enrollment ID: I20231128003396 |
| Provider Name | Roger Shinnerl |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1760684765 PECOS PAC ID: 7719979467 Enrollment ID: I20231201001014 |
| Provider Name | Najah Waters |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1629331426 PECOS PAC ID: 8921255852 Enrollment ID: I20231204002924 |
| Provider Name | Roger Pons |
|---|---|
| Provider Type | Practitioner - Undersea And Hyperbaric Medicine |
| Provider Identifiers | NPI Number: 1548217383 PECOS PAC ID: 7214097450 Enrollment ID: I20240103002076 |
| Provider Name | Noel Phan |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1396241311 PECOS PAC ID: 3072859040 Enrollment ID: I20240403002936 |
| Provider Name | Adam Pearson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1841423589 PECOS PAC ID: 0840638128 Enrollment ID: I20240405000097 |
| Provider Name | Shelby L Payne |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205691425 PECOS PAC ID: 9436598885 Enrollment ID: I20240417003134 |
| Provider Name | Daniel Cybulski |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1487044152 PECOS PAC ID: 4284949637 Enrollment ID: I20240522000340 |
| Provider Name | Jane Luanne Nichols |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1235495672 PECOS PAC ID: 0345782199 Enrollment ID: I20240607000896 |
Student Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 374 East Grand Avenue, Mail Code 674d, Carbondale, IL 62901 Phone: 618-453-3311 Fax: 618-453-4449 | |
The Carbondale Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2601 W Main St, Carbondale, IL 62901 Phone: 618-457-5200 Fax: 618-549-5128 | |
Cedar Court Specialty Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1250 Cedar Ct, Carbondale, IL 62901 Phone: 618-351-1213 Fax: 618-351-1905 | |
Southern Illinois Gi Specialists Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1100 W Diann Ln, Carbondale, IL 62901 Phone: 618-549-8006 Fax: 618-549-8434 | |
Carbondale Community High Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 S Giant City Rd, Carbondale, IL 62902 Phone: 618-457-4722 Fax: 618-457-3353 | |
Center For Medical Arts Rural Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2601 W Main St, Carbondale, IL 62901 Phone: 618-549-5361 Fax: 618-351-4878 | |
Board Of Trustees Of Southern Illinois University Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 300 W Oak St Ste 100, Carbondale, IL 62901 Phone: 217-545-8000 |