| Prime Physicians | |
|
2720 Stone Park Blvd Ste 335 Sioux City IA 51104-3734 | |
| (605) 937-5537 | |
| (712) 279-3640 |
| Full Name | Prime Physicians |
|---|---|
| Speciality | Internal Medicine |
| Location | 2720 Stone Park Blvd Ste 335, Sioux City, Iowa |
| Authorized Official Name and Position | Alexandra N Wolf (CREDENTIALING MANAGER) |
| Authorized Official Contact | 6059375537 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Prime Physicians 2720 Stone Park Blvd Ste 335 Sioux City IA 51104-3734 Ph: (605) 937-5537 | Prime Physicians 2720 Stone Park Blvd Ste 335 Sioux City IA 51104-3734 Ph: (605) 937-5537 |
| NPI Number | 1831598614 |
|---|---|
| Provider Enumeration Date | 08/18/2014 |
| Last Update Date | 04/21/2022 |
| Medicare PECOS PAC ID | 8123343803 |
|---|---|
| Medicare Enrollment ID | O20150223000318 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831598614 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Jolynn Bugbee |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1801858774 PECOS PAC ID: 3678562246 Enrollment ID: I20041110000584 |
| Provider Name | Chakravarthi Pureti |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780809004 PECOS PAC ID: 3375696628 Enrollment ID: I20090804000150 |
| Provider Name | Kantima Phisitkul |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1063604726 PECOS PAC ID: 8820121312 Enrollment ID: I20100804000779 |
| Provider Name | Yong H Pratt |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1477789873 PECOS PAC ID: 8022273564 Enrollment ID: I20130221000005 |
| Provider Name | Amanda L Hogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427480425 PECOS PAC ID: 7012235583 Enrollment ID: I20150413001746 |
| Provider Name | George Makhoul |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104180652 PECOS PAC ID: 7911228069 Enrollment ID: I20150602001191 |
| Provider Name | Matthew R Humpal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609135375 PECOS PAC ID: 6103056171 Enrollment ID: I20150709000476 |
| Provider Name | Ali Aziz |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1750767786 PECOS PAC ID: 1355690710 Enrollment ID: I20180817000303 |
| Provider Name | Erin Michelle Mothershead |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902452030 PECOS PAC ID: 9436481611 Enrollment ID: I20191022001097 |
| Provider Name | Sivjot Binepal |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1134659568 PECOS PAC ID: 9436428380 Enrollment ID: I20200511003479 |
| Provider Name | Kay Lynn Erickson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609487867 PECOS PAC ID: 6204252620 Enrollment ID: I20200817001560 |
| Provider Name | David Tillman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972100618 PECOS PAC ID: 0648690180 Enrollment ID: I20201021002240 |
| Provider Name | Amy L Peirce |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255004784 PECOS PAC ID: 9537565205 Enrollment ID: I20210903000261 |
| Provider Name | Toni M Van Dusen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487328415 PECOS PAC ID: 9931505013 Enrollment ID: I20210915002256 |
| Provider Name | Alex M Gerdes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942936885 PECOS PAC ID: 0840673570 Enrollment ID: I20220812002894 |
| Provider Name | Dakota Bryce Bremser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518690502 PECOS PAC ID: 4385029404 Enrollment ID: I20220909001887 |
| Provider Name | Jennifer Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346851235 PECOS PAC ID: 8123483146 Enrollment ID: I20230426002870 |
| Provider Name | Phani Keerthi Surapaneni |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1356802201 PECOS PAC ID: 3072979061 Enrollment ID: I20230517001769 |
| Provider Name | Kelechi Ibe-ekeocha |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1215565536 PECOS PAC ID: 9436518354 Enrollment ID: I20230710001957 |
| Provider Name | Kendra J Goeden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548995459 PECOS PAC ID: 9032579545 Enrollment ID: I20230715000509 |
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