| Smg Vcs Region | |
|
7264 Warren Sharon Rd Brookfield OH 44403-9691 | |
| (615) 467-4158 | |
| (615) 467-1267 |
| Full Name | Smg Vcs Region |
|---|---|
| Speciality | Internal Medicine |
| Location | 7264 Warren Sharon Rd, Brookfield, Ohio |
| Authorized Official Name and Position | Ashley Koch (CFO) |
| Authorized Official Contact | 6175625359 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smg Vcs Region 9 Galen St Watertown MA 02472-4515 Ph: (617) 562-5359 | Smg Vcs Region 7264 Warren Sharon Rd Brookfield OH 44403-9691 Ph: (615) 467-4158 |
| NPI Number | 1902347438 |
|---|---|
| Provider Enumeration Date | 03/16/2017 |
| Last Update Date | 08/13/2020 |
| Medicare PECOS PAC ID | 2860688728 |
|---|---|
| Medicare Enrollment ID | O20170515002104 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902347438 | NPI | - | NPPES |
| Provider Name | Anne M Stover |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174516835 PECOS PAC ID: 2668386939 Enrollment ID: I20031119000648 |
| Provider Name | David M Kennedy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1235120288 PECOS PAC ID: 1456257195 Enrollment ID: I20031211000847 |
| Provider Name | David A Hoffman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710063987 PECOS PAC ID: 7517869308 Enrollment ID: I20040122001147 |
| Provider Name | David L D'amore |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558454108 PECOS PAC ID: 4789578378 Enrollment ID: I20040224000438 |
| Provider Name | Muhammad Nurul Momen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1366533762 PECOS PAC ID: 4284610536 Enrollment ID: I20040628000127 |
| Provider Name | Paul A Rich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528060217 PECOS PAC ID: 0446228217 Enrollment ID: I20040922000283 |
| Provider Name | Jeffrey A Bedlion |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1194791269 PECOS PAC ID: 3173431673 Enrollment ID: I20040930000448 |
| Provider Name | Kruti M Shah |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1891751780 PECOS PAC ID: 6406813807 Enrollment ID: I20041217000116 |
| Provider Name | Maninder Singh Bedi |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1003851213 PECOS PAC ID: 4082665567 Enrollment ID: I20050202000007 |
| Provider Name | Sabrina Kelly Varga |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427024769 PECOS PAC ID: 7911946975 Enrollment ID: I20050428000731 |
| Provider Name | Charles L Demario |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629070552 PECOS PAC ID: 7810981040 Enrollment ID: I20051018000233 |
| Provider Name | Justin P Mikula |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508839614 PECOS PAC ID: 8426075185 Enrollment ID: I20051101000679 |
| Provider Name | Karen A Gapinski |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1386819829 PECOS PAC ID: 7517985641 Enrollment ID: I20051108000252 |
| Provider Name | Angela L Roberts |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194833509 PECOS PAC ID: 9436178993 Enrollment ID: I20051115000224 |
| Provider Name | Pedro A Ballester |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1659358588 PECOS PAC ID: 3870507650 Enrollment ID: I20060131000966 |
| Provider Name | Roger P Tokars |
|---|---|
| Provider Type | Practitioner - Radiation Oncology |
| Provider Identifiers | NPI Number: 1518990688 PECOS PAC ID: 6204845563 Enrollment ID: I20060413000551 |
| Provider Name | Daniel Ionescu |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861434748 PECOS PAC ID: 5991718918 Enrollment ID: I20060717000105 |
| Provider Name | Gregory A George |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417909243 PECOS PAC ID: 7618915729 Enrollment ID: I20061013000312 |
| Provider Name | James Francis Shina |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1063439651 PECOS PAC ID: 8224035167 Enrollment ID: I20061107000096 |
| Provider Name | James Eugene Boniface |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1538108816 PECOS PAC ID: 1052213758 Enrollment ID: I20061208000366 |
| Provider Name | Roseline Okon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1801998547 PECOS PAC ID: 4082613021 Enrollment ID: I20061220000316 |
| Provider Name | Steven P Hand |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1417092362 PECOS PAC ID: 2163528043 Enrollment ID: I20070509000787 |
| Provider Name | Michael Joseph Devine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245219419 PECOS PAC ID: 6103838230 Enrollment ID: I20070612000205 |
| Provider Name | Anthony Lattanzio |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184611287 PECOS PAC ID: 9335247451 Enrollment ID: I20070613000051 |
| Provider Name | Meredythe A Mcnally |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508830647 PECOS PAC ID: 0446212138 Enrollment ID: I20070814000880 |
| Provider Name | Shyam Bhakta |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1417094780 PECOS PAC ID: 5890887905 Enrollment ID: I20070822000083 |
| Provider Name | Howard G Slemons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154410686 PECOS PAC ID: 4385701754 Enrollment ID: I20090530000001 |
| Provider Name | Nicola Nicoloff |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1801868963 PECOS PAC ID: 6002808797 Enrollment ID: I20091201000219 |
| Provider Name | Thomas Jones |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346234598 PECOS PAC ID: 6800936790 Enrollment ID: I20091229000001 |
| Provider Name | Kenneth E Jones |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114911385 PECOS PAC ID: 7214947837 Enrollment ID: I20100105000100 |
| Provider Name | James Gerard Ryan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1659318699 PECOS PAC ID: 6901811967 Enrollment ID: I20100126000488 |
| Provider Name | Gary Randall Gibson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821097486 PECOS PAC ID: 1456484674 Enrollment ID: I20100809000268 |
| Provider Name | Lee Ann E Hritz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083920060 PECOS PAC ID: 0648464354 Enrollment ID: I20101027000002 |
| Provider Name | Swarajya Lakshmi Perni |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164490603 PECOS PAC ID: 1355536004 Enrollment ID: I20101108001455 |
| Provider Name | Brandon Mikolich |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215102421 PECOS PAC ID: 5698821635 Enrollment ID: I20110621000305 |
| Provider Name | Szymon M Krzyzanowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134384993 PECOS PAC ID: 0547431637 Enrollment ID: I20110921000573 |
| Provider Name | Tolga Icli |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114182979 PECOS PAC ID: 6709043763 Enrollment ID: I20120201001007 |
| Provider Name | Glen R Miske |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1316197080 PECOS PAC ID: 1759438500 Enrollment ID: I20120619000439 |
| Provider Name | Sameera Rahman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205067378 PECOS PAC ID: 5698926491 Enrollment ID: I20121102000338 |
| Provider Name | John J Ambrosino |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1821070327 PECOS PAC ID: 2163478868 Enrollment ID: I20140430002447 |
| Provider Name | Christopher P Kolibash |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1043228414 PECOS PAC ID: 2062417447 Enrollment ID: I20140520002414 |
| Provider Name | Roman Davidenko |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366739039 PECOS PAC ID: 7911123211 Enrollment ID: I20140722002581 |
| Provider Name | Jean E Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700866266 PECOS PAC ID: 2466479555 Enrollment ID: I20140722002720 |
| Provider Name | Penelope Mashburn |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1154650117 PECOS PAC ID: 4587882386 Enrollment ID: I20140819002832 |
| Provider Name | Jacob Alexander Bair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346597523 PECOS PAC ID: 7810203080 Enrollment ID: I20150902001962 |
| Provider Name | Andria D Simmons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164883484 PECOS PAC ID: 5496045536 Enrollment ID: I20160602001052 |
| Provider Name | Lori B Dellick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609229939 PECOS PAC ID: 8820384464 Enrollment ID: I20160908001692 |
| Provider Name | Basem N Doss |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588650113 PECOS PAC ID: 0345344982 Enrollment ID: I20160921002572 |
| Provider Name | Amy Calderon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821310004 PECOS PAC ID: 1850692856 Enrollment ID: I20170518002413 |
| Provider Name | Apurva Padubidri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619397510 PECOS PAC ID: 0547566937 Enrollment ID: I20170914002222 |
| Provider Name | Charmaine Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942722418 PECOS PAC ID: 3476828922 Enrollment ID: I20171009002976 |
| Provider Name | David R Hofius |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1013903285 PECOS PAC ID: 5991693103 Enrollment ID: I20171117001430 |
| Provider Name | Chinedu Angela Igwe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1710207519 PECOS PAC ID: 1951545839 Enrollment ID: I20180108002964 |
| Provider Name | Reetta Maria Marciano |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588989446 PECOS PAC ID: 8921309840 Enrollment ID: I20180306002783 |
| Provider Name | Sabeeh Siddiqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891965489 PECOS PAC ID: 8527135938 Enrollment ID: I20180404001762 |
| Provider Name | Rachel E Casseday |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1538554019 PECOS PAC ID: 6709175078 Enrollment ID: I20180525002027 |
| Provider Name | Thais A Veal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639659204 PECOS PAC ID: 8820341209 Enrollment ID: I20181101001095 |
| Provider Name | Navdeep Tandon |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861812299 PECOS PAC ID: 5698090546 Enrollment ID: I20181106001488 |
| Provider Name | Brian Priest |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1649263211 PECOS PAC ID: 3476582065 Enrollment ID: I20190116003977 |
| Provider Name | Randy Metcalf |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1073506648 PECOS PAC ID: 4486685765 Enrollment ID: I20190808003045 |
| Provider Name | Maisarah Momen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164837530 PECOS PAC ID: 1456641844 Enrollment ID: I20190815003624 |
| Provider Name | Anthony Ryan Russo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366890410 PECOS PAC ID: 4789913930 Enrollment ID: I20190912002644 |
| Provider Name | Mboutidem Etokakpan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1467851634 PECOS PAC ID: 4284937442 Enrollment ID: I20200701002971 |
| Provider Name | Nicole Kristine Lewis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407465610 PECOS PAC ID: 5597184937 Enrollment ID: I20201002002728 |
| Provider Name | Peter Michael Hunkus |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780297945 PECOS PAC ID: 8820409014 Enrollment ID: I20201118003125 |
| Provider Name | Saad Hatahet |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1982180550 PECOS PAC ID: 5395157820 Enrollment ID: I20201207002222 |
| Provider Name | Neven Kosic |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1831162841 PECOS PAC ID: 9335030790 Enrollment ID: I20210608000815 |
| Provider Name | Pablo G Giuseppucci |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1730406067 PECOS PAC ID: 9234327255 Enrollment ID: I20210729003696 |
| Provider Name | Amanda L. Roeder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003396821 PECOS PAC ID: 8224376991 Enrollment ID: I20210902000488 |
| Provider Name | Mohammed Al Areef |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1285156968 PECOS PAC ID: 7618365818 Enrollment ID: I20211020001683 |
| Provider Name | Rachel Ann Beels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679876759 PECOS PAC ID: 7618159815 Enrollment ID: I20211020002125 |
| Provider Name | Kylia Alexander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669134904 PECOS PAC ID: 5395133292 Enrollment ID: I20211026002226 |
| Provider Name | Melissa Lee Moss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851061170 PECOS PAC ID: 0345647848 Enrollment ID: I20220210001838 |
| Provider Name | Savas Mavridis |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1013912070 PECOS PAC ID: 0648336834 Enrollment ID: I20220420001116 |
| Provider Name | George K Joseph |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1699766931 PECOS PAC ID: 4688631724 Enrollment ID: I20220519000740 |
| Provider Name | Sonia S Fizet |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790456986 PECOS PAC ID: 3971982265 Enrollment ID: I20220616000720 |
| Provider Name | Lauren Bentley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871259564 PECOS PAC ID: 0648650945 Enrollment ID: I20220705000828 |
| Provider Name | Megan Teeples |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1134624851 PECOS PAC ID: 3476804634 Enrollment ID: I20220819001197 |
| Provider Name | Jessica Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366988248 PECOS PAC ID: 3476830324 Enrollment ID: I20220901002815 |
| Provider Name | Janice Lynn D'ambrosi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306346101 PECOS PAC ID: 3274898044 Enrollment ID: I20220916002622 |
| Provider Name | Hussam Tallab |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1174903397 PECOS PAC ID: 4385068642 Enrollment ID: I20221213000614 |
| Provider Name | Denise Marie Racick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679286785 PECOS PAC ID: 6709257850 Enrollment ID: I20230127000757 |
| Provider Name | Sheetal Nijhawan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1588821904 PECOS PAC ID: 6204952195 Enrollment ID: I20230525003370 |
| Provider Name | Mark Suzuki |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1851373351 PECOS PAC ID: 6507814019 Enrollment ID: I20230526001431 |
| Provider Name | Ali Kimyaghalam |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1922455146 PECOS PAC ID: 4587033998 Enrollment ID: I20230531003296 |
| Provider Name | Daniel Bee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316914633 PECOS PAC ID: 6709776446 Enrollment ID: I20231030002767 |
| Provider Name | Jennifer Ann Shattahi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508559501 PECOS PAC ID: 9739536590 Enrollment ID: I20231127000766 |
| Provider Name | Ravi Shashank Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689201659 PECOS PAC ID: 2163849662 Enrollment ID: I20231127001466 |
Shani Vaturi Md Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7264 Warren Sharon Rd, Brookfield, OH 44403 Phone: 330-448-3060 Fax: 330-448-2555 | |
Trinity Recovery Health & Wellness Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7128 Warren Sharon Rd, Brookfield, OH 44403 Phone: 330-619-5250 Fax: 330-619-5251 |