| Ut Health Austin | |
|
1601 Trinity Street Austin TX 78712 | |
| (833) 882-2737 | |
| Not Available |
| Full Name | Ut Health Austin |
|---|---|
| Speciality | General Practice |
| Location | 1601 Trinity Street, Austin, Texas |
| Authorized Official Name and Position | Cyrus Martin Harris (VICE PRESIDENT OF MEDICAL AFFAIRS) |
| Authorized Official Contact | 5124955000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ut Health Austin 1601 Trinity Street Austin TX 78712 Ph: () - | Ut Health Austin 1601 Trinity Street Austin TX 78712 Ph: (833) 882-2737 |
| NPI Number | 1073066239 |
|---|---|
| Provider Enumeration Date | 07/25/2016 |
| Last Update Date | 07/26/2024 |
| Medicare PECOS PAC ID | 2668559436 |
|---|---|
| Medicare Enrollment ID | O20080408000293 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073066239 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | John A Bertelson |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215959697 PECOS PAC ID: 5799698460 Enrollment ID: I20031110000014 |
| Provider Name | Jeff E Hagen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710965488 PECOS PAC ID: 9931092327 Enrollment ID: I20040209000745 |
| Provider Name | John M Uecker |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1508889205 PECOS PAC ID: 6507753928 Enrollment ID: I20040301001246 |
| Provider Name | Heather E Cuevas |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1538266861 PECOS PAC ID: 2365331550 Enrollment ID: I20040315000618 |
| Provider Name | Jennifer Aranda |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1902875453 PECOS PAC ID: 6608767298 Enrollment ID: I20040323000913 |
| Provider Name | Teresa L Coats |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1992889844 PECOS PAC ID: 6800881251 Enrollment ID: I20040416000232 |
| Provider Name | Kimberly Carter |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1538193495 PECOS PAC ID: 2668421967 Enrollment ID: I20050113000495 |
| Provider Name | Richard B Briggs |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699740712 PECOS PAC ID: 6507816345 Enrollment ID: I20050128000508 |
| Provider Name | Lisa Doggett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982611026 PECOS PAC ID: 6608827563 Enrollment ID: I20050208000709 |
| Provider Name | Zachary Chipman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083776041 PECOS PAC ID: 2264478841 Enrollment ID: I20050705000969 |
| Provider Name | Michael Nix |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1891857884 PECOS PAC ID: 0345286837 Enrollment ID: I20050706000953 |
| Provider Name | Karl M Buttermann |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831251883 PECOS PAC ID: 7113963612 Enrollment ID: I20050706000999 |
| Provider Name | John G Harkins |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629130513 PECOS PAC ID: 2668418161 Enrollment ID: I20050706001003 |
| Provider Name | Elizabeth Douglass |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1073675401 PECOS PAC ID: 7012949415 Enrollment ID: I20050907000352 |
| Provider Name | Isaac Lavie |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487716478 PECOS PAC ID: 1153340500 Enrollment ID: I20051115001046 |
| Provider Name | Whitney Keller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093877078 PECOS PAC ID: 6608895537 Enrollment ID: I20051121000171 |
| Provider Name | Josephine J Flees |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972617470 PECOS PAC ID: 1658393905 Enrollment ID: I20051229000589 |
| Provider Name | Michael Breen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225190259 PECOS PAC ID: 4385691864 Enrollment ID: I20060130000273 |
| Provider Name | Stephen Don Blair |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962404244 PECOS PAC ID: 1658386081 Enrollment ID: I20060207000292 |
| Provider Name | Alejandro Moreno |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609891126 PECOS PAC ID: 9436153996 Enrollment ID: I20060914000421 |
| Provider Name | Amanda B White |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1164642237 PECOS PAC ID: 9133213374 Enrollment ID: I20070919000696 |
| Provider Name | Radek Bukowski |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1922167352 PECOS PAC ID: 8325125107 Enrollment ID: I20080403000078 |
| Provider Name | Jane C Edmond |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1023007432 PECOS PAC ID: 1759457153 Enrollment ID: I20080909000493 |
| Provider Name | Amy Young |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1518047869 PECOS PAC ID: 1759376080 Enrollment ID: I20081003000679 |
| Provider Name | Jonathan Macclements |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760472625 PECOS PAC ID: 8921167263 Enrollment ID: I20081031000477 |
| Provider Name | Francis P Buckley |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1104816008 PECOS PAC ID: 5890854939 Enrollment ID: I20081105000155 |
| Provider Name | Alison J Brooks-heinzman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043412471 PECOS PAC ID: 3971663238 Enrollment ID: I20081118000417 |
| Provider Name | Mrinalini N Kulkarni |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1568434694 PECOS PAC ID: 6204998909 Enrollment ID: I20081215000056 |
| Provider Name | Adnan A Khan |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1083861249 PECOS PAC ID: 1951463900 Enrollment ID: I20081229000467 |
| Provider Name | Kristin E Mondy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265459762 PECOS PAC ID: 9436181575 Enrollment ID: I20081230000347 |
| Provider Name | Sylvia Deily |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1861436933 PECOS PAC ID: 5698778892 Enrollment ID: I20090116000032 |
| Provider Name | Marian Y Williams-brown |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1861696460 PECOS PAC ID: 9537212642 Enrollment ID: I20090806000127 |
| Provider Name | Wren A Deavers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356392682 PECOS PAC ID: 2860545944 Enrollment ID: I20090807000003 |
| Provider Name | Rita Tsai |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609085042 PECOS PAC ID: 2860547510 Enrollment ID: I20090901000304 |
| Provider Name | Deepak Agrawal |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1417174707 PECOS PAC ID: 7618023177 Enrollment ID: I20090924000388 |
| Provider Name | Dave F Clarke |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871550772 PECOS PAC ID: 9436186871 Enrollment ID: I20100104000092 |
| Provider Name | Elliot M Frohman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689630147 PECOS PAC ID: 9032253059 Enrollment ID: I20100215000395 |
| Provider Name | Gurjeet S Shokar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467520957 PECOS PAC ID: 9931234127 Enrollment ID: I20100312000527 |
| Provider Name | Stephanie J Reich |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1346234143 PECOS PAC ID: 6204962376 Enrollment ID: I20100327000529 |
| Provider Name | Mark V Queralt |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1437160934 PECOS PAC ID: 6002906682 Enrollment ID: I20100407000208 |
| Provider Name | Jennifer Wade |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730401282 PECOS PAC ID: 6002943503 Enrollment ID: I20100414000653 |
| Provider Name | John W. Shore |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1194716035 PECOS PAC ID: 2769415058 Enrollment ID: I20100429000216 |
| Provider Name | Kent T Ellington |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487752986 PECOS PAC ID: 5092611129 Enrollment ID: I20100517000851 |
| Provider Name | Jacki L Turner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700897550 PECOS PAC ID: 7618092552 Enrollment ID: I20100915000367 |
| Provider Name | Lloyd S Berg |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1548295785 PECOS PAC ID: 0345138756 Enrollment ID: I20101019001432 |
| Provider Name | Navkiran K. Shokar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588722151 PECOS PAC ID: 1052505047 Enrollment ID: I20101103001098 |
| Provider Name | James G Baker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1487650156 PECOS PAC ID: 4880690429 Enrollment ID: I20101215001049 |
| Provider Name | Vanessa J Yium |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1598759300 PECOS PAC ID: 7810185691 Enrollment ID: I20101221000142 |
| Provider Name | Steven A Abrams |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790782670 PECOS PAC ID: 5991993735 Enrollment ID: I20101221000886 |
| Provider Name | Richard Youatt Declan Fleming |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1881623114 PECOS PAC ID: 3072798008 Enrollment ID: I20110506000079 |
| Provider Name | Holly S Cross |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1811292212 PECOS PAC ID: 9032395322 Enrollment ID: I20110523000191 |
| Provider Name | Alex B Haynes |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1679609408 PECOS PAC ID: 9931387933 Enrollment ID: I20110622000162 |
| Provider Name | Vivian Pugh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932307253 PECOS PAC ID: 4486843703 Enrollment ID: I20110804000087 |
| Provider Name | Samuel Collier |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508064114 PECOS PAC ID: 9830229202 Enrollment ID: I20110926000410 |
| Provider Name | Kimberly Maureen Brown |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1326019571 PECOS PAC ID: 9638108772 Enrollment ID: I20110926000744 |
| Provider Name | Kerry M O'mahar |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356639173 PECOS PAC ID: 7113193517 Enrollment ID: I20120106000380 |
| Provider Name | Clive Polon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962476762 PECOS PAC ID: 4183882194 Enrollment ID: I20120222000608 |
| Provider Name | Tara T Wagner |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1144422098 PECOS PAC ID: 5698935542 Enrollment ID: I20120329000786 |
| Provider Name | Robin Colleen Hilsabeck |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1356432181 PECOS PAC ID: 0941268544 Enrollment ID: I20120619000288 |
| Provider Name | Roshanak Zinn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1659660991 PECOS PAC ID: 8729244777 Enrollment ID: I20120719000566 |
| Provider Name | Blair Walker |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1649404401 PECOS PAC ID: 8820244247 Enrollment ID: I20120816000927 |
| Provider Name | Marcos Sosa |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912160763 PECOS PAC ID: 7416104716 Enrollment ID: I20120821000796 |
| Provider Name | Koonj A Shah |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1316193907 PECOS PAC ID: 6204084742 Enrollment ID: I20120907000228 |
| Provider Name | Uchenna Ca Ossai |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1508175126 PECOS PAC ID: 0941496038 Enrollment ID: I20120920000730 |
| Provider Name | Shannon Kathleen O Neill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588960819 PECOS PAC ID: 6709035215 Enrollment ID: I20120927000030 |
| Provider Name | Gene Kim |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1639332372 PECOS PAC ID: 2062681521 Enrollment ID: I20121010000502 |
| Provider Name | Matthew Fox |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1740471929 PECOS PAC ID: 6406002518 Enrollment ID: I20121204000382 |
| Provider Name | Jared Benge |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1629307228 PECOS PAC ID: 8820241375 Enrollment ID: I20130111000114 |
| Provider Name | Ashley H Choucroun |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1376704544 PECOS PAC ID: 5698929529 Enrollment ID: I20130131000269 |
| Provider Name | Steven J Warach |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1407925886 PECOS PAC ID: 7911151865 Enrollment ID: I20130131000390 |
| Provider Name | Jessica Trevino |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1912946484 PECOS PAC ID: 8426240755 Enrollment ID: I20130520000046 |
| Provider Name | Jillian Y Bissar |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1144548470 PECOS PAC ID: 4789822917 Enrollment ID: I20130530000256 |
| Provider Name | Paige D Frock |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588908420 PECOS PAC ID: 0547403859 Enrollment ID: I20130905000089 |
| Provider Name | Emily Burns Mcleod |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1053745505 PECOS PAC ID: 2769618552 Enrollment ID: I20131127000618 |
| Provider Name | Valerie C Rosen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1407883580 PECOS PAC ID: 4385871474 Enrollment ID: I20131217000908 |
| Provider Name | Vivian Del Carmen Aguilar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144286014 PECOS PAC ID: 2961490800 Enrollment ID: I20131218000987 |
| Provider Name | Sussann Kotara |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1588899041 PECOS PAC ID: 1658594189 Enrollment ID: I20140602000369 |
| Provider Name | Gayle Ayers |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1508182668 PECOS PAC ID: 6608099015 Enrollment ID: I20140603000585 |
| Provider Name | Jennifer S Summers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1588894323 PECOS PAC ID: 9830315985 Enrollment ID: I20140725000163 |
| Provider Name | Kavitha Kumbum |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1508079302 PECOS PAC ID: 9739071531 Enrollment ID: I20140826001233 |
| Provider Name | Kristin Vinueza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235548736 PECOS PAC ID: 7315269982 Enrollment ID: I20141210000865 |
| Provider Name | William Donald Derrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477958049 PECOS PAC ID: 2961725585 Enrollment ID: I20150106000863 |
| Provider Name | Anne Courtney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306193818 PECOS PAC ID: 8022268929 Enrollment ID: I20150126002136 |
| Provider Name | Julie Farrington |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427114545 PECOS PAC ID: 4789623588 Enrollment ID: I20150724010839 |
| Provider Name | Richard G Key |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750438644 PECOS PAC ID: 0547438384 Enrollment ID: I20151001000313 |
| Provider Name | Kevin J Bozic |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1013960921 PECOS PAC ID: 9739262908 Enrollment ID: I20151014000788 |
| Provider Name | Anvi C Ta |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134537095 PECOS PAC ID: 6709197189 Enrollment ID: I20151110000849 |
| Provider Name | Joseph L Kugler |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1093026734 PECOS PAC ID: 7012218084 Enrollment ID: I20151216000971 |
| Provider Name | Jeffrey M Saniuk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649655382 PECOS PAC ID: 7810299294 Enrollment ID: I20151230002697 |
| Provider Name | Erin M Logue |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1619351806 PECOS PAC ID: 8123323789 Enrollment ID: I20160219001787 |
| Provider Name | Sigrid B Tristan |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912199563 PECOS PAC ID: 4789870411 Enrollment ID: I20160229002990 |
| Provider Name | Ming-chieh Ding |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316258163 PECOS PAC ID: 8921237421 Enrollment ID: I20160321001673 |
| Provider Name | Carrie A Gonzalez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396161725 PECOS PAC ID: 9234436023 Enrollment ID: I20160322001317 |
| Provider Name | James Stuart Ferriss |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1114129541 PECOS PAC ID: 6709078264 Enrollment ID: I20160331002334 |
| Provider Name | Anokhi Jambusaria-pahlajani |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1740442433 PECOS PAC ID: 5193974467 Enrollment ID: I20160427000119 |
| Provider Name | Elizabeth Whitten |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114281631 PECOS PAC ID: 3779872668 Enrollment ID: I20160517000253 |
| Provider Name | Karl M Koenig |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1659483865 PECOS PAC ID: 4789683236 Enrollment ID: I20160621000916 |
| Provider Name | Devin V Williams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154521086 PECOS PAC ID: 9032267455 Enrollment ID: I20160622002622 |
| Provider Name | David C Ring |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1568452746 PECOS PAC ID: 5193620888 Enrollment ID: I20160623000710 |
| Provider Name | Richard B Freeman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1437232899 PECOS PAC ID: 2264489921 Enrollment ID: I20160623001053 |
| Provider Name | Zhouwen Tang |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619297223 PECOS PAC ID: 6507157302 Enrollment ID: I20160627000814 |
| Provider Name | Leorah A Freeman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023463114 PECOS PAC ID: 5799077293 Enrollment ID: I20160701000231 |
| Provider Name | Esther Melamed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144563669 PECOS PAC ID: 8921391327 Enrollment ID: I20160722000561 |
| Provider Name | Audrey Baum |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295836393 PECOS PAC ID: 9537454640 Enrollment ID: I20160827000114 |
| Provider Name | Donna Shanor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1972626042 PECOS PAC ID: 0941598791 Enrollment ID: I20161011000237 |
| Provider Name | Frank Parker Hudson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639331226 PECOS PAC ID: 7810150729 Enrollment ID: I20161025002778 |
| Provider Name | Maj Paulina Henriksson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1033664016 PECOS PAC ID: 4082992409 Enrollment ID: I20161104001340 |
| Provider Name | Justin Frederick Rousseau |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1770862971 PECOS PAC ID: 9032431200 Enrollment ID: I20161110000426 |
| Provider Name | William B Lawson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750499406 PECOS PAC ID: 6800057928 Enrollment ID: I20161112000198 |
| Provider Name | Michele Marie Pierson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841468667 PECOS PAC ID: 6901185941 Enrollment ID: I20161116001006 |
| Provider Name | Aaron Braverman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1053863233 PECOS PAC ID: 3072893874 Enrollment ID: I20161214000854 |
| Provider Name | Long H Nguyen |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1619138468 PECOS PAC ID: 4587951439 Enrollment ID: I20170104002127 |
| Provider Name | James Stuart Wolf |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1023100492 PECOS PAC ID: 1355240953 Enrollment ID: I20170110000426 |
| Provider Name | Cynthia Cecilia Corral |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497057335 PECOS PAC ID: 5597046359 Enrollment ID: I20170110002012 |
| Provider Name | Stephen M Strakowski |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1720009541 PECOS PAC ID: 2062302946 Enrollment ID: I20170123001119 |
| Provider Name | Mary E Feeler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790230324 PECOS PAC ID: 2062795503 Enrollment ID: I20170208000869 |
| Provider Name | Jonathan Geralds |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1972938777 PECOS PAC ID: 4789812843 Enrollment ID: I20170213002173 |
| Provider Name | Mary Elizabeth Peterson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174791115 PECOS PAC ID: 0244315687 Enrollment ID: I20170310000728 |
| Provider Name | Sarah M Felderhoff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699213702 PECOS PAC ID: 9032494182 Enrollment ID: I20170403000089 |
| Provider Name | Thomas R Vetter |
|---|---|
| Provider Type | Practitioner - Pain Management |
| Provider Identifiers | NPI Number: 1225081656 PECOS PAC ID: 7416916671 Enrollment ID: I20170503001403 |
| Provider Name | Rebecca G Rogers |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1639185226 PECOS PAC ID: 3678661881 Enrollment ID: I20170517000500 |
| Provider Name | Laura K Eastep |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457555013 PECOS PAC ID: 8628347770 Enrollment ID: I20170705000311 |
| Provider Name | Kobina D Ghartey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033438684 PECOS PAC ID: 5193969913 Enrollment ID: I20170721000259 |
| Provider Name | Christina A Salazar |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1083902068 PECOS PAC ID: 5193023315 Enrollment ID: I20170802003245 |
| Provider Name | Jamie Shanahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134644636 PECOS PAC ID: 9335412832 Enrollment ID: I20170905002986 |
| Provider Name | John P Andrawis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861744419 PECOS PAC ID: 1759655152 Enrollment ID: I20170925000512 |
| Provider Name | Robert Bryan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1578591616 PECOS PAC ID: 6709778186 Enrollment ID: I20170927000481 |
| Provider Name | Rachel Bowman |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1851735591 PECOS PAC ID: 2466726559 Enrollment ID: I20170928002191 |
| Provider Name | Marcela C Castillo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841516192 PECOS PAC ID: 3375761315 Enrollment ID: I20171002002848 |
| Provider Name | Jorge Almeida |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1558709170 PECOS PAC ID: 0143522821 Enrollment ID: I20171003004490 |
| Provider Name | Grace Caroline Barron |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1730353541 PECOS PAC ID: 5193090009 Enrollment ID: I20171003005681 |
| Provider Name | Henry Guevara |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265843775 PECOS PAC ID: 0446525109 Enrollment ID: I20171005000561 |
| Provider Name | Charley Rose Peterson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1841715158 PECOS PAC ID: 4981979291 Enrollment ID: I20171011003077 |
| Provider Name | Elizabeth A Henson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578016481 PECOS PAC ID: 1052608965 Enrollment ID: I20171108000058 |
| Provider Name | Alyssa Beth Aguirre |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306180989 PECOS PAC ID: 3779849534 Enrollment ID: I20171110000451 |
| Provider Name | David Paydarfar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1134104797 PECOS PAC ID: 8527008101 Enrollment ID: I20171110001839 |
| Provider Name | Anthony E Johnson |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700875176 PECOS PAC ID: 0941440093 Enrollment ID: I20171113001193 |
| Provider Name | Marissa Aileen Wagner Mery |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1831363217 PECOS PAC ID: 0143586842 Enrollment ID: I20171114000420 |
| Provider Name | Mayra Elizabeth Robles-alvarado |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881938983 PECOS PAC ID: 8325305766 Enrollment ID: I20171120003056 |
| Provider Name | Margaret Whitney |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043576127 PECOS PAC ID: 0749424752 Enrollment ID: I20171121002957 |
| Provider Name | Jeny Ghartey |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1235306713 PECOS PAC ID: 7315012440 Enrollment ID: I20171204001816 |
| Provider Name | Rachel Alice High |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1245677582 PECOS PAC ID: 5496027351 Enrollment ID: I20171208002425 |
| Provider Name | Elizabeth A Kvale |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245267616 PECOS PAC ID: 1052584455 Enrollment ID: I20171213000195 |
| Provider Name | Leyna Kathleen Nunez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1043722804 PECOS PAC ID: 3375801582 Enrollment ID: I20171218000247 |
| Provider Name | Lindsey Lee Marie Wineholt |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1467963082 PECOS PAC ID: 6406114578 Enrollment ID: I20171219000270 |
| Provider Name | Vijay Rayalu Gorrepati |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437413937 PECOS PAC ID: 8123321940 Enrollment ID: I20171227000301 |
| Provider Name | Sue Gail Eckhardt |
|---|---|
| Provider Type | Practitioner - Surgical Oncology |
| Provider Identifiers | NPI Number: 1043300726 PECOS PAC ID: 8729052642 Enrollment ID: I20180112001242 |
| Provider Name | Christina L Moussette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780055202 PECOS PAC ID: 9537429667 Enrollment ID: I20180208002629 |
| Provider Name | Lauren D Thaxton |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1760772859 PECOS PAC ID: 5294042966 Enrollment ID: I20180213000265 |
| Provider Name | William J Schwartz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1275516023 PECOS PAC ID: 7416984182 Enrollment ID: I20180214001268 |
| Provider Name | Nicole B Lovell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023525029 PECOS PAC ID: 1456613553 Enrollment ID: I20180402000267 |
| Provider Name | Jess Ambiee |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1316454598 PECOS PAC ID: 3173887254 Enrollment ID: I20180426002231 |
| Provider Name | Christine D Craig |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679885909 PECOS PAC ID: 5092936708 Enrollment ID: I20180507000701 |
| Provider Name | Ewell Steve Roach |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922084011 PECOS PAC ID: 3476535790 Enrollment ID: I20180607001896 |
| Provider Name | David P Brigati |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1578846002 PECOS PAC ID: 9537414610 Enrollment ID: I20180613000873 |
| Provider Name | Ethan Meltzer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467865790 PECOS PAC ID: 5597983429 Enrollment ID: I20180620000569 |
| Provider Name | Tammy Lynn Noel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942712815 PECOS PAC ID: 3173871761 Enrollment ID: I20180730000484 |
| Provider Name | Samantha Shapiro |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518200930 PECOS PAC ID: 4981832540 Enrollment ID: I20180807001659 |
| Provider Name | William H Matsui |
|---|---|
| Provider Type | Practitioner - Hematology/oncology |
| Provider Identifiers | NPI Number: 1568411049 PECOS PAC ID: 6709918782 Enrollment ID: I20180824002389 |
| Provider Name | Adewole S Adamson |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1255630034 PECOS PAC ID: 3971819053 Enrollment ID: I20180904000391 |
| Provider Name | Corinne A Jones |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1992019681 PECOS PAC ID: 7911182001 Enrollment ID: I20180924001920 |
| Provider Name | Winifred Mak |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912160680 PECOS PAC ID: 9638341456 Enrollment ID: I20181002000334 |
| Provider Name | Eric L Crowell |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1831431006 PECOS PAC ID: 7810267283 Enrollment ID: I20181012001342 |
| Provider Name | Sarah Hite |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093296287 PECOS PAC ID: 8921350174 Enrollment ID: I20181016002851 |
| Provider Name | Paul E Tatum |
|---|---|
| Provider Type | Practitioner - Hospice/palliative Care |
| Provider Identifiers | NPI Number: 1821079559 PECOS PAC ID: 8224942263 Enrollment ID: I20181101001555 |
| Provider Name | Charles B Nemeroff |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1326228347 PECOS PAC ID: 6507937653 Enrollment ID: I20181113002022 |
| Provider Name | Angela Jasmine Luna |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538634407 PECOS PAC ID: 7416291091 Enrollment ID: I20181210000127 |
| Provider Name | Steve L Steffensen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326028390 PECOS PAC ID: 6103164728 Enrollment ID: I20190206001894 |
| Provider Name | Laura Quan Man Chow |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1063745727 PECOS PAC ID: 8820130677 Enrollment ID: I20190214003083 |
| Provider Name | D. Jeffrey Newport |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275646291 PECOS PAC ID: 6406913268 Enrollment ID: I20190410002644 |
| Provider Name | David Spelber |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1447646898 PECOS PAC ID: 5991071169 Enrollment ID: I20190605000654 |
| Provider Name | Suzannah K Creech |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1518288455 PECOS PAC ID: 2567795354 Enrollment ID: I20190611000323 |
| Provider Name | Roberto Alejandro Cruz Saldana |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1285016899 PECOS PAC ID: 3577866722 Enrollment ID: I20190612000438 |
| Provider Name | Sze Chun Winson Ho |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1720307242 PECOS PAC ID: 9032347893 Enrollment ID: I20190621001102 |
| Provider Name | Karl Chiang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1689928194 PECOS PAC ID: 0749433100 Enrollment ID: I20190716003409 |
| Provider Name | Carol Alter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1083699870 PECOS PAC ID: 2163454125 Enrollment ID: I20190716003714 |
| Provider Name | Linda A Feagins |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1376745158 PECOS PAC ID: 5092987719 Enrollment ID: I20190725000620 |
| Provider Name | Sylvia Bhuiyan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174183552 PECOS PAC ID: 2466788690 Enrollment ID: I20190725003348 |
| Provider Name | Jahanett Ramirez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750744744 PECOS PAC ID: 8921350430 Enrollment ID: I20190727000116 |
| Provider Name | Johanna I Busch |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518320498 PECOS PAC ID: 6901132984 Enrollment ID: I20190729003229 |
| Provider Name | Alexander C. Rothy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1487098000 PECOS PAC ID: 9931436177 Enrollment ID: I20190809001578 |
| Provider Name | Nicholas F Ortiz |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164878914 PECOS PAC ID: 8628305612 Enrollment ID: I20190814001400 |
| Provider Name | Audrey Marian Addaquay-corey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710353651 PECOS PAC ID: 7618260951 Enrollment ID: I20190822001737 |
| Provider Name | Samuel E Long |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1235576356 PECOS PAC ID: 7416256706 Enrollment ID: I20190830001216 |
| Provider Name | Kristy D Armer |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1437622834 PECOS PAC ID: 6002145281 Enrollment ID: I20190913000303 |
| Provider Name | Patrick Ryan Labrode |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1790331551 PECOS PAC ID: 5698004695 Enrollment ID: I20190916002782 |
| Provider Name | George A Macones |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1386647345 PECOS PAC ID: 1557305307 Enrollment ID: I20190916003529 |
| Provider Name | Cara C Young |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962537399 PECOS PAC ID: 8224198775 Enrollment ID: I20190918002615 |
| Provider Name | Alison Gale Cahill |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679788038 PECOS PAC ID: 3779682356 Enrollment ID: I20190920001871 |
| Provider Name | William Michael Brode |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619362217 PECOS PAC ID: 4486966264 Enrollment ID: I20191016000387 |
| Provider Name | Veena A Patel |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1033452255 PECOS PAC ID: 5193093318 Enrollment ID: I20191016001113 |
| Provider Name | Nicholas M. Barbaro |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1619925443 PECOS PAC ID: 9830273697 Enrollment ID: I20191017001834 |
| Provider Name | Rama V Thyagarajan |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1003886151 PECOS PAC ID: 1658302831 Enrollment ID: I20191024002773 |
| Provider Name | Gregory Anthony Fonzo |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1174858070 PECOS PAC ID: 5890027106 Enrollment ID: I20191105002198 |
| Provider Name | Chelsey C Sparks |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205347952 PECOS PAC ID: 4082972351 Enrollment ID: I20191120000103 |
| Provider Name | Kevin Victor Hackshaw |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1255348785 PECOS PAC ID: 7416921192 Enrollment ID: I20191125002353 |
| Provider Name | Juan M Guzman |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1154715142 PECOS PAC ID: 2567766397 Enrollment ID: I20191127000893 |
| Provider Name | Cristal Latanza Brown |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578730388 PECOS PAC ID: 1153637202 Enrollment ID: I20191216000306 |
| Provider Name | Kyaw Lwin Aung |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1780229047 PECOS PAC ID: 5294169629 Enrollment ID: I20191218000817 |
| Provider Name | Jason A Spees |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1033762828 PECOS PAC ID: 1052748712 Enrollment ID: I20200219001847 |
| Provider Name | Scott J Selinger |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1629211016 PECOS PAC ID: 5799932174 Enrollment ID: I20200408000147 |
| Provider Name | Erin Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467935981 PECOS PAC ID: 3779837893 Enrollment ID: I20200521001655 |
| Provider Name | William David Rumbaugh |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1285076554 PECOS PAC ID: 2860622859 Enrollment ID: I20200521002724 |
| Provider Name | Lorie M Harper |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871613786 PECOS PAC ID: 3870749518 Enrollment ID: I20200602000375 |
| Provider Name | Tera F Howard |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1457647182 PECOS PAC ID: 9133432420 Enrollment ID: I20200706002274 |
| Provider Name | Eileen A Choudhury Bowden |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1699153965 PECOS PAC ID: 8921344136 Enrollment ID: I20200713000515 |
| Provider Name | Tara L Kaufmann |
|---|---|
| Provider Type | Practitioner - Medical Oncology |
| Provider Identifiers | NPI Number: 1477815249 PECOS PAC ID: 6002030103 Enrollment ID: I20200721003183 |
| Provider Name | Denise Laura Johnson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1780047480 PECOS PAC ID: 9032534680 Enrollment ID: I20200730000988 |
| Provider Name | Christine Langner Bartow |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1346603735 PECOS PAC ID: 2567759038 Enrollment ID: I20200730001288 |
| Provider Name | Max S Holtz |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1447613963 PECOS PAC ID: 0749573327 Enrollment ID: I20200929001123 |
| Provider Name | Benjamin James Ehrenfeld |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1003417668 PECOS PAC ID: 0446660062 Enrollment ID: I20201110000023 |
| Provider Name | Anna Hardy Finger |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306449392 PECOS PAC ID: 0042622649 Enrollment ID: I20201223000241 |
| Provider Name | Valerie Bianca Galvan-turner |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1104060425 PECOS PAC ID: 2062651383 Enrollment ID: I20210127000773 |
| Provider Name | Melissa Elaine Miller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1154806974 PECOS PAC ID: 8729494521 Enrollment ID: I20210302002113 |
| Provider Name | Karla Maguire |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1750525333 PECOS PAC ID: 4082768403 Enrollment ID: I20210325001165 |
| Provider Name | Brian Kwun Kwok Lee |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1518056571 PECOS PAC ID: 2365501194 Enrollment ID: I20210426000117 |
| Provider Name | Joshua M Cisler |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1992001234 PECOS PAC ID: 1456502079 Enrollment ID: I20210601000199 |
| Provider Name | Duriel Isaih Hardy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659751527 PECOS PAC ID: 0749680031 Enrollment ID: I20210608001453 |
| Provider Name | Jennifer Lynne Travieso |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1508247776 PECOS PAC ID: 5799099313 Enrollment ID: I20210628003035 |
| Provider Name | Molly Lisa Singer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1629507702 PECOS PAC ID: 7012285992 Enrollment ID: I20210702000236 |
| Provider Name | Justine Cynthia Reilly |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184144198 PECOS PAC ID: 3870903040 Enrollment ID: I20210806000632 |
| Provider Name | Mary Micaela Rieger |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1134548399 PECOS PAC ID: 4587913462 Enrollment ID: I20210817004237 |
| Provider Name | Mikaela M Frissell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1194490375 PECOS PAC ID: 6406251883 Enrollment ID: I20210824000060 |
| Provider Name | Moe Hein Aung |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1255794368 PECOS PAC ID: 1456757277 Enrollment ID: I20210902001401 |
| Provider Name | Sarah Wilson Poole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497425193 PECOS PAC ID: 5991103715 Enrollment ID: I20211008001946 |
| Provider Name | Branden W Daubel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1265999593 PECOS PAC ID: 6608117437 Enrollment ID: I20211012003494 |
| Provider Name | Jacqueline Posada |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1174918114 PECOS PAC ID: 2769743129 Enrollment ID: I20211101001228 |
| Provider Name | Curry L Koening |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821158593 PECOS PAC ID: 6002902673 Enrollment ID: I20211120000032 |
| Provider Name | Maura Ruby Ronquillo |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912433707 PECOS PAC ID: 3678828738 Enrollment ID: I20211202000693 |
| Provider Name | Barbara Suarez Chenoweth |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366018525 PECOS PAC ID: 8527459114 Enrollment ID: I20211215000342 |
| Provider Name | Krystal Marie Duran |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1740933613 PECOS PAC ID: 1658764758 Enrollment ID: I20220214001957 |
| Provider Name | Kelsey Hatton |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1083003602 PECOS PAC ID: 0941558308 Enrollment ID: I20220215001814 |
| Provider Name | Lisa Boyars |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043659923 PECOS PAC ID: 4082903919 Enrollment ID: I20220215002081 |
| Provider Name | Lief Ericsson Fenno |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1710349311 PECOS PAC ID: 0840612602 Enrollment ID: I20220414001931 |
| Provider Name | Bonnie Michelle Scott |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881339760 PECOS PAC ID: 4486031887 Enrollment ID: I20220620001494 |
| Provider Name | Trisha Manis Parekh |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1568755916 PECOS PAC ID: 8224318076 Enrollment ID: I20220623000128 |
| Provider Name | Clarence Thomas Jayde Kee |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1275065682 PECOS PAC ID: 5395019400 Enrollment ID: I20220706000045 |
| Provider Name | Diana Nathalie Andino |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467957779 PECOS PAC ID: 5496004053 Enrollment ID: I20220718000088 |
| Provider Name | Emily Ann Biller |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1700376944 PECOS PAC ID: 8921497322 Enrollment ID: I20220816002990 |
| Provider Name | Erika A Aurioles |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326450644 PECOS PAC ID: 6709269194 Enrollment ID: I20220817003484 |
| Provider Name | Alexandra Rossi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538892468 PECOS PAC ID: 5991188294 Enrollment ID: I20220819000627 |
| Provider Name | Lauren Caldwell |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1477948776 PECOS PAC ID: 3274917935 Enrollment ID: I20220829003479 |
| Provider Name | Amanda Balch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760775639 PECOS PAC ID: 4587893409 Enrollment ID: I20220907002743 |
| Provider Name | Gregory Muller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1962132902 PECOS PAC ID: 0345625174 Enrollment ID: I20220915001015 |
| Provider Name | Mark H Townsend |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1497778351 PECOS PAC ID: 0244423408 Enrollment ID: I20221121000069 |
| Provider Name | Alexandra Guevara |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1528711785 PECOS PAC ID: 5496124158 Enrollment ID: I20221220000907 |
| Provider Name | Sara Dorinda Green-otero |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1497344253 PECOS PAC ID: 7719357946 Enrollment ID: I20230105000897 |
| Provider Name | Ayesha Kabir |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1942997093 PECOS PAC ID: 4789040031 Enrollment ID: I20230511003205 |
| Provider Name | Claire Fitzgerald Harrison |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821610098 PECOS PAC ID: 1254797400 Enrollment ID: I20230515001889 |
| Provider Name | Makayla Mccoskey |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1215498340 PECOS PAC ID: 8325375744 Enrollment ID: I20230620000677 |
| Provider Name | Nerlyne Desravines |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1174917272 PECOS PAC ID: 5395054241 Enrollment ID: I20230706004158 |
| Provider Name | Navid Valizadeh |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073933222 PECOS PAC ID: 1456603794 Enrollment ID: I20230717001202 |
| Provider Name | Bryanna Mantilla |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1437646569 PECOS PAC ID: 7113261272 Enrollment ID: I20230725000560 |
| Provider Name | Amanda W Hayes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083103717 PECOS PAC ID: 8426303157 Enrollment ID: I20230815000867 |
| Provider Name | Priya Elizabeth Kumar-kaparaboyna |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1578943411 PECOS PAC ID: 7810293669 Enrollment ID: I20230911002554 |
| Provider Name | Kari Rene Nations |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1568145019 PECOS PAC ID: 0042674996 Enrollment ID: I20230912001401 |
| Provider Name | Stefanie Noelle Schutz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609567197 PECOS PAC ID: 5698139228 Enrollment ID: I20230914001540 |
| Provider Name | Amy Lan Tao-foster |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952660839 PECOS PAC ID: 7719334127 Enrollment ID: I20231219002900 |
| Provider Name | James Morgan Jackson Burns |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1427346717 PECOS PAC ID: 8123478351 Enrollment ID: I20231229000903 |
| Provider Name | Parisa Khosravi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952924276 PECOS PAC ID: 1850730284 Enrollment ID: I20240418002303 |
| Provider Name | Paul Mueller |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427021955 PECOS PAC ID: 5890838874 Enrollment ID: I20240604004142 |
Harold D Lewis Do Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1901 West William Cannon Drive, Suite 123, Austin, TX 78745 Phone: 512-444-2661 Fax: 512-444-2720 | |
Julie Graves Moy Md Mph Pa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8127 Mesa Dr, B206-54, Austin, TX 78759 Phone: 512-689-8001 | |
Edie E. Shulman M.d., Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11673 Jollyville Rd., Suite B-101, Austin, TX 78759 Phone: 512-339-1535 Fax: 512-339-1526 | |
El Buen Samaritano Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7000 Woodhue Dr, Austin, TX 78745 Phone: 512-439-0701 | |
Concentra Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10001 S Ih 35 Ste 300, Austin, TX 78747 Phone: 512-440-0555 Fax: 214-775-4502 | |
Texas Medclinic Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 9900 S Ih 35, Austin, TX 78748 Phone: 512-291-5577 Fax: 512-291-5576 | |
Doctx3 Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 401 W Slaughter Ln, Suite 300, Austin, TX 78748 Phone: 469-277-8253 |