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1325 N Litchfield Rd Ste 125 Goodyear AZ 85395-1215 | |
| (623) 242-1231 | |
| (623) 242-1232 |
| Full Name | |
|---|---|
| Speciality | Clinic/Center |
| Location | 1325 N Litchfield Rd Ste 125, Goodyear, Arizona |
| Authorized Official Name and Position | Brian Rasmus (VP, CFO TPR) |
| Authorized Official Contact | 4698932532 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 18892 Belfast ME 04915-4083 Ph: (888) 402-7256 | 1325 N Litchfield Rd Ste 125 Goodyear AZ 85395-1215 Ph: (623) 242-1231 |
| NPI Number | 1912979964 |
|---|---|
| Provider Enumeration Date | 02/03/2006 |
| Last Update Date | 09/23/2020 |
| Medicare PECOS PAC ID | 4486566726 |
|---|---|
| Medicare Enrollment ID | O20031104000523 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912979964 | NPI | - | NPPES |
| Provider Name | Jeffrey A Copoloff |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1164461802 PECOS PAC ID: 2163335365 Enrollment ID: I20031112000281 |
| Provider Name | Jason J Cool |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1700886512 PECOS PAC ID: 6305747338 Enrollment ID: I20040114000256 |
| Provider Name | Mankanwal S Sachdev |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1356307839 PECOS PAC ID: 4183527443 Enrollment ID: I20040202000763 |
| Provider Name | Billy J Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114942422 PECOS PAC ID: 7911809140 Enrollment ID: I20040217000861 |
| Provider Name | Peter C Maki |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1306886775 PECOS PAC ID: 6608780523 Enrollment ID: I20040301001128 |
| Provider Name | Charles Matlin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1023074945 PECOS PAC ID: 3173413564 Enrollment ID: I20040318001041 |
| Provider Name | Boeldridge E Mcclain |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992772446 PECOS PAC ID: 9234020413 Enrollment ID: I20040324001572 |
| Provider Name | Madhavagopal V Cherukuri |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1104860337 PECOS PAC ID: 1254324577 Enrollment ID: I20040405000374 |
| Provider Name | Joseph J Hessel |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1306996228 PECOS PAC ID: 3173518974 Enrollment ID: I20040420000586 |
| Provider Name | Susan Pansing |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1306816533 PECOS PAC ID: 6901892017 Enrollment ID: I20040423000460 |
| Provider Name | John M Morgan |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1407890353 PECOS PAC ID: 5799699617 Enrollment ID: I20040512001042 |
| Provider Name | Vicente Diaz-gonzalez |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1790745776 PECOS PAC ID: 1557353356 Enrollment ID: I20040513001258 |
| Provider Name | Amarnauth Singh |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1639170764 PECOS PAC ID: 1052301728 Enrollment ID: I20040514000483 |
| Provider Name | Chia How H Liu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851382899 PECOS PAC ID: 7911997101 Enrollment ID: I20040518000861 |
| Provider Name | Charles S Peterson |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1952302143 PECOS PAC ID: 2769473529 Enrollment ID: I20040520000546 |
| Provider Name | Michael E James |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1760555262 PECOS PAC ID: 7517948409 Enrollment ID: I20040526001320 |
| Provider Name | Erika L Vatsar Fail |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1770535742 PECOS PAC ID: 7416931886 Enrollment ID: I20040614001581 |
| Provider Name | Gary L Waslewski |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1902890031 PECOS PAC ID: 8325023211 Enrollment ID: I20040623001299 |
| Provider Name | Hack J Kim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1588647044 PECOS PAC ID: 5698751766 Enrollment ID: I20040629000118 |
| Provider Name | Linda M Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396709192 PECOS PAC ID: 8426960709 Enrollment ID: I20040701000236 |
| Provider Name | Christine A Harter |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639133903 PECOS PAC ID: 8729065289 Enrollment ID: I20040701001350 |
| Provider Name | Russell G Cohen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1700887460 PECOS PAC ID: 3173501418 Enrollment ID: I20040712001459 |
| Provider Name | Timothy J Byrne |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1376585232 PECOS PAC ID: 9436063351 Enrollment ID: I20040713000111 |
| Provider Name | William A Arnold |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1720042591 PECOS PAC ID: 1850363789 Enrollment ID: I20040810001441 |
| Provider Name | Virender K Sharma |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932184918 PECOS PAC ID: 1355310178 Enrollment ID: I20040929000157 |
| Provider Name | Douglas B Mangan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831181999 PECOS PAC ID: 3274592753 Enrollment ID: I20041012000751 |
| Provider Name | Jill A Mehlhaf |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245201458 PECOS PAC ID: 5193789519 Enrollment ID: I20041116000553 |
| Provider Name | Alex Westerband |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1295849099 PECOS PAC ID: 1456316876 Enrollment ID: I20041124000908 |
| Provider Name | Ananya Das |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1669457206 PECOS PAC ID: 9739145699 Enrollment ID: I20041202001021 |
| Provider Name | Akil Loli |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1962453803 PECOS PAC ID: 0749247872 Enrollment ID: I20041210000147 |
| Provider Name | Krishnaswami Vijayaraghavan |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376598151 PECOS PAC ID: 3971560343 Enrollment ID: I20041216001031 |
| Provider Name | Steven R Vermeys |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1508833054 PECOS PAC ID: 2163480682 Enrollment ID: I20041229000800 |
| Provider Name | Douglas B Freedberg |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1497751283 PECOS PAC ID: 1951350925 Enrollment ID: I20050120000079 |
| Provider Name | John Vanderhoof |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1558471052 PECOS PAC ID: 5193774719 Enrollment ID: I20050120000558 |
| Provider Name | Lawrence A Kline |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1568463669 PECOS PAC ID: 9739131483 Enrollment ID: I20050210000820 |
| Provider Name | David C Zeman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1902854276 PECOS PAC ID: 7911959622 Enrollment ID: I20050215000259 |
| Provider Name | Scott R Schalkle |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1770701492 PECOS PAC ID: 4880646819 Enrollment ID: I20050217000427 |
| Provider Name | Renzo M Cataldo |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1174526677 PECOS PAC ID: 6406894765 Enrollment ID: I20050419000255 |
| Provider Name | Marwan M Bahu |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1114920618 PECOS PAC ID: 0345288619 Enrollment ID: I20050419000337 |
| Provider Name | Warren Mark Breisblatt |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063413177 PECOS PAC ID: 6709826142 Enrollment ID: I20050505000386 |
| Provider Name | Michael R Keller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821062183 PECOS PAC ID: 1658320999 Enrollment ID: I20050512000577 |
| Provider Name | Brent P Hansen |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396716262 PECOS PAC ID: 8820061567 Enrollment ID: I20050613000936 |
| Provider Name | Merick S Kirshner |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1831183870 PECOS PAC ID: 8729011713 Enrollment ID: I20050912000101 |
| Provider Name | Matthew P Wilson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1225018096 PECOS PAC ID: 3870527641 Enrollment ID: I20050921000461 |
| Provider Name | Ayman Jamal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083600845 PECOS PAC ID: 9436114915 Enrollment ID: I20050927000129 |
| Provider Name | Barbara L Garcia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184618530 PECOS PAC ID: 6507891546 Enrollment ID: I20050928001273 |
| Provider Name | Shani S Saks |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023001682 PECOS PAC ID: 5698790541 Enrollment ID: I20051010000644 |
| Provider Name | Peter W Mitchell |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1881686749 PECOS PAC ID: 8022094481 Enrollment ID: I20051103000952 |
| Provider Name | Timothy E Rider |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215998364 PECOS PAC ID: 4688693534 Enrollment ID: I20051121000380 |
| Provider Name | Ashesh H Sanghvi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1336185685 PECOS PAC ID: 5193743102 Enrollment ID: I20051201000910 |
| Provider Name | Tanya B Evans |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528002441 PECOS PAC ID: 4385668078 Enrollment ID: I20060120000511 |
| Provider Name | Annabell N Stimac |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1013018126 PECOS PAC ID: 2668487810 Enrollment ID: I20060209000496 |
| Provider Name | Patrick Lam |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1326095613 PECOS PAC ID: 5991710964 Enrollment ID: I20060313000258 |
| Provider Name | Matthew C Duke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992779250 PECOS PAC ID: 1557378288 Enrollment ID: I20060321000287 |
| Provider Name | Lance Richard Winter |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1386693976 PECOS PAC ID: 9133154651 Enrollment ID: I20060728000260 |
| Provider Name | Angela M Sturdivant |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689622086 PECOS PAC ID: 1355231788 Enrollment ID: I20060809000452 |
| Provider Name | Sanjay Ramakumar |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1437255742 PECOS PAC ID: 3476555772 Enrollment ID: I20070214000380 |
| Provider Name | Linda N Greer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1346297991 PECOS PAC ID: 3577665744 Enrollment ID: I20070220000141 |
| Provider Name | Aye Thandar Win |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1245251941 PECOS PAC ID: 3173596772 Enrollment ID: I20070306000517 |
| Provider Name | Dawn C Campbell |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1154362259 PECOS PAC ID: 6204885361 Enrollment ID: I20070525000128 |
| Provider Name | Vafa Ghaemmaghami |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1659352144 PECOS PAC ID: 7416970504 Enrollment ID: I20070626000827 |
| Provider Name | Tod M Sugihara |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962615856 PECOS PAC ID: 4284725268 Enrollment ID: I20070806000205 |
| Provider Name | Neal A Klein |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1639111743 PECOS PAC ID: 4880508704 Enrollment ID: I20070910000556 |
| Provider Name | Seth D Oesch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427030188 PECOS PAC ID: 1759471865 Enrollment ID: I20071213000129 |
| Provider Name | Hector L Rodriguez-luna |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1467678557 PECOS PAC ID: 9032299052 Enrollment ID: I20080103000446 |
| Provider Name | Sameera T Raza |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396851044 PECOS PAC ID: 7719988419 Enrollment ID: I20080129000415 |
| Provider Name | Annabelle C Porter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1316129562 PECOS PAC ID: 9436233616 Enrollment ID: I20080226000924 |
| Provider Name | James P Corrigan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538157680 PECOS PAC ID: 2567548092 Enrollment ID: I20080325000316 |
| Provider Name | Allison M Peckumn |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1023230778 PECOS PAC ID: 0244306231 Enrollment ID: I20080827000175 |
| Provider Name | Daniel T Fang |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1033170634 PECOS PAC ID: 5092873927 Enrollment ID: I20081022000334 |
| Provider Name | Mark S Bessette |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265426407 PECOS PAC ID: 0446356992 Enrollment ID: I20090316000038 |
| Provider Name | Edward G Ghattas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1164412466 PECOS PAC ID: 9436209798 Enrollment ID: I20090608000144 |
| Provider Name | Robert L Bierman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124023205 PECOS PAC ID: 0840341558 Enrollment ID: I20090619000114 |
| Provider Name | Robert M Shull |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1205047297 PECOS PAC ID: 8628120250 Enrollment ID: I20090713000590 |
| Provider Name | Kandarp R Patel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1801086087 PECOS PAC ID: 6800948761 Enrollment ID: I20090723000600 |
| Provider Name | William Michael Jaffe |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1083648158 PECOS PAC ID: 6204883721 Enrollment ID: I20090812000473 |
| Provider Name | Nelson H Lim |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1366463168 PECOS PAC ID: 4385688233 Enrollment ID: I20090817000649 |
| Provider Name | Adam J Schwartz |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1104030006 PECOS PAC ID: 4789784398 Enrollment ID: I20090818000143 |
| Provider Name | Colette A Toronto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669474243 PECOS PAC ID: 4183776032 Enrollment ID: I20090825000213 |
| Provider Name | Tiffany A Nunnelley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386805034 PECOS PAC ID: 0345395471 Enrollment ID: I20090826000081 |
| Provider Name | Lorraine M Homes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255375481 PECOS PAC ID: 3476699885 Enrollment ID: I20091014000799 |
| Provider Name | Destin Edward Hill |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1609073865 PECOS PAC ID: 7113064528 Enrollment ID: I20091016000236 |
| Provider Name | Jose Ivan A Rago |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477714137 PECOS PAC ID: 0244379774 Enrollment ID: I20091123000418 |
| Provider Name | Jennifer L Willis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275731424 PECOS PAC ID: 5193864221 Enrollment ID: I20091203000393 |
| Provider Name | Jody A Eckhardt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871650564 PECOS PAC ID: 7012919723 Enrollment ID: I20091215000035 |
| Provider Name | Ian M Frankfort |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295790293 PECOS PAC ID: 5294712527 Enrollment ID: I20100205000136 |
| Provider Name | Kristin V Franco |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932399870 PECOS PAC ID: 9537295035 Enrollment ID: I20100408000279 |
| Provider Name | Krishdeep Chadha |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1619147915 PECOS PAC ID: 7618001678 Enrollment ID: I20100813000086 |
| Provider Name | George Paik |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1740266550 PECOS PAC ID: 8729102082 Enrollment ID: I20100824000729 |
| Provider Name | Amon T Ferry |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1669639613 PECOS PAC ID: 5395899389 Enrollment ID: I20100830001043 |
| Provider Name | Marna R Harris |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518071471 PECOS PAC ID: 0143279109 Enrollment ID: I20101115001039 |
| Provider Name | Arcot S Premkumar |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1265496665 PECOS PAC ID: 7618972985 Enrollment ID: I20101124000195 |
| Provider Name | Maressa M Alejandro-reyes |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750328969 PECOS PAC ID: 6002881935 Enrollment ID: I20110112000619 |
| Provider Name | Kelly R Grogan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881752038 PECOS PAC ID: 8123207545 Enrollment ID: I20110131000925 |
| Provider Name | Katerina S Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376837989 PECOS PAC ID: 4688844871 Enrollment ID: I20110825000472 |
| Provider Name | Sasi K Ghanta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114219789 PECOS PAC ID: 7416128061 Enrollment ID: I20110913000004 |
| Provider Name | Amy Soloman |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1982723508 PECOS PAC ID: 1153429337 Enrollment ID: I20110915000190 |
| Provider Name | Jonathan S Mellen |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1609919471 PECOS PAC ID: 3375715014 Enrollment ID: I20110930000518 |
| Provider Name | Jeremy Orwin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194043810 PECOS PAC ID: 0648303503 Enrollment ID: I20120105000984 |
| Provider Name | Shruti Badhwar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497918502 PECOS PAC ID: 0244406593 Enrollment ID: I20120109000238 |
| Provider Name | Buckley J Brewer |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1215205463 PECOS PAC ID: 6709047996 Enrollment ID: I20120416000372 |
| Provider Name | Neeta A Patil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871800581 PECOS PAC ID: 8729262894 Enrollment ID: I20120803000748 |
| Provider Name | Christina M Khoury |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609086081 PECOS PAC ID: 7719157411 Enrollment ID: I20120820001119 |
| Provider Name | Basel Channis |
|---|---|
| Provider Type | Practitioner - Nephrology |
| Provider Identifiers | NPI Number: 1982834594 PECOS PAC ID: 0345490736 Enrollment ID: I20121019000513 |
| Provider Name | Michelle M Mix |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1831385533 PECOS PAC ID: 9335215722 Enrollment ID: I20130417000684 |
| Provider Name | Gerrit Miller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750623401 PECOS PAC ID: 4587800396 Enrollment ID: I20130424000486 |
| Provider Name | Emun Abdu |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1811199912 PECOS PAC ID: 4385815166 Enrollment ID: I20130425000227 |
| Provider Name | Amy Jo Purvis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467708156 PECOS PAC ID: 5496992281 Enrollment ID: I20130515000434 |
| Provider Name | Oday Al Rabadi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1972779643 PECOS PAC ID: 8325288277 Enrollment ID: I20130717000511 |
| Provider Name | Renee M Gazda |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558591644 PECOS PAC ID: 9335382167 Enrollment ID: I20130827000530 |
| Provider Name | Kristen J Costello |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619319753 PECOS PAC ID: 3274776471 Enrollment ID: I20130906000320 |
| Provider Name | Timothy M Bert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1346465010 PECOS PAC ID: 4385888791 Enrollment ID: I20130924000745 |
| Provider Name | Dinraj B Hegde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184612178 PECOS PAC ID: 0941240964 Enrollment ID: I20131022002343 |
| Provider Name | Frederick P Russek |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285610170 PECOS PAC ID: 5890881528 Enrollment ID: I20131029001126 |
| Provider Name | Sharon S Sadeghinia |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770608275 PECOS PAC ID: 7113974916 Enrollment ID: I20131216001480 |
| Provider Name | Scott T Suciu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942539408 PECOS PAC ID: 8921238031 Enrollment ID: I20140310002177 |
| Provider Name | Michael J Sumko |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1992937189 PECOS PAC ID: 6507098845 Enrollment ID: I20140804002160 |
| Provider Name | George Tharwat Gendy |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821275231 PECOS PAC ID: 4688839129 Enrollment ID: I20140808001089 |
| Provider Name | Jacob T Woods |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235424680 PECOS PAC ID: 1052538352 Enrollment ID: I20140811001112 |
| Provider Name | Kristen L Hudson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407279748 PECOS PAC ID: 4880812346 Enrollment ID: I20140825001138 |
| Provider Name | Candice Rodriguez |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1083010730 PECOS PAC ID: 4789908401 Enrollment ID: I20150128000855 |
| Provider Name | Adaire L Webster |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821375874 PECOS PAC ID: 2668634866 Enrollment ID: I20150429002423 |
| Provider Name | Samyuktha Sreenivasan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548526171 PECOS PAC ID: 4284947730 Enrollment ID: I20150713003183 |
| Provider Name | Kenneth A Hood |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861783060 PECOS PAC ID: 4183843923 Enrollment ID: I20150728004816 |
| Provider Name | Neha Chandni Chaturvedi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396911707 PECOS PAC ID: 7416123989 Enrollment ID: I20150827002684 |
| Provider Name | Donny Small |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1619352796 PECOS PAC ID: 0143537548 Enrollment ID: I20150917001308 |
| Provider Name | Matthew Sauget |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740415157 PECOS PAC ID: 0446398788 Enrollment ID: I20150923003061 |
| Provider Name | Amanda Christie Rapp |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1104192525 PECOS PAC ID: 2163739137 Enrollment ID: I20150923003182 |
| Provider Name | Helena In't Veld |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982071429 PECOS PAC ID: 8426366063 Enrollment ID: I20151001001710 |
| Provider Name | Karthik Raghavan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1164699906 PECOS PAC ID: 9739204371 Enrollment ID: I20151005001865 |
| Provider Name | Jenny Ho |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1427315506 PECOS PAC ID: 8022327121 Enrollment ID: I20151012000590 |
| Provider Name | Gregory M Kohler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912383522 PECOS PAC ID: 2668772468 Enrollment ID: I20151203003278 |
| Provider Name | Saifuldeen A Al Qaisi |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1053673723 PECOS PAC ID: 0042516684 Enrollment ID: I20160308002812 |
| Provider Name | Kacey Lohmann |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962861930 PECOS PAC ID: 2668761503 Enrollment ID: I20160517001808 |
| Provider Name | Michelle Gustafson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497126874 PECOS PAC ID: 9739470287 Enrollment ID: I20160614001283 |
| Provider Name | Basil Al Khatib |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1083977599 PECOS PAC ID: 3476845082 Enrollment ID: I20160629003119 |
| Provider Name | Tushar Gohel |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1568699304 PECOS PAC ID: 7911163571 Enrollment ID: I20160630000517 |
| Provider Name | Tammy J Penhollow |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1487632535 PECOS PAC ID: 2769636760 Enrollment ID: I20160712002895 |
| Provider Name | Tracy L Von Aspen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447605639 PECOS PAC ID: 0547553000 Enrollment ID: I20160721002188 |
| Provider Name | Gina Marie Mathew |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1366731358 PECOS PAC ID: 5698085660 Enrollment ID: I20160812001431 |
| Provider Name | Archana Nagarajan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881906733 PECOS PAC ID: 0749415818 Enrollment ID: I20160907002194 |
| Provider Name | Mohammad Monjurul Alam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1356574016 PECOS PAC ID: 1355592304 Enrollment ID: I20160928001100 |
| Provider Name | Vinay Kapadia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598212003 PECOS PAC ID: 0143509554 Enrollment ID: I20161107002498 |
| Provider Name | Ryan A Pinnell |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1174818173 PECOS PAC ID: 4082994363 Enrollment ID: I20161201002087 |
| Provider Name | Megan Bermudez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104377506 PECOS PAC ID: 5395020648 Enrollment ID: I20170329000023 |
| Provider Name | Jessica Tomasello |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1518965953 PECOS PAC ID: 4082716691 Enrollment ID: I20170621002190 |
| Provider Name | Melinda Newman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457743569 PECOS PAC ID: 6305166422 Enrollment ID: I20170718001732 |
| Provider Name | Carly Anne Ernst |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1891112900 PECOS PAC ID: 5294030474 Enrollment ID: I20170725001581 |
| Provider Name | Nicholas Xavier Jebaily |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710206909 PECOS PAC ID: 5799919015 Enrollment ID: I20170725003470 |
| Provider Name | Maria Viadimir Gibson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649388596 PECOS PAC ID: 2860428489 Enrollment ID: I20170807003307 |
| Provider Name | Heatherann Alison Bal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1518379031 PECOS PAC ID: 1254621659 Enrollment ID: I20170815000635 |
| Provider Name | David E Virgil |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598175747 PECOS PAC ID: 8820360449 Enrollment ID: I20170816004229 |
| Provider Name | Melissa S Molyneux |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053722686 PECOS PAC ID: 7012281637 Enrollment ID: I20170920003880 |
| Provider Name | Nickalaus L Gramze |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1487972964 PECOS PAC ID: 0749459410 Enrollment ID: I20170927004188 |
| Provider Name | Alexander Michael Zinn |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1477062768 PECOS PAC ID: 4880960053 Enrollment ID: I20171017000773 |
| Provider Name | Dawn Michelle Maxwell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487163218 PECOS PAC ID: 0143114462 Enrollment ID: I20171023002529 |
| Provider Name | Marium Muzaffar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1306191242 PECOS PAC ID: 4385947902 Enrollment ID: I20171128003220 |
| Provider Name | Jennifer Coleman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1144737339 PECOS PAC ID: 6204196652 Enrollment ID: I20180205001538 |
| Provider Name | Jenna L Gonzales |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275048357 PECOS PAC ID: 4385906007 Enrollment ID: I20180316001383 |
| Provider Name | Leslee Hamadeh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144728130 PECOS PAC ID: 3678835782 Enrollment ID: I20180328003071 |
| Provider Name | Roberto Calderon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1568649812 PECOS PAC ID: 7911030267 Enrollment ID: I20180412002000 |
| Provider Name | Merima Bucaj |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417245267 PECOS PAC ID: 4385896000 Enrollment ID: I20180417000728 |
| Provider Name | Jai S Kim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407892268 PECOS PAC ID: 2163495953 Enrollment ID: I20180515001767 |
| Provider Name | Leonid Vydro |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1902148380 PECOS PAC ID: 7911299987 Enrollment ID: I20180521003232 |
| Provider Name | Cristina Pecci |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588041057 PECOS PAC ID: 2264797836 Enrollment ID: I20180531002401 |
| Provider Name | Palak C Patel |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1568753200 PECOS PAC ID: 3476860552 Enrollment ID: I20180621001957 |
| Provider Name | Joshua Scott Silver |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1790044204 PECOS PAC ID: 3476809336 Enrollment ID: I20180706001411 |
| Provider Name | Carley Campton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457844482 PECOS PAC ID: 8426306994 Enrollment ID: I20180731004169 |
| Provider Name | Jason Adam Norman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1235475369 PECOS PAC ID: 6002032174 Enrollment ID: I20180806000891 |
| Provider Name | Saryna Dent |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1346644879 PECOS PAC ID: 8123341039 Enrollment ID: I20180806001507 |
| Provider Name | Ammar M Alobaidy |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437592102 PECOS PAC ID: 1658629597 Enrollment ID: I20180808003204 |
| Provider Name | Gina Kozul |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1124513114 PECOS PAC ID: 1951650464 Enrollment ID: I20180816001764 |
| Provider Name | Savio C Reddymasu |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1598981979 PECOS PAC ID: 4183724248 Enrollment ID: I20181002000099 |
| Provider Name | Misty Pagan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184119844 PECOS PAC ID: 4385996321 Enrollment ID: I20181002003611 |
| Provider Name | Anne Elizabeth Puggini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548749690 PECOS PAC ID: 5496008765 Enrollment ID: I20181102001777 |
| Provider Name | Rishi Kirit Patel |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1972794659 PECOS PAC ID: 8729148358 Enrollment ID: I20190104001864 |
| Provider Name | Brooke E Wilson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194293043 PECOS PAC ID: 9830437458 Enrollment ID: I20190206001870 |
| Provider Name | Gary Gross |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1760434252 PECOS PAC ID: 2860594330 Enrollment ID: I20190208000418 |
| Provider Name | Jacob Tuttle |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023370053 PECOS PAC ID: 1759529704 Enrollment ID: I20190327001275 |
| Provider Name | Sushant Punjaram Kale |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780809798 PECOS PAC ID: 1456490077 Enrollment ID: I20190521001296 |
| Provider Name | Lige Kaplan |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1780894949 PECOS PAC ID: 5294809802 Enrollment ID: I20190529001282 |
| Provider Name | Angela Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689130007 PECOS PAC ID: 3678806916 Enrollment ID: I20190531000973 |
| Provider Name | Kristin Wilson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1861657231 PECOS PAC ID: 1658435672 Enrollment ID: I20190611002779 |
| Provider Name | Alexander Lewis Coon |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1720124084 PECOS PAC ID: 0244361251 Enrollment ID: I20190612003240 |
| Provider Name | Joshua L Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386106391 PECOS PAC ID: 4486989167 Enrollment ID: I20190717003064 |
| Provider Name | Tina Marie Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700341831 PECOS PAC ID: 9830426618 Enrollment ID: I20190816001854 |
| Provider Name | Matthew A Wade |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1699169003 PECOS PAC ID: 6204139017 Enrollment ID: I20190822002177 |
| Provider Name | Sheena S Spence |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1902071814 PECOS PAC ID: 4082888532 Enrollment ID: I20190909002856 |
| Provider Name | Tim Michael Ratliff |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1306227780 PECOS PAC ID: 4486966017 Enrollment ID: I20191001002876 |
| Provider Name | Alec Pramhus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225481740 PECOS PAC ID: 1557656204 Enrollment ID: I20191001003263 |
| Provider Name | Diana Thayer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063975076 PECOS PAC ID: 5092045294 Enrollment ID: I20191002001028 |
| Provider Name | Mollanda Laura Mazzo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801440904 PECOS PAC ID: 1052642840 Enrollment ID: I20191009000742 |
| Provider Name | Lindsay Fritch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184026031 PECOS PAC ID: 0547550469 Enrollment ID: I20191022003955 |
| Provider Name | Jaime T Sanders |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1790331254 PECOS PAC ID: 7719319656 Enrollment ID: I20191115000490 |
| Provider Name | Jayme L Hawthorne |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619489911 PECOS PAC ID: 5294168951 Enrollment ID: I20191210003290 |
| Provider Name | Divyashree Varma |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1710205000 PECOS PAC ID: 1456673565 Enrollment ID: I20191216001162 |
| Provider Name | Joseph Jenneford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740847615 PECOS PAC ID: 2961836234 Enrollment ID: I20191218002941 |
| Provider Name | Stephanie Sheree Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790334233 PECOS PAC ID: 3072940899 Enrollment ID: I20200217001484 |
| Provider Name | Carl B Bryce |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619315074 PECOS PAC ID: 4183867633 Enrollment ID: I20200408000345 |
| Provider Name | Anubhav Jagadish |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1932365251 PECOS PAC ID: 3476796616 Enrollment ID: I20200511001849 |
| Provider Name | Shelly Bansal |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1174793111 PECOS PAC ID: 4688801806 Enrollment ID: I20200526001717 |
| Provider Name | Samuel Kim |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1215917091 PECOS PAC ID: 1759317720 Enrollment ID: I20200602002929 |
| Provider Name | Benjamin Albert |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1235494741 PECOS PAC ID: 9830415512 Enrollment ID: I20200804002065 |
| Provider Name | Brent Rich |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982614319 PECOS PAC ID: 7911991450 Enrollment ID: I20200804002115 |
| Provider Name | Theron M Liddell |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1528515939 PECOS PAC ID: 2668744673 Enrollment ID: I20200921001545 |
| Provider Name | Allyson Mclean |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679964662 PECOS PAC ID: 5092032656 Enrollment ID: I20201013000362 |
| Provider Name | Lakshmi Kocherlakota |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386171320 PECOS PAC ID: 2062752165 Enrollment ID: I20201026000825 |
| Provider Name | Deanna Kraemer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972100097 PECOS PAC ID: 7618387820 Enrollment ID: I20201029000345 |
| Provider Name | Christopher W. Rourke |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1538771886 PECOS PAC ID: 2466863329 Enrollment ID: I20201124003002 |
| Provider Name | Desiree Little |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326678319 PECOS PAC ID: 0446663181 Enrollment ID: I20210119001806 |
| Provider Name | Garrett Gleaves |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1194325076 PECOS PAC ID: 7113332974 Enrollment ID: I20210209002027 |
| Provider Name | Patricia Bonasera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790378230 PECOS PAC ID: 1951719160 Enrollment ID: I20210427002459 |
| Provider Name | Lakshminarayana Guttikonda |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1790986214 PECOS PAC ID: 3678610219 Enrollment ID: I20210618000105 |
| Provider Name | Demetrios K. Mavroidis |
|---|---|
| Provider Type | Practitioner - Cardiac Surgery |
| Provider Identifiers | NPI Number: 1184602914 PECOS PAC ID: 5092740548 Enrollment ID: I20210701001817 |
| Provider Name | Ish Singla |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1215111422 PECOS PAC ID: 1254572134 Enrollment ID: I20210707003586 |
| Provider Name | Ugonna Ezeh |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629423223 PECOS PAC ID: 3476957226 Enrollment ID: I20210802002077 |
| Provider Name | Richard Dung Pham |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1124439377 PECOS PAC ID: 7719381987 Enrollment ID: I20210810002458 |
| Provider Name | Jaharris Ahmed Collier |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1679928436 PECOS PAC ID: 6800180589 Enrollment ID: I20210825002796 |
| Provider Name | Shashank Jain |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1588824007 PECOS PAC ID: 2264604685 Enrollment ID: I20210826002528 |
| Provider Name | Sunshine Marie Borawski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831761444 PECOS PAC ID: 2466858402 Enrollment ID: I20210831001210 |
| Provider Name | Subhash Chandra |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1174817720 PECOS PAC ID: 4183874894 Enrollment ID: I20210831002187 |
| Provider Name | Rico Andrew Segun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760055099 PECOS PAC ID: 8628474186 Enrollment ID: I20210908002484 |
| Provider Name | Neil Vyas |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1447678917 PECOS PAC ID: 1951709799 Enrollment ID: I20211008002559 |
| Provider Name | Justin Wayne Fuller |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962176917 PECOS PAC ID: 4880082619 Enrollment ID: I20211028001039 |
| Provider Name | Sherry Caforio |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609363159 PECOS PAC ID: 1557759925 Enrollment ID: I20211104001100 |
| Provider Name | Christopher Johnson |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508162330 PECOS PAC ID: 1355525650 Enrollment ID: I20211112000964 |
| Provider Name | Jacob Pfetsch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639756356 PECOS PAC ID: 1850782095 Enrollment ID: I20211227000520 |
| Provider Name | Brian Vernon |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1265639280 PECOS PAC ID: 8022267210 Enrollment ID: I20211228000378 |
| Provider Name | Stacey Anderson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831637529 PECOS PAC ID: 2163706565 Enrollment ID: I20220304001952 |
| Provider Name | Loui Rejjal |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1073931846 PECOS PAC ID: 7214156546 Enrollment ID: I20220728000546 |
| Provider Name | Cameron Teutschel Davis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619427523 PECOS PAC ID: 5698024115 Enrollment ID: I20220805002836 |
| Provider Name | Alexander Carey Wendling |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1114456597 PECOS PAC ID: 0941571004 Enrollment ID: I20220816000747 |
| Provider Name | Shannon M Jennings |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396493789 PECOS PAC ID: 1254714629 Enrollment ID: I20220817002420 |
| Provider Name | Akram Ibrahim |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1508029802 PECOS PAC ID: 7214229152 Enrollment ID: I20220817002449 |
| Provider Name | Kelly Nathan Shortridge |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1558728196 PECOS PAC ID: 6800291196 Enrollment ID: I20220830002113 |
| Provider Name | Thomas Russell Hunt |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1831149665 PECOS PAC ID: 7517919731 Enrollment ID: I20220830004504 |
| Provider Name | Brooke Elise Gambino |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619631587 PECOS PAC ID: 8224413398 Enrollment ID: I20220912000176 |
| Provider Name | Jordan Lee Liles |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1952764219 PECOS PAC ID: 1456736289 Enrollment ID: I20220915000923 |
| Provider Name | Carmela Marfori Fernandez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013633643 PECOS PAC ID: 2961870613 Enrollment ID: I20221130001666 |
| Provider Name | Maricel Olan-cabrera |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659617850 PECOS PAC ID: 2163653007 Enrollment ID: I20230316001701 |
| Provider Name | Sydney Gear |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457051666 PECOS PAC ID: 3072988054 Enrollment ID: I20230404002357 |
| Provider Name | Shannon Kleinschmidt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164123725 PECOS PAC ID: 1355706565 Enrollment ID: I20230421002214 |
| Provider Name | Rhett A Macneille |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629574009 PECOS PAC ID: 6608233127 Enrollment ID: I20230526001969 |
| Provider Name | Genevieve F Dixon |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1922504059 PECOS PAC ID: 5799108866 Enrollment ID: I20230531000678 |
| Provider Name | Sami Rafael Kaldawi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1598260457 PECOS PAC ID: 9931566387 Enrollment ID: I20230531001116 |
| Provider Name | Venita Simpson |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1568756328 PECOS PAC ID: 7517296429 Enrollment ID: I20230601002469 |
| Provider Name | Hao Pan |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1184986838 PECOS PAC ID: 0648524207 Enrollment ID: I20230621001259 |
| Provider Name | Amilyn Mee Young Han Taplin |
|---|---|
| Provider Type | Practitioner - Neurosurgery |
| Provider Identifiers | NPI Number: 1295027472 PECOS PAC ID: 0648539130 Enrollment ID: I20230629000584 |
| Provider Name | Brendan Koistinen |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1457812422 PECOS PAC ID: 4789913070 Enrollment ID: I20230718004299 |
| Provider Name | Angela Marie Morrone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467136044 PECOS PAC ID: 8224490966 Enrollment ID: I20230814000566 |
| Provider Name | Eduardo Salazar |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1689105546 PECOS PAC ID: 9638531296 Enrollment ID: I20230814001717 |
| Provider Name | David M Prutzman |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1477993152 PECOS PAC ID: 6406139716 Enrollment ID: I20230829004440 |
| Provider Name | Daphne Schnase-steier |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699883967 PECOS PAC ID: 4880796812 Enrollment ID: I20230831002990 |
| Provider Name | Gagan Kaur |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1265886816 PECOS PAC ID: 1254786510 Enrollment ID: I20231006002348 |
| Provider Name | Hector Rafael Vazquez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366122525 PECOS PAC ID: 0042666455 Enrollment ID: I20231020002241 |
| Provider Name | Chad Moody |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1699233676 PECOS PAC ID: 9234472309 Enrollment ID: I20240315003715 |
| Provider Name | Akash M Doshi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790245520 PECOS PAC ID: 0143643163 Enrollment ID: I20240404000681 |
| Provider Name | Bryan P Hunter |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740343383 PECOS PAC ID: 2860385077 Enrollment ID: I20240419001681 |
| Provider Name | Lindsay Grissett Curran |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336909886 PECOS PAC ID: 4789025834 Enrollment ID: I20240507004297 |
| Provider Name | Syed Ali |
|---|---|
| Provider Type | Practitioner - Interventional Radiology |
| Provider Identifiers | NPI Number: 1760612014 PECOS PAC ID: 9830481563 Enrollment ID: I20240523001288 |
| Provider Name | Matthew Cale Britton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1629456769 PECOS PAC ID: 2365747284 Enrollment ID: I20240523001952 |
| Provider Name | Natasha Gray |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023537263 PECOS PAC ID: 6002173291 Enrollment ID: I20240705002529 |
| Provider Name | Kristina Skinner |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1790191039 PECOS PAC ID: 8224353313 Enrollment ID: I20240719002639 |
| Provider Name | Nicholas Davis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1780431007 PECOS PAC ID: 6002352184 Enrollment ID: I20240725000372 |
| Provider Name | Tanner Thomas Mcclure |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821599036 PECOS PAC ID: 2961750500 Enrollment ID: I20240814004549 |
| Provider Name | Madeline Maura Lyons |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1912401654 PECOS PAC ID: 8628325412 Enrollment ID: I20240822004449 |
| Provider Name | Maedeh Khayyat Kholghi |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1376049528 PECOS PAC ID: 5799036083 Enrollment ID: I20240920002283 |
| Provider Name | Kalyan C Vunnamadala |
|---|---|
| Provider Type | Practitioner - Thoracic Surgery |
| Provider Identifiers | NPI Number: 1609991207 PECOS PAC ID: 0244549806 Enrollment ID: I20240923001080 |
| Provider Name | Christine Paniti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962049759 PECOS PAC ID: 3678953130 Enrollment ID: I20241015002826 |
| Provider Name | James Y Kim |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1730262882 PECOS PAC ID: 1254417785 Enrollment ID: I20241018002897 |
| Provider Name | Tyson Kelly Travis |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1447660451 PECOS PAC ID: 1052638020 Enrollment ID: I20241029000729 |
| Provider Name | Julia Anne Kemper |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508686726 PECOS PAC ID: 6002340486 Enrollment ID: I20241107001495 |
Rabadi Physicians Pllc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 13575 W Mcdowell Rd, Goodyear, AZ 85395 Phone: 623-536-9911 | |
Super Cool Kids Therapy, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14175 W Indian School Rd, Suite B4-521, Goodyear, AZ 85395 Phone: 623-262-1199 | |
Valley Direct Primary Care, Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13970 W Woodbridge Ave, Goodyear, AZ 85395 Phone: 646-352-2619 | |
Nexx Level Healthcare Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 15664 W Devonshire Ave, Goodyear, AZ 85395 Phone: 623-204-4093 |