| Washington University, Department Of Neurology | |
|
660 S Euclid Ave Saint Louis MO 63110-1010 | |
| (314) 362-3282 | |
| (314) 362-4124 |
| Full Name | Washington University, Department Of Neurology |
|---|---|
| Speciality | Clinic/Center |
| Location | 660 S Euclid Ave, Saint Louis, Missouri |
| Authorized Official Name and Position | Cathy L Eghigian (DIRECTOR, CREDENTIALING OPERATIONS) |
| Authorized Official Contact | 3149350770 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Washington University, Department Of Neurology 7425 Forsyth Blvd Campus Box 8221 Saint Louis MO 63105-2171 Ph: (314) 935-0770 | Washington University, Department Of Neurology 660 S Euclid Ave Saint Louis MO 63110-1010 Ph: (314) 362-3282 |
| NPI Number | 1356382527 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 12/06/2007 |
| Medicare PECOS PAC ID | 9830008770 |
|---|---|
| Medicare Enrollment ID | O20031106000605 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356382527 | NPI | - | NPPES |
| 3687 | Other | MO | GHP MASTER VENDOR NUMBER |
| 552914301 | Medicaid | MO | |
| 552914301 | Other | MO | MEDICAID PHARMACY NUMBER |
| 673341 | Other | MO | AETNA HMO GROUP |
| 0125610 | Other | MO | SPECIAL HEALTH CARE NEEDS |
| 05-01999 | Other | MO | UHC GROUP NUMBER |
| 92215222 | Other | IL | IL BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Robert T Naismith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871519090 PECOS PAC ID: 3870406804 Enrollment ID: I20031106000544 |
| Provider Name | Thy N Huskey |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1861418089 PECOS PAC ID: 1951207166 Enrollment ID: I20031209000740 |
| Provider Name | Tracy K Connell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891713574 PECOS PAC ID: 4183617194 Enrollment ID: I20040406000657 |
| Provider Name | Naomi L Hampton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558579540 PECOS PAC ID: 9739178831 Enrollment ID: I20040512000169 |
| Provider Name | Helen R Race |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114943347 PECOS PAC ID: 3577553031 Enrollment ID: I20040517000129 |
| Provider Name | Jeffrey J Neil |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699793158 PECOS PAC ID: 5092706101 Enrollment ID: I20040519000124 |
| Provider Name | David B Carr |
|---|---|
| Provider Type | Practitioner - Geriatric Medicine |
| Provider Identifiers | NPI Number: 1093733800 PECOS PAC ID: 4284616012 Enrollment ID: I20040604000106 |
| Provider Name | Randall J Bateman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1649296872 PECOS PAC ID: 4385619196 Enrollment ID: I20040826000452 |
| Provider Name | Sylvia Awadalla |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891711107 PECOS PAC ID: 2668448077 Enrollment ID: I20040908000146 |
| Provider Name | Barbara J Snider |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447276662 PECOS PAC ID: 3072574300 Enrollment ID: I20041020001066 |
| Provider Name | Christina A Gurnett |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255359998 PECOS PAC ID: 2860454097 Enrollment ID: I20041101000125 |
| Provider Name | Conrad Weihl |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437175759 PECOS PAC ID: 6901863190 Enrollment ID: I20041220000692 |
| Provider Name | David Veloso Lardizabal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265428593 PECOS PAC ID: 6709812498 Enrollment ID: I20050714000001 |
| Provider Name | Amy D Bertelson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1942226188 PECOS PAC ID: 0446280804 Enrollment ID: I20050816000187 |
| Provider Name | Soe Soe Mar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659397966 PECOS PAC ID: 1557395084 Enrollment ID: I20050923000107 |
| Provider Name | Paul T Kotzbauer |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568488872 PECOS PAC ID: 6709811805 Enrollment ID: I20050928000035 |
| Provider Name | David A Carpenter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801814330 PECOS PAC ID: 4486679602 Enrollment ID: I20051006000876 |
| Provider Name | Nicole J Werner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1700802022 PECOS PAC ID: 7113943531 Enrollment ID: I20051115000882 |
| Provider Name | Rajat Dhar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1649298191 PECOS PAC ID: 8224046602 Enrollment ID: I20060327000427 |
| Provider Name | Robert E Hogan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801813480 PECOS PAC ID: 7315948767 Enrollment ID: I20070126000617 |
| Provider Name | Mary E Bertrand |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1740211986 PECOS PAC ID: 8921101064 Enrollment ID: I20070312000101 |
| Provider Name | Johanna M Hartlein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043320930 PECOS PAC ID: 5395849723 Enrollment ID: I20070324000058 |
| Provider Name | Rimma Ruvinskaya |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1538185855 PECOS PAC ID: 5698870558 Enrollment ID: I20070420000480 |
| Provider Name | Andria Lee Ford |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1316097835 PECOS PAC ID: 0648370460 Enrollment ID: I20070710000240 |
| Provider Name | Bradley L Schlaggar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1144247685 PECOS PAC ID: 3274625710 Enrollment ID: I20070828000865 |
| Provider Name | Timothy M Miller |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255356671 PECOS PAC ID: 8224122023 Enrollment ID: I20070925000223 |
| Provider Name | Becky J Parks |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356369813 PECOS PAC ID: 5496840886 Enrollment ID: I20071001000114 |
| Provider Name | Anne H Cross |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073531596 PECOS PAC ID: 8022108356 Enrollment ID: I20071226000263 |
| Provider Name | Alexandre Rene Carter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235343534 PECOS PAC ID: 7416039003 Enrollment ID: I20080205000364 |
| Provider Name | Joseph T Black |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083798714 PECOS PAC ID: 0941383178 Enrollment ID: I20080212000288 |
| Provider Name | Michael Wong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053338590 PECOS PAC ID: 0840378279 Enrollment ID: I20080424000613 |
| Provider Name | John M Zempel |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356368856 PECOS PAC ID: 0042399362 Enrollment ID: I20080512000194 |
| Provider Name | Craig M Zaidman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1447450507 PECOS PAC ID: 1254404080 Enrollment ID: I20080725000757 |
| Provider Name | Neringa Juknis |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1780600908 PECOS PAC ID: 0042383820 Enrollment ID: I20080728000188 |
| Provider Name | Beau Ances |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972569085 PECOS PAC ID: 1153349840 Enrollment ID: I20080729000412 |
| Provider Name | Raman Kant Malhotra |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1215018452 PECOS PAC ID: 4880627603 Enrollment ID: I20080808000797 |
| Provider Name | Douglas P Larsen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669635181 PECOS PAC ID: 0749355626 Enrollment ID: I20080813000177 |
| Provider Name | Nupur Ghoshal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1205987138 PECOS PAC ID: 0345308458 Enrollment ID: I20081017000716 |
| Provider Name | Renee Bailey Vanstavern |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952348872 PECOS PAC ID: 0941212153 Enrollment ID: I20090416000321 |
| Provider Name | Judith L Weisenberg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1932360245 PECOS PAC ID: 6507916616 Enrollment ID: I20090611000356 |
| Provider Name | Christopher D Smyser |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043235245 PECOS PAC ID: 0042361552 Enrollment ID: I20090623000704 |
| Provider Name | Gregory F Wu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1558426619 PECOS PAC ID: 0446325518 Enrollment ID: I20090626000042 |
| Provider Name | Arun S Varadhachary |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1801002779 PECOS PAC ID: 6002968609 Enrollment ID: I20090713000230 |
| Provider Name | Sindhu S Jacob |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1639256175 PECOS PAC ID: 4385645266 Enrollment ID: I20090811000274 |
| Provider Name | Martin B Wice |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1972564375 PECOS PAC ID: 8628153426 Enrollment ID: I20100206000260 |
| Provider Name | Luigi Maccotta |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730301524 PECOS PAC ID: 5294867313 Enrollment ID: I20100724000138 |
| Provider Name | David H Gutmann |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255359709 PECOS PAC ID: 1153454699 Enrollment ID: I20100804000145 |
| Provider Name | Robert P Fucetola |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1023035656 PECOS PAC ID: 4082748850 Enrollment ID: I20100816000370 |
| Provider Name | Allyson Zazulia |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750307997 PECOS PAC ID: 0749314516 Enrollment ID: I20100816000445 |
| Provider Name | Yo El S Ju |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1528280393 PECOS PAC ID: 5294869038 Enrollment ID: I20100817000078 |
| Provider Name | Richard B Sommerville |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053529164 PECOS PAC ID: 9931233673 Enrollment ID: I20100817000171 |
| Provider Name | David M Holtzman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1972521789 PECOS PAC ID: 8628011822 Enrollment ID: I20100817001422 |
| Provider Name | John C. Morris |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871511329 PECOS PAC ID: 7517091143 Enrollment ID: I20100817001449 |
| Provider Name | Anne M Connolly |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063438380 PECOS PAC ID: 8426182056 Enrollment ID: I20100817001450 |
| Provider Name | Alan Pestronk |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1043236359 PECOS PAC ID: 2365506110 Enrollment ID: I20100817001476 |
| Provider Name | Lawrence N Eisenman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457377673 PECOS PAC ID: 5597899120 Enrollment ID: I20100817001483 |
| Provider Name | Joel S Perlmutter |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1477571156 PECOS PAC ID: 6305970930 Enrollment ID: I20100817001500 |
| Provider Name | Jin Moo Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1366460008 PECOS PAC ID: 3476687005 Enrollment ID: I20100817001524 |
| Provider Name | David B Clifford |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1104844521 PECOS PAC ID: 5193638146 Enrollment ID: I20100818000112 |
| Provider Name | Rachel S Darken |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1134248891 PECOS PAC ID: 9638294911 Enrollment ID: I20100909000753 |
| Provider Name | Arthur L Prensky |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578594099 PECOS PAC ID: 8921291162 Enrollment ID: I20101020001417 |
| Provider Name | Cassandra K Ward |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700065554 PECOS PAC ID: 5395933113 Enrollment ID: I20101221000629 |
| Provider Name | Amy K Licis |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1992914352 PECOS PAC ID: 4284812132 Enrollment ID: I20110624000393 |
| Provider Name | Erik S Musiek |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497959977 PECOS PAC ID: 0143408765 Enrollment ID: I20110630000536 |
| Provider Name | Muhammad T Al Lozi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689690992 PECOS PAC ID: 4082882261 Enrollment ID: I20110713000458 |
| Provider Name | David Callahan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902992696 PECOS PAC ID: 2264511740 Enrollment ID: I20111212000411 |
| Provider Name | Salah G Keyrouz |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1174688667 PECOS PAC ID: 4981700366 Enrollment ID: I20120224000322 |
| Provider Name | Robert C Bucelli |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295932960 PECOS PAC ID: 8325202096 Enrollment ID: I20120608000053 |
| Provider Name | Mwiza Ushe |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225236300 PECOS PAC ID: 9638333248 Enrollment ID: I20120612000195 |
| Provider Name | Scott A Norris |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861649063 PECOS PAC ID: 7315101813 Enrollment ID: I20120613000491 |
| Provider Name | Suzanne E Schindler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053561266 PECOS PAC ID: 6901060409 Enrollment ID: I20120613000552 |
| Provider Name | Robin C Ryther |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356478705 PECOS PAC ID: 6709040207 Enrollment ID: I20120613000573 |
| Provider Name | Gabriela S Debruin |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1144412339 PECOS PAC ID: 5496910580 Enrollment ID: I20120621000706 |
| Provider Name | Terrance T Kummer |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1649396151 PECOS PAC ID: 4880851153 Enrollment ID: I20120621000713 |
| Provider Name | Brian K Day |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992996219 PECOS PAC ID: 1658536743 Enrollment ID: I20120621000715 |
| Provider Name | Amy R Viehoever |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1568649556 PECOS PAC ID: 6103081211 Enrollment ID: I20120622000207 |
| Provider Name | Carliss R Garrett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154680288 PECOS PAC ID: 1850556796 Enrollment ID: I20120627000603 |
| Provider Name | Rafael Galindo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992973580 PECOS PAC ID: 9830354109 Enrollment ID: I20120712000103 |
| Provider Name | Brendan P Lucey |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1619000965 PECOS PAC ID: 5294991519 Enrollment ID: I20120731000570 |
| Provider Name | Afoussatou Boire |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013253970 PECOS PAC ID: 7416192331 Enrollment ID: I20130326000137 |
| Provider Name | Bryan E Mcgill |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1912160805 PECOS PAC ID: 3274776224 Enrollment ID: I20130823000799 |
| Provider Name | Christina Marie Wombles |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992977003 PECOS PAC ID: 7911196910 Enrollment ID: I20131211001893 |
| Provider Name | Amber M Malcolm |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1609203322 PECOS PAC ID: 6204065501 Enrollment ID: I20140207001331 |
| Provider Name | Yuan Fan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1639312481 PECOS PAC ID: 7719131879 Enrollment ID: I20140319000699 |
| Provider Name | Kristin P Guilliams |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1831376482 PECOS PAC ID: 3870725575 Enrollment ID: I20140411000837 |
| Provider Name | Baijayanta Maiti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1861620924 PECOS PAC ID: 5597989368 Enrollment ID: I20140617002558 |
| Provider Name | Baback Arshi |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1194041905 PECOS PAC ID: 5799900262 Enrollment ID: I20140626000628 |
| Provider Name | Siddharth V Jain |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588847529 PECOS PAC ID: 2264658939 Enrollment ID: I20140801001710 |
| Provider Name | Sheel Pathak |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184887341 PECOS PAC ID: 7012134141 Enrollment ID: I20140813000479 |
| Provider Name | Luqi Chi |
|---|---|
| Provider Type | Practitioner - Sleep Medicine |
| Provider Identifiers | NPI Number: 1902090558 PECOS PAC ID: 2668545211 Enrollment ID: I20141202002438 |
| Provider Name | Alejandra Camacho-soto |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1437440633 PECOS PAC ID: 2769793850 Enrollment ID: I20150616001464 |
| Provider Name | Stefanie Geisler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427287812 PECOS PAC ID: 5698086791 Enrollment ID: I20150616001722 |
| Provider Name | Casey Raymond Dunn |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1588807549 PECOS PAC ID: 9133430291 Enrollment ID: I20150617000201 |
| Provider Name | Gregory Scott Day |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1962880757 PECOS PAC ID: 2466765508 Enrollment ID: I20150720001254 |
| Provider Name | Adriane M Spruell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346623956 PECOS PAC ID: 5395059505 Enrollment ID: I20150731016634 |
| Provider Name | Stephanie Wrobel Goldberg |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073742656 PECOS PAC ID: 9537474390 Enrollment ID: I20150824000496 |
| Provider Name | Keiko Sawano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114369881 PECOS PAC ID: 8224345343 Enrollment ID: I20150922000565 |
| Provider Name | Mary Epperson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588095590 PECOS PAC ID: 6002118973 Enrollment ID: I20160108001660 |
| Provider Name | Eric Mcdade |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073649265 PECOS PAC ID: 0648343178 Enrollment ID: I20160301001791 |
| Provider Name | Albert Davis |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538454681 PECOS PAC ID: 2264738657 Enrollment ID: I20160310001990 |
| Provider Name | Mary Hopfinger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679869838 PECOS PAC ID: 4082886452 Enrollment ID: I20160331002300 |
| Provider Name | Peter Kang |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1083977367 PECOS PAC ID: 3476792128 Enrollment ID: I20160520001135 |
| Provider Name | Harpaul Singh Bhamra |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1164781019 PECOS PAC ID: 4880983485 Enrollment ID: I20160520002072 |
| Provider Name | Emily Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164876660 PECOS PAC ID: 4587954391 Enrollment ID: I20160607002342 |
| Provider Name | Chia-ling Phuah |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1639338114 PECOS PAC ID: 6800057035 Enrollment ID: I20160627002055 |
| Provider Name | Prateek Grover |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1023372380 PECOS PAC ID: 9032348123 Enrollment ID: I20160628000170 |
| Provider Name | Rejean Guerriero |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730323197 PECOS PAC ID: 0547421687 Enrollment ID: I20160805001269 |
| Provider Name | Kristin H Hinrichs |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1831541200 PECOS PAC ID: 1052605011 Enrollment ID: I20160815000584 |
| Provider Name | Catherine Goebel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447706924 PECOS PAC ID: 4880981687 Enrollment ID: I20160922000279 |
| Provider Name | Salim Chahin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255539789 PECOS PAC ID: 6204099476 Enrollment ID: I20161219000070 |
| Provider Name | Asher Albertson |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1194164350 PECOS PAC ID: 2062641277 Enrollment ID: I20170511001029 |
| Provider Name | Matthew Loftspring |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891134037 PECOS PAC ID: 6305075813 Enrollment ID: I20170512001225 |
| Provider Name | Sanjeev R Keshary |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1205272960 PECOS PAC ID: 9638476617 Enrollment ID: I20170517001858 |
| Provider Name | Andres Ruiz |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1740518695 PECOS PAC ID: 0446491492 Enrollment ID: I20170517001900 |
| Provider Name | Emily Evans |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1710326939 PECOS PAC ID: 1759510258 Enrollment ID: I20170517001905 |
| Provider Name | Stuart Tomko |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669770947 PECOS PAC ID: 3870860067 Enrollment ID: I20170518000308 |
| Provider Name | Kathryn Marlow |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1144664913 PECOS PAC ID: 4082983663 Enrollment ID: I20170713002100 |
| Provider Name | Wing Fong |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1073821096 PECOS PAC ID: 7719258813 Enrollment ID: I20170808003236 |
| Provider Name | Derek Holder |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1356616494 PECOS PAC ID: 0042581068 Enrollment ID: I20170809000422 |
| Provider Name | Priya R Chaudhari |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952846909 PECOS PAC ID: 5597037374 Enrollment ID: I20170815002045 |
| Provider Name | Emily Michelle Rhodes |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235640012 PECOS PAC ID: 8729345608 Enrollment ID: I20171130002761 |
| Provider Name | Cassandra Marie Wallace |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417354440 PECOS PAC ID: 1456610781 Enrollment ID: I20180112001951 |
| Provider Name | Jennifer Lynn Griffith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1437413598 PECOS PAC ID: 3870848385 Enrollment ID: I20180622002401 |
| Provider Name | Cindy V Ly |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1245542968 PECOS PAC ID: 1658500145 Enrollment ID: I20180627002401 |
| Provider Name | Keisuke Ueda |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497199640 PECOS PAC ID: 1456653690 Enrollment ID: I20180802002527 |
| Provider Name | Justin M Long |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1053725531 PECOS PAC ID: 1951522986 Enrollment ID: I20180802003700 |
| Provider Name | Laura A Jansen |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1235210592 PECOS PAC ID: 8426048927 Enrollment ID: I20180907000151 |
| Provider Name | Shannon C Agner |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881034866 PECOS PAC ID: 1658621610 Enrollment ID: I20180912002381 |
| Provider Name | Ashutosh Mahapatra |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1750700522 PECOS PAC ID: 0446500433 Enrollment ID: I20180913000091 |
| Provider Name | Eric C Landsness |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1255770301 PECOS PAC ID: 6709015928 Enrollment ID: I20181009001472 |
| Provider Name | Bhooma Rajagopalan Aravamuthan |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1821353756 PECOS PAC ID: 9234481888 Enrollment ID: I20181009001479 |
| Provider Name | Sarah Louise Bauer Huang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1073888186 PECOS PAC ID: 9032428230 Enrollment ID: I20181009001482 |
| Provider Name | Jayesh P Patel |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1164839890 PECOS PAC ID: 4789983040 Enrollment ID: I20181009001514 |
| Provider Name | Susan Mary Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316458870 PECOS PAC ID: 6507118841 Enrollment ID: I20181015001294 |
| Provider Name | Tralissa Love |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639644552 PECOS PAC ID: 6608120340 Enrollment ID: I20181114003606 |
| Provider Name | Mary Fink |
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) |
| Provider Identifiers | NPI Number: 1659461606 PECOS PAC ID: 2860711843 Enrollment ID: I20190410000931 |
| Provider Name | Jonathan Tiu |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659767838 PECOS PAC ID: 0244578227 Enrollment ID: I20190513000779 |
| Provider Name | Robert John Rudock |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1215291653 PECOS PAC ID: 8224371349 Enrollment ID: I20190513002024 |
| Provider Name | Brandi Baker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1003298852 PECOS PAC ID: 2860706777 Enrollment ID: I20190514002667 |
| Provider Name | Lindsay Peglar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1780028043 PECOS PAC ID: 7012250327 Enrollment ID: I20190529002325 |
| Provider Name | Isabel Alfradique-dunham |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1669814521 PECOS PAC ID: 5092048413 Enrollment ID: I20190617002396 |
| Provider Name | Mohammad Anadani |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1407237977 PECOS PAC ID: 4183931108 Enrollment ID: I20190619002247 |
| Provider Name | Andrew Findlay |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1063851780 PECOS PAC ID: 1456685148 Enrollment ID: I20190701000521 |
| Provider Name | Flavia Lynn Lee |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760865729 PECOS PAC ID: 1355644766 Enrollment ID: I20190701001147 |
| Provider Name | John R Ciotti |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1992186985 PECOS PAC ID: 6709191497 Enrollment ID: I20190701002337 |
| Provider Name | Kalen R Dionne |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841672441 PECOS PAC ID: 7618281304 Enrollment ID: I20190730000577 |
| Provider Name | Thomas Jonathan Foutz |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891037586 PECOS PAC ID: 8729306865 Enrollment ID: I20190828000860 |
| Provider Name | Leigh Rose Ball |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1134583925 PECOS PAC ID: 7214223734 Enrollment ID: I20190919000913 |
| Provider Name | Alan S Plotzker |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1760868467 PECOS PAC ID: 2961717624 Enrollment ID: I20191018001941 |
| Provider Name | Mian Harris Iftikhar |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1841642659 PECOS PAC ID: 6608108873 Enrollment ID: I20191022000714 |
| Provider Name | Osvaldo J Laurido Soto |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1942615489 PECOS PAC ID: 0345461083 Enrollment ID: I20191111001565 |
| Provider Name | Bhavesh Vasant Trikamji |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1295114197 PECOS PAC ID: 1658675962 Enrollment ID: I20191203000180 |
| Provider Name | Steven Dunham |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1699065151 PECOS PAC ID: 1153635586 Enrollment ID: I20200227001330 |
| Provider Name | Merielle Nicole Bird |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437477932 PECOS PAC ID: 6204267479 Enrollment ID: I20200504002484 |
| Provider Name | Kyle Lester Ogle |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629627625 PECOS PAC ID: 5597097121 Enrollment ID: I20200504002496 |
| Provider Name | Natalie Louise Goedeker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841715554 PECOS PAC ID: 8325469984 Enrollment ID: I20200608000236 |
| Provider Name | Jessica A Spring |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497376487 PECOS PAC ID: 1658793070 Enrollment ID: I20200611002967 |
| Provider Name | Katherine Lynn-funkhouser Leger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144871658 PECOS PAC ID: 8426470774 Enrollment ID: I20200616000439 |
| Provider Name | Benjamin Paul Kay |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1538542329 PECOS PAC ID: 2769804434 Enrollment ID: I20200625001554 |
| Provider Name | Alyssa Erin Smith |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013322361 PECOS PAC ID: 4082946371 Enrollment ID: I20200626000107 |
| Provider Name | Rami Assadi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1265819478 PECOS PAC ID: 8325343247 Enrollment ID: I20200626001431 |
| Provider Name | Yan Wang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184006769 PECOS PAC ID: 0345554531 Enrollment ID: I20200626001697 |
| Provider Name | Elyse A Everett |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1528449824 PECOS PAC ID: 9335453018 Enrollment ID: I20200629003430 |
| Provider Name | Markesha Dabney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912315219 PECOS PAC ID: 8426471921 Enrollment ID: I20200630002430 |
| Provider Name | Kiddy Ume |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659721884 PECOS PAC ID: 4486948858 Enrollment ID: I20200702000451 |
| Provider Name | Oleg V Lobanov |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1497195960 PECOS PAC ID: 0446682736 Enrollment ID: I20200702001249 |
| Provider Name | Kyle Byron Womack |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922065796 PECOS PAC ID: 7214959667 Enrollment ID: I20200722002895 |
| Provider Name | Helen Hwang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1427408178 PECOS PAC ID: 7618391749 Enrollment ID: I20200722002946 |
| Provider Name | Liu L Thio |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1871656272 PECOS PAC ID: 5294159190 Enrollment ID: I20200724001825 |
| Provider Name | Lindsay Michele Frerichs |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1952782708 PECOS PAC ID: 3779897640 Enrollment ID: I20200728003361 |
| Provider Name | Catherine Mcgaffey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942890801 PECOS PAC ID: 6507272937 Enrollment ID: I20210310001492 |
| Provider Name | Matthew R Brier |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1689194730 PECOS PAC ID: 0244501195 Enrollment ID: I20210712000609 |
| Provider Name | Yunshuo Tang |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1467972513 PECOS PAC ID: 6406127307 Enrollment ID: I20210712000730 |
| Provider Name | Junling Dong |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225449069 PECOS PAC ID: 2163728312 Enrollment ID: I20210712002490 |
| Provider Name | Collin Herman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023543196 PECOS PAC ID: 6103197801 Enrollment ID: I20210712002861 |
| Provider Name | Faraze Amir Niazi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1033640172 PECOS PAC ID: 2365711967 Enrollment ID: I20210713001969 |
| Provider Name | Regina Lindsay Triplett |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1023499001 PECOS PAC ID: 9638571680 Enrollment ID: I20210713002175 |
| Provider Name | Shawn H Babur |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083142913 PECOS PAC ID: 3678975356 Enrollment ID: I20210719000659 |
| Provider Name | Robert John Heuermann |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1982091088 PECOS PAC ID: 7517238314 Enrollment ID: I20210730001835 |
| Provider Name | Brendan Thomas Eby |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1184030991 PECOS PAC ID: 1759691538 Enrollment ID: I20210816001714 |
| Provider Name | Sean E Smith |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1700268968 PECOS PAC ID: 9830403716 Enrollment ID: I20210825002081 |
| Provider Name | Marissa Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720480015 PECOS PAC ID: 9638491590 Enrollment ID: I20210827001290 |
| Provider Name | Mai Tu Dang |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164652475 PECOS PAC ID: 2466678776 Enrollment ID: I20211014001884 |
| Provider Name | Robert Lazell White |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1457504417 PECOS PAC ID: 0648448670 Enrollment ID: I20211122001653 |
| Provider Name | Adam Seth Greenblatt |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1336598226 PECOS PAC ID: 6305126731 Enrollment ID: I20220629000380 |
| Provider Name | Sama Astani |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1326530577 PECOS PAC ID: 2163802554 Enrollment ID: I20220701000302 |
| Provider Name | Joyce Akinyi Okendo |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1346747771 PECOS PAC ID: 1658700182 Enrollment ID: I20220701000422 |
| Provider Name | Maria Milagros Galardi |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902256126 PECOS PAC ID: 8921488123 Enrollment ID: I20220706001388 |
| Provider Name | Jonathan Paul Williams |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1700306867 PECOS PAC ID: 4981975885 Enrollment ID: I20220706002865 |
| Provider Name | Enmanuel Jose Perez Martinez |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1467947945 PECOS PAC ID: 7517347446 Enrollment ID: I20220708001901 |
| Provider Name | Jee Young Han |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013412980 PECOS PAC ID: 9739569518 Enrollment ID: I20220711002556 |
| Provider Name | Fabio Augusto Nascimento E Silva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881045573 PECOS PAC ID: 5294116729 Enrollment ID: I20220714004090 |
| Provider Name | Emily Katherine White |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1972039477 PECOS PAC ID: 7810258811 Enrollment ID: I20220720003172 |
| Provider Name | Masoud Majed |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1225569577 PECOS PAC ID: 4880098672 Enrollment ID: I20220727000394 |
| Provider Name | Renatta Nakole Knox |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518386549 PECOS PAC ID: 6204173180 Enrollment ID: I20220729000622 |
| Provider Name | Christopher A Ray |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1881188985 PECOS PAC ID: 1850772245 Enrollment ID: I20221019001007 |
| Provider Name | Abbey Lynne Arnold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336866425 PECOS PAC ID: 5294102067 Enrollment ID: I20221108000782 |
| Provider Name | Andrea Denny |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1902513484 PECOS PAC ID: 4789054867 Enrollment ID: I20230106000144 |
| Provider Name | Renee Adele Shellhaas |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1902821051 PECOS PAC ID: 4688670276 Enrollment ID: I20230107000137 |
| Provider Name | Manouela Vesselinova Valtcheva |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1164917118 PECOS PAC ID: 2668849100 Enrollment ID: I20230531001824 |
| Provider Name | Min Qiao |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1679133698 PECOS PAC ID: 4284964503 Enrollment ID: I20230601000935 |
| Provider Name | Daniel Garbin Di Luca |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1922462597 PECOS PAC ID: 1052778784 Enrollment ID: I20230612000429 |
| Provider Name | Joshua David Newman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1659876019 PECOS PAC ID: 2163804824 Enrollment ID: I20230613002165 |
| Provider Name | Xing Dai |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1578054656 PECOS PAC ID: 3577828847 Enrollment ID: I20230614003212 |
| Provider Name | Charles Andrew Roach |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1588158570 PECOS PAC ID: 1759761992 Enrollment ID: I20230615001894 |
| Provider Name | Wendy Ann Assael |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609436773 PECOS PAC ID: 8426384439 Enrollment ID: I20230628003632 |
| Provider Name | Erin Lee Langton |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1891215885 PECOS PAC ID: 9931589173 Enrollment ID: I20230630001686 |
| Provider Name | Destiny Lee Hooper |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1487188645 PECOS PAC ID: 2860870375 Enrollment ID: I20230706000783 |
| Provider Name | Holly June Hanak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437793049 PECOS PAC ID: 8628482023 Enrollment ID: I20231114001499 |
| Provider Name | Sheila Serra Arackal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063812329 PECOS PAC ID: 0345698585 Enrollment ID: I20231128002055 |
| Provider Name | Kristie Marie Taggart |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700155793 PECOS PAC ID: 9335301167 Enrollment ID: I20231229002810 |
| Provider Name | Joo Hyang Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669175121 PECOS PAC ID: 4880048396 Enrollment ID: I20240104001181 |
| Provider Name | Albert James Fessler |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1790700920 PECOS PAC ID: 1557304003 Enrollment ID: I20240203000290 |
| Provider Name | Michelle D Rudman |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1083274054 PECOS PAC ID: 0244566255 Enrollment ID: I20240306000425 |
| Provider Name | Alexandra Louise Venuto |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376325597 PECOS PAC ID: 1658719190 Enrollment ID: I20240403002834 |
| Provider Name | Christine Juang |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1871135400 PECOS PAC ID: 1355775842 Enrollment ID: I20240410003440 |
St. Louis Center For Preventive And Longevity Medicine, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 777 S New Ballas Rd, Suite 200 E, Saint Louis, MO 63141 Phone: 314-994-1536 Fax: 314-692-0241 | |
Town And Country Primary Care Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3009 N Ballas Rd, Suite 300a, Saint Louis, MO 63131 Phone: 314-872-8999 | |
Family Care Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1001 Lynch St, Saint Louis, MO 63118 Phone: 314-531-5444 Fax: 314-531-0063 | |
Wusm Bjc Aco Providers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 660 S Euclid Ave, Campus Box 8081, Saint Louis, MO 63110 Phone: 314-273-0770 | |
Victus Physician Services, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12607 Olive Blvd, Saint Louis, MO 63141 Phone: 314-327-8070 | |
Salvation Army Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2900 Washington Ave, Saint Louis, MO 63103 Phone: 314-898-1700 Fax: 314-814-8542 | |
Dtg Ii Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3819 Tesson Ct, Saint Louis, MO 63123 Phone: 800-268-7713 Fax: 415-704-3294 |