| Watertown Physician Practices Llc | |
|
1507 Doctors Ct Watertown WI 53094-4101 | |
| (920) 261-4111 | |
| (920) 261-8387 |
| Full Name | Watertown Physician Practices Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1507 Doctors Ct, Watertown, Wisconsin |
| Authorized Official Name and Position | Sara L Miller (DIRECTOR) |
| Authorized Official Contact | 6159207514 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Watertown Physician Practices Llc 1507 Doctors Ct Watertown WI 53094-4101 Ph: (920) 261-4111 | Watertown Physician Practices Llc 1507 Doctors Ct Watertown WI 53094-4101 Ph: (920) 261-4111 |
| NPI Number | 1770964363 |
|---|---|
| Provider Enumeration Date | 06/09/2015 |
| Last Update Date | 05/09/2018 |
| Medicare PECOS PAC ID | 8022329408 |
|---|---|
| Medicare Enrollment ID | O20150626000114 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770964363 | NPI | - | NPPES |
| Provider Name | Katharina S Stewart |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1053380345 PECOS PAC ID: 4486559275 Enrollment ID: I20031204000736 |
| Provider Name | Giorgio Gimelli |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1629044706 PECOS PAC ID: 1557269065 Enrollment ID: I20031222000512 |
| Provider Name | Michelle Koellermeier |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1871598813 PECOS PAC ID: 4183527716 Enrollment ID: I20040130000104 |
| Provider Name | Michael A Grajewski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023085685 PECOS PAC ID: 4981597812 Enrollment ID: I20040205000505 |
| Provider Name | Paul D Volkert |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437143435 PECOS PAC ID: 7618861899 Enrollment ID: I20040210000018 |
| Provider Name | Jerry Jones |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1669437638 PECOS PAC ID: 4587558432 Enrollment ID: I20040211000547 |
| Provider Name | Jay Alan Met |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1013963107 PECOS PAC ID: 1153217179 Enrollment ID: I20040226000267 |
| Provider Name | George A Boush |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1053314070 PECOS PAC ID: 9234028143 Enrollment ID: I20040310001389 |
| Provider Name | Kevin L Ohalloran |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1821007022 PECOS PAC ID: 3870482367 Enrollment ID: I20040318000668 |
| Provider Name | Mala Thenappan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1861447427 PECOS PAC ID: 3577556679 Enrollment ID: I20040405001661 |
| Provider Name | Issam Al-bitar |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1083608087 PECOS PAC ID: 2961496625 Enrollment ID: I20040414000614 |
| Provider Name | Karen Elizabeth Howard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487610184 PECOS PAC ID: 0941295166 Enrollment ID: I20040417000121 |
| Provider Name | Salim M Shammo |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1295791937 PECOS PAC ID: 0345236832 Enrollment ID: I20040421000824 |
| Provider Name | Anil Dogra |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1992788814 PECOS PAC ID: 6800889361 Enrollment ID: I20040505001635 |
| Provider Name | Charles K Stone |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1558322461 PECOS PAC ID: 1658360169 Enrollment ID: I20040510001239 |
| Provider Name | Peter J Quandt |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1790708964 PECOS PAC ID: 1355332529 Enrollment ID: I20040518001461 |
| Provider Name | Philip G Conrardy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780667683 PECOS PAC ID: 2860392685 Enrollment ID: I20040519000942 |
| Provider Name | Greg T Graglia |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1841244555 PECOS PAC ID: 3971586025 Enrollment ID: I20040609001390 |
| Provider Name | Bruce Robert Stevens |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1003870379 PECOS PAC ID: 3678468568 Enrollment ID: I20040614000278 |
| Provider Name | Lana L Sanders |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376505933 PECOS PAC ID: 7214912823 Enrollment ID: I20040618001271 |
| Provider Name | Mathew G Mathai |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1104854363 PECOS PAC ID: 4284610247 Enrollment ID: I20040629000787 |
| Provider Name | Karen L Moncher |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1902872930 PECOS PAC ID: 8123091618 Enrollment ID: I20040813000412 |
| Provider Name | Dongyuan P Cheng |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1326021049 PECOS PAC ID: 9537131214 Enrollment ID: I20040813001136 |
| Provider Name | Ali Sadeghi |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1114901345 PECOS PAC ID: 2961399647 Enrollment ID: I20040819000027 |
| Provider Name | Kristin L Clark |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1710982756 PECOS PAC ID: 7517933823 Enrollment ID: I20040908000972 |
| Provider Name | Elizabeth Ann Baron -kuhn |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1740288737 PECOS PAC ID: 1254309495 Enrollment ID: I20040924000190 |
| Provider Name | Mary Anderson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1487662060 PECOS PAC ID: 1052210762 Enrollment ID: I20040927000962 |
| Provider Name | Ronald Scott Sokovich |
|---|---|
| Provider Type | Practitioner - Urology |
| Provider Identifiers | NPI Number: 1396796074 PECOS PAC ID: 3870552250 Enrollment ID: I20041022000151 |
| Provider Name | Gail A Tasch |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1316929508 PECOS PAC ID: 2365403912 Enrollment ID: I20041026000877 |
| Provider Name | Oscar M Busso |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1508887449 PECOS PAC ID: 5092777664 Enrollment ID: I20041027000683 |
| Provider Name | Paul A Staskowski |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1548224264 PECOS PAC ID: 6002871977 Enrollment ID: I20041120000072 |
| Provider Name | A Akbar |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1144203282 PECOS PAC ID: 4981669520 Enrollment ID: I20041123000775 |
| Provider Name | Ashwini Prasad |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1881678274 PECOS PAC ID: 2365490174 Enrollment ID: I20050108000123 |
| Provider Name | Kathleen Marie O'neill |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1881679173 PECOS PAC ID: 0648229567 Enrollment ID: I20050118001018 |
| Provider Name | Dinesh M Shah |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811966211 PECOS PAC ID: 6709837958 Enrollment ID: I20050204000031 |
| Provider Name | Emily E Stoddard |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1457311441 PECOS PAC ID: 1254382435 Enrollment ID: I20050204000303 |
| Provider Name | Danish Siddiqui |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1215987128 PECOS PAC ID: 0042262917 Enrollment ID: I20050218000539 |
| Provider Name | Janell M Loescher |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1700963352 PECOS PAC ID: 6103879085 Enrollment ID: I20050303000111 |
| Provider Name | Julie M Dejong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1174639082 PECOS PAC ID: 0345294930 Enrollment ID: I20050307000466 |
| Provider Name | Steven D Pals |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1063503217 PECOS PAC ID: 3274519822 Enrollment ID: I20050324000088 |
| Provider Name | Cheryl S Peterson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386737674 PECOS PAC ID: 6608840624 Enrollment ID: I20050331000916 |
| Provider Name | Cary Jay Kohlenberg |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1427134089 PECOS PAC ID: 3971574674 Enrollment ID: I20050414000425 |
| Provider Name | Jennifer M Myszkowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972504637 PECOS PAC ID: 1658312186 Enrollment ID: I20050516000353 |
| Provider Name | James D Erickson |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1588612170 PECOS PAC ID: 8921042771 Enrollment ID: I20050614000119 |
| Provider Name | Rebecca Reim |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043211766 PECOS PAC ID: 2668416744 Enrollment ID: I20050620000605 |
| Provider Name | Patrick Hughes |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1013995281 PECOS PAC ID: 2668418278 Enrollment ID: I20050706000149 |
| Provider Name | Steven P Rhodes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1467426452 PECOS PAC ID: 0244276327 Enrollment ID: I20050711000670 |
| Provider Name | Jenifer A Siragusa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053361246 PECOS PAC ID: 4082641568 Enrollment ID: I20050726001151 |
| Provider Name | Sandra K Roof |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043237910 PECOS PAC ID: 2466481015 Enrollment ID: I20050804000609 |
| Provider Name | Linda C Tampa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1730105750 PECOS PAC ID: 8527097757 Enrollment ID: I20050809000168 |
| Provider Name | Renee B Haefs |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1609883990 PECOS PAC ID: 5092745836 Enrollment ID: I20050822000240 |
| Provider Name | Mary L Zasadil |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1881659175 PECOS PAC ID: 8628009834 Enrollment ID: I20050827000183 |
| Provider Name | George Keng |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1386623684 PECOS PAC ID: 5890688360 Enrollment ID: I20050927000631 |
| Provider Name | Annie F Kelly |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1669449302 PECOS PAC ID: 1850326810 Enrollment ID: I20050928001482 |
| Provider Name | Arturo Eduardo Eyzaguirre |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114029196 PECOS PAC ID: 4587699376 Enrollment ID: I20050929001167 |
| Provider Name | James J Prosser |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1649235672 PECOS PAC ID: 8224053558 Enrollment ID: I20051006000090 |
| Provider Name | David W Sadler |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1568491819 PECOS PAC ID: 0345268587 Enrollment ID: I20051107000613 |
| Provider Name | Joseph Sizensky |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1629020367 PECOS PAC ID: 5597742304 Enrollment ID: I20051202000704 |
| Provider Name | Kevin L Scheu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1083666440 PECOS PAC ID: 2860414869 Enrollment ID: I20051219000631 |
| Provider Name | Mark Allan Meier |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1083671572 PECOS PAC ID: 0143242891 Enrollment ID: I20051222000387 |
| Provider Name | Charles J Havel |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558358143 PECOS PAC ID: 3577591437 Enrollment ID: I20060104000513 |
| Provider Name | Parag A Tipnis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1215973946 PECOS PAC ID: 4981626033 Enrollment ID: I20060821000348 |
| Provider Name | Justin A Sattin |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1013965185 PECOS PAC ID: 8921085606 Enrollment ID: I20060928000296 |
| Provider Name | Chenyang C Zhang |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1215946611 PECOS PAC ID: 3173529369 Enrollment ID: I20061011000367 |
| Provider Name | Horace Lo |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1114988466 PECOS PAC ID: 4688673395 Enrollment ID: I20061206000564 |
| Provider Name | Neil Tabakin |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1841274917 PECOS PAC ID: 3577556026 Enrollment ID: I20061218000278 |
| Provider Name | Steffen P White |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609850627 PECOS PAC ID: 3678566130 Enrollment ID: I20061218000331 |
| Provider Name | John K Amuzu |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1609859651 PECOS PAC ID: 4880687334 Enrollment ID: I20070105000065 |
| Provider Name | Panna A Codner |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1356410898 PECOS PAC ID: 3072539873 Enrollment ID: I20070131000651 |
| Provider Name | Sarah Catherine Moore |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1598715666 PECOS PAC ID: 2769484948 Enrollment ID: I20070201000447 |
| Provider Name | Kristine L Braker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679633580 PECOS PAC ID: 3173525664 Enrollment ID: I20070213000449 |
| Provider Name | Rachel Ronda Damon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487798070 PECOS PAC ID: 5092819334 Enrollment ID: I20070327000361 |
| Provider Name | Kimberly M Lunaas |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1063589869 PECOS PAC ID: 7810095593 Enrollment ID: I20070604000297 |
| Provider Name | Jesus I Iruretagoyena |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1285757997 PECOS PAC ID: 9436257508 Enrollment ID: I20070613000532 |
| Provider Name | Marcus R Chacon |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1609953462 PECOS PAC ID: 2163468364 Enrollment ID: I20070714000222 |
| Provider Name | Timothy M Mcculloch |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1477686830 PECOS PAC ID: 3577573385 Enrollment ID: I20070717000352 |
| Provider Name | Marc S Eiseman |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1124091855 PECOS PAC ID: 2769583277 Enrollment ID: I20070727000758 |
| Provider Name | Mary Lynn Schneider |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942399480 PECOS PAC ID: 1557454394 Enrollment ID: I20070910000610 |
| Provider Name | Brian D Steffin |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1568571248 PECOS PAC ID: 2668575689 Enrollment ID: I20070919000591 |
| Provider Name | Linda O Douglas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538110515 PECOS PAC ID: 6103911342 Enrollment ID: I20071002000775 |
| Provider Name | Peter S Rahko |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1063473981 PECOS PAC ID: 1759461320 Enrollment ID: I20080108000872 |
| Provider Name | James H Stein |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1427019348 PECOS PAC ID: 8628158292 Enrollment ID: I20080108000904 |
| Provider Name | David Cullinane |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1770589236 PECOS PAC ID: 6709776370 Enrollment ID: I20080126000023 |
| Provider Name | Eugene H Kaji |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1093776874 PECOS PAC ID: 8921185935 Enrollment ID: I20080401000644 |
| Provider Name | Douglas E Kopp |
|---|---|
| Provider Type | Practitioner - Cardiac Electrophysiology |
| Provider Identifiers | NPI Number: 1356317358 PECOS PAC ID: 4082791165 Enrollment ID: I20080415000032 |
| Provider Name | Bjorn S Schweinsberg |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1750464533 PECOS PAC ID: 5698840205 Enrollment ID: I20080816000014 |
| Provider Name | Toks Macarthy |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1164608964 PECOS PAC ID: 2264509041 Enrollment ID: I20080919000302 |
| Provider Name | Steven Ewer |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1730207093 PECOS PAC ID: 7416015680 Enrollment ID: I20081017000209 |
| Provider Name | Gary B Harris |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1245339944 PECOS PAC ID: 3274531207 Enrollment ID: I20081017000324 |
| Provider Name | Oluwakunle Oluwatosin |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1396912796 PECOS PAC ID: 1557439262 Enrollment ID: I20081023000761 |
| Provider Name | David C. Cronin |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063496925 PECOS PAC ID: 4880596204 Enrollment ID: I20081118000232 |
| Provider Name | Kurt M Jacobson |
|---|---|
| Provider Type | Practitioner - Interventional Cardiology |
| Provider Identifiers | NPI Number: 1518947712 PECOS PAC ID: 3577598911 Enrollment ID: I20081121000520 |
| Provider Name | Florin Stuleanu |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1316958705 PECOS PAC ID: 9638234644 Enrollment ID: I20090206000441 |
| Provider Name | Erik N Cohen |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1992800783 PECOS PAC ID: 5092766535 Enrollment ID: I20090206000498 |
| Provider Name | Neerajana Gupta |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1962660480 PECOS PAC ID: 9436214749 Enrollment ID: I20090220000410 |
| Provider Name | John V Selthafner |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1013024207 PECOS PAC ID: 8820154065 Enrollment ID: I20090312000635 |
| Provider Name | David G Parkins |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1942397096 PECOS PAC ID: 2264584325 Enrollment ID: I20090721000279 |
| Provider Name | Katherine A Lothe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1518192376 PECOS PAC ID: 4082769567 Enrollment ID: I20090904000412 |
| Provider Name | Erik D Beaver |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1881679975 PECOS PAC ID: 0749327294 Enrollment ID: I20100106000745 |
| Provider Name | Brent Paul Yaeggi |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1427001676 PECOS PAC ID: 7315035565 Enrollment ID: I20100125000821 |
| Provider Name | Terry Lester Turke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740337518 PECOS PAC ID: 7113918798 Enrollment ID: I20100202000195 |
| Provider Name | Mary L Stoffel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1437111036 PECOS PAC ID: 1254336753 Enrollment ID: I20100209000269 |
| Provider Name | Joseph Mcmahon |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1841266889 PECOS PAC ID: 5799820478 Enrollment ID: I20100305000290 |
| Provider Name | Steven E Cattapan |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1457328148 PECOS PAC ID: 9335274042 Enrollment ID: I20100319000732 |
| Provider Name | David A Wolff |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1740223247 PECOS PAC ID: 0042346231 Enrollment ID: I20100326000566 |
| Provider Name | Holly C Van Hecke |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1639139074 PECOS PAC ID: 5890726525 Enrollment ID: I20100331001130 |
| Provider Name | Moazam J Samdani |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083694350 PECOS PAC ID: 0840326575 Enrollment ID: I20100331001203 |
| Provider Name | Adam Foster Dachman |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1285698548 PECOS PAC ID: 3274660345 Enrollment ID: I20100421000546 |
| Provider Name | Katharine D Van Fossen |
|---|---|
| Provider Type | Practitioner - Gynecological Oncology |
| Provider Identifiers | NPI Number: 1356316483 PECOS PAC ID: 5698854180 Enrollment ID: I20100421000892 |
| Provider Name | Ladan Tehrani Mostaghimi |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1720057920 PECOS PAC ID: 3870620727 Enrollment ID: I20100423000651 |
| Provider Name | Christopher D Peters |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396720587 PECOS PAC ID: 9830229624 Enrollment ID: I20100604000340 |
| Provider Name | Steven J Novacheck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629051891 PECOS PAC ID: 2163554106 Enrollment ID: I20100709000672 |
| Provider Name | Terry Mark Roman |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1083895312 PECOS PAC ID: 0648317347 Enrollment ID: I20101019000737 |
| Provider Name | Fahad M Iqbal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1285848291 PECOS PAC ID: 1759438963 Enrollment ID: I20101124000246 |
| Provider Name | Matthew C Tattersall |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1710187018 PECOS PAC ID: 5496934655 Enrollment ID: I20110120000801 |
| Provider Name | Kevin Hibbett |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1912936055 PECOS PAC ID: 1850338534 Enrollment ID: I20110215000538 |
| Provider Name | Ronald K Meyer |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1376522730 PECOS PAC ID: 0244138824 Enrollment ID: I20110406000205 |
| Provider Name | David C Upton |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1457397663 PECOS PAC ID: 9234317546 Enrollment ID: I20110708000300 |
| Provider Name | Joseph T Weber |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1881870277 PECOS PAC ID: 3870761729 Enrollment ID: I20110719000708 |
| Provider Name | Matthew Robert Herald |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275737199 PECOS PAC ID: 7810166824 Enrollment ID: I20110809000328 |
| Provider Name | Brian J Keyes |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1417078890 PECOS PAC ID: 1254596182 Enrollment ID: I20120627000538 |
| Provider Name | Veronica M Loy |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1972780013 PECOS PAC ID: 6406017664 Enrollment ID: I20120723000023 |
| Provider Name | Jeanne M Denk |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1962678086 PECOS PAC ID: 2961654934 Enrollment ID: I20121221000020 |
| Provider Name | Dawn R Giese |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548504996 PECOS PAC ID: 4385898931 Enrollment ID: I20130206000442 |
| Provider Name | Paul A Lisi |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1194943399 PECOS PAC ID: 9335385947 Enrollment ID: I20130425000577 |
| Provider Name | Henry G Riter |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1225049927 PECOS PAC ID: 9931013992 Enrollment ID: I20130611000056 |
| Provider Name | Todd L Goldman |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1588875777 PECOS PAC ID: 6709027253 Enrollment ID: I20130725000128 |
| Provider Name | Anne M Oconnor |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1942245477 PECOS PAC ID: 5597768978 Enrollment ID: I20130820000429 |
| Provider Name | Kathryn L Spors |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1952743072 PECOS PAC ID: 3678717865 Enrollment ID: I20130909000621 |
| Provider Name | Sheila Kerri Sullivan |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1992023493 PECOS PAC ID: 1759525983 Enrollment ID: I20130910000216 |
| Provider Name | Sathish Kumar Cullath Harikrishnan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861421869 PECOS PAC ID: 1355348087 Enrollment ID: I20131008000973 |
| Provider Name | Jason Matthew Sansone |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1942400221 PECOS PAC ID: 7719136282 Enrollment ID: I20131014000249 |
| Provider Name | Ravi Dhingra |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1477507242 PECOS PAC ID: 9739186040 Enrollment ID: I20131016001386 |
| Provider Name | Lori A Brownshield |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255434874 PECOS PAC ID: 5890845283 Enrollment ID: I20131121000849 |
| Provider Name | Daniel K Roberson |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1861826141 PECOS PAC ID: 6204053978 Enrollment ID: I20140805000415 |
| Provider Name | Sajjad Nasir |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1518196807 PECOS PAC ID: 6305077686 Enrollment ID: I20141003001081 |
| Provider Name | Casey J Brown |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487053005 PECOS PAC ID: 9032330253 Enrollment ID: I20141031000502 |
| Provider Name | Kashif M Ali |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1477887453 PECOS PAC ID: 0345482717 Enrollment ID: I20141104000501 |
| Provider Name | Gina Marie Sullivan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427392687 PECOS PAC ID: 5193042505 Enrollment ID: I20150324001492 |
| Provider Name | Steven F Guenther |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1558628073 PECOS PAC ID: 3971824871 Enrollment ID: I20150603003069 |
| Provider Name | Kara Hoppe |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1063677920 PECOS PAC ID: 8224292396 Enrollment ID: I20150709000272 |
| Provider Name | Vijaya Sivalingam Ramalingam |
|---|---|
| Provider Type | Practitioner - Pulmonary Disease |
| Provider Identifiers | NPI Number: 1871724872 PECOS PAC ID: 4880908896 Enrollment ID: I20150805006398 |
| Provider Name | Leslie M Golden |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1336401736 PECOS PAC ID: 9739344094 Enrollment ID: I20150805006493 |
| Provider Name | Rajit Chakravarty |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1396072187 PECOS PAC ID: 3476868613 Enrollment ID: I20150817001584 |
| Provider Name | James A Bockeloh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194787341 PECOS PAC ID: 6901045996 Enrollment ID: I20150915000092 |
| Provider Name | Kathleen M Antony |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1912297102 PECOS PAC ID: 2961667050 Enrollment ID: I20150917001580 |
| Provider Name | Emily E Weiss |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619350667 PECOS PAC ID: 7517275878 Enrollment ID: I20151006002212 |
| Provider Name | Brittany Tobin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477831550 PECOS PAC ID: 1557506599 Enrollment ID: I20151023000719 |
| Provider Name | David F Edwards |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1053404871 PECOS PAC ID: 8325032444 Enrollment ID: I20151228000737 |
| Provider Name | Ajay K Sharma |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1891883328 PECOS PAC ID: 8426947375 Enrollment ID: I20151228001390 |
| Provider Name | Helen E Box |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871657528 PECOS PAC ID: 7012157696 Enrollment ID: I20151230002177 |
| Provider Name | Henry K Bong |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1831213438 PECOS PAC ID: 7517140353 Enrollment ID: I20160114001157 |
| Provider Name | Rita Gilpatrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881642528 PECOS PAC ID: 3072743202 Enrollment ID: I20160201000482 |
| Provider Name | Kim E Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164495602 PECOS PAC ID: 9436174000 Enrollment ID: I20160404001480 |
| Provider Name | Joseph Sullivan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1295022903 PECOS PAC ID: 4284923327 Enrollment ID: I20160720002703 |
| Provider Name | Vipul S Bodar |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1073903803 PECOS PAC ID: 6709179369 Enrollment ID: I20160721000039 |
| Provider Name | Eric J Goldblatt |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1407927502 PECOS PAC ID: 1355230905 Enrollment ID: I20160722000163 |
| Provider Name | Teresa Price |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619425741 PECOS PAC ID: 2769760461 Enrollment ID: I20161101000858 |
| Provider Name | Gloria A Burchett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396014270 PECOS PAC ID: 3375710031 Enrollment ID: I20161102000344 |
| Provider Name | Karen S Lim |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316073836 PECOS PAC ID: 4981834447 Enrollment ID: I20161220001597 |
| Provider Name | Vincent Hinshaw |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346286671 PECOS PAC ID: 7517928385 Enrollment ID: I20170209001694 |
| Provider Name | Nicole C Li |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689943250 PECOS PAC ID: 1052694288 Enrollment ID: I20170213001622 |
| Provider Name | Beth M Pape |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215476874 PECOS PAC ID: 6103102124 Enrollment ID: I20170405002079 |
| Provider Name | Shauna L Lambrecht |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316225303 PECOS PAC ID: 6507142007 Enrollment ID: I20170418001447 |
| Provider Name | Dana Stinnett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871038638 PECOS PAC ID: 8628355070 Enrollment ID: I20170511002815 |
| Provider Name | Susie Drake |
|---|---|
| Provider Type | Practitioner - Ophthalmology |
| Provider Identifiers | NPI Number: 1487092078 PECOS PAC ID: 4981914140 Enrollment ID: I20170524001455 |
| Provider Name | Jason Mcmaster |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1184990178 PECOS PAC ID: 3678892775 Enrollment ID: I20170628000995 |
| Provider Name | Whitney M Van Reesen |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1558780221 PECOS PAC ID: 8123316585 Enrollment ID: I20170713003504 |
| Provider Name | Amy O'boyle |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1679548341 PECOS PAC ID: 9638447949 Enrollment ID: I20170731003632 |
| Provider Name | Rachel Lillian Petro |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1205255163 PECOS PAC ID: 0547483992 Enrollment ID: I20170807000295 |
| Provider Name | Aaron M Carpiaux |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1609169192 PECOS PAC ID: 2769700830 Enrollment ID: I20170905003588 |
| Provider Name | Jason Mark Habeck |
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery |
| Provider Identifiers | NPI Number: 1861753485 PECOS PAC ID: 1355571159 Enrollment ID: I20180724001428 |
| Provider Name | Janine Rhoades |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1841588993 PECOS PAC ID: 8527297191 Enrollment ID: I20180810001142 |
| Provider Name | Michelle Zapinski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841779238 PECOS PAC ID: 5698028553 Enrollment ID: I20181024000131 |
| Provider Name | Lori L Unger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437638830 PECOS PAC ID: 9032462361 Enrollment ID: I20181102000481 |
| Provider Name | Tamy E Perng |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1063628956 PECOS PAC ID: 5193862415 Enrollment ID: I20181213002484 |
| Provider Name | Garrett William Fleming |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1255606430 PECOS PAC ID: 7214208594 Enrollment ID: I20190314001349 |
| Provider Name | Mathew K Kandathil |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1346232097 PECOS PAC ID: 1658394838 Enrollment ID: I20190319000719 |
| Provider Name | Melissa Davey |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891129482 PECOS PAC ID: 3072855253 Enrollment ID: I20190509000694 |
| Provider Name | Michael Joseph Beninati |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1033453600 PECOS PAC ID: 6204122898 Enrollment ID: I20190613000429 |
| Provider Name | James Lamousin |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1043227606 PECOS PAC ID: 8022000215 Enrollment ID: I20190725001624 |
| Provider Name | Dayton M Opel |
|---|---|
| Provider Type | Practitioner - Hand Surgery |
| Provider Identifiers | NPI Number: 1154664100 PECOS PAC ID: 3870879885 Enrollment ID: I20190905001313 |
| Provider Name | Gregory Renck |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1275645400 PECOS PAC ID: 2668557455 Enrollment ID: I20190919002773 |
| Provider Name | Amber Rose Hendriksen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881244358 PECOS PAC ID: 8628401874 Enrollment ID: I20191203000674 |
| Provider Name | Jacquelyn Hanna Adams |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1811330376 PECOS PAC ID: 7911203914 Enrollment ID: I20200629000950 |
| Provider Name | Aaron M Hawkins |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1437415163 PECOS PAC ID: 8224288394 Enrollment ID: I20200701001369 |
| Provider Name | Joseph Hime |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1528324811 PECOS PAC ID: 8123337201 Enrollment ID: I20200727002112 |
| Provider Name | Meghan Cox-pedota |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1144541657 PECOS PAC ID: 2668694969 Enrollment ID: I20201029002168 |
| Provider Name | Nina Jordania |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1164428074 PECOS PAC ID: 8224003108 Enrollment ID: I20201221000094 |
| Provider Name | Atul Sheth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1942392212 PECOS PAC ID: 4284530288 Enrollment ID: I20210128000888 |
| Provider Name | Dana Hatwig |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366095564 PECOS PAC ID: 4880009588 Enrollment ID: I20210210001134 |
| Provider Name | Lexi Derry |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063709491 PECOS PAC ID: 4183847189 Enrollment ID: I20210213000104 |
| Provider Name | Piyush Das |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1265639140 PECOS PAC ID: 7214060763 Enrollment ID: I20210511000378 |
| Provider Name | Kristine Marie Gay |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669066650 PECOS PAC ID: 7517366263 Enrollment ID: I20210528001343 |
| Provider Name | Jenna Racine |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1225449291 PECOS PAC ID: 3971823659 Enrollment ID: I20210629002498 |
| Provider Name | Roberto Javier Vidri Alonso-rochi |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1497042998 PECOS PAC ID: 1658591219 Enrollment ID: I20210722000042 |
| Provider Name | Denise Crosson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063497469 PECOS PAC ID: 3476579053 Enrollment ID: I20210729001709 |
| Provider Name | Kathryn Johnson |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1356787873 PECOS PAC ID: 7012142953 Enrollment ID: I20211110001491 |
| Provider Name | Mary Embrescia |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1659556934 PECOS PAC ID: 8022261197 Enrollment ID: I20220217002284 |
| Provider Name | Janice Hesler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1073764734 PECOS PAC ID: 4385777523 Enrollment ID: I20220404002109 |
| Provider Name | Neza Bharucha |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1467986422 PECOS PAC ID: 3173899440 Enrollment ID: I20220406001948 |
| Provider Name | Maria Cada |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871054460 PECOS PAC ID: 0244561140 Enrollment ID: I20220411002228 |
| Provider Name | Michelle J Wolff |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427141563 PECOS PAC ID: 6608877469 Enrollment ID: I20220413002662 |
| Provider Name | Christina L Blake |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245765841 PECOS PAC ID: 2466724075 Enrollment ID: I20220420003153 |
| Provider Name | Harold G Horn |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801430731 PECOS PAC ID: 0648604058 Enrollment ID: I20220429000173 |
| Provider Name | Stuart Babcock |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1366463689 PECOS PAC ID: 4880756790 Enrollment ID: I20220519002656 |
| Provider Name | Krista Thornberry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710347059 PECOS PAC ID: 1052602158 Enrollment ID: I20220714003292 |
| Provider Name | Kaci Lee Axelson |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1043703325 PECOS PAC ID: 3072997212 Enrollment ID: I20220907001447 |
| Provider Name | Melissa Nehls |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1497245989 PECOS PAC ID: 2769735901 Enrollment ID: I20220914003731 |
| Provider Name | Daniel Feldman Elmes |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1316500994 PECOS PAC ID: 7315271707 Enrollment ID: I20220930000510 |
| Provider Name | Amber Kathlyn Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043947609 PECOS PAC ID: 8123495140 Enrollment ID: I20221104000344 |
| Provider Name | Shana Rutkowski Wright |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417298084 PECOS PAC ID: 6507183449 Enrollment ID: I20221108000680 |
| Provider Name | Sanlare Gordon |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316341159 PECOS PAC ID: 4981905486 Enrollment ID: I20221208000732 |
| Provider Name | David G Smiley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720709751 PECOS PAC ID: 0547639270 Enrollment ID: I20221219002697 |
| Provider Name | Tara Kane |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982885414 PECOS PAC ID: 3779663661 Enrollment ID: I20230316000103 |
| Provider Name | Barbara Rebekah Demares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336775170 PECOS PAC ID: 7214392646 Enrollment ID: I20230508001492 |
| Provider Name | Mark Walter |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1205910643 PECOS PAC ID: 6103858477 Enrollment ID: I20230802002584 |
| Provider Name | Patricia Howard |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1376972349 PECOS PAC ID: 7618311606 Enrollment ID: I20240217000832 |
| Provider Name | Mary Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1336780527 PECOS PAC ID: 3476986415 Enrollment ID: I20240423001499 |
| Provider Name | Jeffrey G Weyeneth |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1912991944 PECOS PAC ID: 5597753970 Enrollment ID: I20240517003004 |
Watertown Physician Practices Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Hospital Dr, Watertown, WI 53098 Phone: 920-261-2020 Fax: 920-261-0457 | |
Turke Family Medicine, S.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 132 Hospital Dr, Watertown, WI 53098 Phone: 920-261-2020 Fax: 920-261-0457 | |
Watertown Internal Medicine Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 Hospital Dr, Suite 2009, Watertown, WI 53098 Phone: 920-262-9833 | |
Nagel Neighborhood Health Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 612 Mary Knoll Ln, Watertown, WI 53098 Phone: 920-631-1310 Fax: 920-335-3570 | |
Wolfe Mobile Medical Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 Grey Fox Run, Watertown, WI 53094 Phone: 920-253-5851 | |
Uwhp Wrmc House Calls Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 Hospital Dr, Ste 2004, Watertown, WI 53098 Phone: 920-253-1230 Fax: 920-262-4333 | |
Family Medical Care Associates, S.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 123 Hospital Dr, Suite 2004, Watertown, WI 53098 Phone: 920-206-7772 Fax: 920-206-1001 |