Other Provider Identifier Issuer 5
PARTNERS PHYSICIAN GROUP MEDICARE GROUP #
AARP-MEDICARE SUPPLEMENT-UNITED HEALTHCARE INSURANCE (36273
APP ASSOCIATE PREVENTION PROFESSIONAL CCB
PARTNERS PHYSICIAN GROUP TYPE 2 NPI NUMBER
CERTIFICATE OF FORMATION FROM THE OFFICE OF SECRETARY OF STATE
MEDICARE PTAN FOR WOUND CARE ASSOCIATES, PRESIDENT/CO-OWNER
BCBS BLUE CARE, ADVANTAGE 65 SELECT, MEDICARE PPO/HMO, GO BLUE
ANTHEM PROVIDER NUMBER UNDER TIN 35-2030653
PARTNERS PHYSICIAN GROUP MEDICAID GROUP #
100006624 0036 CLARION SERVICE COORDINATION
MEDICAID INDIANA- 100070180- NORTON NEUROLOGY SERVICES
TEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES
SANTA CRUZ COUNTY CALIFORNIA MEDICARE GROUP PTAN#
BLUE CROSS BLUE SHIELD REGIONAL PROFESSIONAL NUMBER
AKRON GENERAL CENTER FOR FAMILY MEDICINE GROUP MEDICARE #
PA DRUG & DEVICE REGISTRATION - DISTRIBUTOR
SANTA CRUZ COUNTY HSA-MHSAS MEDI-CAL PROVIDER #
ARIZONA REGULATORY BOARD OF PHYSICIAN ASSISTANTS
SANTA CRUZ COUNTY MEDI-CAL GROUP PROVIDER#
VIRGINIA HEALTH NETWORK (EVMS HEALTH SERVICES)
MEDICARE PART B IMMUNIZATION PROVIDER NUMBER
JOHN HOPKINS/PRIORITY PARTNERS/UNIFORMED SERVICES FAMILY HEALTH/EMPLOYER HEALTH
UNITED BEHAVIORAL HEALTH- WELLMORE GRP/FACILITY
MEDICARE PROVIDER NUMBER FOR DR JOSEE LALIBERTE
CALIFORNIA STATE BOARD OF PHARMACY PERMIT
MEDICAID GRP-BAPTIST EASLEY -LIBERTY FAMILY CARE EFFECTIVE 10-1-2009
RRMC - CARDIOVASCULAR DIAGNOSTIC SERVICES
GROUP TAX FOR BILLING NORTH BEND MEDICAL CENTER
CALIFORNIA PHYSICIAN AND SURGEON LICENSE
CERTIFICATION - LYMPHOLOGY ASSOCIATION OF NORTH AMERICA
INDIVIDUAL PTAN FOR UAP KELLER ENDO, LLC
GROUP NORTH BEND MEDICAL CENTER TAX ID NUMBER
BLUE CROSS BLUE SHIELD TRAD, TRUST, AND MEDICARE BLUE CROSS
BLUE SHIELD/PREMIER BLUE/MEDICARE ADVANTAGE/FIRST PRIORITY LIFE
CIGNA GOVERNMENT SERVICES DMERC REGION C
SANTA CRUZ COUNTY IN CA MEDI-CAL GROUP#S
AKRON GENERAL MEDICAL CENTER MEDICAID GROUP #
BCBS NCA FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
BLUE CROSS BLUE SHIELD MASSACHUSETTS PIN
BC/BS TN - CUMBERLAND BACK PAIN CLINIC, P.C.
NPI NUMBER FOR HANCOCK REGIONAL HOSPITAL -
COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
MEDICAL DEVICE AND EQUIPMENT LICENSE AND GAS OUTLET
BLUE CROSS BLUE SHIELD OF TEXAS INDIVIDUAL RECORD NUMBER
BCBS MARYLAND FOR MEDICAL AND SURGICAL CLINICS OF SOUTHERN MARYLAND
DEPARTMENT OF JUSTICE DRUG ENFORCEMENT AGENCY
MEDICARE INNOVATIVE IMAGING ASSOCIATES INDIVIDUAL PTAN
AMERIGROUP PROVIDER, PEACHSTATE NO., WELLCARE PROVIDER
MUNSTER LOCATION ID LEGACY PTAN # 200871680A
BREINING INSTITUTE: CERTIFIED CO-OCCURRING DISORDER SPECIALIST
MEDICARE PROVIDER ID W/AGENCY GROUP SUFFIX
ANTHEM- CARDIOTHORACIC SURGERY OF LOUISVILLE
MEDICARE PTAN BASIN CLINIC, NATURITA, CO
NORTH BEND MEDICAL CENTER GROUP MEDICAID
HARBOR-UCLA FACULTY PRACTICE PLAN, A MEDICAL GROUP INC.
AETNA - 900 CENTENNIAL BLVD., VOORHEES, NJ
AETNA BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
AETNA THRU OAKLAND PHYSICIANS NETWORK SERVICES
MD WISE- KENTUCKY CHILDREN'S RADIOLOGISTS
US DEPT OF LABOR: 2001 S. CALIFORNIA AVE - LOC 1
RAILROAD MEDICARE- NORTON LEATHERMAN SPINE CENTER
UNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
HEALTH & WELLNESS FAMILY PRACTICE SERVICE PC NPI #
LODI COMMUNITY HOSPITAL MEDICARE GROUP #
COUNTY OF LOS ANGELES-HARBOR UCLA MEDICAL CENTER
GROUP MEDICARE-NORTH BEND MEDICAL ENTER INC
INTERNATIONAL CERTIFIED ADVANCE ALCOHOL & DRUG COUNSELOR
MEDICARE GROUP TRANSACTION ACCESS NUMBER
MEDICARE PTAN FOR INDIVIDUAL (ARLINGTON, WA)
SANTA CRUZ COUNTY CA MEDICARE GROUP PTAN#
PEDIATRIC ANTHEM PIN UNDER TIN 35-2030653
BLUE CROSS-EMERGENCY MANAGEMENT ASSOCIATES PC
DEPT OF JOB & FAMILY SERVICES - MEDICAID PROVIDER NUMBER
NATIONAL GOVERNMENT SERVICES (NJ EMPIRE)
ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION
BCBC-IL GRP PROV # FOR GROUP NAMED: METROPOLITAN MEDICAL CONSULTANTS, S.C.
MO STATE CERTIFIED INTENMSIVE OUTPATIENT ALCOHOL & DRUG REHABILITATION CLINIC
PTAN-TACOMA RADIOLOGICAL ASSOCIATES, PIERCE CO
BOSTON MEDICAL CENTER THROUGH VALLEY HEALTH PHO
OHIO DEPARTMENT OF ALCOHOL AND DRUG ADDICTION SERVICES
MEDICARE PALMETTO GBA PTAN (AUDIOLOGY HEARING AID ASSOCIATES, INC.)
LABOR AND INDUSTRIES CRIME VICTIMS-UNION AVENUE OPEN MRI
MEDICAID INDIANA- CHILDREN'S ORTHOPAEDICS OF LOUISVILLE
AMER COLLEGE OF RADIOLOGY- NUCLEAR MEDICINE ACCREDITATION
AMERIGROUP PIN # FOR PROFESSIONAL BILLING
BLUE CROSS BLUE SHILED INDIVDIUAL NUMBER
BOARD OF EXAMINERS FOR SOCIAL WORKERS - LSW
MEDICARE PART B FOR EYE ASSOCIATES OF OVERLAND PARK
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION #
PASSPORT- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY
VIRGINIA PREMIER HEALTH (EVMS HEALTH SERVICES)
HEALTHY CT-AFFORADABLE HEALTHCARE WELLMORE, INC FACILITY/GROUP
LICENSED PROFESSIONAL COUNSELOR-SUPERVISOR-STATE OF TEXAS
STATE OF HAWAII DEPT. OF COMMERCE AND CONSUMER AFFAIRS
SOUTH CAROLINA ATHLETIC TRAINER'S LICENSE
SANTA CRUZ COUNTY CA MEDI-CAL SITE PROVIDER NUMBERS
MEDICARE ID TYPE UNSPECIFIED/ NO. CALIFORNIA
GROUP MEDICARE NORTH BEND MEDICAL CENTER
NC DEPARTMENT OF HEALTH AND HUMAN SERVICES
MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC - MEDICAID GROUP
BLUECROSS BLUESHIELD OF SC CREDENTIALING FOR PALLIATIVE CARE VISITS
EASTERN SUSSEX PHYSICIAN ORGANIZATION, P.A. (ESPO)
BCBS OF ALABAMA PROVIDER FOR DR. WILLIAM I. OWEN, JR
AKRON CARDIOVASCULAR ASSOCIATES TYPE @ NPI #
MEDICARE GROUP # - MD/DO FEE LOCALITY 99
SERVICE FOR ELDERLY AND PERSONS WITH DISABILITIES
BOARD APPROVED SUPERVISOR FOR COUNSELOR INTERNS
NPI OF ONE OF THE PROVIDERS OF THE GROUP
BLUE CROSS AND BLUE SHIELD OF MASSACHUSETTS
MEDICARE RAILROAD PTAN - DANNY W. GNEWIKOW, PH.D., LLC
ACUTE CARE SURGERY SERVICE AT AKRON GENERAL MEDICARE #
PHYSICIANS MEDICAID NUMBER WITH MULTIPLAN ONLY AND NOT STRAIGHT MEDICAID NUMBER
MEDICARE PART A: 5710 CLIO RD., FLINT, MI 48504
HEALTH AMERICA HEALTH ASSURANCE/ COVENTRY/ FIRST HEALTH
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE NPI
SECRETARY OF STATE-DEPT OF CORPORATIONS NUMBER
CAQH PROVIEW PROVIDER REGISTRY (CAQH PROVIDER #)
HEART RHYTHM ASSOCIATES MEDICAID GROUP #
NYS EMPIRE PLAN UHEALTH CARE LEGACY NUMBER
MEDICARE GROUP PROV # FOR GROUP NAMED: METROPOLITAN MEDICAL CONSULTANTS, S.C.
AMERIHEALTH CARITAS PA - WMG - CAREEXPRESS
ANDREW HARWOOD MEDICARE PTAN EFFECTIVE 05/19/2012
ANTHEM PIN - URGENT CARE UNDER TIN 35-2030653
NPI NUMBER A BETTER WAY MASSAGE, LLC, BELLINGHAM, WA
AMERICAN BOARD OF RADIOLOGY CERTIFICATION
LABOR AND INDUSTRIES CRIME VICTIMS-MEDICAL IMAGING ON 1ST
NORTH CAROLINA CERTIFICATION AND LICENSURE BOARD
MEDICAID DEVELOPMENTAL DISABLE AND REGULAR WAIVER
3555 LOMA VISTA RD, #110, VENTURA, CA 93003
HEART RHYTHM ASSOCIATES MEDICARE GROUP #
ANTHEM INDIANA MEDICAID- WOMEN'S SPECIALISTS
OREGON STATE BOARD OF NURSING FAMILY NURSE PRACTITIONER LICENSE
PARTNERS PHYSICIAN GROUP MEDICARE GROUP PTAN
NORTH BEND MEDICAL CENTER GROUP MEDICARE
MEDICARE B FOR DELTA HEALTH & WELLNESS CENTER
855I WAS ISSUED THREE YEARS AGO ON ADDRESS-REISSUING TODAY
BLUE OPTIONS, BLUE CHOICE, FEDERAL, FLORIDA STATE AND TRADITIONAL BCBS
CAQH (COUNCIL FOR AFFORDABLE QUALITY HEALTHCARE)
HEALTHY INDIANA PLAN- NORTON ORTHO TRAUMA CARE
AMBULANCE CERTIFICATION, DEPT. OF HUMAN SERVICES EMS & TRAUMA SYSTEM PROGRAM
NATIONAL ATHLETIC TRAINERS ASSOCIATION BOARD OF CERTIFICATION - ATC
COMMONWEALTH BIOMEDICAL RESEARCH GROUP PTAN
MHS PHYS OF TX MEDICAID GRP TPI - HARRIS COUNTY
OPTUM BEHAVIORAL HEALTH/UBH GRP/FACILITY WELLMORE
BC/BS OF MA FOR 'PSYCHOLOGICAL CONSULTING, P.C.'
ARCIS HEALTHCARE GROUP RAILROAD MEDICARE PTAN
NORTH BASIN MEDICAL DAVENPORT CLINIC MEDICAID RURAL HEALTH CORE PROVIDER #
BC/BS OF TN - NETWORKS P, S, BLUESELECT, BLUECARE
MEDICAID # FOR CROUCH FAMILY MEDICINE (CLINIC)
NEW MEXICO CONDITIONAL PSYCHOLOGIST PRESCRIBER
IND. MEDICARE PTAN FOR ACUTE CARE SURGERY SERVICE
PASSPORT ADVANTAGE- LUIS M. VELASCO, MD & ASSOC
SENTARA OPTIMA HEALTH (EVMS HEALTH SERVICES)
BLUE CROSS BLUE SHIELD OF NORTH CAROLINA
MEDICAID-TX PROVIDER IDENTIFIER (TPI) # (TYPE: PERFORMING PROVIDER)
LABOR AND INDUSTRIES-UNION AVENUE OPEN MRI
STATE OF INDIANA CSR, PRESCRIPTIVE AUTHORITY
MEDICARE PTAN - YUBA SUTTER HOSPITALIST GROUP
MEDICARE PTAN FOR SOUTHERN EYE SURGERY CENTER LLC
BLUE CROSS/BLUE SHIELD FLORIDA GROUP ID#
ANTHEM PROVIDER NUMBER FOR ARNETT CLINIC, LLC
MEDICAID KY- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY
RAILROAD MEDICARE PROFESSIONAL REHABILITATION SERVICES INC
CAREFIRST BLUECROSS BLUESHIELD MD REGION
GROUP TAX ID - NORTH BEND MEDICAL CENTER
ADULT BEHAVIORAL HEALTH AND INTENSIVE CASE MANAGEMENT
CLINICAL LABARATORY IMPROVEMENT AMENDMENTS (CLIA)
VICTOR SERALDE PROVIDER NUMBER FOR FAIRMOUNT CLINIC
UBH-UNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
BROOKINGS MEDICAL CENTER MEDICARE PART B
MEDICAID- NURSE ANESTHETIST PROVIDER NUMBER
MEDICARE PTAN -- NORTON LEATHERMAN SPINE
OKLAHOMA DEPARTMENT OF REHABILITATION SERVICES
NORTH CAROLINA SUBSTANCE ABUSE PROFESSIONAL PRACTICE BOARD
PALMETTO GBA MEDICARE PTAN NUMBER BLFD OFFICE
MEDICARE KY- CARDIOTHORACIC SURGERY OF LOUISVILLE
CAPITAL BLUE CROSS/KEYSTONE HEALTH PLAN CENTRAL
MOBILE COUNTY HEALTH DEPARTMENT SITE NPI NUMBER
OFFICE OF WORKERS' COMPENSATIONS PROGRAMS, FECA, DEPT OF LABOR
MCLAREN HEALTH PLAN OF MICHIGAN BRIDGEPORT SITE
BEACON HEALTH STRATEGIES-VO AWAKEN THE POWER THERAPY, LLC
MEDICARE SOUTHERN CALIFORNIA MAMMOGRAPHY PTAN
MEDICARE B PTAN FOR MTN PEAKS FAMILY PRACTICE
NORTH GEORGIA MEDICAL CENTER FEDERAL TAX ID
BUTLER HOSPITAL PROFESSIONAL BILLING OFFICE
MEDICARE UPIN GROUP NUMBER FOR GREER OFFICE
UBH-OXFORD HEALTH FREEDOM/LIBERTY WELLMORE, INC.
BCBS NON-PAR PROVIDER # FOR MATTHEW GOODWIN, MD
TEXAS DEPARTMENT OF AGING AND DISABILITY SERVICES HOME & SUPPORT SRVC AGENCY
AKRON GENERAL HOSPITAL IMCA GROUP MEDICAID #
COGNITIVE TRAINING SPECIALIST THROUGH UNIQUE LOGIC & TECHNOLOGY, INC
AMERICAN BEHAVIORAL HEALTH FEDERAL BLUE CROSS
BLUE CROSS AND BLUE SHIELD OF FLORIDA / HEALTH OPTIONS, INC.
AGMC INTERNAL MEDICINE CENTER OF AKRON MEDICAID GROUP #
LODI COMMUNITY HOSPITAL MEDICAID GROUP #
SANTA CRUZ COUNTY, CA MEDICARE GROUP PTAN#
CAPITAL BLUE CROSS/KEYSTONE CENTRAL - GROUP #
GROUP NPI: NEBRAKSA LOWER EXTREMITY SURGERY GROUP, LLC
PARTNERS PHYSICIAN GROUP MEDICAD GROUP # - URGENT CARES
PARTNERS PHYSICIAN GROUP COMMUNITY ACCESS WELLNESS TYPE 2 NPI #
MEDICAID KENTUCKY- NORTON MEDICAL ASSOCIATES
ANTHEM INDIANA MEDICAID- NORTON ORTHO TRAUMA CARE
BLUE CROSS BLUE SHIELD BLUE PLUS OF MINNESOTA
MEDICARE PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
BLUE CROSS/BLUE SHIELD IDENTIFICATION NUMBER
JUNTA DE LICENCIAMIENTO Y DISCPLIA MEDICA
CHCCC, NIPOMO MEDICAL CENTER NPI# 1841217866 GROUP PTAN
PTAN - STREATOR ILLINOIS LOCATION OF SERVICE
PASSPORT- CHILDREN'S ORTHOPAEDICS OF LOUISVILLE
TX DADS - 24 HR SHARED ATTENDANT CARE PROGRAM
AMERIHEALTH CARITAS DISTRICT OF COLUMBIA
BLUE CROSS ID - NORTH CYPRESS ANESTHESIOLOGY ASSOC.
PROVIDER TRANSACTION ACCESS NUMBER (PTAN)
BLUE CROSS BLUE SHIELD OF MICHIGAN TRADITIONAL
PASSPORT ADVANTAGE- NORTON ORTHO TRAUMA CARE
ANTHEM BCBS OF CT -AWAKEN THE POWER THERAPY, LLC
RAILROAD MEDICARE ATTACHED TO GRP# DQ1103
BLUE SHIELD PROVIDER NUMBER GILROY LOCATION
BLUE CROSS BLUE SHIELD OF MICHIGAN/BLUE CARE NETWORK
BLUE CROSS BLUE SHIELD INDIVIDUAL PROVIDER NUMBER
BLUE CROSS BLUE SHIELD OF ALABAMA / NEARMC HOSP
COUNCIL FOR THE NATIONAL REGISTER OF HEALTH SERVICE PROVICERS IN PSYCHOLOGY
MANAGED HEALTH SERVICES- NORTON INPATIENT SPECIALISTS
NEW JERSEY STATE PROGRAMS: PAAD, SENIOR GOLD, ADDP & CYSTIC FIBROSIS
UNITED HEALTHCARE ALL PRODUCTS EXCEPT AMERICHOICE
UNITED HEALTHCARE COMMERCIAL AND MEDICARE PLANS
DCA BOARD OF REGISTERED NURSING LICENSE NUMBER
DHS LICENSE- AMBULATORY CARE CONSISTING OF ADDICTION SERVICES & OTP
BLUE CROSS BLUE SHIELD/BLUE CARE NETWORK
MEDICARE RAILROAD/PALMETTO GBA - INDIVIDUAL
NEW YORK STATE MEDICAL LISCENSE ID NUMBER
PARTNERS PHYSICIAN GROUP TYPE 2 NPI # - HWE
MEDICARE- NORTON NEUROSURGICAL INSTITUTE OF KENTUCKY
CURRY MEDICAL PRACTICE / CURRY MEDICAL CENTER MEDICARE PART B
RAILROAD MEDICARE ASSOCIATED WITH GROUP CF4811
COMMUNITY CHOICE OF MICHIGAN/CARE SOURCE
BLUE CROSS/BLUE SHIELD INDIVIDUAL LEGACY
BLUE CROSS - NORTH CYPRESS ANESTHESIOLOGY ASSOC.
HORIZON BLUE CROSS/BLUE SHIELD OF NEW JERSEY
GROUP NPI FOR MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND
GILMER NURSING HOME MEDICARE PROVIDER NUMBER
MEDICARE PROVIDER NUMBER THAT LINKS INDIVIDUAL TO GROUP
PERSONAL CHOICE PPO OF PENNSYLVANIA (INDEPENDENT BLC)
GROUP PROVIDER TRANSACTION ACCESS NUMBER (GPTAN)
LABOR AND INDUSTRIES-MEDICAL IMAGING ON 1ST
MEDICARE (UNDER KRIST SAMARITAN COUNSELING)
PARTNERS PHYSICIAN GROUP MEDICAID GROUP # - URGENT CARES
ANTHEM PROVIDER NUMBER FOR TIN 35-2030653
LODI COMMUNITY HOSPITAL GROUP MEDICAID #
BLUE CROSS/BLUE SHIELD FEDERAL EMPLOYEE PROGRAM
RAILROAD MEDICARE GROUP ID NUMBER / LRHSI
CENTRAL UTAH PHYSICAL THERAPY SERVICES, INC.
BLUE CROSS BLUE SHIELD GROUP PROVIDER NUMBER
PASSPORT HEALTHPLAN ADVANTAGE HMO MEDICARE
COUNCIL OF CERTIFICATION OF NURSE ANESTHETISTS
DEDERAL WORKMAN'S COMPENSATION DEPT. OF LABOR
INDIVIDUAL NPI NUMBER/THOMAS F. CLEMENTE, DPM
MEDICAL & SURGICAL CLINICS CAREFIRST GROUP - DC
AKRON GENERAL MEDICAL CENTER MEDICARE GROUP #
JAMES W. HARRIS, D.C. BLUE CROSS BLUE SHIELD INDIVIDUAL PROVIDER NUMBER
ANTHEM PIN FOR FAMILY MEDICINE TIN 35-2030653
AKRON GENERAL MEDICAL CENTER - IMCA GROUP MEDICARE #
MEDICARE - FAYETTE COUNTY HEALTH DEPARTMENT
GROUP-NORTH BEND MEDICAL CENTER MEDICAID #
AMERICAN BOARD FOR CERTIFICATION IN ORTHOTICS,PROSTHETICS & PEDORTHICS, INC.
BRIGHT EYES MIDWIFERY & WILD RIVERS WOMEN'S HEALTH, LLC PTAN
PARTNERS PHYSICIAN GROUP MEDICAID GROUP # URGENT CARE
PASSPORT- NORTON MATERNAL FETAL MEDICINE SPECIALISTS
DEAN'S LIST FOR OUTSTANDING ACADEMIC ACHIEVEMENT: KSU KENT STATE UNIVERSITY
FIRST HEALTH LIFE AND HEALTH INSURANCE CO.
STATE OF ALABAMA MEDICAID PARTICIPANT NUMBER - CLEBURNE COUNTY
HEALTHY INDIANA PLAN- NORTON NEUROLOGY SERVICES
VISITS2U, PLLC BUSINESS MEDICARE PTAN NUMBER
MEDICARE B PTAN FOR ALL AMERICAN FAMILIES
BCBSM - BRONSON VICKSBURG OUTPATIENT CENTER
MEDICARE GROUP - MIDWEST COMMUNITY HEALTH ASSOCIATES
ALABAMA LIVER & DIGESTIVE SPECIALISTS ORGANIZATIONAL GROUP NPI
DAVIESS COUNTY HOSPITAL MEDICAID PROVIDER #
AS OF 5/1/2010, CANYON/OSNA DIVISION NPI
PHYSICIAN ASSISTANT COMMITTEE LICENSE NUMBER
NJ OFC OF THE ATTORNEY GENERAL DIV OF CONSUMER AFFAIRS
REGISTER WITH MEDICARE AS A DURABLE MEDICAL EQUIPMENT PROVIDER