Philip J Wagenbach (NPI# 1790797116, PAC ID# 0446271845) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1790797116 |
| PAC ID by PECOS | 0446271845 |
| Professional Enrollment ID | I20151119000526 |
| Full Name | Philip J Wagenbach |
| Organization Legal Name | COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. |
| Address |
275 Route 30 N Bomoseen VT 05732-9647 |
| Phone Number | 8024685641 |
| Gender | M |
| Credential | PA |
| Graduation Year | 2005 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 2961467386 |
| Number of Group Practice Members | 65 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 470005 | RUTLAND REGIONAL MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 275 Route 30 N, Bomoseen, VT 05732-9647 | 8024685641 | COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. |
| Organization Legal Name | COMMUNITY HEALTH CENTERS OF THE RUTLAND REGION, INC. |
| Physicians | 66 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jean Cynthia Letts | Internal Medicine | Community Health Centers of The Rutland Region, Inc. | 278 Vt Route 149, West Pawlet, VT 05775-9798 |
| Elizabeth Anne Sheldon-morris | Physician Assistant | Community Health Centers of The Rutland Region, Inc. | 420 Grove St, Brandon, VT 05733-9062 |
| Erica E Tamblini | Clinical Social Worker | Community Health Centers of The Rutland Region, Inc. | 275 Route 30 N, Bomoseen, VT 05732-9647 |
| David B Turner | Obstetrics/gynecology | Community Health Centers of The Rutland Region, Inc. | 1 General Wing Rd, Rutland, VT 05701-4681 |
| Kim Kurak | Family Medicine | Community Health Centers of The Rutland Region, Inc. | 215 Stratton Rd, Rutland, VT 05701-4621 |
| Richard C Baker | Family Medicine | Community Health Centers of The Rutland Region, Inc. | 71 Allen St, Suite 403, Rutland, VT 05701-4570 |
| Amy P Corey | Physician Assistant | Community Health Centers of The Rutland Region, Inc. | 215 Stratton Rd, Rutland, VT 05701-4621 |
| Chris Masillo | Physician Assistant | Community Health Centers of The Rutland Region, Inc. | 215 Stratton Rd, Rutland, VT 05701-4621 |
| John F Dick | Internal Medicine | Community Health Centers of The Rutland Region, Inc. | 71 Allen St, Suite 403, Rutland, VT 05701-4570 |
| Clara H Martell | Physician Assistant | Community Health Centers of The Rutland Region, Inc. | 275 Route 30 N, Bomoseen, VT 05732-9647 |
| Street Address |
275 ROUTE 30 N |
| City | BOMOSEEN |
| State | VT |
| Zip | 05732-9647 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Erica E Tamblini | Clinical Social Worker | Community Health Centers of The Rutland Region, Inc. | 275 Route 30 N, Bomoseen, VT 05732-9647 |
| Clara H Martell | Physician Assistant | Community Health Centers of The Rutland Region, Inc. | 275 Route 30 N, Bomoseen, VT 05732-9647 |
| Melissa G Cotton | Physician Assistant | Community Health Centers of The Rutland Region, Inc. | 275 Route 30 N, Bomoseen, VT 05732-9647 |
| Robert G Mitchell | Physician Assistant | Community Health Centers of The Rutland Region, Inc. | 275 Route 30 N, Bomoseen, VT 05732-9647 |
| Yohanny Giselle Santana | Clinical Social Worker | Community Health Centers of The Rutland Region, Inc. | 275 Route 30 N, Bomoseen, VT 05732-9647 |
| Pauline Kahng | Physician Assistant | Community Health Centers of The Rutland Region, Inc. | 275 Route 30 N, Bomoseen, VT 05732-9647 |
| Katelyn D Jupin | Physician Assistant | Community Health Centers of The Rutland Region, Inc. | 275 Route 30 N, Bomoseen, VT 05732-9647 |
| Stephen S Kornbluth | Family Medicine | Community Health Centers of The Rutland Region, Inc. | 275 Route 30 N, Bomoseen, VT 05732-9647 |
| City | BOMOSEEN |
| Zip Code | 05732 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | BOMOSEEN + PHYSICIAN ASSISTANT |
Please comment or provide details below to improve the information on Philip J Wagenbach.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.