Matthew G. Prohaska Jr. (NPI# 1164740627, PAC ID# 1355653734) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is ORTHOPEDIC SURGERY.
| Nation Provider ID (NPI) | 1164740627 |
| PAC ID by PECOS | 1355653734 |
| Professional Enrollment ID | I20150629001759 |
| Full Name | Matthew G. Prohaska Jr. |
| Organization Legal Name | NORTHEASTERN VERMONT REGIONAL HOSPITAL INC |
| Address |
1315 Hospital Dr St Johnsbury VT 05819-9210 |
| Phone Number | 8027488141 |
| Gender | M |
| Medical School | MEDICAL COLLEGE OF GEORGIA |
| Graduation Year | 2010 |
| Primary Specialty | ORTHOPEDIC SURGERY |
| Group Practice PAC ID | 3678481405 |
| Number of Group Practice Members | 90 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 471303 | NORTHEASTERN VERMONT REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1315 Hospital Dr, St Johnsbury, VT 05819-9210 | 8027488141 | NORTHEASTERN VERMONT REGIONAL HOSPITAL INC |
| Organization Legal Name | NORTHEASTERN VERMONT REGIONAL HOSPITAL INC |
| Physicians | 92 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jin Li Chan | Clinical Social Worker | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Karey Leigh Pierce | Physical Therapy | Northeastern Vermont Regional Hospital Inc | 569 Main St, Lyndonville, VT 05851-9240 |
| Richard Gerald Taylor | Emergency Medicine | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Rebecca S Barski | Certified Registered Nurse Anesthetist (crna) | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, St Johnsbury, VT 05819-9210 |
| Preeth Sundaran | Cardiovascular Disease (cardiology) | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Warren M Fenner | Physician Assistant | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Aydin A Lathari | Internal Medicine | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Thomas F Broderick | Family Medicine | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Adelaide Adjovu | Nurse Practitioner | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Joachim G Mueller | Cardiac Electrophysiology | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Street Address |
1315 HOSPITAL DR |
| City | ST JOHNSBURY |
| State | VT |
| Zip | 05819-9210 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Richard Gerald Taylor | Emergency Medicine | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Rebecca S Barski | Certified Registered Nurse Anesthetist (crna) | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, St Johnsbury, VT 05819-9210 |
| Preeth Sundaran | Cardiovascular Disease (cardiology) | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Warren M Fenner | Physician Assistant | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Aydin A Lathari | Internal Medicine | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Joachim G Mueller | Cardiac Electrophysiology | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Trisha Mae Bullard | Physician Assistant | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Susan G. Taney | Nurse Practitioner | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Kara J Sexton | Emergency Medicine | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, Saint Johnsbury, VT 05819-9210 |
| Quynhanh H Pham | General Surgery | Northeastern Vermont Regional Hospital Inc | 1315 Hospital Dr, St Johnsbury, VT 05819-9210 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jin Li Chan | Clinical Social Worker | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Thomas F Broderick | Family Medicine | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Adelaide Adjovu | Nurse Practitioner | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Joyce Vitale | Nurse Practitioner | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Eric Siegel | Obstetrics/gynecology | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, St Johnsbury, VT 05819-0905 |
| Claudia E Lee | Internal Medicine | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Jessica L Macleod | Nurse Practitioner | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Irene B Krechetoff | Internal Medicine | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Doreen J. Brado | Nurse Practitioner | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Kara Pitt | Obstetrics/gynecology | Northeastern Vermont Regional Hospital Inc | 714 Breezy Hill Rd, Nvrh Kingdom Internal Medicine, St Johnsbury, VT 05819-0905 |
| Find all physicians in zip 05819 | |||
| City | ST JOHNSBURY |
| Zip Code | 05819 |
| Specialty | ORTHOPEDIC SURGERY |
| City + Specialty | ST JOHNSBURY + ORTHOPEDIC SURGERY |
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| 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.