Shaneli A Fernando (NPI# 1508811654, PAC ID# 4688687536) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is RADIATION ONCOLOGY.
| Nation Provider ID (NPI) | 1508811654 |
| PAC ID by PECOS | 4688687536 |
| Professional Enrollment ID | I20180724002228 |
| Full Name | Shaneli A Fernando |
| Organization Legal Name | RADIOLOGY ASSOCIATES OF APPLETON SC |
| Address |
1580 Commanche Ave Green Bay WI 54313-5751 |
| Phone Number | 9204333764 |
| Gender | F |
| Credential | MD |
| Medical School | UNIVERSITY OF ILLINOIS AT CHICAGO HEALTH SCIENCE CENTER |
| Graduation Year | 2001 |
| Primary Specialty | RADIATION ONCOLOGY |
| Group Practice PAC ID | 6002851862 |
| Number of Group Practice Members | 29 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 520160 | THEDACARE REGIONAL MEDICAL CENTER - APPLETON INC |
| Address | Phone | Organization |
|---|---|---|
| 1818 N Meade St, Appleton, WI 54911-3454 | RADIOLOGY ASSOCIATES OF APPLETON SC | |
| 2500 E Capital Dr, Appleton, WI 54911-8735 | 9203643600 | RADIOLOGY ASSOCIATES OF APPLETON SC |
| 1580 Commanche Ave, Green Bay, WI 54313-5751 | 9204333764 | RADIOLOGY ASSOCIATES OF APPLETON SC |
| Organization Legal Name | RADIOLOGY ASSOCIATES OF APPLETON SC |
| Physicians | 18 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert G Brucker | Diagnostic Radiology | Radiology Associates of Appleton Sc | 309 N Bartlette St, Shawano, WI 54166-2127 |
| Jan H Brekke | Diagnostic Radiology | Radiology Associates of Appleton Sc | 100 County Rd B, Shawano, WI 54166-7072 |
| Kobi S Caracci | Physician Assistant | Radiology Associates of Appleton Sc | 1818 N Meade St, Appleton, WI 54911-3454 |
| Stephen M Bejvan | Diagnostic Radiology | Radiology Associates of Appleton Sc | 100 County Rd B, Shawano, WI 54166-7072 |
| Keyvan Gharabeighlou | Diagnostic Radiology | Radiology Associates of Appleton Sc | 100 County Rd B, Shawano, WI 54166-7072 |
| Gregory J Knudson | Diagnostic Radiology | Radiology Associates of Appleton Sc | 100 County Rd B, Shawano, WI 54166-7072 |
| Timothy A Bernauer | Diagnostic Radiology | Radiology Associates of Appleton Sc | 100 County Rd B, Shawano, WI 54166-7072 |
| Beth E Resch | Nurse Practitioner | Radiology Associates of Appleton Sc | 1818 N Meade St, Appleton, WI 54911-3454 |
| Brice Nelson Alvord | Diagnostic Radiology | Radiology Associates of Appleton Sc | 100 County Rd B, Shawano, WI 54166-7072 |
| Ryan M Schmidt | Diagnostic Radiology | Radiology Associates of Appleton Sc | 100 County Rd B, Shawano, WI 54166-7072 |
| Street Address |
1580 COMMANCHE AVE |
| City | GREEN BAY |
| State | WI |
| Zip | 54313-5751 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nathan D Munson | Radiation Oncology | Radiology Associates of Appleton Sc | 1580 Commanche Ave, Green Bay, WI 54313-5751 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kathleen M Sayers | Clinical Social Worker | Oneida Tribe of Indians of Wisconsin | 2640 W Point Rd, Green Bay, WI 54313-1344 |
| Sharyl M Trail | Clinical Psychologist | Oneida Tribe of Indians of Wisconsin | 2640 W Point Rd, Green Bay, WI 54313-1344 |
| Stephen J Lemmons | Chiropractic | The Wellness Way Green Bay LLC | 2638 Tulip Ln, Suite B, Green Bay, WI 54313-2801 |
| Patrick M Flynn | Chiropractic | The Wellness Way Green Bay LLC | 2638 Tulip Ln, Suite B, Green Bay, WI 54313-2801 |
| Jason W Nobles | Chiropractic | The Wellness Way Green Bay LLC | 2638 Tulip Ln, Suite B, Green Bay, WI 54313-2801 |
| Mitchell Dale Sutton | Chiropractic | The Wellness Way Green Bay LLC | 2638 Tulip Ln, Suite B, Green Bay, WI 54313-2801 |
| Gregory B Abbott | Chiropractic | The Wellness Way Green Bay LLC | 2638 Tulip Ln, Suite B, Green Bay, WI 54313-2801 |
| Roman T Pyasta | Internal Medicine | Aurora Medical Group Inc | 2790 Elm Tree Hl, Howard, WI 54313-3004 |
| Jill M Kellan | Occupational Therapy | Fox Rehabilitation Services Wi LLC | 2790 Elm Tree Hl, Howard, WI 54313-3004 |
| Alaina M Sperber | Chiropractic | Howard Chiropractic Clinic Sc | 721 Cardinal Ln, Suite 100, Green Bay, WI 54313-3216 |
| Find all physicians in zip 54313 | |||
| City | GREEN BAY |
| Zip Code | 54313 |
| Specialty | RADIATION ONCOLOGY |
| City + Specialty | GREEN BAY + RADIATION ONCOLOGY |
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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.