John Stella (NPI# 1508887019, PAC ID# 9133100480) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1508887019 |
| PAC ID by PECOS | 9133100480 |
| Professional Enrollment ID | I20070628000159 |
| Full Name | John Stella |
| Organization Legal Name | KODIAK BOARD CERTIFIED RADIOLOGY, LLC |
| Address |
1915 E Rezanof Dr Kodiak AK 99615-6602 |
| Phone Number | 9074869521 |
| Gender | M |
| Credential | MD |
| Medical School | NEW YORK MEDICAL COLLEGE |
| Graduation Year | 1976 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 7911189022 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 021306 | PROVIDENCE KODIAK ISLAND MEDICAL CTR |
| Address | Phone | Organization |
|---|---|---|
| 1915 E Rezanof Dr, Kodiak, AK 99615-6602 | 9074869521 | KODIAK BOARD CERTIFIED RADIOLOGY, LLC |
| 1915 E Rezanof Dr, Providence Kodiak Island Medical Center, Kodiak, AK 99615-6602 | 9074869521 | KODIAK BOARD CERTIFIED RADIOLOGY, LLC |
| Organization Legal Name | KODIAK BOARD CERTIFIED RADIOLOGY, LLC |
| Physicians | 1 |
| Street Address |
1915 E REZANOF DR |
| City | KODIAK |
| State | AK |
| Zip | 99615-6602 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Janet Abadir | General Surgery | Providence Health and Services Washington | 1915 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Stephen S Burnside | Internal Medicine | Providence Health and Services Washington | 1915 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Wendell H Wilmoth | Diagnostic Radiology | 1915 E Rezanof Dr, Kodiak, AK 99615-6602 | |
| Kathleen S Nussbaum | Nurse Practitioner | Providence Health and Services Washington | 1915 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Alan W Wolf | Orthopedic Surgery | Providence Health and Services Washington | 1915 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jerimiah L Myers | Optometry | 214 W Rezanof Dr, Suite 1, Kodiak, AK 99615-6044 | |
| Kevin Creelman | General Practice | 104 Ctr Ave, Suite 100, Kodiak, AK 99615-6393 | |
| John M Weaver | Clinical Social Worker | Providence Health and Services Washington | 717 E Rezanof Dr, Kodiak, AK 99615-6416 |
| Welby N Jensen | Psychiatry | Providence Health and Services Washington | 717 E Rezanof Dr, Kodiak, AK 99615-6416 |
| Rae Jean Blaschka | Nurse Practitioner | Kodiak Island Medical Associates | 1818 E Rezanof Dr, Kodiak, AK 99615-6505 |
| Mark E Withrow | General Practice | Kodiak Island Medical Associates | 1818 E Rezanof Dr, Kodiak, AK 99615-6505 |
| Carol L Juergens | Internal Medicine | Kodiak Island Medical Associates | 1818 E Rezanof Dr, Kodiak, AK 99615-6505 |
| Laura M Creighton | Chiropractic | 814 E Rezanof Dr, Kodiak, AK 99615-6599 | |
| Melissa K Witteveen | Physician Assistant | Kodiak Island Healthcare Foundation | 1911 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Jenna N Walker | Nurse Practitioner | Kodiak Island Healthcare Foundation | 1911 E Rezanof Dr, Kodiak, AK 99615-6602 |
| Find all physicians in zip 99615 | |||
| City | KODIAK |
| Zip Code | 99615 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | KODIAK + DIAGNOSTIC RADIOLOGY |
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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.