Jaya Praveen Kumar Penagaluri (NPI# 1124258645, PAC ID# 6709037781) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PSYCHIATRY.
| Nation Provider ID (NPI) | 1124258645 |
| PAC ID by PECOS | 6709037781 |
| Professional Enrollment ID | I20180327003059 |
| Full Name | Jaya Praveen Kumar Penagaluri |
| Organization Legal Name | KOOTENAI HEALTH |
| Address |
566 W Prairie Ave Coeur D Alene ID 83815-7766 |
| Phone Number | 2086255155 |
| Gender | M |
| Graduation Year | 2001 |
| Primary Specialty | PSYCHIATRY |
| Group Practice PAC ID | 4789641598 |
| Number of Group Practice Members | 254 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 130049 | KOOTENAI HEALTH |
| Address | Phone | Organization |
|---|---|---|
| 566 W Prairie Ave, Coeur D Alene, ID 83815-7766 | 2086255155 | KOOTENAI HEALTH |
| Organization Legal Name | KOOTENAI HEALTH |
| Physicians | 232 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Nathanael D Gay | Medical Oncology | Kootenai Health | 1440 E Mullan Ave, Post Falls, ID 83854-9064 |
| Amy D Echelberger | Internal Medicine | Kootenai Health | 1300 E Mullan Ave, Suite 1300, Post Falls, ID 83854-6057 |
| Bucklee Eller | Nurse Practitioner | Kootenai Health | 1296 E Polston Ave, Suite C, Post Falls, ID 83854-5217 |
| Sean Tristan T Cook | Infectious Disease | Kootenai Health | 2120 W Ironwood Dr, Coeur D Alene, ID 83814 |
| Matthew G Taylor | Cardiac Electrophysiology | Kootenai Health | 122 W 7th Ave, Suite 310, Spokane, WA 99204-2352 |
| Justin P Garrett | Psychiatry | Kootenai Health | 2199 W Ironwood Ctr Dr, Coeur D Alene, ID 83814-2639 |
| Connor W Quinn | Orthopedic Surgery | Kootenai Health | 1110 W Park Pl, Suite 202, Coeur D Alene, ID 83814-2783 |
| Sarah M Jones | Physician Assistant | Kootenai Health | 700 W Ironwood Dr, Coeur D Alene, ID 83814-4400 |
| Dustin D Dinning | Rheumatology | Kootenai Health | 700 N Ironwood Dr, 275w, Coeur D'alene, ID 83814 |
| Ryan J Gilles | Family Medicine | Kootenai Health | 1919 Lincoln Way, Suite 315, Coeur D Alene, ID 83814-2527 |
| Street Address |
566 W PRAIRIE AVE |
| City | COEUR D ALENE |
| State | ID |
| Zip | 83815-7766 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Craig J Panos | Family Medicine | Kootenai Health | 566 W Prairie Ave, Coeur D Alene, ID 83815-7766 |
| Douglas S Linford | Family Medicine | Kootenai Health | 566 W Prairie Ave, Coeur D Alene, ID 83815-7766 |
| Jeffery Givens | Family Practice | Kootenai Urgent Care LLC | 566 W Prairie Ave, Coeur D Alene, ID 83815-7766 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Alvin D Frantz Iii | Chiropractic | 3115 N Government Way, Suite 5, Coeur D Alene, ID 83815-3700 | |
| Michael James Mckim | Chiropractic | Summit Family Chiropractic | 2634 N Government Way, Coeur D Alene, ID 83815-3750 |
| Ryan J Sousley | Chiropractic | Summit Family Chiropractic | 2634 N Government Way, Coeur D Alene, ID 83815-3750 |
| Troy M Bonham | Chiropractic | Summit Family Chiropractic | 2634 N Government Way, Coeur D Alene, ID 83815-3750 |
| Elizabeth Galene Patzer | Clinical Social Worker | 7905 N Meadowlark Way, Suite A, Coeur D Alene, ID 83815-5041 | |
| Jill E Kuisti | Clinical Social Worker | 7905 N Meadowlark Way, Suite A, Coeur D Alene, ID 83815-5041 | |
| Juliana Bartoletti | Physical Therapy | River City Physical Therapy | 370 E Kathleen Ave, Suite 500, Coeur D Alene, ID 83815-5238 |
| Erin Blakley | Physical Therapy | River City Physical Therapy | 370 E Kathleen Ave, Suite 500, Coeur D Alene, ID 83815-5238 |
| Brian J Hull | Chiropractic | 320 E Neider Ave, Suite 105, Coeuer D'alene, ID 83815-6007 | |
| Charles P Swayze | Chiropractic | 402 W Canfield Ave, Suite 3, Coeurd Alene, ID 83815-7784 | |
| Find all physicians in zip 83815 | |||
| City | COEUR D ALENE |
| Zip Code | 83815 |
| Specialty | PSYCHIATRY |
| City + Specialty | COEUR D ALENE + PSYCHIATRY |
Please comment or provide details below to improve the information on Jaya Praveen Kumar Penagaluri.
| 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.