Khadijat O Balogun (NPI# 1124310743, PAC ID# 9537431721) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is GASTROENTEROLOGY.
| Nation Provider ID (NPI) | 1124310743 |
| PAC ID by PECOS | 9537431721 |
| Professional Enrollment ID | I20170823001793 |
| Full Name | Khadijat O Balogun |
| Organization Legal Name | PROSPECT CT MEDICAL FOUNDATION, INC. |
| Address |
353 Main St Manchester CT 06040-4145 |
| Phone Number | 8606493477 |
| Gender | F |
| Medical School | STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER |
| Graduation Year | 2011 |
| Primary Specialty | GASTROENTEROLOGY |
| Group Practice PAC ID | 7416244496 |
| Number of Group Practice Members | 261 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 070027 | MANCHESTER MEMORIAL HOSPITAL |
| 070012 | ROCKVILLE GENERAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 353 Main St, Manchester, CT 06040-4145 | 8606493477 | PROSPECT CT MEDICAL FOUNDATION, INC. |
| Organization Legal Name | PROSPECT CT MEDICAL FOUNDATION, INC. |
| Physicians | 222 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Eyone Jones | General Surgery | Prospect Ct Medical Foundation, Inc. | 18 Haynes St, Uppr Level, Manchester, CT 06040-4111 |
| Isaac Okyere Ampofo | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 629 Middle Tpke E, Manchester, CT 06040-3731 |
| Kelli A Harper | Family Medicine | Prospect Ct Medical Foundation, Inc. | 175 W Rd, Ellington, CT 06029-3730 |
| Marcy A Calsetta | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 520 Hartford Tpke, Suite M, Vernon, CT 06066-5044 |
| Michele P Barry | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 145 Union St, Vernon Rockville, CT 06066-3025 |
| Juan Diego Holguin | General Surgery | Prospect Ct Medical Foundation, Inc. | 1625 Straits Tpke, Suite 200, Middlebury, CT 06762-1836 |
| Michael D Waddington | Neurology | Prospect Ct Medical Foundation, Inc. | 29 Haynes St, Suite D, Manchester, CT 06040-4139 |
| Wendy S Garvin | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 26 Shenipsh Lake Rd, Tolland, CT 06084-2332 |
| Charles A Mandelberg | Family Medicine | Prospect Ct Medical Foundation, Inc. | 28 Main St, East Hartford, CT 06118-3243 |
| Remi Mathews | Family Medicine | Prospect Ct Medical Foundation, Inc. | 130 Hartford Rd, Manchester, CT 06040-5921 |
| Street Address |
353 MAIN ST |
| City | MANCHESTER |
| State | CT |
| Zip | 06040-4145 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Lauren A Baltrucki | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 353 Main St, Manchester, CT 06040-4145 |
| Dennis M Sheehe | Family Medicine | Geisinger Clinic | 353 Main St, Catawissa, PA 17820-1315 |
| Colin T Swales | Gastroenterology | Hartford Hospital | 353 Main St, Manchester, CT 06040-4145 |
| Anthony Billas | Family Medicine | Geisinger Clinic | 353 Main St, Catawissa, PA 17820-1315 |
| Keri Lee T Pinnock | Gastroenterology | Prospect Ct Medical Foundation, Inc. | 353 Main St, Manchester, CT 06040-4145 |
| Anna Heser | Nurse Practitioner | Geisinger Clinic | 353 Main St, Catawissa, PA 17820-1315 |
| Tina M Carey | Physical Therapy | Fox Rehabilitation Services Inc | 353 Main St, Chatham, NJ 07928-2229 |
| Meghan A Tetreault | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 353 Main St, Manchester, CT 06040-4145 |
| Jennifer Mary Golinski | Occupational Therapy | Fox Rehabilitation Services Inc | 353 Main St, Chatham, NJ 07928-2229 |
| Alexandra Sheppard | Occupational Therapy | Fox Rehabilitation Services Inc | 353 Main St, Chatham, NJ 07928-2229 |
| Find all physicians in the same address | |||
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kelsey Elizabeth Wood | Physician Assistant | Family Medicine Center,llc | 574 Middle E Tpke, Manchester, CT 06040-3730 |
| Christine M Knight | Physical Therapy | Integrated Rehabilitation Services, LLC | 586 E Middle Tpke, Manchester, CT 06040-3730 |
| Jordan Taylor Honahan | Physical Therapy | Integrated Rehabilitation Services, LLC | 586 E Middle Tpke, Manchester, CT 06040-3730 |
| Krista A Catalan | Physical Therapy | Integrated Rehabilitation Services, LLC | 586 E Middle Tpke, Manchester, CT 06040-3730 |
| Zachary David Crickmore | Physical Therapy | Integrated Rehabilitation Services, LLC | 586 E Middle Tpke, Manchester, CT 06040-3730 |
| Eric Stearns | Physical Therapy | Integrated Rehabilitation Services, LLC | 586 E Middle Tpke, Manchester, CT 06040-3730 |
| Kelsey Magrisso | Physical Therapy | Integrated Rehabilitation Services, LLC | 586 E Middle Tpke, Manchester, CT 06040-3730 |
| Kristen Lindsay | Physical Therapy | Integrated Rehabilitation Services, LLC | 586 E Middle Tpke, Manchester, CT 06040-3730 |
| Matthew Reynolds | Physical Therapy | Integrated Rehabilitation Services, LLC | 586 E Middle Tpke, Manchester, CT 06040-3730 |
| Isaac Okyere Ampofo | Nurse Practitioner | Prospect Ct Medical Foundation, Inc. | 629 Middle Tpke E, Manchester, CT 06040-3731 |
| Find all physicians in zip 06040 | |||
| City | MANCHESTER |
| Zip Code | 06040 |
| Specialty | GASTROENTEROLOGY |
| City + Specialty | MANCHESTER + GASTROENTEROLOGY |
Please comment or provide details below to improve the information on Khadijat O Balogun.
| 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.