Priority Health Medicare Provider/Pharmacy Directory

602 Pages·2016·3.18 MB·English

Priority Health Medicare
Provider and pharmacy
directory
Plan year 2016: South
This Provider and Pharmacy Directory was updated -XQHç.

For more recent information or other questions, please contact Priority Health

Medicare toll-free at 888.389.6648 or, for TTY users, 711, seven days a week from

8 a.m. – 8 p.m., or visit prioritymedicare.com.

Y0056_1000_1080_1601 CMS-accepted 08292015
EMMET
North
CHEBOYGAN PRESQUE ISLE
CHARLEVOIX
MONTMORENCY
ANTRIM OTSEGO ALPENA
LEELANAU
BENZIE TRGARVAENRDS E KALKASKA CRAWFORD OSCODA ALCONA
MANISTEE WEXFORD MISSAUKEE ROSCOMMON OGEMAW IOSCO
ARENAC
MASON LAKE OSCEOLA
CLARE GLADWIN
HURON
BAY
OCEANA MECOSTA ISABELLA MIDLAND
East
NEWAYGO TUSCOLA
SAGINAW SANILAC
MONTCALM GRATIOT
MUSKEGON
West
GENESEE LAPEER ST. CLAIR
OTTAWA KENT IONIA CLINTON SHIAWASSEE
MACOMB
OAKLAND
ALLEGAN BARRY EATON INGHAM LIVINGSTON
Southeast
WAYNE
VAN BUREN KALAMAZOO CALHOUN JACKSON WASHTENAW
BERRIEN CASS ST. JOSEPH BRANCH MONROE
HILLSDALE LENAWEE
South
Priority Health Medicare
HMO,HMO-POS and
PPO Plan provider and
pharmacy directory

This directory provides a partial list of Priority Health Medicare's network providers.
This directory is for a subset of our service area as listed below.

South Region:
Berrien, Branch, Calhoun, Cass, Eaton, Hillsdale, Ingham, Jackson, Kalamazoo, Lenawee,
Livingston, Monroe, Saint Joseph, Van Buren, and Washtenaw
Other regional directories for our service area:

East Region:
Bay, Clinton, Genesee, Gratiot, Huron, Isabella, Lapeer, Midland, Saginaw, Saint Clair, Sanilac,
Shiawassee and Tuscola

North Region:
Alcona, Alpena, Antrim, Arenac, Benzie, Charlevoix, Cheboygan, Clare, Crawford, Emmet,
Gladwin, Grand Traverse, Iosco, Kalkaska, Lake, Leelanau, Manistee, Mason, Missaukee,
Montmorency, Ogemaw, Osceola, Oscoda, Otsego, Presque Isle, Roscommon and Wexford

Southeast Region:
Macomb, Oakland and Wayne

West Region:
Allegan, Barry, Ionia, Kent, Mecosta, Montcalm, Muskegon, Newaygo, Oceana and Ottawa
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This directory is current as of June 2016.
Some network providers may have been added or removed from our network after this directory
was printed. We do not guarantee that each provider is still accepting new members. To get the
most up-to-date information about Priority Health Medicare's network providers in your area, you
can use our online Find a Doctor tool at prioritymedicare.com or call Customer Service toll-free
at 888.389.6648, seven days a week, 8 a.m. - 8 p.m. TTY users should call 711. You can
request directories of our entire Priority Health Medicare provider network when you call
Customer Service.
The provider network may change at any time. You will receive notice when necessary.
Priority Health has HMO, HMO-POS and PPO plans with a Medicare contract. Enrollment in
Priority Health Medicare depends on contract renewal.
This document is available in alternate formats (e.g. Braille or large print). Please call toll-free
888.389.6648 (TTY users should call 711), 8 a.m. - 8 p.m., seven days a week, to request a
copy.
ii
Provider Directory

Introduction

This directory provides a list of Priority Health Medicare's network providers. To get detailed
information about your health care coverage, please see your Evidence of Coverage.
If you are enrolled in one of our HMO or HMO-POS plans, you will have to choose one of our
network providers who are listed in this directory to be your primary care physician (PCP). The
term "PCP" will be used throughout this directory. Generally, you must get your health care
coverage from your PCP, except for emergency or urgently needed services, out-of-area dialysis
services and out-of-network services explicitly covered under your Priority Health Medicare Point
of Service (POS) benefit plan.
Selecting a PCP is not required for PPO members. However, you may choose a Physician of
Choice (POC) to be your partner in helping you stay healthy.
The "network providers" listed in this directory have agreed to provide you with your health care,
vision, dental and hearing coverage. You may go to any of our network providers listed in this
directory. Other physicians/providers are available in our network. If you have been going to one
network provider, you are not required to continue going to that same provider. In some cases,
you may get covered services from non-network providers. Referrals are not required; however,
some services may require prior authorization. Covered services that need prior authorization
are listed in your Evidence of Coverage (EOC) booklet.
There may be times when you get a bill from a provider for the full cost of medical care you have
received. In many cases, you should send this bill to us instead of paying it. We will look at the
bill and decide whether the services should be covered. If we decide they should be covered, we
will pay the provider directly. Please refer to Chapter 7 of your Evidence of Coverage for
complete details.
You may get covered emergency medical care whenever you need it, anywhere in the United
States and worldwide. Our plan covers ambulance services in situations where getting to the
emergency room in any other way could endanger your health. If you receive emergency care at
an out-of-network hospital and need inpatient care after your emergency condition is stabilized,
you must have your inpatient care at the out-of-network hospital authorized by the plan. Please
refer to Chapter 4 of your Evidence of Coverage for complete details. With the exception of
emergencies or urgent care, it may cost more to get care from out-of-network providers.
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What is the service area for Priority Health Medicare plans?
The counties in our service area are listed below.

Alcona, Allegan, Alpena, Antrim, Arenac, Barry, Bay, Benzie, Berrien, Branch, Calhoun, Cass,

Charlevoix, Cheboygan, Clare, Clinton, Crawford, Eaton, Emmet, Genesee, Gladwin, Grand

Traverse, Gratiot, Hillsdale, Huron, Ingham, Ionia, Iosco, Isabella, Jackson, Kalamazoo,

Kalkaska, Kent, Lake, Lapeer, Leelanau, Lenawee, Livingston, Macomb, Manistee, Mason,

Mecosta, Midland, Monroe, Montcalm, Montmorency, Missaukee, Muskegon, Newaygo,

Oakland, Oceana, Ogemaw, Osceola, Oscoda, Otsego, Ottawa, Presque Isle, Roscommon,

Saginaw, Sanilac, Shiawassee, St. Clair, St. Joseph, Tuscola, Van Buren, Washtenaw, Wayne

and Wexford.

How do you find Priority Health Medicare providers in your area?
The providers are listed in this directory by provider type (PCP, specialists, hospitals, etc.),
alphabetically by city, practice type, and by provider last name. If you have questions about
Priority Health Medicare or require assistance in selecting a PCP, please call our Customer
Service department at toll-free 888.389.6648, seven days a week, 8 a.m. - 8 p.m. TTY users
should call 711. Or, visit prioritymedicare.com.
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List of Network Providers

This directory is for the South region of our service area. To request other regional directories of

our Priority Health Medicare provider network, please call our Customer Service department at
toll-free 888.389.6648, days a week, 8 a.m. to 8 p.m. TTY users should call 711. Or, go to
prioritymedicare.com and use Find a doctor to locate a provider in our Medicare network.
Alphabetical Listing of

Primary Care Providers 2

Geographic Listing of 2295 PCPs

Primary Care Providers 17

Alphabetical Listing of

Specialists and Behavioral Health 112

Geographic Listing of 6417 Specialists

Specialists 149

Geographic Listing of 1159 Behavioral Health providers

Behavioral Health 425

Geographic Listing of 119 Hospitals

Hospitals 480

Geographic Listing of 71 Skilled Nursing facilities

Skilled Nursing Facilities 486

Geographic Listing of 34 Urgent Care Facilities

Urgent Care Facilities 490

Geographic Listing of 800 Ancillary Services

Ancillary Services 492

Geographic Listing of 280 Chiropractors

Chiropractors 528

Geographic Listing of 393 Vision Care providers

Vision Care 540

Dental Care (not available for PriorityMedicare KeySM (HMO-POS), PriorityMedicare
IdealSM (PPO) or employer sponsored plans) 555
Optional Enhanced Vision, Dental and Hearing Care (not available for employer
sponsored plans) 556
Pharmacy Directory 557

* Priority Health Medicare providers who accept Medicaid are identified with an asterisk.
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ALPHABETICAL LISTING OF PRIMARY CARE PROVIDERS

(PCPs)

Arntz, Stephen J., MD 63
A Pages

Atasi, Bassel H., MD 37, 110
Abbott, Cathleen M., MD 55 Ayala, Jose R., MD 45
Abdalla-Ali, Abdalla M., MD 80 Ayanian, John, MD 26
Abdelkarim, Tariq H., MD 53, 61, 101 Azhary, Hend, MD 55, 75, 84
Abdullah, Muhammad, MD 67 Azim, James N., MD 38
Abhari, Farnaz S., MD 47 B Pages
Abraham, Flommy, MD 38
Adamczyk, Brian A., MD 63 Babe, Laura E., MD 26
Adams, Robert P., MD 46 Baker, Keith R., MD 61
Adams, Stephanneth P., NP 43 Baker, Ronald P., MD 100
Adamson, Angela K., DO 42, 59, 86, 93, 96, 103 Balawender, Jenifer L., DO 55
Agee, Marilyn, MD 104 Balinski, Allen J., MD 102
Ageloff-Kupetz, Shana A., MD 63 Balogh, Linda M., MD 37
Agrawal, Mira, MD 109 Bannon, Susan F., MD 72
Ahrens, JoDee E., MD 105 Barancin, Lisa K., PA-C 92
Akers, Danielle C., MD 63 Barbour, Bruce S., MD 67
Al-Attar, Sabah A., MD 109 Barclay, Beth S., MD 38
Albashiti, Bassam, MD 74 Bard, John L., MD 45, 98
Alcaraz, Christopher A., MD 72 Barden, Kathryne J., NP 103
Alday, Debra L., NP 17, 43 Barkway, Laurie L., DO 102
Alexander, Elizabeth A., MD 55 Barlekamp, Harold C., MD 104
Alexander, Kristy J., NP 49 Barnes, Joy L., MD 104
Alexander, Neil, MD 24 Barnes-Kalkowski, Kimberly, NP 43
Alford, James A., MD 50 Barone, Holly E., PA-C 78
Alimenti, Sigita G., MD 97 Barrett, Prudence L., MD 98
Alkhoury Fallouh, Nabil, MD 25 Barry, Henry C., MD 55, 75, 84
Allen, John T., DO 44 Bartelme, Ricardo R., MD 18
Allen, Richard J., DO 75 Baruti, Timur A., MD 83
Allen, Richard J., MD 99 Batchu, Madhu M., MD 95
Al-sheikh, Maher G., MD 90 Batra, Narinder K., MD 17
Altamash, Amy M., NP 103 Baxter, Ryan J., MD 95
Altman, Jonathan A., MD 75 Beard, David, NP 71
Alvarado, Christopher J., DO 61 Bell, Gail M., NP 23
Alvarado, Julie A., NP 78, 107 Bell, Randy K., MD 67
Alvarado, Liz, NP 43 Bell, Stephen R., DO 89
Alvarez, David J., DO 18, 107 Benavides Martinez, Victor H., MD 55
Amaria, Noshir Y., DO 75, 84 Benbow, Melissa K., MD 58, 80, 91
Amaria, Yazdi N., MD 101 Benevich, Therese M., MD 99, 110
Amendt, Andria L., MD 80 Bennett, Leslie M., MD 61
Amin, Anita V., MD 25, 26 Beredo, Rolando M., MD 67
An, Lawrence C., MD 26 Berg, Chiquita L., MD 67
Andries, Kathleen M., MD 97 Berland, Daniel W., MD 26
Anglin, Amy, NP 65 Berry, Tania L., DO 49
Ankuda, Claire K., MD 50, 54, 107 Bettcher, Catherine M., MD 18, 50
Annan, Abigail A., MD 68 Beyene, Yemisrach A., MD 90
Anzicek, Kathleen, DO 60 Bhan, Raakesh C., MD 44
Apgar, Barbara S., MD 18, 50 Bhaskar, Hemlata, MD 17
Araoz, Jennifer L., NP 85 Bhatt, Hitesh M., DO 62, 79
Arenz, Kelly L., DO 46 Bhurgri, Aamer H., MD 88
Arivoli, Mehalai, MD 53 Bialecki-Haase, Dee Ann, MD 93
Armstead, Renee C., MD 18, 87 Bibicoff, Nina K., NP 23
This directory lists participating providers in the South region as of June 2016 and may change. For the most

up-to-date participating provider information, please contact Customer Service at 888.389.6648 from

8 a.m. to 8 p.m., seven days a week. TTY users should call 711.

2
* Priority Health Medicare providers who accept Medicaid are identified with an asterisk.
ALPHABETIC LISTING OF PRIMARY CARE PROVIDERS (PCPs)
Bruderly, Michael I., MD 18
B (continued) Pages
Bruno, Joseph A., MD 68
Bieniasz, Mary E., NP 109 Brzezinski, Megan, DO 75
Bigelow, Bruce, MD 63 Buchi, Andrea B., MD 38
Billi, John E., MD 26 Buchweitz, Cynthia A., MD 55
Bivens, William B., MD 64 Buenaflor, Filomena F., MD 102
Blaum, Caroline S., MD 24 Bull, Stacy S., MD 55
Bleil, Gordon R., MD 99 Bur, Sarah L., MD 52
Blitz, Susan G., MD 26 Burgess, Howard J., MD 55
Bloomer, Roger E., MD 64 Burgess, Michael W., DO 64
Bluhm, Brian H., MD 18 Burke, Anna M., DO 26
Boakye, Kwasi O., MD 61 Burkow, Lester, DO 54
Bobba, Jyothirmai, MD 86, 93, 96, 103 Burman-Solovyeva, Irina Z., MD 109
Bode, Ernest G., MD 105 Burnard, Karen S., MD 93
Bogan, William R., MD 44 Burnell, Jeffrey S., DO 87
Boggs, Nicholas E., DO 89 Burnham, Jennifer, NP 43
Bohnsack, Kevin J., MD 87 Burrows, Acacia L., PA-C 43
Bohrer, Aaron M., DO 79, 107 Burrows, Heather L., MD 39
Boinepalli, Pratima, MD 80, 85, 91 Bush, Gerald M., PA-C 92
Boley, Bryon D., MD 68 Bush, William A., DO 63
Bomer, James J., MD 101 Buskulic, Francesca M., DO 107
Boose, Michelle D., MD 104 Butt, Imdad H., MD 67
Boote, Jennifer, DO 80 Butters, Luke G., PA-C 65, 68, 83
Booth, Mark A., MD 62 Bwititi, Tamayi, MD 68, 86
Bord, Cheryl L., NP 23 Byrens, David M., MD 84
Born, Eric E., DO 92 C Pages
Born, Frederick W., DO 97
Bosworth, Quinn M., DO 90 Cabala, Albert A., MD 72
Bouknight, Reynard R., MD 57 Cabaltica, Rex B., MD 89
Boyce, Sharon, MD 17 Cahill, Daniel F., MD 109
Boyer, Debra L., MD 111 Camara, Robert P., DO 62
Boyer, Martha, NP 43 Campbell, Douglas G., MD 72
Bradstreet, Tracy, NP 43 Campbell, Matthew J., MD 97
Brady, Ashley A., PA-C 65 Carbajo, Nancy, MD 27, 60
Brady, Tracy D., MD 17 Carey, Colleen M., MD 74
Brandt, Roberta, PA-C 83 Carl, Dana L., NP 85
Brandt, Sean K., DO 68 Carlson, Barbara S., MD 97, 100
Breakey, Robert A., MD 107 Carlson, Susan M., MD 72
Bregni-Page, Carla T., DO 50 Carow, James F., MD 92
Breitzer, Gerard M., DO 80, 81, 91 Carrion, Eriberto, MD 59
Brenner, Karen E., MD 111 Carroll-Crist, Betsy, PA-C 17, 62
Brenner, Karl F., MD 26 Cartmill, William C., MD 92
Briggs, Chris G., PA-C 42 Caruso, Ralph M, DO 68, 69, 93
Brigham, Robin L., PA-C 65 Casey, Amber R., DO 96
Brinley, Floyd J., MD 26 Castillo, Jennifer E., MD 27
Brittan, Kathy J., MD 92 Caszatt, Sarah T., NP 65
Britton, Richard H., DO 75 Cegielski, John W., MD 42
Brooks, R. David, DO 107 Cervin-Wagner, Michelle I., DO 107
Brophy, Brian J., MD 26 Chahal, Gurpreet S., MD 57
Brothers, Joel M., MD 26 Chamarthi, Sree V., MD 52
Broughton, Fleur L., MD 90 Chamness, William S., MD 39
Brown, David C., DO 68 Chang, Boonchoo O., MD 49, 55
Browne, Maria Theresa O., MD 46 Chang, Megan T., MD 39
Browne, Shannon A., MD 47 Chang, Peter S., MD 17, 42
Bruce, Matthew D., DO 64 Chang, Tammy, MD 107
This directory lists participating providers in the South region as of June 2016 and may change. For the most

up-to-date participating provider information, please contact Customer Service at 888.389.6648 from

8 a.m. to 8 p.m., seven days a week. TTY users should call 711.

3
* Priority Health Medicare providers who accept Medicaid are identified with an asterisk.
ALPHABETIC LISTING OF PRIMARY CARE PROVIDERS (PCPs)
Chapin, Camy C., MD 81 Crawford-Johnson, Tywanda R., MD 64
Chapman, Duncan R., MD 59, 69, 86, 93, 96, 103 Cretsinger, Cynthia A., PA-C 71
Chartier, Michelle M., DO 89 Cribb, Jack E., DO 50
Chaudhry, Sajid A., MD 109 Crites, Haley, PA-C 43
Chavey, William E., MD 18, 107 Crooks, M. Jonathan, MD 72
Chebes, Andrzej M., MD 104 Crump, John, MD 98
Cheema, Charan K., DO 17 Cuison, Jeanjiko D., MD 81, 85
Chen, Dennis D., MD 27 Culton, Hugh H., MD 81
Chen, Julia, MD 27 Curtis, Jeremy M., NP 65
Chen, Roger H., MD 18, 107 Custodio, Sara B., MD 72
Chen, Xian, MD 27
D Pages
Chen, Yanni, DO 52
Chermak, Linda M., MD 50 Dabney, Penny L., NP 78
Chernin, Dennis K., MD 23 Dadivas, Cecile C., MD 100
Cherry, Melvin, MD 79 Daiber, Robert R., MD 75
Chi, PaoLin E., MD 39 Daill, Michelle L., MD 55
Chick, Davoren A., MD 27 Dallas, Stephen N., MD 72
Chip, Jerold N., MD 99 Dandois, Michael J., DO 69
Chiu, Sin-Ching, MD 104 Daniel, Aaron M., MD 63, 110
Cho, Daniel K., MD 27 Daniel, Shanthini A., MD 74
Chopra, Vineet I, MD 27 Darah, George N., DO 101
Choudhury, Amimul A., MD 88 Darey, Amber D., MD 93
Choxi, Hetal H., MD 18, 19, 50, 54, 107 Darios, Robert J., MD 76
Christensen, Rachel S., DO 81, 91 Darlington, Erin L., DO 100
Chung, Younho, MD 44 DaSilva, Marissa H., NP 109
Chupp, Gregory L., MD 52 Davidson, Melissa A., MD 73
Cicone, Bruce D., MD 109 Davies, Amy B., NP 65
Ciesielski, Matt A., DO 93 Davis, James H., NP 107
Cigolle, Christine T., MD 107 Davis, Kristy K., DO 101
Clark, Shirin E., DO 75 Davis, Matthew M., MD 37
Clark, Stephanie M., MD 27 Davis, Troy D., DO 83
Clarke, Michael S., MD 69, 93 De Leon, Jocelyn B., MD 74, 95
Coenen, Julie F., NP 50 Dean, Corey R., MD 110
Cohen, Alicia J., MD 19, 50, 107 Debacker, Michael J., MD 93, 98
Colberg, Douglas L., MD 42 Degraff, Nicole S., PA-C 106
Cole, Raymond E., DO 49 Dehaan, Caralyn K., DO 99
Coleman-Miezan, Patricia, MD 79 Dehlin, Charles B., DO 79
Colletti, Cheryl A., DO 64 Dela Cruz, Mark T., MD 88
Collier, Kristin M., MD 27 DeMots, William J., MD 17, 103
Collins, Kelli B., DO 45 Demuth, Robin H., MD 55, 76
Compean, Jose R., MD 88 Den Houter, Willard B., MD 109
Conant, Clark E., DO 64 Denay, Keri L., MD 19
Conant, Jeffrey D., PA-C 65 Denham, Sarah J., DO 62, 76
Constantino, Raya, MD 91 Derck, Cara E., DO 46, 89
Cook, Mary J., NP 57 Desai, Bipin P., MD 48
Cook, Naomi J., MD 19 Desai, Sudhir L., MD 44
Cooke, Amy E., MD 39 DeSantis, Angela, MD 89
Cooke, David A., MD 27, 98 Deskins, Sharon P., MD 45, 97
Cooke, James M., MD 19, 50, 107 Deva, Shivakumar R., MD 67
Coombs, Raechel E., DO 83, 84 DeWeerd, Jeffrey S., DO 84
Cooper, Jonathan S., DO 76 DeWitt, Dana A., DO 64
Coppinger, Jeffrey M., MD 95 Dewyer, Rodney L., MD 27
Cordoba-Naguit, Maria Adela A., MD 102 Dickson, Alison L., MD 39, 48, 63, 99, 111
Courtnage, Susan L., MD 59 Dickson, Cheryl A., MD 74
Cox, Amanda M., MD 47 Diehl, Ashley E., MD 86, 95, 96
Coy, Ted G., MD 50
This directory lists participating providers in the South region as of June 2016 and may change. For the most

up-to-date participating provider information, please contact Customer Service at 888.389.6648 from

8 a.m. to 8 p.m., seven days a week. TTY users should call 711.

4
* Priority Health Medicare providers who accept Medicaid are identified with an asterisk.