ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP22529VT01 AAKRE KIMBERLY MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7337 PEDIATRICS 01YP22529VT02 AAKRE KIMBERLY MD WINDSOR HOSPITAL CORP WOODSTOCK VT 05091 (802) 457-3030 PEDIATRICS 23YP34527NH01 ABBOTT CARA APRN WENTWORTH DOUGLASS PHYSICIAN CORP LEE NH 03861 (603) 868-3300 FAMILY NURSE PRACTITIONERS 23YP30990NH01 ABBOTT MCCALL APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 226-3400 FAMILY NURSE PRACTITIONERS 01YP16108NH01 ABEL SUSAN MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4400 PEDIATRICS 01YP16108NH03 ABEL SUSAN MD DARTMOUTH HITCHCOCK CLINIC MERRIMACK NH 03054 (603) 424-4713 PEDIATRICS 01YP16108NH04 ABEL SUSAN MD DARTMOUTH HITCHCOCK CLINIC MILFORD NH 03055 (603) 673-2515 PEDIATRICS 01YP16108NH05 ABEL SUSAN MD DARTMOUTH HITCHCOCK CLINIC HUDSON NH 03051 (603) 577-3410 PEDIATRICS 01YP16108NH06 ABEL SUSAN MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRICS 01YP36640MA01 ABELE MICHAEL MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3200 INTERNAL MEDICINE 01YP33636NH02 ABEYSINGHE CHAMPA MD HEALTH FIRST FAMILY CARE CENTER LACONIA NH 03246 (603) 366-1070 INTERNAL MEDICINE 01YP05379ME02 ABRAHAM PHILIP MD PHILIP ABRAHAM MD SANFORD ME 04073 (207) 490-7968 INTERNAL MEDICINE 23YP40153ME01 ABRAHAMSON CASSIDY APRN YORK HOSPITAL YORK ME 03909 (207) 363-4321 INTERNAL MEDICINE NURSE PRACTITIONER 04YP36196NH01 ABRAMOWITZ BRUCE DO ELLIOT PHYSICIANS NETWORK WINDHAM NH 03087 (603) 894-0063 FAMILY MEDICINE 01YP24965MA01 ABREU STEVEN MD LAHEY CLINIC INC LEXINGTON MA 02421 (781) 372-7000 INTERNAL MEDICINE 23YP39782NH01 ADAM NICOLE APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC CONCORD NH 03301 (603) 369-4530 FAMILY NURSE PRACTITIONERS 01YP02926ME03 ADAMS TODD MD YORK HOSPITAL MOODY ME 04054 (207) 646-8386 INTERNAL MEDICINE 01YP02926ME04 ADAMS TODD MD YORK HOSPITAL YORK ME 03909 (207) 351-3530 INTERNAL MEDICINE 04YP03268NH01 ADAMS GLENN DO WEEKS MEDICAL CENTER GROVETON NH 03582 (603) 788-2521 FAMILY MEDICINE 23YP36010VT01 ADJOVU ADELAIDE APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 FAMILY NURSE PRACTITIONERS 23YP12818NH14 AFFLECK KATHERINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 FAMILY NURSE PRACTITIONERS 23YP21950NH01 AGARWAL JOYCE APRN ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 FAMILY NURSE PRACTITIONERS 01YP36831MA01 AGARWAL SANGITA MD MEDICAL CARE OF BOSTON MANAGEMENT CORP METHUEN MA 01844 (978) 688-1220 FAMILY MEDICINE 01YP17978MA01 AGGARWAL NIDHI MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 23YP37065NH01 AHERN KATELYN APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 01YP24683NH02 AHMED ASMA MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 INTERNAL MEDICINE 01YP33604MA01 AIME NOEL TATIANA BERNDE MD LAHEY CLINIC INC N BILLERICA MA 01862 (978) 663-6666 INTERNAL MEDICINE 01YP33604MA02 AIME NOEL TATIANA BERNDE MD LAHEY CLINIC INC WILMINGTON MA 01887 (978) 694-9610 INTERNAL MEDICINE 23YP23544NH02 AISTON TRICIA APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 883-1626 FAMILY NURSE PRACTITIONERS 0107498YPVT01 AJAMIE JOHN MD NORTHERN COUNTIES HEALTH CARE INC ST JOHNSBURY VT 05819 (802) 748-5041 FAMILY MEDICINE 23YP40069NH01 ALAIMO AMANDA APRN LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY NURSE PRACTITIONERS 23YP41548NH01 ALAIMO AMANDA APRN CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY NURSE PRACTITIONERS 01YP04771NH01 ALBUSHIES THOMAS MD CONCORD PEDIATRICS PA CONCORD NH 03301 (603) 224-1929 PEDIATRICS 01YP33084NH02 ALDRIDGE MAUDE MD LRGHEALTHCARE BELMONT NH 03220 (603) 528-0995 PEDIATRICS 01YP33084NH03 ALDRIDGE MAUDE MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 PEDIATRICS 01YP11774NH02 ALEXANDER JOHN MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 594-6337 INTERNAL MEDICINE 0107797YPMA01 ALEXANDER SIDNEY MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8461 INTERNAL MEDICINE 23YP32969VT01 ALFANO EMILY APRN NORTHERN COUNTIES HEALTH CARE INC HARDWICK VT 05843 (802) 472-3300 FAMILY NURSE PRACTITIONERS 01YP35912VT01 ALFARAZ CARLOS MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 FAMILY MEDICINE 0103258YPNH02 AL-HOJERRY KEENAN MD KEENAN ALHOJERRY MD PLLC PORTSMOUTH NH 03801 (603) 433-8488 FAMILY MEDICINE 01YP39091NH01 AL-HUMAIDHI NOOR MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-1436 FAMILY MEDICINE 01YP18812NH01 ALI PAMELA MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 314-6500 INTERNAL MEDICINE 04YP39081NH01 ALI SHEERY DO ELLIOT PHYSICIANS NETWORK WINDHAM NH 03087 (603) 894-0063 FAMILY MEDICINE 01YP19103NH01 ALLEN CHRISTOPHER MD CONCORD HOSPITAL INC EPSOM NH 03234 (603) 736-6200 FAMILY MEDICINE 01YP02334MA04 ALLMAN TRICIA MD STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 683-9177 INTERNAL MEDICINE 01YP02334MA05 ALLMAN TRICIA MD STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 683-9177 INTERNAL MEDICINE

Page 1 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP08629NH01 ALVAREZ CONSUELO MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 INTERNAL MEDICINE 01YP23530NH01 ALVAREZ HILARY MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 01YP20794NH01 ALWAN SALLY MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY MEDICINE 23YP42486NH01 AMATUCCI VANESSA APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 740-2503 FAMILY NURSE PRACTITIONERS 23YP42486NH02 AMATUCCI VANESSA APRN WENTWORTH DOUGLASS PHYSICIAN CORP SOMERSWORTH NH 03878 (603) 692-6676 FAMILY NURSE PRACTITIONERS 01YP33749NH01 AMIRTHAM DEBORAH MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 626-4392 FAMILY MEDICINE 01YP42335NH01 ANDERSON JOHN MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 PEDIATRICS 01YP42503NH01 ANDERSON DEREK MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4664 FAMILY MEDICINE 01YP42503NH02 ANDERSON DEREK MD MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 FAMILY MEDICINE 01YP42503NH03 ANDERSON DEREK MD MONADNOCK COMMUNITY HOSPITAL ANTRIM NH 03440 (603) 588-4200 FAMILY MEDICINE 01YP42503NH04 ANDERSON DEREK MD MONADNOCK COMMUNITY HOSPITAL RINDGE NH 03461 (603) 899-9563 FAMILY MEDICINE 01YP42503NH05 ANDERSON DEREK MD MONADNOCK COMMUNITY HOSPITAL JAFFREY NH 03452 (603) 532-8755 FAMILY MEDICINE 23YP39838NH01 ANDERSON KERRY APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC AMHERST NH 03031 (603) 249-8883 FAMILY NURSE PRACTITIONERS 23YP30920MA01 ANDERSON STACEY APRN LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 FAMILY NURSE PRACTITIONERS 23YP36579NH01 ANDERSON SUZANNE APRN HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7475 FAMILY NURSE PRACTITIONERS 23YP36579NH02 ANDERSON SUZANNE APRN HUGGINS HOSPITAL ALTON NH 03809 (603) 875-6151 FAMILY NURSE PRACTITIONERS 23YP36579NH03 ANDERSON SUZANNE APRN HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7500 FAMILY NURSE PRACTITIONERS 23YP36579NH04 ANDERSON SUZANNE APRN HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7588 FAMILY NURSE PRACTITIONERS 23YP36579NH05 ANDERSON SUZANNE APRN HUGGINS HOSPITAL MOULTONBOROUGH NH 03254 (603) 476-2216 FAMILY NURSE PRACTITIONERS 23YP36579NH06 ANDERSON SUZANNE APRN HUGGINS HOSPITAL OSSIPEE NH 03864 (603) 539-6996 FAMILY NURSE PRACTITIONERS 23YP36579NH07 ANDERSON SUZANNE APRN HUGGINS HOSPITAL TAMWORTH NH 03886 (603) 323-3311 FAMILY NURSE PRACTITIONERS 01YP02932NH02 ANDRECYK GREGORY MD WENTWORTH DOUGLASS PHYSICIAN CORP SOMERSWORTH NH 03878 (603) 692-6676 FAMILY MEDICINE 01YP02932NH15 ANDRECYK GREGORY MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY MEDICINE 04YP41473NH01 ANDROLIA ADAM DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 04YP41473NH02 ANDROLIA ADAM DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 04YP41473NH03 ANDROLIA ADAM DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 04YP41473NH04 ANDROLIA ADAM DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 04YP41473NH05 ANDROLIA ADAM DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP18588VT01 ANDRUS BRUCE MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 INTERNAL MEDICINE 01YP18588VT02 ANDRUS BRUCE MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7100 INTERNAL MEDICINE 04YP41979NH01 ANIBAL BRITTANY DO SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-3700 PEDIATRICS 04YP08442NH01 ANTINERELLA NICOLE DO CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 INTERNAL MEDICINE 04YP08442NH02 ANTINERELLA NICOLE DO CONCORD HOSPITAL INC CONCORD NH 03301 (603) 227-7000 INTERNAL MEDICINE 01YP29314MA01 APONTE-RIVERA MAYSABEL MD MEDICAL CARE OF BOSTON MANAGEMENT CORP HAVERHILL MA 01830 (978) 521-2106 INTERNAL MEDICINE 04YP26591MA01 ARENA DIANA DO LAHEY CLINIC INC WILMINGTON MA 01887 (978) 694-9610 INTERNAL MEDICINE 04YP26591MA02 ARENA DIANA DO LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-3839 INTERNAL MEDICINE 23YP32736NH01 ARMSTRONG BEVERLY APRN VALLEY REGIONAL HOSPITAL NEWPORT NH 03773 (603) 542-7855 FAMILY NURSE PRACTITIONERS 01YP20629VT01 ARNOLD EWA MD CARLOS G OTIS HEALTHCARE CTR TOWNSHEND VT 05353 (802) 365-4331 FAMILY MEDICINE 0400503YPNH01 ARONSON MARK DO LRGHEALTHCARE LACONIA NH 03246 (603) 527-2969 FAMILY MEDICINE 0105373YPNH01 ARSENAULT DIANE MD MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY MEDICINE 23YP38806NH01 ARSENEAULT STEPHANIE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 FAMILY NURSE PRACTITIONERS 23YP38806NH02 ARSENEAULT STEPHANIE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY NURSE PRACTITIONERS 23YP38806NH03 ARSENEAULT STEPHANIE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY NURSE PRACTITIONERS 01YP38747NH01 ARSNOW CHRISTINE MD CONCORD PEDIATRICS PA CONCORD NH 03301 (603) 224-1929 PEDIATRICS 04YP38038MA01 ASCH ALEXANDER DO MEDICAL CARE OF BOSTON MANAGEMENT CORP AMESBURY MA 01913 (978) 388-1400 FAMILY MEDICINE 01YP14852NH01 ASHRAF SADAF MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 INTERNAL MEDICINE

Page 2 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 0103843YPNH02 ASTOLFI THOMAS MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 FAMILY MEDICINE 01YP24548NH01 ATHAR MASOOMA MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 GERIATRIC MEDICINE 01YP29173NH01 ATKINSON LISA MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-6108 FAMILY MEDICINE 23YP37765NH01 ATTIAS JONATHAN APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-3388 FAMILY NURSE PRACTITIONERS 04YP04767NH04 AVERY JOHN DO WEEKS MEDICAL CENTER N STRATFORD NH 03590 (603) 922-5039 FAMILY MEDICINE 01YP25168NH01 AVRAMOV VLADIMIR MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 595-0063 INTERNAL MEDICINE 01YP40579NH01 AWEH NELSON MD VANTAGE HEALTHCARE LLC PELHAM NH 03076 (781) 867-2050 INTERNAL MEDICINE 01YP41710NH01 AWEH NELSON MD GPS PHYSICIAN GROUP PC DOVER NH 03820 (603) 743-4110 INTERNAL MEDICINE 01YP39201NH01 AYER CHADANI MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-5315 INTERNAL MEDICINE 23YP40763NH01 AYERS ROANNA APRN ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 442-5630 FAMILY NURSE PRACTITIONERS 01YP36631NH01 AZKUL BASSEM MD NEW ERA MEDICINE PLLC MANCHESTER NH 03102 (603) 622-8665 FAMILY MEDICINE 01YP24953MA01 BABAYAN EMMA MD EAGLE MEDICINE ASSOCIATES LAWRENCE MA 01841 (978) 725-5913 INTERNAL MEDICINE 01YP15354NH01 BACHELDER SHEILLA MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 FAMILY MEDICINE 23YP33873NH01 BACON MARY APRN PEMBROKE WELLNESS CENTER PLLC PEMBROKE NH 03275 (603) 485-7788 FAMILY NURSE PRACTITIONERS 01YP08029NH02 BADAU IOAN MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 INTERNAL MEDICINE 01YP03113NH02 BADGER M MD THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY MEDICINE 04YP41902NH01 BADGER JENNIFER DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 04YP41902NH02 BADGER JENNIFER DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 04YP41902NH03 BADGER JENNIFER DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 04YP41902NH04 BADGER JENNIFER DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 04YP41902NH05 BADGER JENNIFER DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP33375NH02 BADMAN DENNIS MD WAKEFIELD FAMILY MEDICINE LLC SANBORNVILLE NH 03872 (603) 871-8227 FAMILY MEDICINE 01YP37301NH01 BALI GURVINDER MD LRGHEALTHCARE LACONIA NH 03246 (603) 527-2792 INTERNAL MEDICINE 23YP10034ME03 BALL JEAN APRN FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 ADULT NURSE PRACTITIONERS 23YP10034ME04 BALL JEAN APRN APPLEDORE MEDICAL GROUP INC FARMINGTON NH 03835 (603) 755-9801 ADULT NURSE PRACTITIONERS 23YP10034ME05 BALL JEAN APRN APPLEDORE MEDICAL GROUP INC SANBORNVILLE NH 03872 (603) 522-0186 ADULT NURSE PRACTITIONERS 01YP39679NH01 BALLARD JONATHAN MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 23YP33962NH01 BALLENTINE STEPHANIE APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 595-0063 FAMILY NURSE PRACTITIONERS 01YP32815NH01 BANNERMAN ELANA MD FOUNDATION MEDICAL PARTNERS INC HUDSON NH 03051 (603) 886-3979 FAMILY MEDICINE 01YP03530NH02 BANNISTER JAY MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 01YP33215NH01 BARBARITA CAITLIN MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-7101 PEDIATRICS 01YP20500VT01 BARBEAU DELORES MD SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 885-1166 FAMILY MEDICINE 01YP27338VT01 BARBER LAURA MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY MEDICINE 23YP39732VT01 BARIBAULT HEATHER APRN PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 PEDIATRIC NURSE PRACTITIONERS 23YP16414MA02 BARKAN SHERYL NP STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 683-9177 ADULT NURSE PRACTITIONERS 0104845YPNH03 BARKSDALE JOHN MD CONCORD HOSPITAL INC EPSOM NH 03234 (603) 736-6200 FAMILY MEDICINE 01YP12536NH02 BARLEY PETER MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 FAMILY MEDICINE 04YP33511NH01 BARLOW JAMES DO APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY MEDICINE 04YP33511NH02 BARLOW JAMES DO APPLEDORE MEDICAL GROUP INC DURHAM NH 03824 (603) 431-2516 FAMILY MEDICINE 04YP20243NH01 BARLOW BARRY ANNE DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 04YP20243NH02 BARLOW BARRY ANNE DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 04YP20243NH03 BARLOW BARRY ANNE DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 04YP20243NH04 BARLOW BARRY ANNE DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 04YP20243NH05 BARLOW BARRY ANNE DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP28297NH01 BARNES ROY MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-1251 FAMILY MEDICINE 01YP28297NH02 BARNES ROY MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-7771 FAMILY MEDICINE

Page 3 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP18312MA01 BARNETT KAREN MD CHILD HEALTH CENTER INC METHUEN MA 01844 (978) 685-0977 PEDIATRICS 01YP30327NH02 BARON KYLE MD LRGHEALTHCARE MEREDITH NH 03253 (603) 279-7433 FAMILY MEDICINE 04YP33359NH01 BARRETT JULIANN DO VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-6700 FAMILY MEDICINE 04YP33359NH03 BARRETT JULIANN DO VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-6900 FAMILY MEDICINE 04YP33359NH04 BARRETT JULIANN DO VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-1251 FAMILY MEDICINE 01YP37000NH01 BARTLETT MACKENZIE MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-5860 PEDIATRICS 0104188YPNH02 BARTOLINI J MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 INTERNAL MEDICINE 23YP32361VT01 BARTON SUSAN APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 886-8900 FAMILY NURSE PRACTITIONERS 23YP32361VT02 BARTON SUSAN APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC LUDLOW VT 05149 (802) 228-8867 FAMILY NURSE PRACTITIONERS 23YP32361VT03 BARTON SUSAN APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 FAMILY NURSE PRACTITIONERS 01YP23336NH01 BATES BARBARA MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 23YP28658NH01 BAUM WILLIAM APRN LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY NURSE PRACTITIONERS 23YP32429NH01 BAXTER-ROGERS CYMANDE APRN WHITE MOUNTAIN COMMUNITY HEALTH CENTER CONWAY NH 03818 (603) 447-8900 FAMILY NURSE PRACTITIONERS 0101181YPNH02 BAYER SUSAN MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 286-3331 FAMILY MEDICINE 0100858YPNH04 BEAHM PAMELA MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 889-6671 PEDIATRICS 0100858YPNH05 BEAHM PAMELA MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 PEDIATRICS 0100858YPNH06 BEAHM PAMELA MD ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3870 PEDIATRICS 0100858YPNH07 BEAHM PAMELA MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 882-3000 PEDIATRICS 0100858YPNH08 BEAHM PAMELA MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 PEDIATRICS 0109720YPNH02 BEALS BRIAN MD COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 PEDIATRICS 01YP36383NH01 BEAMS MARJORIE MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE 01YP36383NH02 BEAMS MARJORIE MD GREATER SEACOAST COMMUNITY HEALTH ROCHESTER NH 03867 (603) 516-9300 FAMILY MEDICINE 01YP36383NH03 BEAMS MARJORIE MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 23YP32082ME01 BEARDSLEY JANET APRN BRIDGTON HOSPITAL NAPLES ME 04055 (207) 693-6106 ADULT NURSE PRACTITIONERS 01YP05494MA02 BEAUDOIN STEPHEN MD PARTNERS COMMUNITY PHYS ORGANIZATION INC NEWBURYPORT MA 01950 (978) 499-7200 INTERNAL MEDICINE 23YP26665VT01 BEAUDRY MELISSA APRN NORTHERN COUNTIES HEALTH CARE INC DANVILLE VT 05828 (802) 684-2275 FAMILY NURSE PRACTITIONERS 23YP30563NH01 BEAUDRY ROBERT APRN FOUNDATION MEDICAL PARTNERS INC HUDSON NH 03051 (603) 886-3979 FAMILY NURSE PRACTITIONERS 01YP40186NH01 BEAUFAIT DAVID MD FAMILY HEALTH CENTER LEBANON NH 03766 (603) 448-1941 FAMILY MEDICINE 23YP21766NH01 BEAULIEU LISA APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 GERIATRIC NURSE PRACTITIONERS 23YP02559NH01 BEAULIEU EMILY APRN SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-2555 FAMILY NURSE PRACTITIONERS 23YP31011NH01 BEAUPRE AMY APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY NURSE PRACTITIONERS 01YP41685NH01 BECKER DANIEL MD APPLEDORE MEDICAL GROUP INC FARMINGTON NH 03835 (603) 755-9801 FAMILY MEDICINE 01YP42513NH01 BECKER DANIEL MD PMC MEDICAL GROUP LLC NEWINGTON NH 03801 (603) 436-9100 FAMILY MEDICINE 01YP42513NH02 BECKER DANIEL MD PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY MEDICINE 23YP18413NH01 BEDELL GINA APRN WEEKS MEDICAL CENTER LANCASTER NH 03584 (603) 788-2521 FAMILY NURSE PRACTITIONERS 23YP18413NH02 BEDELL GINA APRN WEEKS MEDICAL CENTER N STRATFORD NH 03590 (603) 922-5039 FAMILY NURSE PRACTITIONERS 23YP18413NH03 BEDELL GINA APRN WEEKS MEDICAL CENTER COLEBROOK NH 03576 (603) 237-4971 FAMILY NURSE PRACTITIONERS 01YP03296VT02 BEEHLER II CECIL MD SPRINGFIELD MEDICAL CARE SYSTEMS INC LUDLOW VT 05149 (802) 228-8867 FAMILY MEDICINE 01YP03296VT02 BEEHLER II CECIL MD SPRINGFIELD MEDICAL CARE SYSTEMS INC LUDLOW VT 05149 (802) 228-8867 FAMILY MEDICINE 01YP03296VT03 BEEHLER II CECIL MD SPRINGFIELD MEDICAL CARE SYSTEMS INC LUDLOW VT 05149 (802) 228-8867 FAMILY MEDICINE 01YP03296VT03 BEEHLER II CECIL MD SPRINGFIELD MEDICAL CARE SYSTEMS INC LUDLOW VT 05149 (802) 228-8867 FAMILY MEDICINE 23YP37322NH01 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC LEBANON NH 03766 (802) 478-0597 FAMILY NURSE PRACTITIONERS 23YP37322NH02 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC CANAAN NH 03741 (802) 478-0597 FAMILY NURSE PRACTITIONERS 23YP37322NH03 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC HANOVER NH 03755 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP37322NH04 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC CLAREMONT NH 03743 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP37322NH05 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC HANOVER NH 03755 (866) 679-0831 FAMILY NURSE PRACTITIONERS

Page 4 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP37322NH06 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC JAFFREY NH 03452 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP37322NH07 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC KEENE NH 03431 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP37322NH08 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC MANCHESTER NH 03101 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP37322NH09 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC MANCHESTER NH 03101 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP37322NH10 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC NORTH CONWAY NH 03860 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP37322NH11 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC NEW IPSWICH NH 03071 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP37322NH12 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC NEW LONDON NH 03257 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP37322NH13 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC NEWPORT NH 03773 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP37322NH14 BEGGS VIRGINIA APRN BETTER LIFE PARTNERS INC MANCHESTER NH 03103 (866) 679-0831 FAMILY NURSE PRACTITIONERS 0100076YPNH01 BELSON ROGER MD ROGER BELSON MD HENNIKER NH 03242 (603) 428-3262 INTERNAL MEDICINE 01YP15477VT01 BENDER MARY MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7337 PEDIATRICS 01YP15477VT02 BENDER MARY MD WINDSOR HOSPITAL CORP WOODSTOCK VT 05091 (802) 457-3030 PEDIATRICS 01YP41308NH01 BENHORMA REDA MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 23YP30919NH01 BENNETT MAEVE APRN MONADNOCK COMMUNITY HOSPITAL JAFFREY NH 03452 (603) 532-8775 FAMILY NURSE PRACTITIONERS 23YP30919NH02 BENNETT MAEVE APRN MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 FAMILY NURSE PRACTITIONERS 23YP30919NH03 BENNETT MAEVE APRN MONADNOCK COMMUNITY HOSPITAL RINDGE NH 03461 (603) 899-9563 FAMILY NURSE PRACTITIONERS 01YP31029NH01 BENNETT LYDIA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP31029NH02 BENNETT LYDIA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP31029NH03 BENNETT LYDIA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP31029NH04 BENNETT LYDIA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP31029NH05 BENNETT LYDIA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE PEDIATRIC ASSOCIATES OF HAMPTON & 04YP16822NH01 BENTON LISA DO PORTSMOUTH NH 03801 (603) 436-7171 PEDIATRICS PEDIATRICPORTSMOUTH ASSOCIATES PC OF HAMPTON & 04YP16822NH02 BENTON LISA DO HAMPTON NH 03842 (603) 929-3838 PEDIATRICS PORTSMOUTH PC 23YP41932NH01 BENTON LINDSAY APRN DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRIC NURSE PRACTITIONERS 01YP42030NH01 BENTWOOD JENNIFER MD MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY MEDICINE 01YP42030NH02 BENTWOOD JENNIFER MD MID-STATE HEALTH CENTER BRISTOL NH 03222 (603) 744-6200 FAMILY MEDICINE 01YP00322MA01 BERARDUCCI MICHAEL MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 23YP30564NH01 BERGER JANET APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-3300 FAMILY NURSE PRACTITIONERS 01YP12222NH01 BERGERON-KILLOUGH KATRIN MD LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY MEDICINE 01YP12222NH02 BERGERON-KILLOUGH KATRIN MD LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY MEDICINE 01YP12222NH03 BERGERON-KILLOUGH KATRIN MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY MEDICINE 23YP38200NH01 BERINGER SUSAN APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 01YP31578MA01 BERKOWITZ JOSHUA MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 0108570YPNH01 BERMAN MARK MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-7338 FAMILY MEDICINE 04YP18270NH01 BERNARD ELLEN DO CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY MEDICINE 04YP18270NH02 BERNARD ELLEN DO CORE PHYSICIANS LLC EPPING NH 03042 (603) 679-5114 FAMILY MEDICINE 01YP02812VT01 BERRIAN SARAH MD NORTHERN COUNTIES HEALTH CARE INC CONCORD VT 05824 (802) 695-2512 FAMILY MEDICINE 0106012YPMA01 BERRY KEVIN MD KEVIN BERRY MD METHUEN MA 01844 (978) 794-0234 CARDIOVASCULAR DISEASE 0102897YPNH06 BERRY PAUL MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE 04YP20896NH01 BERRY ANDREA DO MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY MEDICINE 04YP20896NH02 BERRY ANDREA DO MID-STATE HEALTH CENTER BRISTOL NH 03222 (603) 744-6200 FAMILY MEDICINE 04YP20481NH01 BERUBE JAYNE DO WEEKS MEDICAL CENTER WHITEFIELD NH 03598 (603) 837-9005 PEDIATRICS 04YP20481NH02 BERUBE JAYNE DO WEEKS MEDICAL CENTER WHITEFIELD ME 03598 (603) 922-5039 PEDIATRICS 23YP40825NH01 BETANCES CHRISTINA APRN MW WELLNESS VENTURES I LLC LONDONDERRY NH 03053 (603) 782-9081 ADULT NURSE PRACTITIONERS 01YP25193NH02 BETANCUR RESTREPO ILDA MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4400 INTERNAL MEDICINE 01YP25193NH03 BETANCUR RESTREPO ILDA MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 921-6022 INTERNAL MEDICINE

Page 5 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP30689NH01 BETCHART CRAIG MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 FAMILY MEDICINE 01YP30689NH02 BETCHART CRAIG MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY MEDICINE 01YP35785NH01 BHULABHAI BHAVIK MD WENTWORTH DOUGLASS PHYSICIAN CORP BARRINGTON NH 03825 (603) 664-2135 FAMILY MEDICINE 01YP35785NH02 BHULABHAI BHAVIK MD WENTWORTH DOUGLASS PHYSICIAN CORP NEWMARKET NH 03857 (603) 659-0901 FAMILY MEDICINE 01YP35785NH03 BHULABHAI BHAVIK MD WENTWORTH DOUGLASS PHYSICIAN CORP SOMERSWORTH NH 03878 (603) 692-6676 FAMILY MEDICINE 01YP35785NH04 BHULABHAI BHAVIK MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY MEDICINE 01YP35785NH05 BHULABHAI BHAVIK MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY MEDICINE 04YP36170NH01 BICKFORD ANDREA DO ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 626-8652 FAMILY MEDICINE 01YP30817NH01 BILAL SALVA MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 FAMILY MEDICINE 01YP40558NH01 BILAL HARIS MD VANTAGE HEALTHCARE LLC PELHAM NH 03076 (781) 867-2050 INTERNAL MEDICINE 01YP41254NH01 BILAL HARIS MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 01YP00332MA01 BILODEAU THOMAS MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 0105963YPNH01 BINCZEWSKI BRIAN MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 INTERNAL MEDICINE 01YP41690NH01 BISHOP STEPHEN MD CONCORD HOSPITAL INC HOPKINTON NH 03229 (603) 228-7575 FAMILY MEDICINE 01YP27359VT01 BISSON LINDA MD NORTHERN COUNTIES HEALTH CARE INC DANVILLE VT 05828 (802) 698-2275 FAMILY MEDICINE 23YP03149NH03 BIXBY DEBRA APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-5131 FAMILY NURSE PRACTITIONERS 23YP36372NH01 BLACK GORDON APRN COTTAGE HOSPITAL WOODSVILLE NH 03785 (603) 747-2900 FAMILY NURSE PRACTITIONERS 01YP14899MA02 BLACK CHERYLYN MD LAHEY PHYSICIAN COMMUNITY ORGANIZATION I INC LYNNFIELD MA 01940 (781) 213-4040 FAMILY MEDICINE 0107944YPNH01 BLACKWOOD MARK MD WENTWORTH DOUGLASS PHYSICIAN CORP DURHAM NH 03824 (603) 868-5080 FAMILY MEDICINE 0107944YPNH04 BLACKWOOD MARK MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY MEDICINE 23YP41310NH01 BLAISDELL SAMANTHA APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 23YP41198NH01 BLANCHARD KRISTEN APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 ADULT NURSE PRACTITIONERS 23YP41198NH02 BLANCHARD KRISTEN APRN GPS PHYSICIAN GROUP PC NORTH CONWAY NH 03860 (859) 291-4800 ADULT NURSE PRACTITIONERS 23YP39484NH01 BLANCHETTE EMILY APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 FAMILY NURSE PRACTITIONERS 04YP41436NH01 BLATT NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8079 FAMILY MEDICINE 04YP41436NH02 BLATT NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8051 FAMILY MEDICINE 04YP41436NH03 BLATT NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP SOMERSWORTH NH 03878 (603) 692-6676 FAMILY MEDICINE 04YP41436NH04 BLATT NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP SOMERSWORTH NH 03878 (603) 692-6676 FAMILY MEDICINE 04YP41436NH05 BLATT NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP SOMERSWORTH NH 03878 (603) 682-6676 FAMILY MEDICINE 04YP41436NH06 BLATT NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8079 FAMILY MEDICINE 01YP02650VT02 BLOFSON TONY MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 254-1311 FAMILY MEDICINE 01YP07105MA02 BLOOM STEVEN MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3230 PEDIATRICS 0106057YPNH03 BLOOMER JAMES MD YOUR MEDICAL HOME LLC EXETER NH 03833 (603) 418-6310 FAMILY MEDICINE 2308769YPNH02 BLOOMER KATHLEEN APRN YOUR MEDICAL HOME LLC EXETER NH 03833 (603) 418-6310 PEDIATRIC NURSE PRACTITIONERS 23YP26915NH01 BLOWEN JOHN MARK APRN KEENAN ALHOJERRY MD PLLC PORTSMOUTH NH 03801 (603) 433-8488 FAMILY NURSE PRACTITIONERS 01YP23352VT01 BLUMBERG JILL MD WHITE RIVER FAMILY PRACTICE PC WHITE RIVER JUNCTION VT 05001 (802) 295-6132 FAMILY MEDICINE 23YP02847NH03 BOARDMAN MAUREEN APRN LITTLE RIVERS HEALTH CARE INC BRADFORD VT 05033 (802) 222-9317 FAMILY NURSE PRACTITIONERS 01YP22983MA01 BOCHMAN MARISA MD LAHEY CLINIC INC SOUTH HAMILTON MA 01982 (978) 468-7346 FAMILY MEDICINE 01YP22983MA02 BOCHMAN MARISA MD LAHEY CLINIC INC IPSWICH MA 01938 (978) 356-5522 FAMILY MEDICINE 01YP40099NH01 BOHEEN ERICA MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 PEDIATRICS 01YP18677VT02 BOLON CLAIRE MD UPPER VALLEY PEDIATRICS PLLC BRADFORD VT 05033 (802) 222-4722 PEDIATRICS 01YP19030NH01 BONAFEDE KATHRYN MD LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY MEDICINE 01YP19030NH02 BONAFEDE KATHRYN MD LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY MEDICINE 23YP21301NH01 BONIAS CRYSTAL APRN GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY NURSE PRACTITIONERS 23YP21301NH02 BONIAS CRYSTAL APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 01YP31122MA01 BOORA SOWMYA MD COMMUNITY MEDICAL ASSOCIATES INC LAWRENCE MA 01841 (978) 946-8550 INTERNAL MEDICINE

Page 6 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 0406037YPVT01 BORIE KENNETH DO GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY MEDICINE 01YP05148MA01 BOTTNER TAMMY MD RIVERSIDE PEDIATRICS NEWBURYPORT MA 01950 (978) 465-0322 PEDIATRICS 01YP36543NH01 BOUCHER MARCY MD CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8060 FAMILY MEDICINE 01YP07176MA02 BOULANGER PAULA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (888) 227-3762 PEDIATRICS 23YP30278NH01 BOURQUE MELISSA APRN HUGGINS HOSPITAL MOULTONBORO NH 03254 (603) 476-2216 ADULT NURSE PRACTITIONERS 01YP00342MA01 BOUTHOT BETH MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP00342MA02 BOUTHOT BETH MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 23YP36264NH01 BOUTSELIS HANNAH APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 623-3343 FAMILY NURSE PRACTITIONERS 0107559YPNH02 BOWER GEORGE MD GEORGE J BOWER MD MILFORD NH 03055 (603) 673-8480 INTERNAL MEDICINE 01YP41333VT01 BOWERS AMANDA MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8626 PEDIATRICS 01YP18361NH03 BOYADZHIEV IVAN MD DARTMOUTH HITCHCOCK CLINIC MILFORD NH 03055 (603) 673-2515 FAMILY MEDICINE 04YP27779NH01 BOYLAN MARIA DO ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 FAMILY MEDICINE 23YP40716NH01 BOYLE JANIE APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY NURSE PRACTITIONERS 01YP05202NH01 BRACKETT CHARLES MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 01YP15843ME01 BRADEN TREVOR MD YORK HOSPITAL KITTERY ME 03904 (207) 439-4430 FAMILY MEDICINE 23YP28300VT01 BRADO DOREEN APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 FAMILY NURSE PRACTITIONERS 04YP31329NH01 BRAESE NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY MEDICINE 04YP31329NH02 BRAESE NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8051 FAMILY MEDICINE 04YP31329NH03 BRAESE NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3664 FAMILY MEDICINE 04YP31329NH04 BRAESE NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2268 FAMILY MEDICINE 04YP31329NH05 BRAESE NANCY DO WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8051 FAMILY MEDICINE 04YP41574NH01 BRAESE NANCY DO GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 04YP41574NH02 BRAESE NANCY DO GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 953-0066 FAMILY MEDICINE 01YP08419NH01 BRAGA CHRISTOPHER MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY MEDICINE 01YP02114MA01 BRAIMON JENNIFER MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 23YP37515ME01 BRAND ANNA APRN YORK HOSPITAL SANFORD ME 04073 (207) 608-8425 FAMILY NURSE PRACTITIONERS 23YP37515ME02 BRAND ANNA APRN YORK HOSPITAL WELLS ME 04090 (207) 646-5211 FAMILY NURSE PRACTITIONERS 23YP42403VT01 BRASWELL BRENT APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 FAMILY NURSE PRACTITIONERS 01YP31363NH01 BRAUN MARY MD LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 INTERNAL MEDICINE 01YP05464ME03 BREAULT TERESA MD NORTH BERWICK FAMILY MEDICINE NORTH BERWICK ME 03906 (207) 676-8559 FAMILY MEDICINE 01YP07617NH01 BREHIO TERI MD CONCORD HOSPITAL INC HILLSBORO NH 03244 (603) 464-3434 FAMILY MEDICINE 0404854YPME01 BRENNAN STEPHEN DO STEPHEN R BRENNAN DO PA YORK ME 03909 (207) 363-5437 PEDIATRICS 01YP08755MA02 BRENNAN BEVERLY MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (888) 227-3762 INTERNAL MEDICINE 01YP08755MA03 BRENNAN BEVERLY MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 469-7100 INTERNAL MEDICINE 01YP34791NH01 BRENNAN ALISON MD UNIVERSITY SYSTEM OF NEW HAMPSHIRE DURHAM NH 03824 (603) 862-9355 INTERNAL MEDICINE 23YP40797NH01 BRENT NICOLE APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-9661 ADULT NURSE PRACTITIONERS 01YP36496NH01 BRESS JAMES MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 INTERNAL MEDICINE 01YP00345MA01 BREW ROBERT MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 2309043YPVT02 BRISTOL MARLENE APRN LITTLE RIVERS HEALTH CARE INC WELLS RIVER VT 05081 (802) 757-2325 FAMILY NURSE PRACTITIONERS 23YP23011NH01 BROCKELMAN LAURIE APRN MONADNOCK COMMUNITY HOSPITAL JAFFREY NH 03452 (603) 532-8775 GERIATRIC NURSE PRACTITIONERS 23YP23011NH02 BROCKELMAN LAURIE APRN MONADNOCK COMMUNITY HOSPITAL ANTRIM NH 03440 (603) 588-4200 GERIATRIC NURSE PRACTITIONERS 23YP23011NH03 BROCKELMAN LAURIE APRN MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 GERIATRIC NURSE PRACTITIONERS 23YP23011NH04 BROCKELMAN LAURIE APRN MONADNOCK COMMUNITY HOSPITAL RINDGE NH 03461 (603) 899-9563 GERIATRIC NURSE PRACTITIONERS 0406746YPVT02 BRODERICK THOMAS DO NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 FAMILY MEDICINE 0106364YPVT03 BRODY DAVID MD DAVID BRODY MD ST JOHNSBURY VT 05819 (802) 748-2123 INTERNAL MEDICINE 04YP32837ME01 BROKUS KATHRYN DO YORK HOSPITAL KITTERY ME 03904 (207) 439-4430 FAMILY MEDICINE

Page 7 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 0105551YPNH01 BRONSTEIN ERIC MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 FAMILY MEDICINE 01YP05313ME01 BROOKS ANN MD WATERBORO VILLAGE PEDIATRICS LLC PA EAST WATERBORO ME 04030 (207) 247-6742 PEDIATRICS 01YP05313ME02 BROOKS ANN MD WATERBORO VILLAGE PEDIATRICS LLC PA BIDDEFORD ME 04005 (207) 294-8700 PEDIATRICS 23YP23858NH01 BROOKS TRISHA APRN CONCORD HOSPITAL INC PENACOOK NH 03303 (603) 753-4302 FAMILY NURSE PRACTITIONERS 0104899YPNH01 BROOKS JR THEODORE MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0104899YPNH02 BROOKS JR THEODORE MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 0104899YPNH03 BROOKS JR THEODORE MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 0104899YPNH05 BROOKS JR THEODORE MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 0104899YPNH06 BROOKS JR THEODORE MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP27459NH01 BROWN ANNIKA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY MEDICINE 23YP12147VT02 BROWN PATRICIA APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC LUDLOW VT 05149 (802) 228-8867 FAMILY NURSE PRACTITIONERS 23YP12147VT05 BROWN PATRICIA APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC LUDLOW VT 05149 (802) 228-8867 FAMILY NURSE PRACTITIONERS 23YP39987NH01 BROWN GRACE APRN LITTLETON HOSPITAL ASSOCIATION LITTLETON NH 03561 (603) 444-4070 FAMILY NURSE PRACTITIONERS 01YP03151MA01 BROWNE SUSAN MD CHILD HEALTH CENTER INC METHUEN MA 01844 (978) 685-0977 PEDIATRICS 23YP38378NH01 BROWN-PERRY WENDY APRN CONCORD PEDIATRICS PA CONCORD NH 03301 (603) 224-1929 PEDIATRIC NURSE PRACTITIONERS 23YP42009NH01 BRUCHAS EMILY APRN CENTR FOR FUNCT MEDICINE AND WELLBEING LLC PORTSMOUTH NH 03801 (603) 380-9159 ADULT NURSE PRACTITIONERS 23YP08326VT01 BRUMSON APRIL APRN SOJOURNS COMMUNITY HEALTH CLINIC WESTMINSTER VT 05158 (802) 722-4023 ADULT NURSE PRACTITIONERS 0102481YPNH01 BRUNDAGE BARBARA MD DERRY PEDIATRICS PRACTICE PA DERRY NH 03038 (603) 434-0327 PEDIATRICS 01YP41961NH01 BRUNELLE KERMIT MD INDIAN STREAM HEALTH CENTER INC COLEBROOK NH 03576 (603) 237-8336 PEDIATRICS 23YP26860ME01 BRUNNER ALLISA APRN YORK HOSPITAL YORK ME 03909 (207) 698-6700 FAMILY NURSE PRACTITIONERS 23YP40097NH01 BRUNO TIANA APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC PETERBOROUGH NH 03458 (603) 924-7267 FAMILY NURSE PRACTITIONERS 23YP41647NH01 BRUNO TIANA APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 0106696YPNH01 BUCHANAN JOHN MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 888-5573 FAMILY MEDICINE 01YP41938NH01 BUCHANAN JOHN MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY MEDICINE 0103934YPNH02 BUCHANAN ELIZABETH MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-1436 FAMILY MEDICINE 0103934YPNH03 BUCHANAN ELIZABETH MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 775-0000 FAMILY MEDICINE 01YP03809MA01 BUCHER ERIC MD CHILDRENS HEALTHCARE HAVERHILL MA 01830 (978) 373-6557 PEDIATRICS 01YP03809MA02 BUCHER ERIC MD CHILDRENS HEALTHCARE NEWBURYPORT MA 01950 (978) 465-7121 PEDIATRICS 23YP39146NH01 BUCHHOLZ KATELYN APRN PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY NURSE PRACTITIONERS 23YP28213NH01 BUCKLEY HOLLY APRN DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-6108 FAMILY NURSE PRACTITIONERS 01YP27189NH01 BUDDENSEE MELISSA MD AMMONOOSUC COMMUNITY HEALTH SERVICES INC FRANCONIA NH 03580 (603) 823-7078 FAMILY MEDICINE 23YP28114NH01 BUJNO LISA APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC LITTLETON NH 03561 (603) 444-2464 FAMILY NURSE PRACTITIONERS 01YP30575NH01 BULAUITAN MANUEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP30575NH02 BULAUITAN MANUEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP30575NH03 BULAUITAN MANUEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP30575NH04 BULAUITAN MANUEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP30575NH05 BULAUITAN MANUEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 23YP42268NH01 BUNNELL KATIE APRN APPLEDORE MEDICAL GROUP INC SANBORNVILLE NH 03872 (603) 522-0186 FAMILY NURSE PRACTITIONERS 01YP30185NH01 BUONO DAVID MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY MEDICINE 01YP24538NH01 BUONOMANO JOANN MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE 01YP24538NH02 BUONOMANO JOANN MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 23YP39553VT01 BURCH SUMMER APRN CARLOS G OTIS HEALTHCARE CTR TOWNSHEND VT 05353 (802) 365-7357 FAMILY NURSE PRACTITIONERS 01YP36407NH01 BURDICK KRISTIN MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY MEDICINE 01YP28335NH01 BURDICK JULIA MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 INTERNAL MEDICINE 01YP33980VT02 BURGESS KATHLEEN MD PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 FAMILY MEDICINE 04YP13918ME01 BURKE RACHEL DO YORK HOSPITAL SOUTH BERWICK ME 03908 (207) 384-9212 FAMILY MEDICINE

Page 8 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP24526NH01 BURKE CARLY APRN FOUNDATION MEDICAL PARTNERS INC HUDSON NH 03051 (603) 886-3979 ADULT NURSE PRACTITIONERS 23YP20672VT01 BURNELL KATHRYN APRN NORTHERN COUNTIES HEALTH CARE INC DANVILLE VT 05828 (802) 684-2275 FAMILY NURSE PRACTITIONERS 23YP36370NH01 BURNETT ANGELA APRN ST JOSEPH HOSPITAL HUDSON NH 03051 (603) 882-6700 FAMILY NURSE PRACTITIONERS 01YP36401NH01 BUSTAMANTE CHRISTOPHER MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY MEDICINE 01YP29969NH01 BYERS WILLIAM MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 PEDIATRICS 01YP41568NH01 BYRNE THOMAS MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE 01YP34099MA01 CABRERA MIGUEL MD LAWRENCE HEALTH SOLUTIONS LAWRENCE MA 01841 (978) 258-1057 INTERNAL MEDICINE 23YP13595NH02 CADEGAN-PAQUETTE LEAH APRN ELLIOT PHYSICIANS NETWORK ALLENSTOWN NH 03275 (603) 485-7861 FAMILY NURSE PRACTITIONERS 01YP13817NH01 CALCAGNI JOHNSON KRISTEN MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-8900 PEDIATRICS 04YP02752NH03 CALEGARI JEFFREY DO CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 314-4700 INTERNAL MEDICINE 01YP03154NH01 CALHOUN CHRISTOPHER MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 314-6500 FAMILY MEDICINE 01YP41955NH01 CALHOUN CHRISTOPHER MD CATHOLIC MEDICAL CENTER GOFFSTOWN NH 03045 (603) 314-4500 FAMILY MEDICINE 0106485YPNH02 CALORAS DANIEL MD SPRINGFIELD MEDICAL CARE SYSTEMS INC CHARLESTOWN NH 03603 (603) 826-5711 FAMILY MEDICINE 0400619YPNH01 CAMMILLERI JR THOMAS DO GREATER HAMPSTEAD FAMILY MEDICINE PC HAMPSTEAD NH 03841 (603) 329-5222 FAMILY MEDICINE 01YP00351MA01 CAMPAGNA ANTHONY MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8481 INTERNAL MEDICINE 01YP00351MA02 CAMPAGNA ANTHONY MD LAHEY CLINIC INC WINCHESTER MA 01890 (781) 744-8000 INTERNAL MEDICINE 01YP00351MA03 CAMPAGNA ANTHONY MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 01YP00351MA04 CAMPAGNA ANTHONY MD LAHEY CLINIC INC BEVERLY MA 01915 (781) 744-8481 INTERNAL MEDICINE 0407821YPNH01 CAMPBELL PATRICIA DO DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 PEDIATRICS 01YP39237VT01 CAMPBELL CLAIRE MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 FAMILY MEDICINE 01YP00352MA01 CAMPBELL BRUCE MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 0401515YPVT01 CANTLIN TERRY DO GIFFORD MEDICAL CENTER BETHEL VT 05032 (802) 234-9913 FAMILY MEDICINE 04YP28280NH01 CANZANELLO ERIC DO DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 0109107YPNH01 CAPPETTA CHARLES MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4400 PEDIATRICS 01YP39799NH01 CAPRON THEODORE MD SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-1881 FAMILY MEDICINE 01YP12122NH01 CARDENAS JAVIER MD COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 FAMILY MEDICINE 23YP33462VT01 CARLISLE STEBENNE SUZANNE APRN IDEAL PRIMARY CARE WHITE RIVER JUNCTION VT 05001 (802) 698-8028 FAMILY NURSE PRACTITIONERS 23YP38841NH01 CARLSON MARY APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 PEDIATRIC NURSE PRACTITIONERS 01YP03810MA01 CARMICHAEL THOMAS MD CHILDRENS HEALTHCARE HAVERHILL MA 01830 (978) 373-6557 PEDIATRICS 01YP03810MA02 CARMICHAEL THOMAS MD CHILDRENS HEALTHCARE NEWBURYPORT MA 01950 (978) 465-7121 PEDIATRICS 01YP28333NH01 CARNEY MARK MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRICS 04YP25569ME01 CARNEY NICOLE DO YORK HOSPITAL SOUTH BERWICK ME 03908 (207) 384-9212 FAMILY MEDICINE 23YP29108ME01 CARPENTER SALLY APRN YORK HOSPITAL MOODY ME 04054 (207) 646-8386 ADULT NURSE PRACTITIONERS 23YP29108ME02 CARPENTER SALLY APRN YORK HOSPITAL YORK ME 03909 (207) 351-3530 ADULT NURSE PRACTITIONERS 01YP39439NH01 CARPENTIER DOMINIQUE MD MARTIN'S POINT HEALTH CARE PORTSMOUTH NH 03801 (603) 431-5154 FAMILY MEDICINE 01YP36231NH01 CARTER JENNIFER MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 INTERNAL MEDICINE 01YP36231NH02 CARTER JENNIFER MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 INTERNAL MEDICINE 01YP36231NH03 CARTER JENNIFER MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 INTERNAL MEDICINE 01YP36231NH04 CARTER JENNIFER MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 INTERNAL MEDICINE 01YP36231NH05 CARTER JENNIFER MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 775-0000 INTERNAL MEDICINE 01YP36231NH06 CARTER JENNIFER MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 INTERNAL MEDICINE 01YP36231NH07 CARTER JENNIFER MD CORE PHYSICIANS LLC HAMPTON NH 03842 (603) 929-1195 INTERNAL MEDICINE 01YP36231NH08 CARTER JENNIFER MD CORE PHYSICIANS LLC KINGSTON NH 03848 (603) 642-3910 INTERNAL MEDICINE 01YP36231NH09 CARTER JENNIFER MD CORE PHYSICIANS LLC DURHAM NH 03824 (603) 868-5832 INTERNAL MEDICINE 01YP36231NH10 CARTER JENNIFER MD CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 382-4972 INTERNAL MEDICINE 01YP36231NH11 CARTER JENNIFER MD CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 INTERNAL MEDICINE

Page 9 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP36231NH12 CARTER JENNIFER MD CORE PHYSICIANS LLC PORTSMOUTH NH 03801 (603) 658-2344 INTERNAL MEDICINE 0108306YPNH01 CARTIER MARK MD MARK P CARTIER MD INC YORK ME 03909 (207) 363-8852 FAMILY MEDICINE 0108321YPNH01 CARUSO DON MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 01YP22697NH01 CASENAS RITCHE MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 624-4380 INTERNAL MEDICINE 23YP41100NH01 CASEY JUDITH APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 ADULT NURSE PRACTITIONERS 23YP41100NH02 CASEY JUDITH APRN GPS PHYSICIAN GROUP PC NORTH CONWAY NH 03860 (859) 291-4800 ADULT NURSE PRACTITIONERS 01YP07473NH01 CASHMAN MAUREEN MD FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 335-2401 FAMILY MEDICINE 01YP07473NH02 CASHMAN MAUREEN MD FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 FAMILY MEDICINE 01YP41474NH01 CASHMAN MAUREEN MD APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 335-2401 FAMILY MEDICINE 01YP07700NH01 CASIO JACINTO MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 INTERNAL MEDICINE 23YP41819NH01 CASSIDY MARYLOU APRN INTEGRITY HEALTH & WELLNESS CLINIC DUBLIN NH 03444 (603) 831-1191 FAMILY NURSE PRACTITIONERS 01YP08021NH02 CASTOR BELINDA MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03102 (603) 625-6198 INTERNAL MEDICINE 01YP37498NH01 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC LEBANON NH 03766 (802) 478-0597 INTERNAL MEDICINE 01YP37498NH02 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC CANAAN NH 03741 (802) 478-0597 INTERNAL MEDICINE 01YP37498NH03 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC HANOVER NH 03755 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH04 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC CLAREMONT NH 03743 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH05 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC HANOVER NH 03755 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH06 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC JAFFREY NH 03452 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH07 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC KEENE NH 03431 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH08 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC MANCHESTER NH 03101 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH09 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC MANCHESTER NH 03101 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH10 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC NORTH CONWAY NH 03860 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH11 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC NEW IPSWICH NH 03071 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH12 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC NEW LONDON NH 03257 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH13 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC NEWPORT NH 03773 (866) 679-0831 INTERNAL MEDICINE 01YP37498NH14 CAUDILL-SLOSBERG MARGARET MD BETTER LIFE PARTNERS INC MANCHESTER NH 03103 (866) 679-0831 INTERNAL MEDICINE 0104509YPNH01 CAYER PATRICIA MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8350 PEDIATRICS 23YP39670NH01 CELIA CHERYL APRN GREENHOUSE NATURAL MEDICINE LLC AMHERST NH 03031 (603) 249-5771 FAMILY NURSE PRACTITIONERS 23YP37505MA01 CHABOT DEBBIE APRN LAHEY CLINIC INC AMESBURY MA 01913 (978) 388-5050 FAMILY NURSE PRACTITIONERS 01YP34885MA01 CHALLAGULLA MADHAVI MD PARTNERS COMMUNITY PHYS ORGANIZATION INC ANDOVER MA 01810 (978) 783-5000 INTERNAL MEDICINE 01YP18238MA01 CHALOORI PRATHIMA MD STEWARD MEDICAL GROUP INC ANDOVER MA 01810 (978) 269-0017 FAMILY MEDICINE 01YP04642NH01 CHAN KENNETH MD ANDOVER PEDIATRICS PC ANDOVER MA 01810 (978) 475-4522 PEDIATRICS 01YP21654VT01 CHANDRAMOULI SADHANASREE MD SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 885-1166 FAMILY MEDICINE 01YP13988NH01 CHAPMAN STEVEN MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 653-9663 PEDIATRICS 01YP24057NH01 CHAPPELL ELAINE MD COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2040 FAMILY MEDICINE 2308433YPNH01 CHAREST JEANNE APRN COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2040 PEDIATRIC NURSE PRACTITIONERS 01YP03861NH01 CHASE ELIZABETH MD ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 434-1919 INTERNAL MEDICINE 01YP37588NH01 CHATANI-HINZE MAYUMI MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY MEDICINE 01YP25489MA02 CHATFIELD MARCIA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3250 INTERNAL MEDICINE 01YP18409NH01 CHEHADE ANNE MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7555 INTERNAL MEDICINE 23YP40096NH01 CHEN LINGYAN APRN LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY NURSE PRACTITIONERS 01YP12339MA01 CHEN CONNIE MD LAHEY CLINIC INC LEXINGTON MA 02421 (781) 372-7000 INTERNAL MEDICINE 23YP36457MA01 CHICHESTER MARTHA APRN MEDICAL CARE OF BOSTON MANAGEMENT CORP HAVERHILL MA 01830 (978) 373-4400 ADULT NURSE PRACTITIONERS 23YP41848NH01 CHICHESTER MARTHA APRN ADVANCED CARE HOUSE CALLS OF NH LLC EPPING NH 03042 (603) 686-6204 ADULT NURSE PRACTITIONERS 04YP12575NH01 CHIN WARREN DO THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY MEDICINE 01YP18245MA03 CHOO PETER MD AUTUMN GRACE MEDICAL ASSOCIATES PC METHUEN MA 01844 (978) 682-3939 INTERNAL MEDICINE

Page 10 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP08439NH01 CHOPRA MANISH MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 INTERNAL MEDICINE 01YP20321NH01 CHOPRA ALPANA MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03103 (603) 626-5113 FAMILY MEDICINE 01YP35369NH01 CHOU LORETTA MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 PEDIATRICS 01YP35369NH02 CHOU LORETTA MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 PEDIATRICS 23YP30550NH01 CHRANG NONG APRN PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY NURSE PRACTITIONERS 23YP35885NH01 CHRISEMER JENNIFER APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY NURSE PRACTITIONERS 23YP33208NH02 CHRISTIANSEN JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 FAMILY NURSE PRACTITIONERS 04YP31350NH01 CHRISTO STEPHEN DO CORE PHYSICIANS LLC KINGSTON NH 03848 (603) 642-3910 FAMILY MEDICINE 04YP31350NH02 CHRISTO STEPHEN DO CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY MEDICINE 04YP31350NH03 CHRISTO STEPHEN DO CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 FAMILY MEDICINE 04YP31350NH04 CHRISTO STEPHEN DO CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 FAMILY MEDICINE 04YP31350NH05 CHRISTO STEPHEN DO CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 FAMILY MEDICINE 04YP31350NH06 CHRISTO STEPHEN DO CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY MEDICINE 04YP31350NH07 CHRISTO STEPHEN DO CORE PHYSICIANS LLC HAMPTON NH 03842 (603) 929-1195 FAMILY MEDICINE 04YP31350NH08 CHRISTO STEPHEN DO CORE PHYSICIANS LLC KINGSTON NH 03848 (603) 642-3910 FAMILY MEDICINE 04YP31350NH09 CHRISTO STEPHEN DO CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 382-4972 FAMILY MEDICINE 04YP31350NH10 CHRISTO STEPHEN DO CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 04YP31350NH11 CHRISTO STEPHEN DO CORE PHYSICIANS LLC PORTSMOUTH NH 03801 (603) 658-2344 FAMILY MEDICINE 23YP19157NH01 CHUNG RACHEL APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03103 (603) 626-5113 FAMILY NURSE PRACTITIONERS 01YP36785NH01 CHUNG EDWARD MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 889-6671 PEDIATRICS 01YP36785NH02 CHUNG EDWARD MD ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3870 PEDIATRICS 01YP36785NH03 CHUNG EDWARD MD ST JOSEPH HOSPITAL NASHUA NH 03062 (603) 880-1440 PEDIATRICS 01YP04774NH02 CIAK CARL MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 INTERNAL MEDICINE 23YP39148NH01 CILLO SAMANTHA APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC CONCORD NH 03301 (603) 226-6561 FAMILY NURSE PRACTITIONERS 01YP07156NH01 CIVITELLA JENNIFER MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4600 FAMILY MEDICINE 01YP07156NH02 CIVITELLA JENNIFER MD MONADNOCK COMMUNITY HOSPITAL ANTRIM NH 03440 (603) 588-4200 FAMILY MEDICINE 01YP18755NH01 CLAIRMONT THOMAS MD APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 436-6115 INTERNAL MEDICINE 0102871YPNH02 CLANCY PATRICIA MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 226-3400 FAMILY MEDICINE 0109649YPNH02 CLARDY ELIZABETH MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 01YP03212NH02 CLARK PAUL MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 INTERNAL MEDICINE 01YP27463NH01 CLARK SUSANNAH MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 INTERNAL MEDICINE 23YP42540NH01 CLARK SARAH APRN SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0437 FAMILY NURSE PRACTITIONERS 0100673YPNH03 CLAUSSEN CAROLYN MD CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8060 FAMILY MEDICINE 0106838YPNH02 CLAUSSEN BRIAN MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 622-6491 FAMILY MEDICINE 0105210YPVT02 CLAY GARY MD SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 FAMILY MEDICINE 0105210YPVT02 CLAY GARY MD SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 FAMILY MEDICINE 23YP26864NH01 CLEARY MICHELLE NP SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 FAMILY NURSE PRACTITIONERS 0100551YPNH01 CLIFFORD JAMES MD LRGHEALTHCARE GILFORD NH 03249 (603) 527-2955 FAMILY MEDICINE 01YP30401NH01 CLIFFORD JAMES MD LRGHEALTHCARE LACONIA NH 03246 (603) 524-5151 FAMILY MEDICINE 23YP32233NH02 CLINE KENDRA APRN FRISBIE MEMORIAL HOSPITAL SOMERSWORTH NH 03878 (603) 692-3115 FAMILY NURSE PRACTITIONERS 23YP32233NH03 CLINE KENDRA APRN APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 330-3404 FAMILY NURSE PRACTITIONERS 23YP16616NH01 CLOUTIER LEONA APRN THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY NURSE PRACTITIONERS 0100778YPNH01 COBLE SUZANNE MD SUZANNE COBLE MD KEENE NH 03431 (603) 357-9959 FAMILY MEDICINE 01YP41301VT01 COHEN ELLEN MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8787 INTERNAL MEDICINE 0104096YPNH01 COHEN MAURICE MD NORTHEAST GASTROENTEROLOGY ASSOCIATES PC SALEM NH 03079 (603) 898-5082 INTERNAL MEDICINE 0109762YPNH02 COHEN MITCHELL MD ST JOSEPH HOSPITAL NASHUA NH 03062 (603) 595-3614 INTERNAL MEDICINE

Page 11 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 0109762YPNH03 COHEN MITCHELL MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 INTERNAL MEDICINE 23YP42129NH01 COLBY KATRINA APRN INDIAN STREAM HEALTH CENTER INC COLEBROOK NH 03576 (603) 237-8336 FAMILY NURSE PRACTITIONERS 01YP33633NH01 COLBY BENJAMIN MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 226-3400 FAMILY MEDICINE 01YP33633NH02 COLBY BENJAMIN MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 0409226YPNH07 COLE BERTRAND DO PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY MEDICINE 0409226YPNH08 COLE BERTRAND DO PMC MEDICAL GROUP LLC NEWINGTON NH 03801 (603) 431-3166 FAMILY MEDICINE 0409226YPNH09 COLE BERTRAND DO PMC MEDICAL GROUP LLC CONCORD NH 03301 (603) 415-0330 FAMILY MEDICINE 01YP38643NH01 COLELLA DANETTE MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 PEDIATRICS 01YP38643NH02 COLELLA DANETTE MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 PEDIATRICS 01YP38643NH03 COLELLA DANETTE MD GREATER SEACOAST COMMUNITY HEALTH SEABROOK NH 03874 (603) 766-2626 PEDIATRICS 01YP38643NH04 COLELLA DANETTE MD GREATER SEACOAST COMMUNITY HEALTH ROCHESTER NH 03867 (603) 335-4522 PEDIATRICS 01YP38643NH05 COLELLA DANETTE MD GREATER SEACOAST COMMUNITY HEALTH ROCHESTER NH 03867 (603) 516-9300 PEDIATRICS 01YP38643NH06 COLELLA DANETTE MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 PEDIATRICS 0104604YPNH02 COLLINS PAUL MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03103 (603) 626-5113 FAMILY MEDICINE 23YP41831NH01 COLLINS ASHLEY APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC AMHERST NH 03031 (603) 249-8883 FAMILY NURSE PRACTITIONERS 23YP37545NH01 COMPAGNA ROBERTA APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 FAMILY NURSE PRACTITIONERS 23YP37545NH02 COMPAGNA ROBERTA APRN WENTWORTH DOUGLASS PHYSICIAN CORP SOMERSWORTH NH 03878 (603) 692-6676 FAMILY NURSE PRACTITIONERS 23YP41326ME01 COMPAGNA ROBERTA APRN WENTWORTH DOUGLASS PHYSICIAN CORP SOUTH BERWICK ME 03908 (207) 384-4949 FAMILY NURSE PRACTITIONERS 23YP41722ME01 COMPAGNA ROBERTA APRN WENTWORTH DOUGLASS PHYSICIAN CORP SOUTH BERWICK ME 03908 (207) 384-4949 FAMILY NURSE PRACTITIONERS 23YP16899NH01 COMPOS HEIDI APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 FAMILY NURSE PRACTITIONERS 23YP14926NH01 CONDODEMETRAKY STEPHANIE APRN CATHOLIC MEDICAL CENTER GOFFSTOWN NH 03045 (603) 314-4700 ADULT NURSE PRACTITIONERS 01YP40274NH01 CONKLING HILLARY MD LRGHEALTHCARE LACONIA NH 03246 (603) 524-9201 INTERNAL MEDICINE 23YP40753NH01 CONLON RONI APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC CONCORD NH 03301 (603) 226-6561 ADULT NURSE PRACTITIONERS 23YP40753NH02 CONLON RONI APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 ADULT NURSE PRACTITIONERS 01YP40305NH01 CONNELLY DANIELA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP40305NH02 CONNELLY DANIELA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP40305NH03 CONNELLY DANIELA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP40305NH04 CONNELLY DANIELA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP40305NH05 CONNELLY DANIELA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 0106550YPNH02 CONNOLLY KEVIN MD LITTLE RIVERS HEALTH CARE INC BRADFORD VT 05033 (802) 222-9317 INTERNAL MEDICINE 01YP14900MA02 CONNOLLY LISA MD LAHEY PHYSICIAN COMMUNITY ORGANIZATION INC LYNNFIELD MA 01940 (781) 213-4040 FAMILY MEDICINE 23YP38465NH01 CONWAY KATHLEEN APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 FAMILY NURSE PRACTITIONERS 23YP38465NH02 CONWAY KATHLEEN APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY NURSE PRACTITIONERS 23YP41027VT01 CONWAY-EDWARDS COLLEEN APRN BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8787 FAMILY NURSE PRACTITIONERS 01YP36359NH01 COOK PETER MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 314-5900 INTERNAL MEDICINE 01YP41224NH01 COOLEY ELIZABETH MD WEEKS MEDICAL CENTER LANCASTER NH 03584 (603) 788-2521 FAMILY MEDICINE 2309580YPNH01 COOMBS AMY APRN WHOLE LIFE HEALTH CARE NEWINGTON NH 03801 (603) 431-6677 FAMILY NURSE PRACTITIONERS 01YP36565VT01 COOMBS RACHEL MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY MEDICINE 01YP08516ME01 COOMEY WILLIAM MD WILLIAM COOMEY MD ELIOT ME 03903 (207) 439-2774 INTERNAL MEDICINE 23YP32143NH01 COOPER EMILY APRN MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 FAMILY NURSE PRACTITIONERS 23YP32143NH02 COOPER EMILY APRN MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4680 FAMILY NURSE PRACTITIONERS 23YP29427NH01 COOPER KATHERINE APRN VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-6900 GERIATRIC NURSE PRACTITIONERS 23YP29427NH02 COOPER KATHERINE APRN VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-6700 GERIATRIC NURSE PRACTITIONERS 23YP29427NH05 COOPER KATHERINE APRN VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-7771 GERIATRIC NURSE PRACTITIONERS 2301041YPNH01 COOPER PIELA REBECCA APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 595-0063 INTERNAL MEDICINE NURSE PRACTITIONER 04YP15119NH01 CORBETT JEFFREY DO DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY MEDICINE

Page 12 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP15119NH02 CORBETT JEFFREY DO DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2500 FAMILY MEDICINE 04YP15119NH03 CORBETT JEFFREY DO DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 FAMILY MEDICINE 04YP05087ME02 CORBETT SANDRA DO YORK HOSPITAL YORK ME 03909 (207) 363-8430 FAMILY MEDICINE 01YP00368MA01 CORKERY JOSEPH MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 23YP32753NH01 CORRIGAN DEBRA APRN ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 434-1919 FAMILY NURSE PRACTITIONERS 01YP24825MA01 COSTAGLIOLA JOSEPH MD LAHEY CLINIC INC WILMINGTON MA 01887 (978) 694-9610 INTERNAL MEDICINE 01YP24825MA02 COSTAGLIOLA JOSEPH MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 04YP33719NH01 COSTELLO JAMISON DO HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7588 FAMILY MEDICINE 04YP33719NH02 COSTELLO JAMISON DO HUGGINS HOSPITAL OSSIPEE NH 03864 (603) 539-6996 FAMILY MEDICINE 04YP33719NH03 COSTELLO JAMISON DO HUGGINS HOSPITAL TAMWORTH NH 03886 (603) 323-3311 FAMILY MEDICINE 04YP33719NH04 COSTELLO JAMISON DO HUGGINS HOSPITAL ALTON NH 03809 (603) 875-6151 FAMILY MEDICINE 04YP33719NH05 COSTELLO JAMISON DO HUGGINS HOSPITAL MOULTONBOROUGH NH 03254 (603) 476-2216 FAMILY MEDICINE 01YP03925ME01 COTE JEFFREY MD WELLS FAMILY PRACTICE LLC WELLS ME 04090 (207) 646-0676 FAMILY MEDICINE 23YP31115NH01 COTE-MELENDEZ MONIQUE APRN ELLIOT PHYSICIANS NETWORK ALLENSTOWN NH 03275 (603) 485-7861 FAMILY NURSE PRACTITIONERS 01YP33970NH01 COULTER SUSAN MD LRGHEALTHCARE BELMONT NH 03220 (603) 528-0995 PEDIATRICS 01YP33970NH02 COULTER SUSAN MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 PEDIATRICS 23YP28747NH02 COUPER REBECCA APRN LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 PEDIATRIC NURSE PRACTITIONERS 23YP28747NH03 COUPER REBECCA APRN LRGHEALTHCARE BELMONT NH 03220 (603) 528-0995 PEDIATRIC NURSE PRACTITIONERS 0100462YPNH01 COURTEMANCHE DOLLY MD CONCORD PEDIATRICS PA CONCORD NH 03301 (603) 224-1929 PEDIATRICS 0105163YPNH02 COVEY MARK MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-8900 PEDIATRICS 0103485YPVT01 COXON MARCUS MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY MEDICINE 01YP33785NH01 COZZI MICHAEL MD ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 624-8652 FAMILY MEDICINE 23YP37054NH01 CRAIG KRISTEN APRN MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY NURSE PRACTITIONERS 01YP16685NH01 CRAMER ELIZABETH MD CONCORD PEDIATRICS PA CONCORD NH 03301 (603) 224-1929 PEDIATRICS 23YP31520NH01 CRAWFORD TARA APRN FOUNDATION MEDICAL PARTNERS INC AMHERST NH 03031 (603) 673-5885 FAMILY NURSE PRACTITIONERS 01YP00371MA01 CRAWFORD BETSEY MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 23YP41627NH01 CREMONE JENNIFER APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY NURSE PRACTITIONERS 01YP32706NH01 CREPPY MICHAEL MD COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2040 FAMILY MEDICINE 01YP00373MA02 CRISCITIELLO RONALD MD LAHEY CLINIC INC ARLINGTON MA 02474 (781) 641-0100 INTERNAL MEDICINE 01YP14585ME01 CROMER DORIS MD YORK HOSPITAL WELLS ME 04090 (207) 641-6540 FAMILY MEDICINE 0102759YPNH01 CROSBY CAROLYN MD LRGHEALTHCARE MEREDITH NH 03253 (603) 279-7433 FAMILY MEDICINE 23YP15478NH01 CROSS DEBORAH APRN WHITE MOUNTAIN COMMUNITY HEALTH CENTER CONWAY NH 03818 (603) 447-8900 FAMILY NURSE PRACTITIONERS 04YP25817NH01 CROTEAU RACHEL DO DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 04YP30862NH01 CROW REBECCA DO DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 0100769YPNH01 CRUSBERG HEIDI MD LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-5605 FAMILY MEDICINE 0100769YPNH02 CRUSBERG HEIDI MD LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 895-3351 FAMILY MEDICINE 0100769YPNH03 CRUSBERG HEIDI MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY MEDICINE 04YP16842NH01 CULLEN MARY DO AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 04YP16842NH02 CULLEN MARY DO AMOSKEAG HEALTH MANCHESTER NH 03103 (603) 626-9500 FAMILY MEDICINE 04YP16842NH03 CULLEN MARY DO AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 663-5382 FAMILY MEDICINE 04YP16842NH04 CULLEN MARY DO AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 668-6629 FAMILY MEDICINE 04YP16842NH05 CULLEN MARY DO AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 01YP31952NH01 CUNIS DAVID MD SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-3700 PEDIATRICS 0107387YPNH02 CUNNIFF JOSEPH MD ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 552-1400 INTERNAL MEDICINE 23YP39343NH01 CURLEY SHENANDOAH APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC CONCORD NH 03301 (603) 226-6561 FAMILY NURSE PRACTITIONERS 23YP41966NH01 CURLEY SHENANDOAH APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS

Page 13 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP32320VT01 CURRAN CHELSEA APRN WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 FAMILY NURSE PRACTITIONERS 04YP19186NH01 CURRIER MICHELLE DO CONCORD HOSPITAL INC HOPKINTON NH 03229 (603) 228-7575 FAMILY MEDICINE 01YP00375MA01 CUSHING GARY MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-2088 INTERNAL MEDICINE 23YP30866NH01 CUTLER MICHELLE APRN KEADY FAMILY PRACTICE CHARLESTOWN NH 03603 (603) 863-7777 FAMILY NURSE PRACTITIONERS 23YP30866NH02 CUTLER MICHELLE APRN KEADY FAMILY PRACTICE CLAREMONT NH 03743 (603) 863-7777 FAMILY NURSE PRACTITIONERS 23YP30866NH03 CUTLER MICHELLE APRN KEADY FAMILY PRACTICE NEWPORT NH 03773 (603) 863-7777 FAMILY NURSE PRACTITIONERS 23YP35577NH01 CZARNEC KATHLEEN APRN ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 FAMILY NURSE PRACTITIONERS 23YP35577NH02 CZARNEC KATHLEEN APRN ST JOSEPH HOSPITAL HUDSON NH 03051 (603) 882-6700 FAMILY NURSE PRACTITIONERS 0102394YPNH01 DACEY LINDA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 01YP12119NH02 DACUYCUY MARY ABIGAIL MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 INTERNAL MEDICINE 0105256YPNH02 D'AGOSTINO ROBERT MD FOUNDATION MEDICAL PARTNERS INC MILFORD NH 03055 (603) 672-7600 FAMILY MEDICINE 01YP41601NH01 DAIGLE MARC MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY MEDICINE 0109438YPNH01 DALEY JOHN MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0109438YPNH02 DALEY JOHN MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 0109438YPNH03 DALEY JOHN MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 0109438YPNH05 DALEY JOHN MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 0109438YPNH06 DALEY JOHN MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP13828MA02 DAMIANI SUZANNE MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8700 PEDIATRICS 01YP28773MA01 DAMIANI ALDO MD LAHEY CLINIC INC PEABODY MA 01960 (978) 538-4300 INTERNAL MEDICINE 01YP00380MA01 DANA NAVA MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP41277NH01 DANI NIRALI MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 01YP35919NH01 DANIELSON VALERIE MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 FAMILY MEDICINE 04YP14927NH01 DANIELSON CARYN DO ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 641-5386 INTERNAL MEDICINE 01YP00381MA01 DANOWITZ JAY MD LAHEY CLINIC INC NORTH BILLERICA MA 01862 (978) 663-6666 INTERNAL MEDICINE 01YP00381MA02 DANOWITZ JAY MD LAHEY CLINIC INC ARLINGTON MA 02474 (781) 641-0100 INTERNAL MEDICINE 01YP18847VT01 DARGIS BRIGITTE MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 FAMILY MEDICINE 23YP25287VT02 DARIUS CHARLY APRN PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 FAMILY NURSE PRACTITIONERS 01YP03887NH01 DAS ANINDITA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 594-6030 PEDIATRICS 01YP12260NH02 DASARI SANDHYA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-3080 INTERNAL MEDICINE 23YP35960MA01 D'AUGUSTA CATHY APRN LAHEY CLINIC INC WILMINGTON MA 01887 (978) 694-9610 FAMILY NURSE PRACTITIONERS 2305973YPNH01 D'AUTEUIL JENNIFER APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2750 PEDIATRIC NURSE PRACTITIONERS 01YP23220NH01 DAVE HETAL MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 INTERNAL MEDICINE 01YP24904NH01 DAVIE EMILY MD DOVER PEDIATRICS PLLC DOVER NH 03820 (603) 742-4048 PEDIATRICS 04YP12110NH02 DAVIES DANIEL DO APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 433-8434 INTERNAL MEDICINE 0103842YPNH01 DAVILA MARIA MD MARIA DAVILA MD HOOKSETT NH 03106 (603) 485-4702 INTERNAL MEDICINE 01YP03695MA01 DAVIS SHERRILL MD PEDIATRIC PROFESSIONAL ASSOCIATES PC METHUEN MA 01844 (978) 683-1974 PEDIATRICS 23YP39842NH01 DAVIS AMY APRN COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 FAMILY NURSE PRACTITIONERS 0101072YPNH02 DAVIS JULIE MD WHITE RIVER FAMILY PRACTICE PC WHITE RIVER JUNCTION VT 05001 (802) 295-6132 FAMILY MEDICINE 23YP23061NH01 DAVIS JULINE APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY NURSE PRACTITIONERS 01YP35706NH02 DAVIS-SCHAFFER BRITTANY MD DEEPAK SHARMA MD PC SALEM NH 03079 (603) 893-1521 PEDIATRICS 01YP42065NH01 DAVIS-SCHAFFER BRITTANY MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRICS 04YP36108MA01 DAWSON JAMES DO LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 2307227YPNH02 DAWSON SHANTA APRN CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 PEDIATRIC NURSE PRACTITIONERS 01YP37328NH01 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC CANAAN NH 03741 (802) 478-0597 INTERNAL MEDICINE 01YP37328NH02 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC HANOVER NH 03755 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH03 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC CLAREMONT NH 03743 (866) 679-0831 INTERNAL MEDICINE

Page 14 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP37328NH04 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC HANOVER NH 03755 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH05 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC JAFFREY NH 03452 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH06 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC KEENE NH 03431 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH07 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC LEBANON NH 03766 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH08 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC MANCHESTER NH 03101 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH09 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC MANCHESTER NH 03101 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH10 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC NORTH CONWAY NH 03860 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH11 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC NEW IPSWICH NH 03071 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH12 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC NEW LONDON NH 03257 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH13 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC NEWPORT NH 03773 (866) 679-0831 INTERNAL MEDICINE 01YP37328NH14 DE GIJSEL DAVID MD BETTER LIFE PARTNERS INC MANCHESTER NH 03103 (866) 679-0831 INTERNAL MEDICINE 23YP37604NH01 DE LA ROSA CHERYL APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-2759 FAMILY NURSE PRACTITIONERS 01YP12607NH01 DE VERA ADELA MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4668 PEDIATRICS 01YP42468NH01 DE VERA JOSEPH MD VANTAGE HEALTHCARE LLC PELHAM NH 03076 (781) 867-2050 INTERNAL MEDICINE 01YP11807NH02 DEBLASIO BONESHO ALEXANDRA MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 PEDIATRICS 0103168YPNH03 DECKER THOMAS MD WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8050 INTERNAL MEDICINE 0103168YPNH04 DECKER THOMAS MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE 0103168YPNH05 DECKER THOMAS MD WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8050 INTERNAL MEDICINE 01YP26668VT01 DEGE JAY MD NORTHERN COUNTIES HEALTH CARE INC ST JOHNSBURY VT 05819 (802) 748-5041 FAMILY MEDICINE 23YP39082NH01 DEL PERUGIA-STODDART CORINNE APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 0102465YPNH01 DELLA GROTTA GARY MD DERRY PEDIATRICS PRACTICE PA DERRY NH 03038 (603) 434-0327 PEDIATRICS 23YP29101NH01 DELROSSI KIMBERLY APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4804 FAMILY NURSE PRACTITIONERS 23YP26224NH01 DELUCA ANNE APRN CATHOLIC MEDICAL CENTER HOOKSETT NH 03106 (603) 663-1990 ADULT NURSE PRACTITIONERS 04YP28229NH01 DEMASI PAUL DO FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 330-7905 INTERNAL MEDICINE 04YP38110NH01 DEMASI PAUL DO HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7475 INTERNAL MEDICINE 04YP38110NH02 DEMASI PAUL DO HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7565 INTERNAL MEDICINE 04YP38110NH03 DEMASI PAUL DO HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7588 INTERNAL MEDICINE 01YP20054NH01 DEMATTEO CARL MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 0104796YPNH02 DENNIS DEBORAH MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 FAMILY MEDICINE 01YP31466MA01 DERKEVORKIAN NAZARET MD PARTNERS COMMUNITY PHYS ORGANIZATION INC ANDOVER MA 01810 (978) 783-5000 FAMILY MEDICINE 01YP03189NH02 DESENA MATTHEW MD LONDONDERRY PEDIATRICS PA LONDONDERRY NH 03053 (603) 437-1003 PEDIATRICS 01YP02786MA01 DESIATO JOSEPH MD COMMUNITY PEDIATRIC OF ANDOVER ANDOVER MA 01810 (978) 475-0300 PEDIATRICS 01YP26417MA01 DESOCIO CRISTI MD FOUNDATION MEDICAL PARTNERS INC PEPPERELL MA 01463 (978) 433-6317 FAMILY MEDICINE 23YP34572MA01 DEVEJIAN KATHLEEN APRN COMMUNITY MEDICAL ASSOCIATES INC LAWRENCE MA 01841 (978) 683-4000 FAMILY NURSE PRACTITIONERS 23YP31564NH01 DEVRIES JENNIFER APRN FOUNDATION MEDICAL PARTNERS INC PELHAM NH 03076 (603) 635-5400 FAMILY NURSE PRACTITIONERS 23YP36757NH01 DHLIWAYO THANDIWE APRN CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8060 FAMILY NURSE PRACTITIONERS 01YP36592NH01 DIAMOND CHRISTOPHER MD UNIVERSITY SYSTEM OF NEW HAMPSHIRE DURHAM NH 03824 (603) 862-9355 FAMILY MEDICINE 01YP41462NH01 DIBBLE JR FRANK MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY MEDICINE 01YP16494NH02 DIBRIGIDA LISA MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 PEDIATRICS 01YP16494NH03 DIBRIGIDA LISA MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 PEDIATRICS 01YP16494NH04 DIBRIGIDA LISA MD AMOSKEAG HEALTH MANCHESTER NH 03103 (603) 626-9500 PEDIATRICS 01YP16494NH05 DIBRIGIDA LISA MD AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 663-5382 PEDIATRICS 0404777YPME01 DICAPUA SAMUEL DO WELLS FAMILY PRACTICE LLC WELLS ME 04090 (207) 646-0676 FAMILY MEDICINE 01YP30812NH02 DICK MARK MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE 01YP28117NH01 DICK LESLIE MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRICS 04YP18264VT01 DICKEY KARI DO BRATTLEBORO MEMORIAL HOSPITAL PUTNEY VT 05346 (802) 387-5581 FAMILY MEDICINE

Page 15 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP28340NH01 DICKINSON ARCHIE MD DARTMOUTH HITCHCOCK CLINIC MERRIMACK NH 03054 (603) 440-7722 FAMILY MEDICINE 01YP28340NH02 DICKINSON ARCHIE MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY MEDICINE 01YP28340NH03 DICKINSON ARCHIE MD DARTMOUTH HITCHCOCK CLINIC MILFORD NH 03055 (603) 673-2515 FAMILY MEDICINE 01YP28340NH04 DICKINSON ARCHIE MD DARTMOUTH HITCHCOCK CLINIC HUDSON NH 03051 (603) 577-3410 FAMILY MEDICINE 0104668YPNH01 DIEDERICH GARY MD MID-STATE HEALTH CENTER BRISTOL NH 03222 (603) 744-6200 FAMILY MEDICINE 01YP40671NH01 DIEDERICH GARY MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 23YP29454NH02 DIEDERICHS KATRINA APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY NURSE PRACTITIONERS 23YP29454NH03 DIEDERICHS KATRINA APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 FAMILY NURSE PRACTITIONERS 01YP32709MA01 DIETRICH GRETCHEN MD LAHEY CLINIC INC ARLINGTON MA 02474 (781) 641-0100 FAMILY MEDICINE 23YP34627VT01 DIGEORGE AMANDA APRN WHITE RIVER FAMILY PRACTICE PC WHITE RIVER JUNCTION VT 05001 (802) 295-6132 FAMILY NURSE PRACTITIONERS 23YP36497MA01 DIMOU CIARA APRN LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE NURSE PRACTITIONER 0105356YPVT01 DINICOLA LOUIS MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 PEDIATRICS 01YP26448VT01 DINICOLA CHRISTINA MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 PEDIATRICS 23YP39903NH02 DION SARA APRN APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 332-2401 FAMILY NURSE PRACTITIONERS 0108096YPNH02 DIONNE PIERRE MD PIERRE DIONNE MD HUDSON NH 03051 (603) 595-8989 FAMILY MEDICINE 0401021YPNH02 DIPASTINA JOHN DO DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 FAMILY MEDICINE 2308135YPNH01 DITULIO MARGARET APRN ROCKINGHAM FAMILY HLTHCARE COLLABORATIVE INC ATKINSON NH 03811 (603) 362-4444 FAMILY NURSE PRACTITIONERS 01YP28447MA01 DIXIT ROHIT MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8800 INTERNAL MEDICINE 01YP28005VT01 DJALAYER KASRA MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 INTERNAL MEDICINE 01YP36866NH01 DJALAYER KASRA MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 INTERNAL MEDICINE 01YP35744NH01 DO PONTE LORENA MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY MEDICINE 0102211YPNH03 DOANE PETER MD LRGHEALTHCARE LACONIA NH 03246 (603) 524-5151 FAMILY MEDICINE 01YP23332NH01 DOANE PETER MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 FAMILY MEDICINE 01YP03300NH02 DOBBERTIN JOYCE MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 FAMILY MEDICINE 0102786YPNH04 DOBBINS ANN MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 889-6671 PEDIATRICS 0102786YPNH05 DOBBINS ANN MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 PEDIATRICS 0102786YPNH06 DOBBINS ANN MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 PEDIATRICS 01YP31764MA01 DOBSON DAVID MD LAHEY CLINIC INC BEVERLY MA 01915 (978) 927-1919 INTERNAL MEDICINE 23YP26638NH01 DOHERTY PATRICIA APRN ELLIOT PHYSICIANS NETWORK RAYMOND NH 03077 (603) 895-8000 FAMILY NURSE PRACTITIONERS 23YP17465NH01 DOHERTY KAREN APRN ELLIOT PHYSICIANS NETWORK RAYMOND NH 03077 (603) 895-8000 FAMILY NURSE PRACTITIONERS 23YP28406NH01 DOHERTY JANE APRN DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 FAMILY NURSE PRACTITIONERS 01YP33655VT01 DOLKART KENNETH MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 INTERNAL MEDICINE 23YP42245NH01 DOLLA BIKRAMJEET APRN PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY NURSE PRACTITIONERS PEDIATRIC ASSOCIATES OF HAMPTON & 01YP15521NH01 DOMINICK KEITH MD PORTSMOUTH NH 03801 (603) 436-7171 PEDIATRICS PEDIATRICPORTSMOUTH ASSOCIATES PC OF HAMPTON & 01YP15521NH02 DOMINICK KEITH MD HAMPTON NH 03842 (603) 929-3838 PEDIATRICS PORTSMOUTH PC 23YP36283NH02 DONAGHEY CARA-JEAN APRN ST JOSEPH HOSPITAL HUDSON NH 03051 (603) 882-6700 ADULT NURSE PRACTITIONERS 23YP36283NH03 DONAGHEY CARA-JEAN APRN ST JOSEPH HOSPITAL MERRIMACK NH 03054 (603) 424-4181 ADULT NURSE PRACTITIONERS 23YP36283NH04 DONAGHEY CARA-JEAN APRN ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3014 ADULT NURSE PRACTITIONERS 23YP36283NH05 DONAGHEY CARA-JEAN APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4804 ADULT NURSE PRACTITIONERS 23YP36283NH06 DONAGHEY CARA-JEAN APRN ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 ADULT NURSE PRACTITIONERS 23YP36808NH01 DONAHUE CHONG-AE APRN ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 FAMILY NURSE PRACTITIONERS 23YP36808NH02 DONAHUE CHONG-AE APRN ST JOSEPH HOSPITAL HUDSON NH 03051 (603) 882-6700 FAMILY NURSE PRACTITIONERS 23YP36808NH03 DONAHUE CHONG-AE APRN ST JOSEPH HOSPITAL MERRIMACK NH 03054 (603) 424-4181 FAMILY NURSE PRACTITIONERS 23YP36808NH04 DONAHUE CHONG-AE APRN ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3014 FAMILY NURSE PRACTITIONERS 23YP36808NH05 DONAHUE CHONG-AE APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4804 FAMILY NURSE PRACTITIONERS 23YP36808NH07 DONAHUE CHONG-AE APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 FAMILY NURSE PRACTITIONERS

Page 16 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP25431NH01 DONAHUE CORA APRN LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY NURSE PRACTITIONERS 23YP25431NH02 DONAHUE CORA APRN LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY NURSE PRACTITIONERS 23YP39445NH01 DONAHUE STEPHANIE APRN ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 624-8652 FAMILY NURSE PRACTITIONERS 23YP02556NH02 DONOVAN KATHLEEN APRN COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 FAMILY NURSE PRACTITIONERS 04YP05233NH03 DONOVAN KEVIN DO FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 FAMILY MEDICINE 04YP05233NH04 DONOVAN KEVIN DO APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 335-2401 FAMILY MEDICINE 23YP26824NH01 DOPP KATRINA APRN MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 ADULT NURSE PRACTITIONERS 01YP20275NH01 DOUCET CHRISTEN MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 FAMILY MEDICINE 23YP34321NH01 DOUGHERTY ROSEMARY APRN HARBOR HOMES INC NASHUA NH 03060 (603) 821-7788 FAMILY NURSE PRACTITIONERS 01YP42127NH01 DOUGLAS ROBERT MD INDIAN STREAM HEALTH CENTER INC COLEBROOK NH 03576 (603) 237-8336 FAMILY MEDICINE 04YP07717NH02 DOW ROBERT DO ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 552-1400 FAMILY MEDICINE 23YP24875NH02 DOWNS ELIZABETH APRN FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 332-8981 INTERNAL MEDICINE NURSE PRACTITIONER 04YP37364NH01 DOWNS RIMA DO DARTMOUTH HITCHCOCK CLINIC HUDSON NH 03051 (603) 577-3410 FAMILY MEDICINE 04YP37364NH02 DOWNS RIMA DO DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY MEDICINE 01YP05032NH01 DOYLE LISA MD ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 624-8652 FAMILY MEDICINE 01YP20017VT02 DREBITKO CLARE MD WINDSOR HOSPITAL CORP WOODSTOCK VT 05091 (802) 457-3030 PEDIATRICS 01YP20017VT03 DREBITKO CLARE MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 PEDIATRICS 01YP32995NH01 DREFFER DOUGLAS MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP32995NH02 DREFFER DOUGLAS MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP32995NH03 DREFFER DOUGLAS MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP32995NH04 DREFFER DOUGLAS MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP32995NH05 DREFFER DOUGLAS MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP22760MA01 DRESSEL JENNIFER MD FOUNDATION MEDICAL PARTNERS INC PEPPERELL MA 01463 (978) 433-6317 FAMILY MEDICINE 01YP26521MA01 DRESSEL BRIAN MD FOUNDATION MEDICAL PARTNERS INC PEPPERELL MA 01463 (978) 433-6317 FAMILY MEDICINE 23YP20202NH01 DUBE CHRISTINE APRN NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 FAMILY NURSE PRACTITIONERS 23YP30799MA01 DUBE MONICA APRN LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 FAMILY NURSE PRACTITIONERS 01YP31424NH01 DUBEAU CATHERINE MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 23YP17363NH01 DUCHARME KAREN APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY NURSE PRACTITIONERS 23YP39725NH01 DUCLOS KATHRYN APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC AMHERST NH 03031 (603) 249-8883 FAMILY NURSE PRACTITIONERS 23YP22873NH01 DUCLOS SHANNON APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 FAMILY NURSE PRACTITIONERS 23YP41324NH01 DUFFROY LUDOVIC APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 ADULT NURSE PRACTITIONERS 01YP17212MA01 DUFFY JOCELYN MD STEWARD MEDICAL GROUP INC ANDOVER MA 01810 (978) 269-0017 FAMILY MEDICINE 01YP38516MA01 DUFFY JOCELYN MD COMMUNITY MEDICAL ASSOCIATES INC LAWRENCE MA 01841 (978) 946-8550 FAMILY MEDICINE 23YP22746NH01 DUGAN LYNNE APRN HEALTH FIRST FAMILY CARE CENTER FRANKLIN NH 03235 (603) 934-1464 FAMILY NURSE PRACTITIONERS 23YP31611NH01 DUHAIME JON APRN ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 552-1400 FAMILY NURSE PRACTITIONERS 23YP23200NH02 DULAC CAITLIN APRN LRGHEALTHCARE ANDOVER NH 03216 (603) 735-4363 ADULT NURSE PRACTITIONERS 23YP25870NH01 DULAC CAITLIN APRN LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-6562 ADULT NURSE PRACTITIONERS 23YP14269NH01 DUMAIS JESSICA APRN CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8060 FAMILY NURSE PRACTITIONERS 04YP35834NH01 DUNAHAY JARED DO ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8350 PEDIATRICS 01YP38296VT01 DUNCAN LAURA MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 INTERNAL MEDICINE 23YP26467NH01 DUNCAN TRACY APRN KEADY FAMILY PRACTICE CLAREMONT NH 03743 (603) 826-3434 FAMILY NURSE PRACTITIONERS 23YP26467NH02 DUNCAN TRACY APRN KEADY FAMILY PRACTICE NEWPORT NH 03773 (603) 863-7777 FAMILY NURSE PRACTITIONERS 01YP00701MA01 DUNCAN ROBERT MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 04YP35479NH01 DUNETZ DANIELLE DO FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 891-0083 PEDIATRICS 01YP38274MA01 DUNN CELESTE MD CHILDRENS HEALTHCARE HAVERHILL MA 01830 (978) 373-6557 PEDIATRICS 23YP23646NH01 DUPLINSKY SARAH APRN SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-3500 FAMILY NURSE PRACTITIONERS

Page 17 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP23646NH02 DUPLINSKY SARAH APRN SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 383-3005 FAMILY NURSE PRACTITIONERS 23YP38268NH01 DUPRE MARY APRN DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2500 FAMILY NURSE PRACTITIONERS 23YP38268NH02 DUPRE MARY APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY NURSE PRACTITIONERS 0103878YPNH01 DUPUIS DENIS MD BEDFORD INTERNAL MEDICINE, PA BEDFORD NH 03110 (603) 645-6652 INTERNAL MEDICINE 23YP36286NH01 DUQUETTE BONNIE APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-3300 FAMILY NURSE PRACTITIONERS 0105166YPNH03 DURAND LYNN MD CONCORD HOSPITAL INC HOPKINTON NH 03229 (603) 228-7575 FAMILY MEDICINE 0105166YPNH04 DURAND LYNN MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 23YP20872NH01 DUSTIN AMANDA APRN COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2900 FAMILY NURSE PRACTITIONERS 23YP20872NH02 DUSTIN AMANDA APRN COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2040 FAMILY NURSE PRACTITIONERS 04YP39041NH01 DUWEL KIRK DO CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 622-6491 FAMILY MEDICINE 01YP04199NH01 DUXBURY MELISSA MD FOUNDATION MEDICAL PARTNERS INC HUDSON NH 03051 (603) 886-3979 FAMILY MEDICINE 01YP42514NH01 DUXBURY MELISSA MD DARTMOUTH HITCHCOCK CLINIC HUDSON NH 03051 (603) 577-3410 FAMILY MEDICINE 23YP10095NH01 EATON RAINA APRN COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2900 FAMILY NURSE PRACTITIONERS 23YP28389NH01 ECKENBERGER SARAH APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY NURSE PRACTITIONERS 23YP28389NH02 ECKENBERGER SARAH APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 FAMILY NURSE PRACTITIONERS 23YP28389NH03 ECKENBERGER SARAH APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY NURSE PRACTITIONERS 23YP28389NH04 ECKENBERGER SARAH APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3664 FAMILY NURSE PRACTITIONERS 23YP28389NH05 ECKENBERGER SARAH APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 FAMILY NURSE PRACTITIONERS 04YP39691NH01 EDMUNDS JILLIAN DO DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 INTERNAL MEDICINE 04YP39691NH02 EDMUNDS JILLIAN DO DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 INTERNAL MEDICINE 0108112YPNH01 EDWARDS PATRICIA MD CONCORD PEDIATRICS PA CONCORD NH 03301 (603) 224-1929 PEDIATRICS 01YP03772NH06 EDWARDS TYLER MD FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 335-2401 FAMILY MEDICINE 01YP07954NH01 EGENOLF CRISTI MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP07954NH02 EGENOLF CRISTI MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP07954NH03 EGENOLF CRISTI MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP07954NH04 EGENOLF CRISTI MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP07954NH05 EGENOLF CRISTI MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 23YP38924NH01 EGLI AMANDA APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 663-8718 FAMILY NURSE PRACTITIONERS 23YP38924NH02 EGLI AMANDA APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 782-7414 FAMILY NURSE PRACTITIONERS 23YP38924NH03 EGLI AMANDA APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 665-7450 FAMILY NURSE PRACTITIONERS 23YP37056NH01 EHRLICH JAMES APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY NURSE PRACTITIONERS 23YP42037NH01 EINEBERG KRISTIN APRN BETTER LIFE PARTNERS INC HANOVER NH 03755 (866) 679-0831 ADULT NURSE PRACTITIONERS 23YP42037NH02 EINEBERG KRISTIN APRN BETTER LIFE PARTNERS INC NEW IPSWICH NH 03071 (866) 679-0831 ADULT NURSE PRACTITIONERS 23YP42037NH03 EINEBERG KRISTIN APRN BETTER LIFE PARTNERS INC JAFFREY NH 03452 (866) 679-0831 ADULT NURSE PRACTITIONERS 23YP42037NH04 EINEBERG KRISTIN APRN BETTER LIFE PARTNERS INC KEENE NH 03431 (866) 679-0831 ADULT NURSE PRACTITIONERS 23YP42037NH05 EINEBERG KRISTIN APRN BETTER LIFE PARTNERS INC KEENE NH 03431 (866) 679-0831 ADULT NURSE PRACTITIONERS 01YP31410NH02 EISENBERG ERIC MD APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 330-3404 INTERNAL MEDICINE 01YP14601NH01 EISENBERG ELLEN MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 01YP39867NH01 ELBROLOSY BASEM MD COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 FAMILY MEDICINE 23YP41019NH01 ELDREDGE KIM APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-2759 FAMILY NURSE PRACTITIONERS 01YP36422MA01 ELETRIBY RANA MD LAHEY CLINIC INC BURLINGTON MA 01803 (781) 744-7000 INTERNAL MEDICINE 0105371YPNH02 ELGERT STEPHEN MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 FAMILY MEDICINE 23YP29149NH01 ELGUERO BRIDGETTE APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 FAMILY NURSE PRACTITIONERS 04YP34304NH01 ELIEZER CAREN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 INTERNAL MEDICINE 04YP34304NH02 ELIEZER CAREN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 INTERNAL MEDICINE 04YP34304NH03 ELIEZER CAREN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 INTERNAL MEDICINE

Page 18 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP34304NH04 ELIEZER CAREN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 INTERNAL MEDICINE 04YP34304NH05 ELIEZER CAREN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 INTERNAL MEDICINE 23YP33651VT01 ELLIOTT KATHY APRN PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 ADULT NURSE PRACTITIONERS 23YP33651VT02 ELLIOTT KATHY APRN PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 ADULT NURSE PRACTITIONERS 23YP02713NH05 ELLIS JAMIE APRN ALLIANCE HEALTH SERVICES BEDFORD NH 03110 (603) 695-2572 FAMILY NURSE PRACTITIONERS 23YP40278NH01 ELLIS MORRISSETTE LISA APRN LRGHEALTHCARE LACONIA NH 03246 (603) 524-9201 FAMILY NURSE PRACTITIONERS 01YP02806NH01 EMERY ROSS MD SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-2555 PEDIATRICS 01YP03155NH01 EMMICK GUS MD ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 641-5386 INTERNAL MEDICINE 01YP03984NH01 EMMICK JASON MD ELLIOT PHYSICIANS NETWORK RAYMOND NH 03077 (603) 895-8000 INTERNAL MEDICINE 01YP03984NH01 EMMICK JASON MD ELLIOT PHYSICIANS NETWORK RAYMOND NH 03077 (603) 895-8000 INTERNAL MEDICINE 23YP31341NH01 ENGLAND LYNNE APRN FOUNDATION MEDICAL PARTNERS INC PELHAM NH 03076 (603) 635-5400 FAMILY NURSE PRACTITIONERS 23YP40423NH01 ENMAN LOU-ELLEN APRN ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 314-6500 FAMILY NURSE PRACTITIONERS 01YP41646NH01 EPHREM VERCIN MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 01YP37802NH01 ERICKSON SARA MD HUGGINS HOSPITAL ALTON NH 03809 (603) 515-2093 INTERNAL MEDICINE 01YP37941NH01 ERICKSON SARA MD APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY MEDICINE 01YP39961ME01 ERICKSON SARA MD YORK HOSPITAL WELLS ME 04090 (207) 351-2116 INTERNAL MEDICINE 01YP34369ME01 ERICKSON EMILY MD YORK HOSPITAL KITTERY ME 03904 (207) 439-4430 FAMILY MEDICINE 0105106YPNH02 ERISMAN SUSAN MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 INTERNAL MEDICINE 01YP00618MA01 ERLER ANITA MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 01YP14809MA01 ERLER DANIEL MD LAHEY CLINIC INC LEXINGTON MA 02421 (781) 372-7100 INTERNAL MEDICINE 01YP12629MA03 ESPINOSA ANA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (888) 227-3762 PEDIATRICS 01YP12629MA04 ESPINOSA ANA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8700 PEDIATRICS 01YP37276MA01 EURICH LAURA MD LAHEY CLINIC INC SOUTH HAMILTON MA 01982 (978) 468-7346 FAMILY MEDICINE 01YP37276MA02 EURICH LAURA MD LAHEY CLINIC INC IPSWICH MA 01938 (978) 356-5522 FAMILY MEDICINE 23YP21290VT01 EVANS BARBARA APRN BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8665 FAMILY NURSE PRACTITIONERS 23YP11977VT02 EVANS CAROLINE APRN LITTLE RIVERS HEALTH CARE INC EAST CORINTH VT 05040 (802) 439-5321 FAMILY NURSE PRACTITIONERS 0100064YPVT03 EVANS THOMAS MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8865 FAMILY MEDICINE 23YP26819VT01 EVERETT CARYN APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-7500 FAMILY NURSE PRACTITIONERS 23YP26819VT02 EVERETT CARYN APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 FAMILY NURSE PRACTITIONERS 23YP12808NH01 FADER KIMBERLY APRN MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY NURSE PRACTITIONERS 0107149YPNH02 FAGAN DAVID MD MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 INTERNAL MEDICINE 23YP31459NH01 FAHEY MARY LYNN APRN WHOLE LIFE HEALTH CARE NEWINGTON NH 03801 (603) 431-6677 ADULT NURSE PRACTITIONERS 23YP24803NH01 FALICON ELIZABETH APRN LIFE LONG CARE OF NEW LONDON PLLC NEW LONDON NH 03257 (603) 526-4144 FAMILY NURSE PRACTITIONERS 01YP27731NH01 FANBURG SUSAN MD FOUNDATION MEDICAL PARTNERS INC MERRIMACK NH 03054 (603) 429-3155 PEDIATRICS 01YP34489MA01 FARHA DURATHUN MD STEWARD MEDICAL GROUP INC LAWRENCE MA 01841 (978) 989-9811 INTERNAL MEDICINE 23YP37777NH01 FARMER CAITLIN APRN APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 433-8434 ADULT NURSE PRACTITIONERS 23YP37777NH02 FARMER CAITLIN APRN APPLEDORE MEDICAL GROUP INC HAMPTON NH 03842 (603) 929-2137 ADULT NURSE PRACTITIONERS 01YP35944NH01 FARRA RAPHAEL MD RAPHAEL FARRA MD MANCHESTER NH 03104 (603) 623-3013 INTERNAL MEDICINE 2309351YPVT02 FARRELL SUSAN APRN UPPER VALLEY PEDIATRICS PLLC BRADFORD VT 05033 (802) 222-4722 PEDIATRIC NURSE PRACTITIONERS 01YP16862NH01 FARRELL COURTNEY MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-4000 INTERNAL MEDICINE 01YP17541MA01 FARZAN DAVID MD MERRIMACK MEDICAL & WALK IN CENTER, LLC LAWRENCE MA 01841 (978) 688-3100 FAMILY MEDICINE 0107593YPNH01 FAULKNER NATHAN MD CONCORD PEDIATRICS PA CONCORD NH 03301 (603) 224-1929 PEDIATRICS 01YP14735MA01 FAUST III ROBERT MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 23YP15495NH01 FAUTEUX JESSICA APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 PEDIATRIC NURSE PRACTITIONERS 01YP39812NH01 FAZAL ZANIRA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 01YP39518NH01 FELDMANN THERESA MD AZAR A KORBEY MD PLLC SALEM NH 03079 (603) 893-7905 PEDIATRICS

Page 19 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 0102282YPNH01 FELDMANN WILLIAM MD AZAR A KORBEY MD PLLC SALEM NH 03079 (603) 893-7905 INTERNAL MEDICINE 0103860YPNH01 FELGATE RODNEY MD RODNEY A FELGATE MD LINCOLN NH 03251 (603) 745-8136 FAMILY MEDICINE 01YP03576NH01 FENG MONA MD GREAT BAY PEDIATRICS NEWMARKET NH 03857 (603) 659-1600 PEDIATRICS 01YP27243NH01 FENTON RANDALL MD MEDICAL CARE OF BOSTON MANAGEMENT CORP SALEM NH 03079 (603) 870-5452 FAMILY MEDICINE 04YP18369NH01 FERGUSON SHARON DO DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 04YP13749NH01 FERLAN MARK DO ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 624-4380 INTERNAL MEDICINE 23YP39034NH01 FERNANDES JUANITA APRN LRGHEALTHCARE BELMONT NH 03220 (603) 528-0990 FAMILY NURSE PRACTITIONERS 01YP35528NH01 FERNANDEZ KIEMELE MARISSA MD CORE PHYSICIANS LLC HAMPTON NH 03842 (603) 929-1195 FAMILY MEDICINE 23YP13423MA01 FERRARA LORYN ARNP MERRIMACK VALLEY MEDICAL ASSOCIATES PC METHUEN MA 01844 (978) 725-4822 ADULT NURSE PRACTITIONERS 23YP04201NH01 FERRERI CHRISTINA APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8350 FAMILY NURSE PRACTITIONERS 04YP30794NH01 FERRIS DAVID DO AMMONOOSUC COMMUNITY HEALTH SERVICES INC LITTLETON NH 03561 (603) 444-2464 FAMILY MEDICINE 23YP30526NH01 FERRIS LIZA APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY NURSE PRACTITIONERS 0107963YPNH01 FERRUCCI FERNANDO MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8350 PEDIATRICS 04YP41435NH01 FETCHERO JOHN DO CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 382-4972 FAMILY MEDICINE 01YP03471NH01 FEYRER SHEILA MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 PEDIATRICS 01YP34112NH01 FICHERA PHILLIP MD DARTMOUTH HITCHCOCK CLINIC HUDSON NH 03051 (603) 577-3410 FAMILY MEDICINE 01YP34112NH02 FICHERA PHILLIP MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY MEDICINE 23YP31346VT01 FIELDS BETTY APRN WINDSOR HOSPITAL CORP WOODSTOCK VT 05091 (802) 457-3030 INTERNAL MEDICINE NURSE PRACTITIONER 23YP30509NH01 FIGUEREO ATHENA APRN CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 314-4700 FAMILY NURSE PRACTITIONERS 01YP10288MA01 FINAN TAMAR MD LAHEY CLINIC INC ARLINGTON MA 02474 (781) 641-0100 INTERNAL MEDICINE 0106430YPVT01 FINE SHARON MD NORTHERN COUNTIES HEALTH CARE INC DANVILLE VT 05828 (802) 684-2275 FAMILY MEDICINE 23YP41936NH01 FINNERAN ELISSA APRN CORE PHYSICIANS LLC HAMPTON NH 03842 (603) 929-1195 INTERNAL MEDICINE NURSE PRACTITIONER 01YP33975MA01 FINOCCHIARO DARCI MD LAHEY CLINIC INC BEVERLY MA 01915 (978) 927-1919 INTERNAL MEDICINE 01YP37668VT01 FISCHBUCH PAUL MD SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 886-8914 PEDIATRICS 01YP37668VT02 FISCHBUCH PAUL MD SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 PEDIATRICS 01YP33159MA01 FISCHER MICHAEL MD PARTNERS COMMUNITY PHYS ORGANIZATION INC ANDOVER MA 01810 (978) 783-5000 PEDIATRICS 23YP11619NH01 FISCHLER NICOLE APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC LITTLETON NH 03561 (603) 444-2464 FAMILY NURSE PRACTITIONERS 01YP25121NH01 FISHBEIN JENNIFER MD CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 314-4700 INTERNAL MEDICINE 01YP25121NH02 FISHBEIN JENNIFER MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03102 (603) 663-5310 INTERNAL MEDICINE 23YP40470NH01 FISHER ANN APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC PORTSMOUTH NH 03801 (603) 431-2530 FAMILY NURSE PRACTITIONERS 01YP31031NH01 FITZGERALD JAMES MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP31031NH02 FITZGERALD JAMES MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP31031NH03 FITZGERALD JAMES MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP31031NH04 FITZGERALD JAMES MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP31031NH05 FITZGERALD JAMES MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP33667NH01 FITZGERALD CHRISTINE MD FOUNDATION MEDICAL PARTNERS INC MERRIMACK NH 03054 (603) 429-3155 PEDIATRICS 23YP34798NH01 FITZGERALD ANDREA APRN CONCORD HOSPITAL INC HOPKINTON NH 03229 (603) 228-7575 FAMILY NURSE PRACTITIONERS 01YP34362MA01 FITZGIBBONS LISA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3230 PEDIATRICS 0102448YPNH01 FLEET STEPHEN MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7588 INTERNAL MEDICINE 01YP35996VT01 FLORANCE EMILIJA MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY MEDICINE 23YP23300NH01 FOGG CATHERINE APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03102 (603) 625-6198 INTERNAL MEDICINE NURSE PRACTITIONER 23YP40827NH01 FOGG ASHLYNN APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 623-3343 FAMILY NURSE PRACTITIONERS 01YP23201MA02 FOLEY BRENDA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8880 PEDIATRICS 2309084YPVT02 FOOTE NANCY APRN UPPER VALLEY PEDIATRICS PLLC BRADFORD VT 05033 (802) 222-4722 PEDIATRIC NURSE PRACTITIONERS 0102708YPNH01 FORD JOHN MD WEEKS MEDICAL CENTER WHITEFIELD NH 03598 (603) 837-9005 FAMILY MEDICINE 23YP40604NH01 FORREST DUSTIN APRN DUSTIN FORREST APRN CONWAY NH 03818 (603) 770-4856 FAMILY NURSE PRACTITIONERS

Page 20 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP19689NH01 FORREST EILEEN MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-8900 PEDIATRICS 2309354YPNH01 FORTIN CELINE APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 889-3667 FAMILY NURSE PRACTITIONERS 23YP41278NH01 FOSTER SHELLEY APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 23YP18561VT01 FOSTER-ROBINSON JONI APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 885-1166 FAMILY NURSE PRACTITIONERS 23YP18561VT02 FOSTER-ROBINSON JONI APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 886-8914 FAMILY NURSE PRACTITIONERS 01YP35671NH01 FOTHERGILL JOHN MD NORTH COUNTRY MEDICAL AND WELLNESS LLC COLEBROOK NH 03576 (603) 331-0500 INTERNAL MEDICINE 01YP16427MA02 FOWLER KENNETH MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8700 INTERNAL MEDICINE 01YP18525NH01 FOX LAURA MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 INTERNAL MEDICINE 01YP18525NH02 FOX LAURA MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC WINDHAM NH 03087 (603) 216-0400 INTERNAL MEDICINE 0106126YPNH02 FOX KATHARINE MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 226-3400 FAMILY MEDICINE 01YP18254NH01 FOX PATRICK MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 226-3400 FAMILY MEDICINE 0106034YPVT01 FOX ROGER MD MOUNTAIN VALLEY HEALTH COUNCIL INC LONDONDERRY VT 05148 (802) 824-6901 INTERNAL MEDICINE 01YP14650MA01 FRAGA POLLY MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 04YP30312NH01 FRANCHI-WINTERS RACHEL DO AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 04YP30312NH02 FRANCHI-WINTERS RACHEL DO AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 663-5382 FAMILY MEDICINE 04YP30312NH03 FRANCHI-WINTERS RACHEL DO AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 668-6629 FAMILY MEDICINE 04YP30312NH04 FRANCHI-WINTERS RACHEL DO AMOSKEAG HEALTH MANCHESTER NH 03103 (603) 626-9500 FAMILY MEDICINE 04YP30312NH05 FRANCHI-WINTERS RACHEL DO AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 23YP33154NH01 FRANCIS ASHLEY APRN SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-3700 FAMILY NURSE PRACTITIONERS 04YP42217MA01 FRANCIS AMY DO PARTNERS COMMUNITY PHYS ORGANIZATION INC ANDOVER MA 01810 (978) 783-5000 INTERNAL MEDICINE 01YP22817NH01 FRANCIS PATRICK MD DARTMOUTH HITCHCOCK CLINIC LYME NH 03768 (603) 650-1070 INTERNAL MEDICINE 0104343YPNH01 FRECHETTE RICHARD MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4664 FAMILY MEDICINE 0104343YPNH02 FRECHETTE RICHARD MD MONADNOCK COMMUNITY HOSPITAL ANTRIM NH 03440 (603) 588-4200 FAMILY MEDICINE 04YP23335NH01 FREEMAN JR EARL DO SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-2555 FAMILY MEDICINE 04YP22453NH01 FRENKIEWICH BRIAN DO NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 FAMILY MEDICINE 0108947YPNH02 FRIEND PAUL MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 FAMILY MEDICINE 0108947YPNH04 FRIEND PAUL MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-2060 FAMILY MEDICINE 0108947YPNH05 FRIEND PAUL MD LRGHEALTHCARE GILFORD NH 03249 (603) 524-5816 FAMILY MEDICINE 0101699YPNH01 FRUMKIN MITCHELL MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4400 PEDIATRICS 0100782YPNH02 FRY LAURA MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 0100782YPNH03 FRY LAURA MD AMOSKEAG HEALTH MANCHESTER NH 03103 (603) 626-9500 FAMILY MEDICINE 0100782YPNH04 FRY LAURA MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 668-6629 FAMILY MEDICINE 0100782YPNH05 FRY LAURA MD AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 626-9500 FAMILY MEDICINE 0100782YPNH06 FRY LAURA MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 01YP31447NH01 FRYDMAN EMILY MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 PEDIATRICS 23YP31288MA01 FRYDRYK ABIGAIL APRN STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 687-3023 FAMILY NURSE PRACTITIONERS 23YP31288MA02 FRYDRYK ABIGAIL APRN STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 683-9177 FAMILY NURSE PRACTITIONERS 23YP38978NH01 FUCCI AMANDA APRN HUGGINS HOSPITAL ALTON NH 03809 (603) 515-2093 FAMILY NURSE PRACTITIONERS 23YP38978NH02 FUCCI AMANDA APRN HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7574 FAMILY NURSE PRACTITIONERS 23YP38978NH03 FUCCI AMANDA APRN HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7588 FAMILY NURSE PRACTITIONERS 23YP38978NH04 FUCCI AMANDA APRN HUGGINS HOSPITAL OSSIPEE NH 03864 (603) 539-6996 FAMILY NURSE PRACTITIONERS 23YP38978NH05 FUCCI AMANDA APRN HUGGINS HOSPITAL MOULTONBORO NH 03254 (603) 476-2216 FAMILY NURSE PRACTITIONERS 23YP38978NH06 FUCCI AMANDA APRN HUGGINS HOSPITAL TAMWORTH NH 03886 (603) 323-3311 FAMILY NURSE PRACTITIONERS 23YP38978NH07 FUCCI AMANDA APRN HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7500 FAMILY NURSE PRACTITIONERS 01YP24969VT01 FULHAM SARAH MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-2611 INTERNAL MEDICINE 01YP42086NH01 FULLER JOSEPH MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE

Page 21 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP42086NH02 FULLER JOSEPH MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP42176NH01 FULLER JR JOSEPH MD APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 332-5211 FAMILY MEDICINE 2305934YPNH02 FULLER-WIESNER DEIRDRE A APRN CONCORD HOSPITAL INC HOPKINTON NH 03229 (603) 228-7575 FAMILY NURSE PRACTITIONERS 04YP34573VT01 FUNAIOLI-SHEEHAN JENNIFER DO BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-0341 FAMILY MEDICINE 23YP23487NH02 FURBER KATHERINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY NURSE PRACTITIONERS 23YP23487NH03 FURBER KATHERINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DURHAM NH 03824 (603) 868-5080 FAMILY NURSE PRACTITIONERS 23YP23487NH04 FURBER KATHERINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP SOMERSWORTH NH 03878 (603) 692-6676 FAMILY NURSE PRACTITIONERS 23YP23487NH05 FURBER KATHERINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY NURSE PRACTITIONERS 23YP33927ME01 FURBER KATHERINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP SOUTH BERWICK ME 03908 (207) 384-4949 FAMILY NURSE PRACTITIONERS 04YP18432NH01 FURLAN JULIE DO HUGGINS HOSPITAL MOULTONBORO NH 03254 (603) 476-2216 FAMILY MEDICINE 23YP35963NH01 GABAI IVY APRN HARBOR HOMES INC NASHUA NH 03060 (603) 821-7788 FAMILY NURSE PRACTITIONERS 01YP29552MA01 GADON MARGARET MD LAHEY CLINIC INC ARLINGTON MA 02474 (781) 641-0100 INTERNAL MEDICINE 01YP27228VT01 GADOWSKI AMY MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-2611 INTERNAL MEDICINE 01YP35234NH01 GAGNON DAVID MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE 2309980YPNH19 GAGNON MARY APRN WENTWORTH DOUGLASS PHYSICIAN CORP LEE NH 03861 (603) 868-3300 FAMILY NURSE PRACTITIONERS 01YP26376NH01 GALANES SARI MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 INTERNAL MEDICINE 04YP23652NH01 GALASSO ANDREA DO ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 434-1919 INTERNAL MEDICINE 01YP23651ME01 GALBRAITH DAVID MD GALBRAITH FAMILY MEDICINE LLC LIMERICK ME 04048 (207) 793-9586 FAMILY MEDICINE 01YP23649ME01 GALBRAITH KATHRYN MD GALBRAITH FAMILY MEDICINE LLC LIMERICK ME 04048 (207) 793-9586 FAMILY MEDICINE 01YP02639MA02 GALIZIO STEPHEN MD STEPHEN J GALIZIO MD PC NORTH ANDOVER MA 01845 (978) 681-4700 INTERNAL MEDICINE 01YP02555NH01 GALLAGHER MAUREEN MD APPLEDORE MEDICAL GROUP INC HAMPTON NH 03842 (603) 929-2137 INTERNAL MEDICINE 23YP37166NH01 GALVIN LAUREL APRN SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-3700 FAMILY NURSE PRACTITIONERS 01YP04238NH01 GANEM DEBORAH MD FOUNDATION MEDICAL PARTNERS INC MILFORD NH 03055 (603) 672-7600 INTERNAL MEDICINE 01YP10309MA01 GANZ KAREN MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 01YP30407MA01 GARABEDIAN TORKOM MD COMMUNITY MEDICAL ASSOCIATES INC LAWRENCE MA 01841 (978) 946-8550 INTERNAL MEDICINE 01YP14966NH01 GARCIA MARGRET MD WENTWORTH DOUGLASS PHYSICIAN CORP LEE NH 03861 (603) 868-3300 FAMILY MEDICINE 01YP38028NH01 GARDNER E BENJAMIN MD MASCOMA COMMUNITY HEALTHCARE INC CANAAN NH 03741 (603) 523-4343 PEDIATRICS 04YP11080NH02 GARLIN DEBRA DO FOUNDATION MEDICAL PARTNERS INC MERRIMACK NH 03054 (603) 429-3155 FAMILY MEDICINE 23YP36126NH01 GAUDETTE BOWLEY JACLYN APRN CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY NURSE PRACTITIONERS 0100365YPME02 GAUTHIER MICHAEL MD YORK HOSPITAL YORK ME 03909 (207) 363-8430 FAMILY MEDICINE 23YP40948NH01 GAUTHIER JENNIFER APRN CORE PHYSICIANS LLC EPPING NH 03042 (603) 293-2100 FAMILY NURSE PRACTITIONERS 0102374YPVT01 GEAGAN KATHLEEN MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7337 PEDIATRICS 23YP40052NH01 GEDDES SETU APRN CONCORD HOSPITAL INC PEMBROKE NH 03275 (603) 485-8441 FAMILY NURSE PRACTITIONERS 01YP07636NH01 GEFFKEN DOMINIC MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 04YP42328NH01 GEISHAUSER BEN DO DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY MEDICINE 23YP36026ME01 GELLER ALLISON APRN ALLISON GELLER APRN KITTERY ME 03904 (603) 562-5578 FAMILY NURSE PRACTITIONERS 23YP36026ME02 GELLER ALLISON APRN ALLISON GELLER APRN YORK ME 03909 (603) 562-5578 FAMILY NURSE PRACTITIONERS 01YP03986NH03 GELLER ALEXANDER MD FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 INTERNAL MEDICINE 01YP03986NH04 GELLER ALEXANDER MD FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 330-3404 INTERNAL MEDICINE 01YP03986NH05 GELLER ALEXANDER MD APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 330-3404 INTERNAL MEDICINE 0105822YPMA01 GENDLERMAN MICHAEL MD MICHAEL GENDLERMAN MD LAWRENCE MA 01843 (978) 682-0930 INTERNAL MEDICINE 0100413YPMA01 GENDLERMAN JOSEF MD JOSEF GENDLERMAN MD LAWRENCE MA 01843 (978) 682-0930 INTERNAL MEDICINE 0109790YPVT02 GENEREAUX STEPHEN MD LITTLE RIVERS HEALTH CARE INC WELLS RIVER VT 05081 (802) 757-2325 FAMILY MEDICINE 23YP39123MA01 GENETTI KATHLEEN APRN FOUNDATION MEDICAL PARTNERS INC PEPPERELL MA 01463 (978) 433-6317 FAMILY NURSE PRACTITIONERS 01YP20897NH01 GEORGE MARION MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03103 (603) 663-8200 INTERNAL MEDICINE 01YP17588ME01 GEORGE ARGILLA MD YORK HOSPITAL YORK ME 03909 (207) 363-8430 FAMILY MEDICINE

Page 22 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP08448NH02 GERCHMAN ERIC MD BRIDGTON HOSPITAL FRYEBURG ME 04037 (207) 935-3383 FAMILY MEDICINE 04YP40041NH01 GERHART ADRIENNE DO CONCORD HOSPITAL INC PENACOOK NH 03303 (603) 753-4302 FAMILY MEDICINE 23YP22158VT01 GERRISH ASHLEY APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 ADULT NURSE PRACTITIONERS 01YP20691NH01 GESSNER WILLIAM MD COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 FAMILY MEDICINE 01YP16470VT01 GEURTS MAURICE MD CARLOS G OTIS HEALTHCARE CTR TOWNSHEND VT 05353 (802) 365-4331 FAMILY MEDICINE 01YP33987NH01 GHIMIRE LAXMI MD LRGHEALTHCARE BELMONT NH 03220 (603) 528-0995 PEDIATRICS 01YP33987NH02 GHIMIRE LAXMI MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 PEDIATRICS 01YP42546ME01 GIBSON STACEY MD YORK HOSPITAL YORK ME 03909 (207) 363-8430 FAMILY MEDICINE 23YP39940NH01 GIEDD ANN APRN ANN GIEDD PLLC EATON CENTER NH 03832 (603) 447-4958 INTERNAL MEDICINE NURSE PRACTITIONER 01YP10261NH01 GIFFORD KIMBERLY MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 PEDIATRICS 23YP28025NH01 GILBERT RYAN APRN LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY NURSE PRACTITIONERS 23YP28025NH02 GILBERT RYAN APRN LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY NURSE PRACTITIONERS 0104780YPME03 GILROY III JAMES MD YORK HOSPITAL MOODY ME 04054 (207) 646-8386 INTERNAL MEDICINE 0104780YPME04 GILROY III JAMES MD YORK HOSPITAL YORK ME 03909 (207) 351-3530 INTERNAL MEDICINE 01YP24851MA01 GIORGETTI MICHAEL MD MERRIMACK MEDICAL & WALK IN S LAWRENCE MA 01841 (978) 688-3100 FAMILY MEDICINE 01YP30072NH01 GITTLEMAN COREY MD ST JOSEPH HOSPITAL MERRIMACK NH 03054 (603) 424-4181 FAMILY MEDICINE 01YP30072NH02 GITTLEMAN COREY MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 FAMILY MEDICINE 01YP40627NH01 GITTLEMAN COREY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP40627NH02 GITTLEMAN COREY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP40627NH03 GITTLEMAN COREY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP40627NH04 GITTLEMAN COREY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP40627NH05 GITTLEMAN COREY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP40627NH06 GITTLEMAN COREY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP30699NH01 GLAZER DEBORAH MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 FAMILY MEDICINE 01YP34492MA01 GLENNEY AARON MD LAHEY CLINIC INC AMESBURY MA 01913 (978) 388-5050 FAMILY MEDICINE 04YP25115NH01 GLOVER SARAH DO DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 INTERNAL MEDICINE 0106976YPNH01 GLOWA PATRICIA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-4000 FAMILY MEDICINE 23YP35835NH01 GODIN JUSTIN APRN DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2500 FAMILY NURSE PRACTITIONERS 01YP33150NH01 GOFF KATHY MD PELHAM HEALTHCARE ASSOCIATES PLLC PELHAM NH 03076 (603) 635-2802 FAMILY MEDICINE 0102936YPMA01 GOGJIAN MICHAEL MD MICHAEL GOGJIAN MD NORTH ANDOVER MA 01845 (978) 689-9488 INTERNAL MEDICINE 23YP40479NH01 GOGUEN ALI APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC CONCORD NH 03301 (603) 369-4530 FAMILY NURSE PRACTITIONERS 04YP03636VT02 GOLDBERG CRAIG DO CRAIG GOLDBERG DO BRATTLEBORO VT 05301 (802) 254-4545 FAMILY MEDICINE 04YP03192NH03 GOLDBERG MATTHEW DO WENTWORTH DOUGLASS PHYSICIAN CORP LEE NH 03861 (603) 868-3300 FAMILY MEDICINE 04YP03192NH15 GOLDBERG MATTHEW DO WENTWORTH DOUGLASS PHYSICIAN CORP NEWMARKET NH 03857 (603) 659-0901 FAMILY MEDICINE 04YP03808NH01 GOLDMAN SAMUEL DO ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 INTERNAL MEDICINE 01YP14268NH01 GOLDMAN KLINGLER ANGELA MD CONCORD HOSPITAL INC WARNER NH 03278 (603) 456-6106 FAMILY MEDICINE 23YP41059NH01 GOLDSTEIN ERIKA APRN CENTER STATE WELLNESS LLC CONCORD NH 03301 (603) 556-7101 FAMILY NURSE PRACTITIONERS 01YP31017MA01 GOLZARI HOUTAN MD SEACOAST MEDICAL ASSOC NEWBURYPORT MA 01950 (978) 462-1555 INTERNAL MEDICINE 23YP02541NH01 GOODMAN ERIC APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 PEDIATRIC NURSE PRACTITIONERS 23YP40824NH01 GOODWIN LAUREN APRN CATHOLIC MEDICAL CENTER GOFFSTOWN NH 03045 (603) 314-4500 FAMILY NURSE PRACTITIONERS 23YP40570NH01 GOONAN DENISE APRN THRIVEE PC MANCHESTER NH 03102 (603) 622-8665 FAMILY NURSE PRACTITIONERS 23YP37242VT01 GORDON MADONNA APRN UPPER VALLEY PEDIATRICS PLLC BRADFORD VT 05033 (802) 222-4722 PEDIATRIC NURSE PRACTITIONERS 01YP00640MA01 GORDON FREDRIC MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 0106180YPMA03 GORELIK BRONIE MD STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 687-6355 PEDIATRICS 0106180YPMA04 GORELIK BRONIE MD STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 687-6355 PEDIATRICS 0107811YPMA01 GORN JOEL MD LAWRENCE FAMILY DOCTORS LLC LAWRENCE MA 01840 (978) 688-1919 FAMILY MEDICINE

Page 23 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP37845NH01 GORVEATT VICTORIA APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC PORTSMOUTH NH 03801 (610) 444-6350 FAMILY NURSE PRACTITIONERS 23YP18895NH01 GOSSELIN SUSAN APRN ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 641-5386 FAMILY NURSE PRACTITIONERS 04YP26181NH02 GOTTFREDSEN LEA DO FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 330-3404 INTERNAL MEDICINE 04YP38892NH01 GOTTFREDSEN LEA DO CATHOLIC MEDICAL CENTER MANCHESTER NH 03102 (603) 625-6198 INTERNAL MEDICINE 01YP22536NH01 GOUBERT ANA MD LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY MEDICINE 23YP16010VT01 GOULD KRISTA FNP WHITE RIVER FAMILY PRACTICE PC WHITE RIVER JUNCTION VT 05001 (802) 295-6132 FAMILY NURSE PRACTITIONERS 23YP29974NH01 GOULD LURIE CAROL APRN MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY NURSE PRACTITIONERS 23YP25112VT01 GOYETTE KATHERINE APRN WHITE RIVER FAMILY PRACTICE PC WHITE RIVER JCT VT 05001 (802) 295-6132 FAMILY NURSE PRACTITIONERS 23YP37289VT01 GRACE KIRSTEN APRN UPPER VALLEY PEDIATRICS PLLC BRADFORD VT 05033 (802) 222-4722 FAMILY NURSE PRACTITIONERS 01YP25722NH01 GRANAHAN EILEEN MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 PEDIATRICS 23YP40389NH01 GRAY GABRIELLE APRN LRGHEALTHCARE BELMONT NH 03220 (603) 528-0990 FAMILY NURSE PRACTITIONERS 23YP15413NH01 GRAY STEFANIE APRN ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 FAMILY NURSE PRACTITIONERS 01YP34903ME01 GREEN ALISON MD YORK HOSPITAL SANFORD ME 04073 (207) 608-8425 FAMILY MEDICINE 23YP29466NH01 GREEN STEPHANIE APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY NURSE PRACTITIONERS 01YP36167NH01 GREENFELD ANDREA MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 INTERNAL MEDICINE 01YP36167NH02 GREENFELD ANDREA MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 314-6500 INTERNAL MEDICINE 23YP36197NH01 GREENFIELD ALISE APRN NATURAE LLC PORTSMOUTH NH 03801 (603) 610-8882 FAMILY NURSE PRACTITIONERS 23YP42029NH01 GREENWELL BARBARA APRN MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 ADULT NURSE PRACTITIONERS 01YP17971NH01 GREER LAURA MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 PEDIATRICS 23YP38682NH01 GRENON HEATHER APRN LRGHEALTHCARE GILFORD NH 03249 (603) 527-7114 FAMILY NURSE PRACTITIONERS 23YP02804NH02 GRIFFIN CHARLES DANIEL APRN LRGHEALTHCARE BELMONT NH 03220 (603) 528-0990 FAMILY NURSE PRACTITIONERS 23YP02804NH03 GRIFFIN CHARLES DANIEL APRN LRGHEALTHCARE LACONIA NH 03246 (603) 527-2896 FAMILY NURSE PRACTITIONERS 23YP41243NH01 GROCE HAZEL APRN DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2500 FAMILY NURSE PRACTITIONERS 01YP15125NH01 GROFF TRICIA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-4000 PEDIATRICS 04YP40459NH01 GROVER ANUPRIYA DO APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY MEDICINE 01YP37438MA01 GRUBER LISA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3230 PEDIATRICS 01YP03334NH01 GRUCHOT SHANON MD LONDONDERRY PEDIATRICS PA LONDONDERRY NH 03053 (603) 437-1003 PEDIATRICS 04YP18509ME01 GRZYSIEWICZ AMY DO YORK HOSPITAL KITTERY ME 03904 (207) 439-4430 FAMILY MEDICINE 01YP27543MA01 GUERRERO-PAJELA EVE MD STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 687-6355 PEDIATRICS 04YP35347NH01 GUIDI MICHAEL DO CORE PHYSICIANS LLC HAMPTON NH 03842 (603) 929-1195 FAMILY MEDICINE 04YP42494NH01 GUIDI MICHAEL DO PMC MEDICAL GROUP LLC NEWINGTON NH 03801 (603) 436-9100 FAMILY MEDICINE 04YP42494NH02 GUIDI MICHAEL DO PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY MEDICINE 01YP14941NH02 GUPTA NEERA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 888-5573 INTERNAL MEDICINE 01YP42186NH01 GUPTA NEERA MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 INTERNAL MEDICINE 01YP03323NH01 GURKA JOSEPH MD JOSEPH GURKA MD SALEM NH 03079 (603) 893-8330 INTERNAL MEDICINE 23YP34145NH01 GURUNG SUNAMI APRN AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY NURSE PRACTITIONERS 23YP34145NH02 GURUNG SUNAMI APRN AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 663-5382 FAMILY NURSE PRACTITIONERS 23YP34145NH03 GURUNG SUNAMI APRN AMOSKEAG HEALTH MANCHESTER NH 03103 (603) 626-9500 FAMILY NURSE PRACTITIONERS 23YP34145NH04 GURUNG SUNAMI APRN AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 668-6629 FAMILY NURSE PRACTITIONERS 23YP34145NH05 GURUNG SUNAMI APRN AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY NURSE PRACTITIONERS 01YP00647MA01 GUTIERREZ GLENN MD LAHEY CLINIC INC BILLERICA MA 01862 (978) 663-6666 INTERNAL MEDICINE 23YP42485NH01 GUTWILLIG STEVEN APRN ALTRIX PRIMARY CARE - NASHUA LLC NASHUA NH 03062 (603) 821-4009 FAMILY NURSE PRACTITIONERS 23YP40406NH01 HACHEY TABITHA APRN THRIVEE PC MANCHESTER NH 03102 (603) 622-8665 FAMILY NURSE PRACTITIONERS 01YP19831NH01 HAFFNER ARTHUR MD FAMILY HEALTH MATTERS OF SALEM SALEM NH 03079 (603) 386-0100 FAMILY MEDICINE 2305871YPNH01 HAGAN EVELYN APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC WHITEFIELD NH 03598 (603) 837-2333 FAMILY NURSE PRACTITIONERS 23YP33731NH01 HAHN VANESSA APRN LRGHEALTHCARE LACONIA NH 03246 (603) 527-2969 FAMILY NURSE PRACTITIONERS

Page 24 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP10542NH02 HAJDUK MATTHEW MD ELLIOT PHYSICIANS NETWORK WINDHAM NH 03087 (603) 685-0150 PEDIATRICS 01YP35062MA01 HALE DAN MD COMMUNITY MEDICAL ASSOCIATES INC LAWRENCE MA 01841 (978) 683-4000 PEDIATRICS 0104728YPNH01 HALEY JOHN MD MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 FAMILY MEDICINE 01YP10091VT01 HALL ALDEN MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 INTERNAL MEDICINE 0106059YPVT03 HALL ELIOT MD SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 PEDIATRICS 23YP27914NH02 HALL JOHN APRN WENTWORTH DOUGLASS PHYSICIAN CORP LEE NH 03861 (603) 868-3300 FAMILY NURSE PRACTITIONERS 23YP27914NH03 HALL JOHN APRN WENTWORTH DOUGLASS PHYSICIAN CORP NEWMARKET NH 03857 (603) 659-0901 FAMILY NURSE PRACTITIONERS 01YP34064NH01 HALLQUIST ROBIN MD AMMONOOSUC COMMUNITY HEALTH SERVICES INC WHITEFIELD NH 03598 (603) 837-2333 FAMILY MEDICINE 23YP19827NH01 HALSTED ARLENE APRN NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 ADULT NURSE PRACTITIONERS 0107205YPVT04 HAMILTON MARK MD SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 886-2526 INTERNAL MEDICINE 04YP22170NH01 HAMILTON RACHEL DO THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5461 FAMILY MEDICINE 01YP33826NH01 HAN ANPING MD APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY MEDICINE 0108450YPNH01 HAND CHRISTINE MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0108450YPNH02 HAND CHRISTINE MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 0108450YPNH03 HAND CHRISTINE MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 0108450YPNH04 HAND CHRISTINE MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 0108450YPNH05 HAND CHRISTINE MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP25281NH01 HANDA ASHIMA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-3080 INTERNAL MEDICINE 01YP28765NH01 HANLON TERRANCE MD CORE PHYSICIANS LLC HAMPTON NH 03842 (603) 929-1195 INTERNAL MEDICINE 01YP03945NH02 HANRAHAN MELISSA MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 FAMILY MEDICINE 23YP35115NH01 HANRAHAN JENIFER APRN DARTMOUTH HITCHCOCK CLINIC WINCHESTER NH 03470 (603) 239-6351 INTERNAL MEDICINE NURSE PRACTITIONER 01YP02739NH01 HANSEN DEBORAH MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 PEDIATRICS 01YP41307NH01 HANSON HEIDI-ANNE MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 04YP41640NH01 HAQUE INSHA DO CONCORD HOSPITAL INC PENACOOK NH 03303 (603) 753-4302 FAMILY MEDICINE 23YP29473NH01 HARALABATOS ANTHONY APRN EVERCARE MEDICAL ASSOCIATES SALEM NH 03079 (603) 685-4609 FAMILY NURSE PRACTITIONERS 01YP34962NH01 HARKER PHENTON MD APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY MEDICINE 23YP24692VT01 HARLOW CHRISTINA APRN GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY NURSE PRACTITIONERS 01YP02093NH02 HARRIGAN DEBORAH MD FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 330-3404 FAMILY MEDICINE 01YP02093NH03 HARRIGAN DEBORAH MD FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 FAMILY MEDICINE 01YP02093NH04 HARRIGAN DEBORAH MD APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 330-3404 FAMILY MEDICINE 01YP41274NH01 HARRIGAN DEBORAH MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP41274NH02 HARRIGAN DEBORAH MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE 01YP07842MA01 HARRIS STEVEN MD STEVEN J HARRIS MD PC NORTH ANDOVER MA 01845 (978) 685-9600 PEDIATRICS 23YP31452VT01 HARRIS JONATHAN APRN BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-2611 FAMILY NURSE PRACTITIONERS 23YP23244NH02 HARRISON ELIZABETH APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP23244NH03 HARRISON ELIZABETH APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP23244NH04 HARRISON ELIZABETH APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP23244NH05 HARRISON ELIZABETH APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP23244NH06 HARRISON ELIZABETH APRN GREATER SEACOAST COMMUNITY HEALTH SEABROOK NH 03874 (603) 766-2626 FAMILY NURSE PRACTITIONERS 01YP41588NH01 HARYADI YULIUS MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE 01YP41588NH02 HARYADI YULIUS MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 INTERNAL MEDICINE 01YP28044MA01 HASAN IMRAN MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 04YP38758NH01 HASKELL CAROLYN DO MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY MEDICINE 04YP41981NH01 HASKELL CAROLYN DO MID-STATE HEALTH CENTER ALEXANDRIA NH 03222 (603) 744-6200 FAMILY MEDICINE 04YP41981NH02 HASKELL CAROLYN DO MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY MEDICINE 01YP33005NH01 HASSAN GHINWA MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 623-3343 FAMILY MEDICINE

Page 25 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 0105695YPNH01 HASSETT WILLIAM MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 FAMILY MEDICINE 01YP27826ME01 HASSETT WILLIAM MD WENTWORTH DOUGLASS PHYSICIAN CORP ELIOT ME 03903 (207) 451-9600 FAMILY MEDICINE 23YP36600NH01 HATCH BARBARA APRN COTTAGE HOSPITAL WOODSVILLE NH 03785 (603) 747-2900 FAMILY NURSE PRACTITIONERS 01YP33482NH01 HATTAN MARY MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 23YP31015NH01 HATTON KRISTEN APRN DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 FAMILY NURSE PRACTITIONERS 23YP32010NH01 HAYES JOANNE APRN ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 FAMILY NURSE PRACTITIONERS 0104781YPNH01 HEATH HARLEY MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7620 PEDIATRICS 23YP25735VT01 HECK TINA APRN NORTHERN COUNTIES HEALTH CARE INC ISLAND POND VT 05846 (802) 723-4300 FAMILY NURSE PRACTITIONERS 01YP32194NH01 HEDBERG VIKING MD MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 PEDIATRICS 23YP30665NH01 HEDBERG KATHLEEN APRN MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY NURSE PRACTITIONERS 0109637YPNH01 HEIT ROCHELLE MD RIVER ROAD PEDIATRICS PLLC BEDFORD NH 03110 (603) 622-8619 PEDIATRICS 23YP38959NH01 HEITZMAN FLORENCE APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 FAMILY NURSE PRACTITIONERS 01YP05493NH02 HENEGAN MARIKA MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 01YP05493NH03 HENEGAN MARIKA MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 01YP41912MA01 HENRY DRISANA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC ANDOVER MA 01810 (978) 783-5030 PEDIATRICS 01YP21471MA01 HENSLEY JENNIFER MD ANDOVER PEDIATRICS PC ANDOVER MA 01810 (978) 475-4522 PEDIATRICS 01YP25816VT01 HEPLER AMANDA MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8455 FAMILY MEDICINE 01YP31161NH01 HERFORT OLIVER MD NEW LONDON HOSPITAL ASSOCIATION NEWPORT NH 03773 (603) 863-4100 INTERNAL MEDICINE 01YP31161NH02 HERFORT OLIVER MD NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 INTERNAL MEDICINE 01YP41850NH01 HERNANDEZ AMANDA MD ADVANCED CARE HOUSE CALLS OF NH LLC EPPING NH 03042 (603) 686-6204 INTERNAL MEDICINE 01YP29972NH02 HERNANDEZ AVILES ANA SILVIA MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 PEDIATRICS 01YP29972NH03 HERNANDEZ AVILES ANA SILVIA MD LRGHEALTHCARE BELMONT NH 03220 (603) 528-0995 PEDIATRICS 01YP03214NH01 HERNDON M MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-4000 INTERNAL MEDICINE 01YP22165NH01 HERTFORD JO ANN MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 01YP36945NH01 HESSELSON LEILA MD CONCORD HOSPITAL INC EPSOM NH 03234 (603) 736-6200 FAMILY MEDICINE 01YP22003NH01 HEVERN GERARD MD ELLIOT PHYSICIANS NETWORK ALLENSTOWN NH 03275 (603) 485-7861 FAMILY MEDICINE 23YP11842NH01 HEWITT KAREN B APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE NURSE PRACTITIONER 23YP40759NH01 HIGGINS ALLISON APRN CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8052 FAMILY NURSE PRACTITIONERS 01YP23212NH01 HILES JR CHARLES MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7588 INTERNAL MEDICINE 01YP23212NH02 HILES JR CHARLES MD HUGGINS HOSPITAL OSSIPEE NH 03864 (603) 539-6996 INTERNAL MEDICINE 04YP32875NH01 HILTON STEVEN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 04YP32875NH02 HILTON STEVEN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 04YP32875NH03 HILTON STEVEN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 04YP32875NH04 HILTON STEVEN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 04YP32875NH05 HILTON STEVEN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 04YP14630MA02 HINDLE LINDA DO GEORGETOWN FAMILY MEDICINE LLC BOXFORD MA 01921 (978) 887-0222 FAMILY MEDICINE 04YP05469ME03 HINTERMEISTER CHARLES DO NORTH BERWICK FAMILY MEDICINE NORTH BERWICK ME 03906 (207) 676-8559 FAMILY MEDICINE 23YP08796NH02 HIRSCHFELD CHARISSE APRN THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY NURSE PRACTITIONERS 0109253YPNH01 HODGES KEVIN MD COASTAL PEDIATRICS PORTSMOUTH NH 03801 (603) 431-7393 PEDIATRICS 01YP35542NH01 HOERMAN WALTER MD GREATER SEACOAST COMMUNITY HEALTH ROCHESTER NH 03867 (603) 749-2345 PEDIATRICS 23YP37741NH01 HOGAN VICTORIA APRN FAMILY HEALTH MATTERS OF SALEM SALEM NH 03079 (603) 386-0100 FAMILY NURSE PRACTITIONERS 23YP38187NH01 HOLLERAN ALEXA APRN ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 FAMILY NURSE PRACTITIONERS 01YP02391NH01 HOLLISTER JOHN MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 PEDIATRICS 23YP21732NH01 HOLLORAN CYNTHIA APRN SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-2555 FAMILY NURSE PRACTITIONERS 23YP12541NH01 HOLT DONNA APRN ELLIOT PHYSICIANS NETWORK WINDHAM NH 03087 (603) 894-0063 FAMILY NURSE PRACTITIONERS 23YP28349NH01 HOLUB SMITH CATHERINE APRN DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRIC NURSE PRACTITIONERS

Page 26 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP16950NH01 HOLZINGER JENNIFER DO ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 624-8652 FAMILY MEDICINE 0109285YPVT02 HOMAN FAY MD LITTLE RIVERS HEALTH CARE INC WELLS RIVER VT 05081 (802) 757-2325 FAMILY MEDICINE 01YP05413NH02 HONG THOMAS MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 INTERNAL MEDICINE 01YP05413NH03 HONG THOMAS MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC WINDHAM NH 03087 (603) 216-0400 INTERNAL MEDICINE 04YP34066NH01 HONG HYUNOUK DO DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY MEDICINE 01YP34079VT01 HOOVER KAREN MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-2611 INTERNAL MEDICINE 01YP41834NH01 HOPE TODD MD INDIAN STREAM HEALTH CENTER INC COLEBROOK NH 03576 (603) 237-8336 INTERNAL MEDICINE 01YP42466NH01 HOPE TODD MD CRANMORE HEALTH PARTNERS LLC NORTH CONWAY NH 03860 (603) 730-5356 INTERNAL MEDICINE 01YP40832NH01 HOQUE SHAIKH MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 INTERNAL MEDICINE 01YP40832NH02 HOQUE SHAIKH MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 INTERNAL MEDICINE 01YP40832NH03 HOQUE SHAIKH MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 INTERNAL MEDICINE 01YP40832NH04 HOQUE SHAIKH MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 INTERNAL MEDICINE 01YP40832NH05 HOQUE SHAIKH MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 INTERNAL MEDICINE 2309186YPNH02 HORDIS CAROL APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 889-3667 ADULT NURSE PRACTITIONERS 01YP13653NH01 HORT SHOSHANA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 653-9500 INTERNAL MEDICINE 0108725YPNH01 HOUSTON KERRY MD LONDONDERRY PEDIATRICS PA LONDONDERRY NH 03053 (603) 437-1003 PEDIATRICS 0107565YPNH03 HOUSTON BIRGIT MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4400 FAMILY MEDICINE 23YP33199NH01 HOWARD RUSSELL APRN HEALTH FIRST FAMILY CARE CENTER FRANKLIN NH 03235 (603) 934-1464 FAMILY NURSE PRACTITIONERS 23YP33199NH02 HOWARD RUSSELL APRN HEALTH FIRST FAMILY CARE CENTER LACONIA NH 03246 (603) 366-1070 FAMILY NURSE PRACTITIONERS 04YP13477NH02 HOWE ROBERT DO CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 04YP13477NH03 HOWE ROBERT DO CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 382-4972 FAMILY MEDICINE 04YP13477NH04 HOWE ROBERT DO CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 23YP22191VT01 HOWES CYNTHIA APRN BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8626 PEDIATRIC NURSE PRACTITIONERS 23YP41249NH01 HOWES ANGELA APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 01YP28006VT01 HOYTE SANDRA MD SPRINGFIELD MEDICAL CARE SYSTEMS INC LONDONDERRY VT 05148 (802) 824-6904 INTERNAL MEDICINE 01YP22937MA01 HUANG LI LI MD LAHEY CLINIC INC BEVERLY MA 01915 (978) 927-1919 INTERNAL MEDICINE 04YP41396NH01 HUBBELL FRANKLIN DO SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-3500 GENERAL PRACTICE 23YP30366NH01 HUDSON LAURA APRN MY FRIENDS GYNECOLOGIST LLC DOVER NH 03820 (603) 516-0000 FAMILY NURSE PRACTITIONERS 23YP35863NH01 HUDSON LAURA APRN COMPASS FAMILY HEALTH LLC DOVER NH 03820 (603) 749-0001 FAMILY NURSE PRACTITIONERS 23YP29683NH01 HUGGINS ALLISON APRN CONCORD HOSPITAL INC PENACOOK NH 03303 (603) 753-4302 FAMILY NURSE PRACTITIONERS 23YP34806NH01 HULL JESSICA APRN ELLIOT PHYSICIANS NETWORK AMHERST NH 03031 (603) 249-3000 FAMILY NURSE PRACTITIONERS 01YP17649MA01 HUNT KAREN MD MERRIMACK MEDICAL & WALK IN CENTER, LLC LAWRENCE MA 01841 (978) 688-3100 FAMILY MEDICINE 0105102YPNH03 HUNTER CONVERSE MD ALLIANCE HEALTH SERVICES BEDFORD NH 03110 (603) 695-2500 PEDIATRICS 01YP08197MA01 HURLEY NANCY MD ANDOVER PEDIATRICS PC ANDOVER MA 01810 (978) 475-4522 PEDIATRICS 0100323YPNH01 HURLEY JAMES MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-7101 PEDIATRICS 01YP03686NH01 HUSARIK NANCY MD ELLIOT PHYSICIANS NETWORK RAYMOND NH 03077 (603) 895-8000 INTERNAL MEDICINE 01YP31252NH01 HUSSAIN KHWAJA MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY MEDICINE 23YP33973NH01 HUSTON LYDIA APRN LRGHEALTHCARE LACONIA NH 03246 (603) 527-2896 FAMILY NURSE PRACTITIONERS 23YP33973NH02 HUSTON LYDIA APRN LRGHEALTHCARE LACONIA NH 03246 (603) 527-2946 FAMILY NURSE PRACTITIONERS 23YP40003NH01 HUTTER CAITLYN APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC AMHERST NH 03031 (603) 249-8883 FAMILY NURSE PRACTITIONERS 23YP31954NH01 HYDE WILMA APRN SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-3700 PEDIATRIC NURSE PRACTITIONERS PEDIATRIC ASSOCIATES OF HAMPTON & 0109871YPNH01 HYER KIMBERLY MD PORTSMOUTH NH 03801 (603) 436-7171 PEDIATRICS PEDIATRICPORTSMOUTH ASSOCIATES PC OF HAMPTON & 0109871YPNH02 HYER KIMBERLY MD HAMPTON NH 03842 (603) 929-3838 PEDIATRICS PORTSMOUTH PC 0100563YPNH01 IDELKOPE GEORGE MD GEORGE IDELKOPE, MD HINSDALE NH 03451 (603) 336-5948 FAMILY MEDICINE 01YP41276NH01 IDOIDZE NINO MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 23YP39320NH01 ILLG CARRIE APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 889-3667 FAMILY NURSE PRACTITIONERS

Page 27 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP38455VT01 INGERICK SAMANTHA APRN UPPER VALLEY PEDIATRICS PLLC BRADFORD VT 05033 (802) 222-4722 PEDIATRIC NURSE PRACTITIONERS 01YP32096MA01 INGRAM WILLIAM MD HIGHLAND PRIMARY CARE NEWBURYPORT MA 01950 (978) 463-7770 INTERNAL MEDICINE 01YP37766NH01 IONESCU COSMIN MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 INTERNAL MEDICINE 01YP05480MA02 IOSIF GERMAN MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3250 INTERNAL MEDICINE 04YP07187NH03 IRWIN BRIAN DO HUGGINS HOSPITAL TAMWORTH NH 03886 (603) 323-3311 FAMILY MEDICINE 04YP07187NH04 IRWIN BRIAN DO HUGGINS HOSPITAL OSSIPEE NH 03864 (603) 539-6996 FAMILY MEDICINE 04YP07187NH05 IRWIN BRIAN DO HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7588 FAMILY MEDICINE 04YP07187NH06 IRWIN BRIAN DO HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7574 FAMILY MEDICINE 23YP29280NH01 IRZYK JACQUELINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY NURSE PRACTITIONERS 23YP29280NH02 IRZYK JACQUELINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8050 FAMILY NURSE PRACTITIONERS 23YP29280NH03 IRZYK JACQUELINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP BARRINGTON NH 03825 (603) 664-2135 FAMILY NURSE PRACTITIONERS 23YP29280NH04 IRZYK JACQUELINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8050 FAMILY NURSE PRACTITIONERS 23YP29280NH05 IRZYK JACQUELINE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY NURSE PRACTITIONERS 01YP34363MA01 ITZKOWITZ MARK MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 GERIATRIC MEDICINE 23YP41095ME01 IVANOVA VERA APRN YORK HOSPITAL YORK ME 03909 (207) 351-3530 FAMILY NURSE PRACTITIONERS 23YP41095ME02 IVANOVA VERA APRN YORK HOSPITAL MOODY ME 04054 (207) 351-3530 FAMILY NURSE PRACTITIONERS 01YP29251NH01 JABLONKA MARCIO MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 INTERNAL MEDICINE 01YP29251NH02 JABLONKA MARCIO MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC BEDFORD NH 03110 (603) 216-0400 INTERNAL MEDICINE 01YP21360MA01 JACKSON WILLIAM MD WILLIAM G JACKSON MD LLC SALISBURY MA 01952 (978) 462-3009 INTERNAL MEDICINE 01YP21636NH01 JACOBS JESSICA MD LITTLETON HOSPITAL ASSOCIATION LITTLETON NH 03561 (603) 444-2803 PEDIATRICS 23YP36912NH01 JACQUES REBECCA APRN DOVER PEDIATRICS PLLC DOVER NH 03820 (603) 742-4048 PEDIATRIC NURSE PRACTITIONERS 23YP36868NH01 JACQUES JOSEPHINE APRN FOUNTAINS OF HEALTH LLC NASHUA NH 03060 (603) 943-8923 FAMILY NURSE PRACTITIONERS 01YP29704MA01 JALEEL MOHAMMED MD TODAY'S WELLNESS PLLC NORTH ANDOVER MA 01845 (978) 687-2273 INTERNAL MEDICINE 01YP20968NH02 JAMES RUTH MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP20968NH03 JAMES RUTH MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP20968NH04 JAMES RUTH MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP20968NH05 JAMES RUTH MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP20968NH06 JAMES RUTH MD GREATER SEACOAST COMMUNITY HEALTH SEABROOK NH 03874 (603) 766-2626 FAMILY MEDICINE 0104057YPNH01 JAMES JEREMY MD LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY MEDICINE 0104057YPNH02 JAMES JEREMY MD LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY MEDICINE 0104057YPNH03 JAMES JEREMY MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY MEDICINE 01YP08552NH02 JAMPANI SUSHAMA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-3080 INTERNAL MEDICINE 01YP35366NH01 JANEWAY ELEANOR MD HEALTH FIRST FAMILY CARE CENTER FRANKLIN NH 03235 (603) 934-1464 INTERNAL MEDICINE 01YP29858NH01 JANG SUNG MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 FAMILY MEDICINE 01YP28397NH01 JANKOWSKA EWA MD DARTMOUTH HITCHCOCK CLINIC MERRIMACK NH 03054 (603) 424-4713 FAMILY MEDICINE 01YP28397NH02 JANKOWSKA EWA MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY MEDICINE 0106703YPNH01 JARAMILLO MARTHA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-3300 INTERNAL MEDICINE 23YP26965NH01 JAWOROWSKI KAYE APRN ELLIOT PHYSICIANS NETWORK ALLENSTOWN NH 03275 (603) 485-7861 FAMILY NURSE PRACTITIONERS 01YP27432NH01 JAYNES SCOTT MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY MEDICINE 04YP20628ME01 JEAN NATHAN DO YORK HOSPITAL KITTERY ME 03904 (207) 439-4430 FAMILY MEDICINE 01YP37521MA01 JEE SUNG BAE MD MEDICAL CARE OF BOSTON MANAGEMENT CORP METHUEN MA 01844 (978) 409-1137 FAMILY MEDICINE 01YP20461MA01 JEFFCOAT LYDIA MD SEACOAST AFFILIATED GROUP PRACTICE NEWBURYPORT MA 01950 (978) 465-0635 INTERNAL MEDICINE 0405236YPME02 JENDZEJEC STEPHEN DO YORK HOSPITAL YORK ME 03909 (207) 363-8430 FAMILY MEDICINE 23YP37808NH01 JENKINS KATHRYN APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY NURSE PRACTITIONERS 23YP37808NH02 JENKINS KATHRYN APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY NURSE PRACTITIONERS 23YP37808NH03 JENKINS KATHRYN APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY NURSE PRACTITIONERS

Page 28 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP37808NH04 JENKINS KATHRYN APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY NURSE PRACTITIONERS 23YP37808NH05 JENKINS KATHRYN APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY NURSE PRACTITIONERS 23YP23343NH01 JENNINGS JORGENSON LAURIE APRN LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 FAMILY NURSE PRACTITIONERS 23YP33180NH01 JESSOP ELLEN APRN SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-3500 FAMILY NURSE PRACTITIONERS 23YP40986NH01 JESSOP ELLEN APRN FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 330-3404 FAMILY NURSE PRACTITIONERS 01YP31744MA01 JETT LAURA MD LAHEY CLINIC INC AMESBURY MA 01913 (978) 388-5050 FAMILY MEDICINE 23YP40584VT01 JOHN KATIE APRN GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY NURSE PRACTITIONERS 23YP20433ME01 JOHNSEN GALE APRN SACOPEE VALLEY HEALTH CENTER PORTER ME 04068 (207) 625-8126 FAMILY NURSE PRACTITIONERS 01YP28352NH01 JOHNSON DAVID MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 INTERNAL MEDICINE 23YP25028NH01 JOHNSON JESSICA APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 FAMILY NURSE PRACTITIONERS 01YP36643NH01 JOHNSON REIKO MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 314-4567 FAMILY MEDICINE 01YP36643NH02 JOHNSON REIKO MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 782-7414 FAMILY MEDICINE 01YP36643NH03 JOHNSON REIKO MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 663-8718 FAMILY MEDICINE 01YP18261NH01 JOHNSON RYAN MD DOVER PEDIATRICS PLLC DOVER NH 03820 (603) 742-4048 PEDIATRICS 0105554YPNH01 JOHNSON THOMAS MD N E ALLERGY ASTHMA IMMUN & PRIMARY CARE PC DERRY NH 03038 (603) 432-7558 INTERNAL MEDICINE 0105554YPNH02 JOHNSON THOMAS MD N E ALLERGY ASTHMA IMMUN & PRIMARY CARE PC SALEM NH 03079 (603) 898-1892 INTERNAL MEDICINE 0105554YPNH03 JOHNSON THOMAS MD N E ALLERGY ASTHMA IMMUN & PRIMARY CARE PC NORTH ANDOVER MA 01845 (978) 683-4299 INTERNAL MEDICINE 0105554YPNH04 JOHNSON THOMAS MD N E ALLERGY ASTHMA IMMUN & PRIMARY CARE PC NEWBURYPORT MA 01950 (978) 465-7815 INTERNAL MEDICINE 2304540YPNH01 JOHNSON MARYANN APRN LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY NURSE PRACTITIONERS 2304540YPNH02 JOHNSON MARYANN APRN LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY NURSE PRACTITIONERS 2304540YPNH03 JOHNSON MARYANN APRN LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY NURSE PRACTITIONERS 23YP37602VT01 JOHNSTON AUDREY APRN LITTLE RIVERS HEALTH CARE INC EAST CORINTH VT 05040 (802) 439-5321 FAMILY NURSE PRACTITIONERS 01YP18326NH01 JOHNSTON JAMES MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-4000 FAMILY MEDICINE 01YP18845ME01 JOKONYA CHIEDZA MD WENTWORTH DOUGLASS PHYSICIAN CORP SOUTH BERWICK ME 03908 (207) 384-4949 FAMILY MEDICINE 01YP26679NH01 JOKONYA CHIEDZA MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY MEDICINE 04YP36250NH01 JONES ALEXANDER DO ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03103 (603) 626-5113 FAMILY MEDICINE 01YP11990NH01 JONES JENNIFER MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 PEDIATRICS 0409306YPNH01 JONES JENNIFER DO DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2600 INTERNAL MEDICINE 23YP21030NH02 JONES PAUL APRN STEWARD MEDICAL GROUP INC SALEM NH 03079 (603) 685-6977 FAMILY NURSE PRACTITIONERS 01YP41503ME01 JONES GLENN MD YORK HOSPITAL YORK ME 03909 (207) 351-1710 PEDIATRICS 01YP41503ME02 JONES GLENN MD YORK HOSPITAL WELLS ME 04090 (207) 646-5211 PEDIATRICS 0107443YPNH01 JONES STEVEN MD LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY MEDICINE 0107443YPNH03 JONES STEVEN MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY MEDICINE 0107319YPNH01 JORDAN STEPHEN MD NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 INTERNAL MEDICINE 23YP42128NH01 JORDAN DOROTHY APRN INDIAN STREAM HEALTH CENTER INC COLEBROOK NH 03576 (603) 237-8336 ADULT NURSE PRACTITIONERS 01YP30632NH01 JORDAN MICHAEL MD DARTMOUTH HITCHCOCK CLINIC MERRIMACK NH 03054 (603) 424-4713 FAMILY MEDICINE 01YP30632NH02 JORDAN MICHAEL MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY MEDICINE 01YP30090NH01 JOSHI GIRISH MD PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY MEDICINE 23YP38286NH01 JOSLIN SONIA APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 FAMILY NURSE PRACTITIONERS 01YP31715VT01 JOYCE MARY MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 FAMILY MEDICINE 01YP34614MA01 KACHAVOS PETER MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 469-7100 INTERNAL MEDICINE 01YP36519NH01 KAHANE JOSHUA MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 FAMILY MEDICINE 23YP17308NH02 KAHN AARON APRN FRISBIE MEMORIAL HOSPITAL FARMINGTON NH 03835 (603) 755-9801 FAMILY NURSE PRACTITIONERS 23YP17308NH03 KAHN AARON APRN APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 335-2401 FAMILY NURSE PRACTITIONERS 01YP33872NH01 KAITZ STEVEN MD PEMBROKE WELLNESS CENTER PLLC PEMBROKE NH 03275 (603) 485-7788 FAMILY MEDICINE 01YP20025MA01 KALISH RICHARD MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE

Page 29 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP20025MA02 KALISH RICHARD MD LAHEY CLINIC INC IPSWICH MA 01938 (978) 356-5522 INTERNAL MEDICINE 01YP40282NH01 KALLMERTEN DANIEL MD LRGHEALTHCARE LACONIA NH 03246 (603) 524-9201 INTERNAL MEDICINE 01YP00686MA01 KANEF MATTHEW MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 01YP37507MA01 KANTAS SPYRIDON MD MEDICAL CARE OF BOSTON MANAGEMENT CORP ANDOVER MA 01810 (978) 409-1137 INTERNAL MEDICINE 01YP11992VT01 KANTROWITZ JOSHUA MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC SAINT JOHNSBURY VT 05819 (802) 748-5131 PEDIATRICS 04YP28398NH01 KAPLOE MICHAEL DO DARTMOUTH HITCHCOCK CLINIC MILFORD NH 03055 (603) 673-2515 FAMILY MEDICINE 0103069YPNH01 KARAGIANNIS EMILIANOS MD EMILIANOS KARAGIANNIS MD MANCHESTER NH 03104 (603) 624-8085 INTERNAL MEDICINE 23YP36522NH01 KARALIUS TODD APRN COTTAGE HOSPITAL WOODSVILLE NH 03785 (603) 747-2900 FAMILY NURSE PRACTITIONERS 04YP32568MA01 KARAVASILIS ANGELA DO LAHEY CLINIC INC BEVERLY MA 01915 (978) 927-1919 FAMILY MEDICINE 0105888YPNH01 KARLSON KRISTINE MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-4000 FAMILY MEDICINE 23YP20941VT01 KARTER ROXANNE APRN BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-2611 ADULT NURSE PRACTITIONERS 01YP10282NH01 KASSCHAU MICHAEL MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 01YP25604MA02 KATZ DOUGLAS MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8800 INTERNAL MEDICINE 01YP02722MA03 KAUL SHARDA MD STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 685-7111 INTERNAL MEDICINE 01YP04780NH01 KAUPP GREGORY MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 594-6337 PEDIATRICS 01YP04173NH01 KAZAL LOUIS MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-4000 FAMILY MEDICINE 23YP36302NH01 KAZANOWSKI SARA APRN CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8060 FAMILY NURSE PRACTITIONERS 01YP23825NH01 KAZMOUZ SAFWAN MD MEDICINE AT YOUR DOOR LLC CONCORD NH 03301 (734) 718-0196 FAMILY MEDICINE 0106272YPNH02 KEANE ELIZABETH MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 PEDIATRICS 0106272YPNH03 KEANE ELIZABETH MD AMOSKEAG HEALTH MANCHESTER NH 03103 (603) 626-9500 PEDIATRICS 0106272YPNH04 KEANE ELIZABETH MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 PEDIATRICS 0106272YPNH05 KEANE ELIZABETH MD AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 626-9500 PEDIATRICS 23YP30436NH01 KEARNEY BRITTANY APRN CATHOLIC MEDICAL CENTER GOFFSTOWN NH 03045 (603) 314-4500 FAMILY NURSE PRACTITIONERS 23YP28120NH01 KEATON KIM APRN DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-6108 INTERNAL MEDICINE NURSE PRACTITIONER 0106355YPNH02 KEEFE HASSETT VIRGINIA MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3664 INTERNAL MEDICINE 0106355YPNH03 KEEFE HASSETT VIRGINIA MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE 01YP07200ME02 KEENAN JOEL MD YORK PRIMARY CARE YORK ME 03909 (207) 361-4902 INTERNAL MEDICINE 01YP11009NH02 KEENAN TIMOTHY MD CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 01YP11009NH03 KEENAN TIMOTHY MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY MEDICINE 01YP11009NH04 KEENAN TIMOTHY MD CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 01YP28355NH01 KEGEL PATRICIA MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 FAMILY MEDICINE 01YP11055NH01 KEHAS DAVID MD ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 624-8652 FAMILY MEDICINE 01YP35636NH01 KELLEY GENEVIEVE MD WHITE MOUNTAIN FAMILY HEALTHCARE LITTLETON LITTLETON NH 03561 (603) 444-2010 FAMILY MEDICINE 01YP32546NH01 KELLY ROBERT MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 929-1195 FAMILY MEDICINE 01YP31923NH01 KELSEY FREDERICK MD HEALTH FIRST FAMILY CARE CENTER FRANKLIN NH 03235 (603) 934-1464 INTERNAL MEDICINE 01YP42339NH01 KELSEY JAMES MD FAMILY HEALTH CENTER LEBANON NH 03766 (603) 448-1941 PEDIATRICS 01YP16114NH01 KENDALL MARVIN MD WHITE MOUNTAIN FAMILY HEALTHCARE LITTLETON LITTLETON NH 03561 (603) 444-2010 FAMILY MEDICINE 2305927YPNH02 KENISON MARY APRN WEEKS MEDICAL CENTER GROVETON NH 03582 (603) 788-2521 FAMILY NURSE PRACTITIONERS 01YP33583NH01 KENNEDY MEAGHAN MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY MEDICINE 23YP34011NH01 KENNEDY FARRUGIA APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC CHARLESTOWN NH 03603 (603) 826-5711 FAMILY NURSE PRACTITIONERS 23YP39800NH01 KENNEDY AMY APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC CONCORD NH 03301 (603) 369-4530 FAMILY NURSE PRACTITIONERS 23YP36194NH01 KENNEY TARA APRN GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY NURSE PRACTITIONERS 23YP19832NH01 KENNEY ROSALYN APRN FAMILY HEALTH MATTERS OF SALEM SALEM NH 03079 (603) 386-0100 FAMILY NURSE PRACTITIONERS 0106944YPNH02 KERNAN NICOLA MD ST JOSEPH HOSPITAL MERRIMACK NH 03054 (603) 424-4181 FAMILY MEDICINE 0107140YPNH02 KERNAN DONALD MD COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 FAMILY MEDICINE 23YP33466NH01 KERSHBAUMER NICHOLAS APRN ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 641-5386 FAMILY NURSE PRACTITIONERS

Page 30 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP03763MA02 KERSTEN KIMBERLY DO SEACOAST AFFILIATED GROUP PRACTICE NEWBURYPORT MA 01950 (978) 465-7719 INTERNAL MEDICINE 01YP28400NH01 KHAN NADIA MD DARTMOUTH HITCHCOCK CLINIC MILFORD NH 03055 (603) 673-2515 FAMILY MEDICINE 01YP39438NH01 KHAN HERNANDEZ KARIM MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY MEDICINE 01YP36111MA01 KHERLOPIAN ALEC MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 01YP36111MA02 KHERLOPIAN ALEC MD LAHEY CLINIC INC PEABODY MA 01960 (781) 744-7000 INTERNAL MEDICINE 0107432YPMA01 KIDD LAWRENCE MD LAWRENCE G KIDD MD PC LAWRENCE MA 01841 (978) 682-3686 INTERNAL MEDICINE 23YP33483VT01 KIDDER GRETCHEN APRN GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY NURSE PRACTITIONERS 01YP02396NH01 KIEFFER KELLY MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 04YP05263NH01 KILROY JONATHAN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 04YP05263NH02 KILROY JONATHAN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 04YP05263NH03 KILROY JONATHAN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 04YP05263NH04 KILROY JONATHAN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 04YP05263NH05 KILROY JONATHAN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 04YP05263NH06 KILROY JONATHAN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 23YP41686ME01 KILROY EMILY APRN HARBOR PEDIATRICS PA YORK ME 03909 (207) 606-2032 FAMILY NURSE PRACTITIONERS 01YP19918NH01 KIM JOOHAHN MD ALLIANCE HEALTH SERVICES BEDFORD NH 03110 (603) 695-2500 INTERNAL MEDICINE 01YP28963NH01 KINBROOK MICHELLE MD CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8052 INTERNAL MEDICINE 01YP33542NH01 KINBROOK MICHELLE MD CATHOLIC MEDICAL CENTER HOOKSETT NH 03106 (603) 314-5980 INTERNAL MEDICINE 01YP10981NH01 KING CYNTHIA MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 01YP40756MA01 KING JOHN MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3200 FAMILY MEDICINE 0108595YPNH01 KING RAYMOND MD KING MEDICAL ASSOCIATES NASHUA NH 03060 (603) 595-2300 INTERNAL MEDICINE 01YP14005NH01 KIPROP PETER MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 01YP14005NH02 KIPROP PETER MD AMOSKEAG HEALTH MANCHESTER NH 03103 (603) 626-9500 FAMILY MEDICINE 01YP14005NH03 KIPROP PETER MD AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 626-9500 FAMILY MEDICINE 01YP14005NH05 KIPROP PETER MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 668-6629 FAMILY MEDICINE 01YP14005NH06 KIPROP PETER MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 23YP02810NH02 KIRBY KIM APRN CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY NURSE PRACTITIONERS 23YP30571NH01 KIRBY ELIZABETH APRN WENTWORTH DOUGLASS PHYSICIAN CORP NEWMARKET NH 03857 (603) 659-0901 FAMILY NURSE PRACTITIONERS 23YP30571NH02 KIRBY ELIZABETH APRN WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8065 FAMILY NURSE PRACTITIONERS 23YP30571NH03 KIRBY ELIZABETH APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY NURSE PRACTITIONERS 23YP30571NH04 KIRBY ELIZABETH APRN WENTWORTH DOUGLASS PHYSICIAN CORP BARRINGTON NH 03825 (603) 664-2135 FAMILY NURSE PRACTITIONERS 23YP30571NH05 KIRBY ELIZABETH APRN WENTWORTH DOUGLASS PHYSICIAN CORP LEE NH 03861 (603) 868-3300 FAMILY NURSE PRACTITIONERS 23YP30571NH06 KIRBY ELIZABETH APRN WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 659-0901 FAMILY NURSE PRACTITIONERS 01YP11809NH01 KIRK JOHN MD NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 INTERNAL MEDICINE 0107834YPNH01 KIRK STEPHEN MD SALEM NH PHYSICIANS NETWORK PC SALEM NH 03079 (603) 898-6363 INTERNAL MEDICINE 0107834YPNH02 KIRK STEPHEN MD SALEM NH PHYSICIANS NETWORK PC METHUEN MA 01844 (978) 685-5627 INTERNAL MEDICINE 01YP40171NH01 KLEBENOV DAVID MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY MEDICINE 01YP40617NH01 KLEBENOV DAVID MD MONADNOCK COMMUNITY HOSPITAL RINDGE NH 03461 (603) 899-9563 FAMILY MEDICINE 01YP40617NH02 KLEBENOV DAVID MD MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 FAMILY MEDICINE 01YP40617NH03 KLEBENOV DAVID MD MONADNOCK COMMUNITY HOSPITAL JAFFREY NH 03452 (603) 532-8775 FAMILY MEDICINE 23YP24983NH02 KLECZKOWSKI ALICIA APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 668-6489 FAMILY NURSE PRACTITIONERS 04YP08501NH01 KLONEL STEPHEN DO MONADNOCK COMMUNITY HOSPITAL JAFFREY NH 03452 (603) 532-8775 FAMILY MEDICINE 04YP08501NH02 KLONEL STEPHEN DO MONADNOCK COMMUNITY HOSPITAL RINDGE NH 03461 (603) 899-9563 FAMILY MEDICINE 04YP08501NH03 KLONEL STEPHEN DO MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 FAMILY MEDICINE 01YP03386NH01 KLUNK L JOHN MD ELLIOT PHYSICIANS NETWORK RAYMOND NH 03077 (603) 895-8000 INTERNAL MEDICINE 23YP28750MA01 KNOWLES LAUREN APRN LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 FAMILY NURSE PRACTITIONERS

Page 31 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP23698NH01 KNUUTI ERIN APRN NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-2911 FAMILY NURSE PRACTITIONERS 01YP03277NH02 KODALI SRILATHA MD PELHAM HEALTHCARE ASSOCIATES PLLC PELHAM NH 03076 (603) 635-2802 INTERNAL MEDICINE 23YP33242NH01 KOKAL KAYLA APRN KEADY FAMILY PRACTICE CLAREMONT NH 03743 (603) 863-7777 FAMILY NURSE PRACTITIONERS 23YP33242NH02 KOKAL KAYLA APRN KEADY FAMILY PRACTICE CHARLESTOWN NH 03603 (603) 863-7777 FAMILY NURSE PRACTITIONERS 01YP25110VT01 KOLPA EMILY MD PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 PEDIATRICS 01YP32191NH01 KOOMSON JUDE MD MEDICAL CARE OF BOSTON MANAGEMENT CORP SALEM NH 03079 (603) 870-5452 INTERNAL MEDICINE 01YP04165NH04 KOOP JENNIFER MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP04165NH05 KOOP JENNIFER MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP04165NH06 KOOP JENNIFER MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP04165NH07 KOOP JENNIFER MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP04165NH08 KOOP JENNIFER MD GREATER SEACOAST COMMUNITY HEALTH SEABROOK NH 03874 (603) 766-2626 FAMILY MEDICINE 01YP12236NH01 KOPP STACEY MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4400 PEDIATRICS 23YP42006NH01 KORBEY SAMANTHA APRN AZAR A KORBEY MD PLLC SALEM NH 03079 (603) 893-7905 FAMILY NURSE PRACTITIONERS 0106242YPNH01 KORBEY AZAR MD AZAR A KORBEY MD PLLC SALEM NH 03079 (603) 893-7905 FAMILY MEDICINE 01YP34539MA01 KORNEGAY-ROUGEAU ROBIN MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3256 PEDIATRICS 23YP26158VT01 KOSHOWSKI LORI APRN NORTHERN COUNTIES HEALTH CARE INC ST JOHNSBURY VT 05819 (802) 748-5041 FAMILY NURSE PRACTITIONERS 01YP39672NH01 KOSHY AJAY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP39672NH02 KOSHY AJAY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP39672NH03 KOSHY AJAY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP39672NH04 KOSHY AJAY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP39672NH05 KOSHY AJAY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP25436ME01 KOUSAIE GEORGE MD YORK HOSPITAL NORTH BERWICK ME 03906 (207) 676-1280 FAMILY MEDICINE 01YP35239NH01 KOUSAIE GEORGE MD WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8050 FAMILY MEDICINE 01YP35239NH02 KOUSAIE GEORGE MD WENTWORTH DOUGLASS PHYSICIAN CORP NEWMARKET NH 03857 (603) 659-0901 FAMILY MEDICINE 01YP35239NH03 KOUSAIE GEORGE MD WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8050 FAMILY MEDICINE 04YP41414NH01 KOVANKO ALEXANDER DO CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY MEDICINE 0104196YPNH03 KOWALSKI LOUIS MD LOUIS KOWALSKI MD NEW LONDON NH 03257 (603) 526-6929 INTERNAL MEDICINE 01YP12586NH01 KRASNOF REBECCA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP12586NH03 KRASNOF REBECCA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP12586NH04 KRASNOF REBECCA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP12586NH05 KRASNOF REBECCA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP12586NH06 KRASNOF REBECCA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0108171YPVT01 KRAUS DANA MD NORTHERN COUNTIES HEALTH CARE INC ST JOHNSBURY VT 05819 (802) 748-5041 FAMILY MEDICINE 04YP34564VT01 KRECHETOFF IRENE DO NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-7500 FAMILY MEDICINE 01YP07195NH01 KRIEBEL GREGORY MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-7101 PEDIATRICS 01YP39809NH01 KRISHNAN SANJAY MD VANTAGE HEALTHCARE LLC PELHAM NH 03076 (781) 867-2050 INTERNAL MEDICINE 0109018YPNH01 KROLEWSKI SUSAN MD SUSAN KROLEWSKI MD PLLC PORTSMOUTH NH 03801 (603) 433-4774 FAMILY MEDICINE 01YP00409MA01 KRUTT KENNETH MD LAHEY CLINIC INC BILLERICA MA 01862 (978) 663-6666 INTERNAL MEDICINE 01YP00409MA02 KRUTT KENNETH MD LAHEY CLINIC INC ARLINGTON MA 02474 (781) 641-0100 INTERNAL MEDICINE 01YP03044NH06 KUCHIPUDI ANITHA MD FOUNDATION MEDICAL PARTNERS INC PELHAM NH 03076 (603) 635-5400 INTERNAL MEDICINE 23YP30523NH01 KUMARI PRARTHANA APRN CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8060 FAMILY NURSE PRACTITIONERS 01YP22622ME01 KUMIN MICHAEL MD WENTWORTH DOUGLASS PHYSICIAN CORP SOUTH BERWICK ME 03908 (207) 384-4949 FAMILY MEDICINE 01YP22622ME02 KUMIN MICHAEL MD WENTWORTH DOUGLASS PHYSICIAN CORP ELIOT ME 03903 (207) 451-9600 FAMILY MEDICINE 01YP26683NH01 KUMIN MICHAEL MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY MEDICINE 23YP23804NH01 KUMIN JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-7338 FAMILY NURSE PRACTITIONERS 23YP23804NH02 KUMIN JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY NURSE PRACTITIONERS

Page 32 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP23804NH03 KUMIN JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY NURSE PRACTITIONERS 01YP21486NH01 KURISH ADAM MD ATLANTIC INTERNAL MEDICINE & PEDIATRICS INC PORTSMOUTH NH 03801 (603) 373-0096 INTERNAL MEDICINE 01YP22641NH01 KYLE DANIEL MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-8900 PEDIATRICS 01YP39229VT01 LA ROCCA RACHEL MD WINDSOR HOSPITAL CORP WOODSTOCK VT 05091 (802) 457-3030 FAMILY MEDICINE 23YP16492VT01 LABRECQUE MARY APRN GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-2428 ADULT NURSE PRACTITIONERS 23YP24554NH01 LACASSE VICTORIA APRN DARTMOUTH HITCHCOCK CLINIC LYME NH 03768 (603) 650-1070 FAMILY NURSE PRACTITIONERS 23YP38764NH01 LACASSE REBECCA APRN MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 ADULT NURSE PRACTITIONERS 23YP38764NH02 LACASSE REBECCA APRN MID-STATE HEALTH CENTER ALEXANDRIA NH 03222 (603) 744-6200 ADULT NURSE PRACTITIONERS 0104470YPNH03 LAFLEUR RICHARD MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 INTERNAL MEDICINE 0104470YPNH04 LAFLEUR RICHARD MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC WINDHAM NH 03087 (603) 216-0400 INTERNAL MEDICINE 01YP28360NH01 LAFORTUNE-GREENBERG TESSA MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRICS 01YP23364NH02 LAHEY IMELYN MD AMMONOOSUC COMMUNITY HEALTH SERVICES INC WOODSVILLE NH 03785 (603) 747-3740 FAMILY MEDICINE 0103651YPNH01 LAKE CHRISTOPHER MD COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2040 GENERAL PRACTICE 0105061YPNH01 LALLY TERRI MD DOVER PEDIATRICS PLLC DOVER NH 03820 (603) 742-4048 PEDIATRICS 23YP30160VT01 LAM SARA APRN UPPER VALLEY PEDIATRICS PLLC BRADFORD VT 05033 (802) 222-4722 PEDIATRIC NURSE PRACTITIONERS 01YP23518NH01 LAMB ASHLEY MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 PEDIATRICS 01YP37589NH01 LAMB ASHLEY MD UNIVERSITY SYSTEM OF NEW HAMPSHIRE DURHAM NH 03824 (603) 862-9355 FAMILY MEDICINE 23YP08141NH04 LAMBERTANZ DANIELLE APRN CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 PEDIATRIC NURSE PRACTITIONERS 0102369YPNH01 LAMMERS KEITH MD ELLIOT PHYSICIANS NETWORK AMHERST NH 03031 (603) 249-3000 FAMILY MEDICINE 23YP38335NH01 LAMONTAGNE JESSICA APRN THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY NURSE PRACTITIONERS 0104855YPME03 LAMPERT RICHARD MD YORK HOSPITAL YORK ME 03909 (207) 351-1710 PEDIATRICS 0104855YPME04 LAMPERT RICHARD MD YORK HOSPITAL WELLS ME 04090 (207) 641-6555 PEDIATRICS 23YP17271NH01 LAMSTEIN MARY APRN WHOLE LIFE HEALTH CARE NEWINGTON NH 03801 (603) 431-6677 FAMILY NURSE PRACTITIONERS 04YP30801NH01 LANAGAN TAD DO CONCORD HOSPITAL INC PENACOOK NH 03303 (603) 753-4302 FAMILY MEDICINE 23YP30450NH01 LANAGAN SARAH APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 226-3400 FAMILY NURSE PRACTITIONERS 0107284YPMA02 LANDMAN MICHAEL MD MICHAEL J LANDMAN MD PC LAWRENCE MA 01841 (978) 686-2400 INTERNAL MEDICINE 23YP02407NH01 LANDON CAROL APRN MERRIMACK VILLAGE FAMILY PRACTICE CTR MERRIMACK NH 03054 (603) 424-8120 FAMILY NURSE PRACTITIONERS 01YP33967MA02 LANDRY TERESE MD LAHEY PHYSICIAN COMMUNITY ORGANIZATION I INC LYNNFIELD MA 01940 (781) 213-4040 FAMILY MEDICINE 0400810YPMA01 LANE LEO DO MERRIMACK VALLEY MEDICAL ASSOCIATES PC METHUEN MA 01844 (978) 725-4822 INTERNAL MEDICINE 01YP14349NH01 LANG KENNETH MD COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2900 FAMILY MEDICINE 23YP16139NH02 LANGA BRIDGET APRN LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY NURSE PRACTITIONERS 23YP16139NH03 LANGA BRIDGET APRN LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY NURSE PRACTITIONERS 23YP37933NH01 LANGA PRISCA APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 GERIATRIC NURSE PRACTITIONERS 01YP28976VT01 LANGE ERWIN MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY MEDICINE 04YP13529NH01 LANIER MELANIE DO CORE PHYSICIANS LLC EXETER NH 03833 (603) 778-2899 INTERNAL MEDICINE 23YP38787NH01 LAPAGE RICHARD APRN CROSSROADS FAMILY MEDICINE PLLC CONCORD NH 03301 (603) 856-8828 ADULT NURSE PRACTITIONERS 23YP40739NH01 LAPLANTE JULIE APRN CONCORD HOSPITAL INC WARNER NH 03278 (603) 456-6106 FAMILY NURSE PRACTITIONERS 04YP03949NH01 LARACY RICHARD DO SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-2555 PEDIATRICS 0105531YPNH01 LARAMEE RACHEL MD DOVER PEDIATRICS PLLC DOVER NH 03820 (603) 742-4048 PEDIATRICS 01YP02657NH02 LARKIN ROBERT MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 668-6489 INTERNAL MEDICINE 0104361YPNH01 LAROCCA CHRISTOPHER MD DARTMOUTH HITCHCOCK CLINIC WALPOLE NH 03608 (603) 756-3960 FAMILY MEDICINE 23YP26209NH01 LAROCHE JAMIE APRN LRGHEALTHCARE LACONIA NH 03246 (603) 524-5151 FAMILY NURSE PRACTITIONERS 23YP40625NH01 LAROCHELLE KEVIN APRN WEEKS MEDICAL CENTER NORTH STRATFORD NH 03590 (603) 922-5039 FAMILY NURSE PRACTITIONERS 0108076YPNH03 LAROUCHE MONIQUE MD CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 0108076YPNH05 LAROUCHE MONIQUE MD CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 04YP13900MA01 LASPINA RICHARD DO PEDIATRIC PROFESSIONAL ASSOCIATES PC METHUEN MA 01844 (978) 683-1974 PEDIATRICS

Page 33 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP40151NH01 LASSOR JAMESON APRN LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY NURSE PRACTITIONERS 23YP40151NH02 LASSOR JAMESON APRN LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 659-3106 FAMILY NURSE PRACTITIONERS 23YP40151NH03 LASSOR JAMESON APRN LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY NURSE PRACTITIONERS 23YP40151NH04 LASSOR JAMESON APRN LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 659-3106 FAMILY NURSE PRACTITIONERS 04YP35054NH01 LATHAM BRUCE DO SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-3500 FAMILY MEDICINE 04YP41623NH01 LATHAM BRUCE DO BRUCE LATHAM DO TAMWORTH NH 03886 (603) 323-6199 FAMILY MEDICINE 23YP05303NH01 LAU GERALDINE APRN SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-2555 FAMILY NURSE PRACTITIONERS 23YP20520NH02 LAUNH JESSICA APRN FOUNDATION MEDICAL PARTNERS INC AMHERST NH 03031 (603) 673-5885 FAMILY NURSE PRACTITIONERS 23YP14145NH01 LAURENT CHRISTOPHER APRN WEEKS MEDICAL CENTER LANCASTER NH 03584 (603) 788-2521 ADULT NURSE PRACTITIONERS 23YP14145NH02 LAURENT CHRISTOPHER APRN WEEKS MEDICAL CENTER WHITEFIELD NH 03598 (603) 837-9005 ADULT NURSE PRACTITIONERS 23YP14145NH04 LAURENT CHRISTOPHER APRN WEEKS MEDICAL CENTER LITTLETON NH 03561 (603) 444-2277 ADULT NURSE PRACTITIONERS 0103271YPNH01 LAUTER M DAVID MD M DAVID LAUTER MD PC PORTSMOUTH NH 03801 (603) 433-7500 FAMILY MEDICINE 23YP33668NH01 LAVALLEE JENNIFER APRN FOUNDATION MEDICAL PARTNERS INC MERRIMACK NH 03054 (603) 429-3155 PEDIATRIC NURSE PRACTITIONERS 23YP33614NH01 LAVARNWAY LISA APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 622-6491 FAMILY NURSE PRACTITIONERS 01YP05174VT03 LAWRENCE MELANIE MD NEWBURY HEALTH CLINIC PLLC NEWBURY VT 05051 (802) 866-3010 FAMILY MEDICINE 0109995YPNH02 LAWRENCE STEPHEN MD CONCORD HOSPITAL INC HOPKINTON NH 03229 (603) 228-7575 FAMILY MEDICINE 0103063YPNH01 LAWSON PHILIP MD AMMONOOSUC COMMUNITY HEALTH SERVICES INC LITTLETON NH 03561 (603) 444-2464 FAMILY MEDICINE 23YP28865NH01 LAZOTT TAMMY APRN WEEKS MEDICAL CENTER LANCASTER NH 03584 (603) 788-2521 FAMILY NURSE PRACTITIONERS 01YP35953NH01 LEARSON DEBORAH MD WENTWORTH DOUGLASS PHYSICIAN CORP NEWMARKET NH 03857 (603) 659-0901 FAMILY MEDICINE 01YP35953NH02 LEARSON DEBORAH MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY MEDICINE 01YP35953NH03 LEARSON DEBORAH MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY MEDICINE 01YP35953NH04 LEARSON DEBORAH MD WENTWORTH DOUGLASS PHYSICIAN CORP DURHAM NH 03824 (603) 868-5080 FAMILY MEDICINE 01YP40128ME01 LEARSON DEBORAH MD WENTWORTH DOUGLASS PHYSICIAN CORP SOUTH BERWICK ME 03908 (207) 384-4949 FAMILY MEDICINE 23YP37319NH01 LEARY BROOKE APRN ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-5860 PEDIATRIC NURSE PRACTITIONERS 23YP37319NH02 LEARY BROOKE APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8300 PEDIATRIC NURSE PRACTITIONERS 23YP37319NH03 LEARY BROOKE APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8350 PEDIATRIC NURSE PRACTITIONERS 23YP37319NH04 LEARY BROOKE APRN ELLIOT PHYSICIANS NETWORK WINDHAM NH 03087 (603) 685-0150 PEDIATRIC NURSE PRACTITIONERS 0105179YPNH04 LEBLANC STEPHAN MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 889-6671 PEDIATRICS 0105179YPNH05 LEBLANC STEPHAN MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 PEDIATRICS 0105179YPNH06 LEBLANC STEPHAN MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 PEDIATRICS 04YP03774NH03 LEBLANC SCOTT DO CATHOLIC MEDICAL CENTER HOOKSETT NH 03106 (603) 314-5980 INTERNAL MEDICINE 01YP05495MA02 LEE SHERWOOD MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3230 PEDIATRICS 01YP13044VT02 LEE CLAUDIA MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-7500 INTERNAL MEDICINE 01YP13044VT03 LEE CLAUDIA MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 INTERNAL MEDICINE 01YP08546NH02 LEE KAROLYN MD ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 552-1400 FAMILY MEDICINE 01YP37031VT01 LEFER THEODORE MD CARLOS G OTIS HEALTHCARE CTR TOWNSHEND VT 05353 (802) 365-4331 FAMILY MEDICINE 23YP13607MA02 LEHAN CATHERINE ARNP PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8700 FAMILY NURSE PRACTITIONERS 2308143YPNH01 LEIGHTON CATHERINE APRN RIVER ROAD PEDIATRICS PLLC BEDFORD NH 03110 (603) 622-8619 PEDIATRIC NURSE PRACTITIONERS 01YP03454NH04 LEMEI SUSAN MD SUSAN LEMEI MD PC CHESTER VT 05143 (802) 875-5660 FAMILY MEDICINE 04YP00831ME01 LEMKE SHAYNA DO BRIDGTON HOSPITAL BRIDGTON ME 04009 (207) 647-2311 FAMILY MEDICINE 0408704YPNH02 LEONG PATRICK DO ST JOSEPH HOSPITAL MERRIMACK NH 03054 (603) 424-4181 FAMILY MEDICINE 0107381YPVT02 LEPPMAN JOHN MD SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 INTERNAL MEDICINE 0107381YPVT02 LEPPMAN JOHN MD SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 INTERNAL MEDICINE 0409050YPMA01 LERMAN LAWRENCE DO PEDIATRIC PROFESSIONAL ASSOCIATES PC METHUEN MA 01844 (978) 683-1974 PEDIATRICS 01YP24731VT01 LESAGE-HORTON HEATHER MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8626 PEDIATRICS 01YP37716ME01 LESPINASSE MAGGY MD YORK HOSPITAL YORK ME 03909 (207) 351-1710 PEDIATRICS

Page 34 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP25242VT01 LESSAC-CHENEN SIMONE MD LITTLE RIVERS HEALTH CARE INC WELLS RIVER VT 05081 (802) 757-2325 FAMILY MEDICINE 01YP25242VT03 LESSAC-CHENEN SIMONE MD LITTLE RIVERS HEALTH CARE INC BRADFORD VT 05033 (802) 222-9317 FAMILY MEDICINE 0100444YPNH02 LESTER SARAH MD NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5363 PEDIATRICS 23YP40197NH01 LEUCHTENBERGER CARA APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 FAMILY NURSE PRACTITIONERS 23YP34695NH01 LEVESQUE PAMELA APRN FRISBIE MEMORIAL HOSPITAL FARMINGTON NH 03835 (603) 755-9801 FAMILY NURSE PRACTITIONERS 23YP34695NH02 LEVESQUE PAMELA APRN FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 335-2401 FAMILY NURSE PRACTITIONERS 23YP34695NH03 LEVESQUE PAMELA APRN FRISBIE MEMORIAL HOSPITAL FARMINGTON NH 03835 (603) 755-9801 FAMILY NURSE PRACTITIONERS 23YP34695NH04 LEVESQUE PAMELA APRN FRISBIE MEMORIAL HOSPITAL BARRINGTON NH 03825 (603) 664-9003 FAMILY NURSE PRACTITIONERS 23YP34695NH05 LEVESQUE PAMELA APRN FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 755-9801 FAMILY NURSE PRACTITIONERS 01YP25373VT01 LEVIN IVAN MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 INTERNAL MEDICINE 01YP25373VT02 LEVIN IVAN MD WINDSOR HOSPITAL CORP WOODSTOCK VT 05091 (802) 457-3030 INTERNAL MEDICINE 0107125YPNH02 LEWIS ERIC MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7574 FAMILY MEDICINE 0107125YPNH03 LEWIS ERIC MD HUGGINS HOSPITAL ALTON NH 03809 (603) 875-6151 FAMILY MEDICINE 0107125YPNH04 LEWIS ERIC MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7500 FAMILY MEDICINE 01YP29676NH01 LEWIS BRYAN MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7555 INTERNAL MEDICINE 01YP03174VT02 LEWIS THOMAS MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-2611 INTERNAL MEDICINE 23YP39414NH01 LEWIS ELISE APRN FOUNDATION MEDICAL PARTNERS INC AMHERST NH 03031 (603) 402-2038 FAMILY NURSE PRACTITIONERS 04YP36594NH01 LIBMAN MATTHEW DO CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 314-4700 INTERNAL MEDICINE 04YP36594NH02 LIBMAN MATTHEW DO CATHOLIC MEDICAL CENTER MANCHESTER NH 03102 (603) 663-8743 INTERNAL MEDICINE 01YP12661NH02 LILLY KATHARINA MD APPLEDORE MEDICAL GROUP INC DURHAM NH 03824 (603) 431-2516 FAMILY MEDICINE 01YP12661NH04 LILLY KATHARINA MD APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY MEDICINE 01YP37394MA01 LIM ANDREW MD STEWARD MEDICAL GROUP INC LAWRENCE MA 01841 (978) 722-7979 FAMILY MEDICINE 23YP29906VT01 LINDEN EVA APRN GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY NURSE PRACTITIONERS 01YP16397VT01 LINDER ELIZABETH MD CARLOS G OTIS HEALTHCARE CTR TOWNSHEND VT 05353 (802) 365-4331 PEDIATRICS 01YP16403VT01 LINDER MOSS MD CARLOS G OTIS HEALTHCARE CTR TOWNSHEND VT 05353 (802) 365-4331 FAMILY MEDICINE 04YP15028NH01 LITSCH SARAH DO CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 382-4972 FAMILY MEDICINE 04YP03866MA03 LITTLE GAVIN DO GAVIN C LITTLE DO LLC SALISBURY MA 01952 (978) 462-3433 INTERNAL MEDICINE 01YP33792NH01 LIU STEPHEN MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 01YP07846NH03 LIU SHUWEI MD AZAR A KORBEY MD PLLC SALEM NH 03079 (603) 893-7905 FAMILY MEDICINE 01YP14898MA01 LO ELIZABETH MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 01YP39277NH01 LOESCHER PETER MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 442-5630 FAMILY MEDICINE 01YP02887NH03 LOESER PETER MD CROSSROADS FAMILY MEDICINE PLLC CONCORD NH 03301 (603) 856-8828 FAMILY MEDICINE 0100891YPNH01 LOEW CHARLOTTE MD LOEW FAMILY MEDICAL PRACTICE PLLC SALEM NH 03079 (603) 898-9834 FAMILY MEDICINE 23YP22821NH02 LOGAN KRISTIN APRN AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 PEDIATRIC NURSE PRACTITIONERS 23YP22821NH03 LOGAN KRISTIN APRN AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 PEDIATRIC NURSE PRACTITIONERS 23YP22821NH04 LOGAN KRISTIN APRN AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 626-9500 PEDIATRIC NURSE PRACTITIONERS 23YP22821NH05 LOGAN KRISTIN APRN AMOSKEAG HEALTH MANCHESTER NH 03103 (603) 626-9500 PEDIATRIC NURSE PRACTITIONERS 0103668YPNH02 LOH STEVEN MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-8900 PEDIATRICS 0103668YPNH03 LOH STEVEN MD CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 658-1823 PEDIATRICS 0107280YPNH01 LOMBARDO BRIAN MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 FAMILY MEDICINE 01YP29294MA01 LOPES ANAVERA MD MEDICAL CARE OF BOSTON MANAGEMENT CORP AMESBURY MA 01913 (978) 388-1400 FAMILY MEDICINE 01YP37201MA01 LOPEZ ANTHONY MD PARTNERS COMMUNITY PHYS ORGANIZATION INC NEWBURYPORT MA 01950 (978) 499-7200 INTERNAL MEDICINE 01YP12480NH01 LOPEZ-VALLES JO-ANN MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 PEDIATRICS 01YP12480NH02 LOPEZ-VALLES JO-ANN MD LRGHEALTHCARE BELMONT NH 03220 (603) 528-0995 PEDIATRICS 01YP33362VT01 LOPRESTI LEIGH MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY MEDICINE 04YP30616NH01 LORAH JAY DO ALLIANCE HEALTH SERVICES BEDFORD NH 03110 (603) 695-2500 FAMILY MEDICINE

Page 35 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP30367NH01 LORD MONICA APRN GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY NURSE PRACTITIONERS 23YP30367NH02 LORD MONICA APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP36857NH01 LORD-VOSHELL PAMELA APRN WENTWORTH DOUGLASS PHYSICIAN CORP SOMERSWORTH NH 03878 (603) 692-6676 FAMILY NURSE PRACTITIONERS 23YP36857NH02 LORD-VOSHELL PAMELA APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-7338 FAMILY NURSE PRACTITIONERS 01YP38282NH01 LORING KAREN MD FAMILY HEALTH CENTER LEBANON NH 03766 (603) 448-1941 INTERNAL MEDICINE 23YP28728VT01 LOSKUTOFF ERIN APRN LITTLE RIVERS HEALTH CARE INC EAST CORINTH VT 05040 (802) 439-5321 ADULT NURSE PRACTITIONERS 01YP17087NH01 LOUD KEITH MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 PEDIATRICS 01YP18992NH01 LOUGHRAN TIMOTHY MD APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 433-8434 INTERNAL MEDICINE 23YP25377VT01 LOURIE JEFFREY APRN GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY NURSE PRACTITIONERS 0405710YPNH04 LOW SCOTT DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0405710YPNH05 LOW SCOTT DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 0405710YPNH07 LOW SCOTT DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 0405710YPNH08 LOW SCOTT DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 0405710YPNH09 LOW SCOTT DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 23YP40434VT01 LOWERY ANNE APRN PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 ADULT NURSE PRACTITIONERS 23YP40434VT02 LOWERY ANNE APRN PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 ADULT NURSE PRACTITIONERS 04YP08497NH01 LOWNE JOSEPH DO CONCORD HOSPITAL INC PEMBROKE NH 03275 (603) 485-8441 FAMILY MEDICINE 23YP35562NH01 LOZIER VALERIE APRN THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY NURSE PRACTITIONERS 23YP19409NH01 LOZMAN-OXMAN REBECCA APRN NEW LONDON HOSPITAL ASSOCIATION NEWPORT NH 03773 (603) 863-4100 PEDIATRIC NURSE PRACTITIONERS 01YP20613NH01 LU QI MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 INTERNAL MEDICINE 01YP28143NH01 LUCHSINGER JOANNA MD CORE PHYSICIANS LLC KINGSTON NH 03848 (603) 642-3910 FAMILY MEDICINE 01YP28143NH02 LUCHSINGER JOANNA MD CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 01YP28143NH03 LUCHSINGER JOANNA MD CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 01YP32641NH01 LUNDEEN-YOUNG CARRIE MD FOUNDATION MEDICAL PARTNERS INC MILFORD NH 03055 (603) 672-7600 FAMILY MEDICINE 01YP03819MA01 LUNDGREN LARS MD CHILDRENS HEALTHCARE NEWBURYPORT MA 01950 (978) 465-7121 PEDIATRICS 0109567YPNH03 LUNDQUIST PETER MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 889-3667 INTERNAL MEDICINE 01YP16551NH01 LUNGULESCU OVIDIU MD CATHOLIC MEDICAL CENTER HOOKSETT NH 03106 (603) 314-5980 INTERNAL MEDICINE 04YP15858NH02 LUNIANSKI DAVID DO GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE 23YP31617NH01 LUONGO DOROTHY APRN ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-5860 PEDIATRIC NURSE PRACTITIONERS 01YP39165NH01 LUQUE SASHKA MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-5860 PEDIATRICS 0104868YPNH01 LURIE JONATHAN MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 0108222YPNH03 LUTZ STEPHEN MD MARTIN'S POINT HEALTH CARE PORTSMOUTH NH 03801 (603) 431-5154 FAMILY MEDICINE 0104907YPNH01 LYNCH GREGORY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0104907YPNH02 LYNCH GREGORY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 0104907YPNH05 LYNCH GREGORY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 0104907YPNH06 LYNCH GREGORY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 0104907YPNH07 LYNCH GREGORY MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 23YP34562NH01 LYON SEAN APRN LIFE LONG CARE OF NEW LONDON PLLC NEW LONDON NH 03257 (603) 526-4144 FAMILY NURSE PRACTITIONERS 0106177YPNH02 LYONS MICHAEL MD WHITE RIVER FAMILY PRACTICE PC WHITE RIVER JUNCTION VT 05001 (802) 295-6132 FAMILY MEDICINE 01YP28363NH01 MA HONGBAO MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 FAMILY MEDICINE 23YP26879NH01 MACAULAY SANDRA APRN CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-1436 FAMILY NURSE PRACTITIONERS 23YP33288NH01 MACDERMOTT KIMBERLY APRN THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY NURSE PRACTITIONERS 01YP07266MA01 MACDONALD PAUL MD LAHEY CLINIC INC WILMINGTON MA 01887 (978) 694-9610 INTERNAL MEDICINE 23YP04017NH02 MACDONALD DANIELLE APRN LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 FAMILY NURSE PRACTITIONERS 23YP35483ME01 MACE ASHLEY APRN YORK HOSPITAL YORK ME 03909 (207) 363-8430 FAMILY NURSE PRACTITIONERS 23YP41343NH01 MACGREGOR JILL APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03063 (603) 402-2070 FAMILY NURSE PRACTITIONERS

Page 36 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP32118NH01 MACGREGOR LESLIE APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 FAMILY NURSE PRACTITIONERS 2302152YPNH01 MACGREGOR FORD BARBARA APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC FRANCONIA NH 03580 (603) 823-7078 FAMILY NURSE PRACTITIONERS 01YP36477NH01 MACKWOOD MATTHEW MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY MEDICINE 23YP02012NH02 MACLEAN KATHLEEN APRN FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 335-2401 FAMILY NURSE PRACTITIONERS 23YP02012NH03 MACLEAN KATHLEEN APRN FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 FAMILY NURSE PRACTITIONERS 23YP17226VT02 MACLEOD JESSICA APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-7500 ADULT NURSE PRACTITIONERS 23YP17226VT03 MACLEOD JESSICA APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 ADULT NURSE PRACTITIONERS 23YP40439VT01 MACLEOD JESSICA APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 ADULT NURSE PRACTITIONERS 01YP40033NH01 MACLEOD DAVID MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 23YP40754NH01 MACQUEEN LAUREN APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 594-6030 PEDIATRIC NURSE PRACTITIONERS 0108383YPNH02 MADDEN JENNIFER MD DR JENNIFER MADDEN'S FAMILY PRACTICE PLLC AMHERST NH 03031 (603) 769-3308 FAMILY MEDICINE 01YP38530MA01 MADDOX JOHN MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3230 PEDIATRICS 2307287YPNH01 MAGUIRE ELEANOR APRN DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4400 PEDIATRIC NURSE PRACTITIONERS 2307287YPNH02 MAGUIRE ELEANOR APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 PEDIATRIC NURSE PRACTITIONERS 01YP39234MA01 MAHAJAN MANJU MD STEWARD MEDICAL GROUP INC GROTON MA 01450 (978) 449-0282 FAMILY MEDICINE 01YP40624NH01 MAHAPATRA SOURYA MD VANTAGE HEALTHCARE LLC PELHAM NH 03076 (781) 867-2050 INTERNAL MEDICINE 01YP05106NH04 MAHMUDI SHANTA MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4804 FAMILY MEDICINE 01YP05106NH05 MAHMUDI SHANTA MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 921-6022 FAMILY MEDICINE 0108668YPNH03 MAHON PAULA MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 663-8718 FAMILY MEDICINE 0108668YPNH05 MAHON PAULA MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 663-8716 FAMILY MEDICINE 0108668YPNH06 MAHON PAULA MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 665-7450 FAMILY MEDICINE 23YP28614NH01 MAJESKI CAROLANNE APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 FAMILY NURSE PRACTITIONERS 0101478YPME03 MAJOR MICHAEL MD YORK HOSPITAL MOODY ME 04054 (207) 646-8386 INTERNAL MEDICINE 0101478YPME04 MAJOR MICHAEL MD YORK HOSPITAL YORK ME 03909 (207) 351-3530 INTERNAL MEDICINE 01YP33634NH01 MALCOLM JOHN MD NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 FAMILY MEDICINE 01YP40160VT01 MALEK MARVIN MD SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 886-8900 INTERNAL MEDICINE 01YP40160VT02 MALEK MARVIN MD SPRINGFIELD MEDICAL CARE SYSTEMS INC LUDLOW VT 05149 (802) 228-8867 INTERNAL MEDICINE 01YP40160VT03 MALEK MARVIN MD SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 INTERNAL MEDICINE 01YP31757MA01 MALIK NEHA MD LAHEY CLINIC INC ARLINGTON MA 02474 (781) 641-0100 INTERNAL MEDICINE 01YP40294NH01 MALLARI MARGARET MD GENESIS ELDERCARE PHYSICIAN SERVICES INC KEENE NH 03431 (603) 352-7311 INTERNAL MEDICINE 01YP00442MA01 MALONE ERIN MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP04707NH02 MALONSO RESTITUTO MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3664 INTERNAL MEDICINE 01YP04707NH03 MALONSO RESTITUTO MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE 23YP37846NH01 MANALO LESTER APRN UNIVERSITY SYSTEM OF NEW HAMPSHIRE DURHAM NH 03824 (603) 862-9355 FAMILY NURSE PRACTITIONERS 01YP33705NH01 MANCHERJE MICHELLE MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 FAMILY MEDICINE 01YP33500NH01 MANDEL MICHELE MD ELLIOT PHYSICIANS NETWORK WINDHAM NH 03087 (603) 685-0150 PEDIATRICS 01YP24880NH01 MANE HEATHER MD ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 552-1400 INTERNAL MEDICINE 23YP39804NH01 MANN JENNIFER APRN MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4664 FAMILY NURSE PRACTITIONERS 23YP39804NH02 MANN JENNIFER APRN MONADNOCK COMMUNITY HOSPITAL JAFFREY NH 03452 (603) 532-8775 FAMILY NURSE PRACTITIONERS 23YP39804NH03 MANN JENNIFER APRN MONADNOCK COMMUNITY HOSPITAL RINDGE NH 03461 (603) 899-9563 FAMILY NURSE PRACTITIONERS 23YP39804NH04 MANN JENNIFER APRN MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 FAMILY NURSE PRACTITIONERS 23YP23810NH01 MANNING CAROL APRN GLOBAL FAMILY HEALTH LLC NASHUA NH 03060 (603) 943-7064 FAMILY NURSE PRACTITIONERS 23YP04647NH02 MANNING GRIFFIN P APRN NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 FAMILY NURSE PRACTITIONERS 01YP05311ME01 MARESCOT KEASHA MD WATERBORO VILLAGE PEDIATRICS LLC PA EAST WATERBORO ME 04030 (207) 247-6742 PEDIATRICS 01YP05311ME02 MARESCOT KEASHA MD WATERBORO VILLAGE PEDIATRICS LLC PA BIDDEFORD ME 04005 (207) 294-8700 PEDIATRICS 0100095YPMA01 MARINO ANTHONY MD ANTHONY F MARINO MD PC METHUEN MA 01844 (978) 689-2540 INTERNAL MEDICINE

Page 37 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP08252NH02 MARKS HEATHER MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 INTERNAL MEDICINE 23YP30655NH01 MARQUIS HENSON CARLY APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 ADULT NURSE PRACTITIONERS 01YP08642NH01 MARTEL AMY MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 01YP08642NH02 MARTEL AMY MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7400 FAMILY MEDICINE 04YP27505NH01 MARTIN TYLER DO CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 01YP33965MA01 MARVASTI FATHYEH MD LAHEY CLINIC INC N BILLERICA MA 01862 (978) 663-6666 FAMILY MEDICINE 23YP34549MA01 MARVIN MEGHANN APRN LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 FAMILY NURSE PRACTITIONERS 23YP34549MA02 MARVIN MEGHANN APRN LAHEY CLINIC INC PEABODY MA 01960 (781) 744-8000 FAMILY NURSE PRACTITIONERS 23YP38780NH01 MASCIOLI PAIGE APRN BECKET ACADEMY INC HAMPTON NH 03842 (603) 601-8729 FAMILY NURSE PRACTITIONERS 0105556YPNH01 MASON PETER MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 FAMILY MEDICINE 23YP35521NH01 MASURE KATRINA APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 01YP12113NH01 MATHER CHERI MD DARTMOUTH HITCHCOCK CLINIC LYME NH 03768 (603) 650-1070 INTERNAL MEDICINE 01YP04782NH01 MATOS MICHAEL MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7620 PEDIATRICS 01YP33383ME01 MATTA DANIEL MD BRIDGTON HOSPITAL BRIDGTON ME 04009 (207) 647-2311 FAMILY MEDICINE 01YP27479NH01 MATTHEW LEAH MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY MEDICINE 0103185YPNH02 MAULL JOHN MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 778-2899 INTERNAL MEDICINE 04YP25268NH01 MAXWELL LEISA DO FOUNDATION MEDICAL PARTNERS INC HUDSON NH 03051 (603) 886-3979 FAMILY MEDICINE 0104373YPNH01 MAZANOWSKI DONALD MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 01YP32146NH01 MAZUR JON MD HARBOR HOMES INC NASHUA NH 03060 (603) 821-7788 INTERNAL MEDICINE 01YP38969NH01 MAZUR JON MD GENESIS ELDERCARE PHYSICIAN SERVICES INC BEDFORD NH 03110 (603) 623-8805 INTERNAL MEDICINE 04YP22584ME01 MCALLISTER LISA DO BRIDGTON HOSPITAL FRYEBURG ME 04037 (207) 935-3383 FAMILY MEDICINE 23YP33999NH01 MCCALL NADINE APRN WHOLE LIFE HEALTH CARE NEWINGTON NH 03801 (603) 431-6677 FAMILY NURSE PRACTITIONERS 01YP15839NH01 MCCAMPBELL NINA MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 FAMILY MEDICINE 04YP23264NH01 MCCARTEN MICHAEL DO ELLIOT PHYSICIANS NETWORK WINDHAM NH 03087 (603) 894-0063 FAMILY MEDICINE 0102319YPNH02 MCCARTHY GREGORY MD GUIDANCE MEDICAL ASSOCIATES GILFORD NH 03249 (603) 527-0052 INTERNAL MEDICINE 0102319YPNH02 MCCARTHY GREGORY MD GUIDANCE MEDICAL ASSOCIATES GILFORD NH 03249 (603) 527-0052 INTERNAL MEDICINE 0102319YPNH03 MCCARTHY GREGORY MD GUIDANCE MEDICAL ASSOCIATES LACONIA NH 03246 (603) 527-0052 INTERNAL MEDICINE 0102319YPNH03 MCCARTHY GREGORY MD GUIDANCE MEDICAL ASSOCIATES LACONIA NH 03246 (603) 527-0052 INTERNAL MEDICINE 01YP00459MA01 MCCARTHY JOHN MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP03964NH01 MCCLINTOCK LORA MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4680 INTERNAL MEDICINE 01YP17117VT03 MCCLURE LAUREN MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8455 FAMILY MEDICINE 04YP41038NH01 MCCOLE JUDITH DO MW WELLNESS VENTURES I LLC LONDONDERRY NH 03053 (603) 782-9081 FAMILY MEDICINE 23YP33169NH01 MCCORMACK AMY APRN MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY NURSE PRACTITIONERS 23YP34984VT01 MCCORMACK DAVID APRN CARLOS G OTIS HEALTHCARE CTR TOWNSHEND VT 05353 (802) 365-4331 FAMILY NURSE PRACTITIONERS 01YP36168NH01 MCCOY ANNAMARIA MD ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 552-1400 FAMILY MEDICINE 01YP31569NH01 MCCREEDY SAMUEL MD COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 FAMILY MEDICINE 23YP39119NH01 MCDONALD KAREN APRN LRGHEALTHCARE MEREDITH NH 03253 (603) 279-7433 FAMILY NURSE PRACTITIONERS 01YP34609NH01 MCDOWELL JOHN MD COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 FAMILY MEDICINE 01YP18990ME01 MCELROY CANDICE MD YORK HOSPITAL YORK ME 03909 (207) 363-8430 FAMILY MEDICINE 01YP18990ME02 MCELROY CANDICE MD YORK HOSPITAL NORTH BERWICK ME 03906 (207) 676-1280 FAMILY MEDICINE 23YP41247NH01 MCFADDEN JENNIFER APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 23YP36292NH01 MCGEE CYNTHIA APRN WHITE MOUNTAIN COMMUNITY HEALTH CENTER CONWAY NH 03818 (603) 447-8900 FAMILY NURSE PRACTITIONERS 23YP32567MA01 MCGRATH TIMOTHY APRN LAHEY CLINIC INC PEABODY MA 01960 (781) 744-7000 INTERNAL MEDICINE NURSE PRACTITIONER 23YP33723NH01 MCGRATH LAUREN APRN CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY NURSE PRACTITIONERS 01YP05451MA02 MCGRAVEY ANN MD KIDS DR NORTH ANDOVER MA 01845 (978) 682-3300 PEDIATRICS 01YP05315ME01 MCGUCKIN JOHN MD JOHN MCGUCKIN MD SANFORD ME 04073 (207) 324-3226 FAMILY MEDICINE

Page 38 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP10292NH01 MCKEAN KIMBERLY DO DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY MEDICINE 23YP33862NH02 MCKENNA TARA APRN APPLEDORE MEDICAL GROUP INC SANBORNVILLE NH 03872 (603) 522-0186 FAMILY NURSE PRACTITIONERS 23YP33904NH01 MCKENNA TARA APRN FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 FAMILY NURSE PRACTITIONERS 04YP25697NH01 MCKENZIE RICHARD DO LITTLETON HOSPITAL ASSOCIATION LITTLETON NH 03561 (603) 444-7070 FAMILY MEDICINE 23YP10460NH01 MCLANE ALICE APRN COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 FAMILY NURSE PRACTITIONERS 04YP05108NH02 MCLEOD JR MICHAEL DO CONCORD HOSPITAL INC HOPKINTON NH 03229 (603) 228-7575 FAMILY MEDICINE 23YP33475VT01 MCLURE JAIME APRN BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 387-5581 FAMILY NURSE PRACTITIONERS 23YP33468NH01 MCMULLEN LAUREN APRN APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY NURSE PRACTITIONERS 2304731YPNH01 MCNAMEE SUSAN APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 595-7388 PEDIATRIC NURSE PRACTITIONERS 01YP27158NH01 MCNEELY ERIN MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 INTERNAL MEDICINE 01YP18772NH01 MCQUEEN CLAUDIA MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 778-2899 INTERNAL MEDICINE 01YP04045MA01 MCQUILLEN DANIEL MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8608 INTERNAL MEDICINE 01YP36366MA01 MCWHA KENNETH MD SEACOAST AFFILIATED GROUP PRACTICE NEWBURYPORT MA 01950 (978) 465-0635 FAMILY MEDICINE 01YP36240NH01 MCWILLIAMS SAMUEL MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 PEDIATRICS 23YP26904NH01 MEDEIROS SARAH APRN CROSSROADS FAMILY MEDICINE PLLC CONCORD NH 03301 (603) 856-8828 PEDIATRIC NURSE PRACTITIONERS 01YP08825NH02 MEDORA CHRISTINE MD HANOVER CONTINUITY CLINIC LLC HANOVER NH 03755 (603) 643-3320 INTERNAL MEDICINE 23YP39981NH01 MEDRADO JULIANA APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC MANCHESTER NH 03102 (603) 668-8161 FAMILY NURSE PRACTITIONERS 23YP42270NH01 MEEGAN JANET APRN APPLEDORE MEDICAL GROUP INC SOMERSWORTH NH 03878 (603) 692-6066 FAMILY NURSE PRACTITIONERS 23YP40623NH01 MEIER MARCELLA APRN VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-6700 FAMILY NURSE PRACTITIONERS 23YP40623NH02 MEIER MARCELLA APRN VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-6900 FAMILY NURSE PRACTITIONERS 23YP40623NH03 MEIER MARCELLA APRN VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-1251 FAMILY NURSE PRACTITIONERS 0108326YPNH01 MELAMED YAIR MD MY PHYSICIAN PC NASHUA NH 03063 (603) 577-9090 INTERNAL MEDICINE 01YP14959NH02 MELENDY ELIZABETH MD CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 257-4000 PEDIATRICS 01YP00464MA01 MELIN JUDITH MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 04YP29191NH01 MELLISH TODD DO SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 INTERNAL MEDICINE 04YP29191NH02 MELLISH TODD DO SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC BEDFORD NH 03110 (603) 216-0400 INTERNAL MEDICINE 2307269YPNH05 MENARD CLAIRE APRN PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY NURSE PRACTITIONERS 01YP36500MA01 MENDONCA FEITOSA RUIVO FABIOLA MD COMMUNITY MEDICAL ASSOCIATES INC LAWRENCE MA 01841 (978) 946-8550 INTERNAL MEDICINE 01YP41312NH01 MENON ASHWATY MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY MEDICINE 23YP39797NH01 MEREDITH MARGARET APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC AMHERST NH 03031 (603) 249-8883 FAMILY NURSE PRACTITIONERS 04YP28401NH01 MERKEL MARY DO DARTMOUTH HITCHCOCK CLINIC MERRIMACK NH 03054 (603) 424-4713 FAMILY MEDICINE 04YP28401NH02 MERKEL MARY DO DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY MEDICINE 01YP10768MA01 MERKREBS ALICE MD NEWBURYPORT PEDIATRICS INC NEWBURYPORT MA 01950 (978) 462-7108 PEDIATRICS 23YP22960NH02 MERMER LOUISE APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 889-6671 PEDIATRIC NURSE PRACTITIONERS 23YP22960NH03 MERMER LOUISE APRN ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 PEDIATRIC NURSE PRACTITIONERS 23YP22960NH04 MERMER LOUISE APRN ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3870 PEDIATRIC NURSE PRACTITIONERS 23YP22960NH05 MERMER LOUISE APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 PEDIATRIC NURSE PRACTITIONERS 23YP35943NH01 MERRILL HEATHER APRN ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3870 PEDIATRIC NURSE PRACTITIONERS 23YP35943NH02 MERRILL HEATHER APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 PEDIATRIC NURSE PRACTITIONERS 23YP35943NH03 MERRILL HEATHER APRN ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 PEDIATRIC NURSE PRACTITIONERS 01YP36187NH01 MESSIER MARK MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 FAMILY MEDICINE 01YP36187NH02 MESSIER MARK MD ST JOSEPH HOSPITAL HUDSON NH 03051 (603) 882-6700 FAMILY MEDICINE 01YP36187NH03 MESSIER MARK MD ST JOSEPH HOSPITAL MERRIMACK NH 03054 (603) 424-4181 FAMILY MEDICINE 01YP36187NH04 MESSIER MARK MD ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3014 FAMILY MEDICINE 01YP36187NH05 MESSIER MARK MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4804 FAMILY MEDICINE 01YP18487VT01 METSCH LAURA MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-2611 INTERNAL MEDICINE

Page 39 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP37538NH01 MEY SOKHARITH MD CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 382-4972 FAMILY MEDICINE 04YP03614NH01 MEYER HERB T DO HERB T MEYER DO DANVILLE NH 03819 (603) 303-0646 FAMILY MEDICINE 23YP38762NH01 MEYER KERRY APRN CORE PHYSICIANS LLC KINGSTON NH 03848 (603) 642-3910 FAMILY NURSE PRACTITIONERS 2304900YPNH02 MICHAUD JANICE APRN CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-8900 PEDIATRIC NURSE PRACTITIONERS 2304900YPNH03 MICHAUD JANICE APRN CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 658-1823 PEDIATRIC NURSE PRACTITIONERS 01YP19937NH01 MICHAUD STEPHEN MD CATHOLIC MEDICAL CENTER GOFFSTOWN NH 03045 (603) 314-4500 FAMILY MEDICINE 0109642YPNH02 MILCHEV VALENTIN MD LRGHEALTHCARE LACONIA NH 03246 (603) 524-5151 INTERNAL MEDICINE 23YP40372NH02 MILES JUDY APRN APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 335-2401 FAMILY NURSE PRACTITIONERS 01YP40010NH01 MILETTO FERNANDA MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-6900 INTERNAL MEDICINE 01YP40010NH02 MILETTO FERNANDA MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-7771 INTERNAL MEDICINE 01YP40011NH01 MILETTO FERNANDA MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-6700 INTERNAL MEDICINE 01YP40011NH02 MILETTO FERNANDA MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-7771 INTERNAL MEDICINE 04YP32588NH01 MILLER LAURA DO FOUNDATION MEDICAL PARTNERS INC MERRIMACK NH 03054 (603) 429-3155 PEDIATRICS 23YP20737NH02 MILLER JOSEPH APRN APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 332-0238 PEDIATRIC NURSE PRACTITIONERS 01YP39487VT01 MILLER CHRISTINA MD SOJOURNS COMMUNITY HEALTH CLINIC WESTMINSTER VT 05158 (802) 722-4023 GENERAL PRACTICE 0107452YPNH02 MILLIGAN III FRANCIS MD CONCORD HOSPITAL INC HOPKINTON NH 03229 (603) 228-7575 FAMILY MEDICINE 0103194YPNH02 MILLS CARA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 594-6030 PEDIATRICS 23YP40730NH01 MILOT KELLY APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 01YP15336NH01 MIN PATRICIA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 653-9500 INTERNAL MEDICINE 0107787YPNH01 MINTZ HOLLY MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-5860 PEDIATRICS 01YP00471MA01 MIRBACH BRUCE MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 0106879YPNH03 MISHCON MERRIT MD TILTON MEDICAL ASSOCIATES PLLC TILTON NH 03276 (603) 286-8907 FAMILY MEDICINE 23YP05046NH01 MISIASZEK JUDY A APRN NEW CREATION HEALING CENTER INC KINGSTON NH 03848 (603) 642-6700 FAMILY NURSE PRACTITIONERS 0103592YPNH01 MISIEWICZ JOSEPH MD JOSEPH MISIEWICZ FAMILY PRACTICE MEREDITH NH 03253 (603) 279-2267 FAMILY MEDICINE 23YP12769NH01 MITCHELL JUDITH APRN CONCORD PEDIATRICS PA CONCORD NH 03301 (603) 224-1929 PEDIATRIC NURSE PRACTITIONERS 23YP35241NH01 MITCHELL-BEAM MICHAEL APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 01YP24951NH01 MITSCHELE MATTHEW MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY MEDICINE 01YP24951NH02 MITSCHELE MATTHEW MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 FAMILY MEDICINE 01YP25670NH01 MITSOPOULOS SPIROS MD SPIROS MITSOPOULOS MD PLLC MANCHESTER NH 03103 (603) 663-8230 INTERNAL MEDICINE 04YP37272MA01 MOAK-BLEST HAYLEY DO LAHEY CLINIC INC SOUTH HAMILTON MA 01982 (978) 468-7346 FAMILY MEDICINE 04YP37272MA02 MOAK-BLEST HAYLEY DO LAHEY CLINIC INC IPSWICH MA 01938 (978) 356-5522 FAMILY MEDICINE 23YP36297NH01 MOBLEY KIM-LY APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-3080 FAMILY NURSE PRACTITIONERS 04YP15289ME01 MOHER HEATHER DO YORK HOSPITAL KITTERY ME 03904 (207) 439-4430 FAMILY MEDICINE 23YP13627NH03 MOLLOY ANNE APRN CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8052 FAMILY NURSE PRACTITIONERS 23YP13627NH04 MOLLOY ANNE APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 314-5900 FAMILY NURSE PRACTITIONERS 23YP13627NH05 MOLLOY ANNE APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 623-3343 FAMILY NURSE PRACTITIONERS 01YP41963NH01 MOLNAR-GABOR STEVEN MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE 01YP41963NH02 MOLNAR-GABOR STEVEN MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP04610NH01 MONAHAN LILA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 891-0083 PEDIATRICS 23YP38375NH01 MOORE LANA APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 23YP04736NH01 MOORE DEBORAH APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 INTERNAL MEDICINE NURSE PRACTITIONER 01YP36089ME01 MOORE JERRI MD YORK HOSPITAL YORK ME 03909 (207) 351-1710 PEDIATRICS 23YP41965NH01 MOORE KELLY APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 INTERNAL MEDICINE NURSE PRACTITIONER 23YP41965NH02 MOORE KELLY APRN GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 422-8208 INTERNAL MEDICINE NURSE PRACTITIONER 23YP26698NH01 MOOREHEAD MARTHA APRN LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-4259 FAMILY NURSE PRACTITIONERS 23YP26698NH02 MOOREHEAD MARTHA APRN LRGHEALTHCARE LACONIA NH 03246 (603) 524-5151 FAMILY NURSE PRACTITIONERS

Page 40 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP26698NH03 MOOREHEAD MARTHA APRN LRGHEALTHCARE BELMONT NH 03220 (603) 528-0990 FAMILY NURSE PRACTITIONERS 23YP41440NH01 MOOREHEAD MARTHA APRN EPHREM MEDICAL SERVICES LLC LACONIA NH 03246 (603) 455-8175 FAMILY NURSE PRACTITIONERS 23YP03684NH01 MORAN DANIEL APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE NURSE PRACTITIONER 01YP41996NH01 MORAN PETER MD MONADNOCK HEALTH CARE LLC COLEBROOK NH 03576 (603) 237-4262 FAMILY MEDICINE 04YP32916NH01 MORGAN KAREN DO FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 595-7388 PEDIATRICS 23YP36314ME01 MORGAN ERIN APRN YORK HOSPITAL YORK ME 03909 (207) 363-4321 FAMILY NURSE PRACTITIONERS 23YP37681NH01 MORIN SARA APRN HEALTH FIRST FAMILY CARE CENTER FRANKLIN NH 03235 (603) 934-0177 FAMILY NURSE PRACTITIONERS 23YP37681NH02 MORIN SARA APRN HEALTH FIRST FAMILY CARE CENTER LACONIA NH 03246 (603) 366-1070 FAMILY NURSE PRACTITIONERS 01YP40551VT01 MORISSETTE SABINA MD BRATTLEBORO MEMORIAL HOSPITAL PUTNEY VT 05346 (802) 387-5581 FAMILY MEDICINE 23YP22385NH01 MORRILL JENNA APRN ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 552-1400 FAMILY NURSE PRACTITIONERS 01YP29892NH01 MORRIS DEAN MD DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2500 FAMILY MEDICINE 04YP30329VT01 MORRISON JEREMY DO BRATTLEBORO MEMORIAL HOSPITAL PUTNEY VT 05346 (802) 387-5581 FAMILY MEDICINE 23YP35137NH01 MORRISON MELISSA APRN LRGHEALTHCARE BELMONT NH 03220 (603) 528-0990 FAMILY NURSE PRACTITIONERS 23YP35137NH02 MORRISON MELISSA APRN LRGHEALTHCARE LACONIA NH 03246 (603) 527-2819 FAMILY NURSE PRACTITIONERS 23YP35137NH03 MORRISON MELISSA APRN LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-2060 FAMILY NURSE PRACTITIONERS 01YP36353NH01 MORRISON JULIE MD CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8060 FAMILY MEDICINE 04YP02562NH01 MORRISSEY GREGORY DO APPLEDORE MEDICAL GROUP INC HAMPTON NH 03842 (603) 929-2137 INTERNAL MEDICINE 01YP14151NH01 MORROW CATHLEEN MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-4000 FAMILY MEDICINE 01YP21050NH01 MORSE JACQUELINE MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 23YP41621NH01 MOSHER TAYLOR APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 315-5900 FAMILY NURSE PRACTITIONERS 23YP26903NH01 MOULTON AMANDA APRN ELLIOT PHYSICIANS NETWORK RAYMOND NH 03077 (603) 895-8000 FAMILY NURSE PRACTITIONERS 01YP15185NH02 MOZUMDER MOUSHUMI MD ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3014 FAMILY MEDICINE 0105023YPNH01 MUELLO WENDY MD WEEKS MEDICAL CENTER LANCASTER NH 03584 (603) 788-2521 INTERNAL MEDICINE 0103355YPNH01 MUIR J GAVIN MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 0103355YPNH02 MUIR J GAVIN MD AMOSKEAG HEALTH MANCHESTER NH 03103 (603) 626-9500 FAMILY MEDICINE 0103355YPNH03 MUIR J GAVIN MD AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 663-5382 FAMILY MEDICINE 0103355YPNH04 MUIR J GAVIN MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 0103355YPNH05 MUIR J GAVIN MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 01YP36991MA01 MULCHANDANI NEETU MD LAHEY CLINIC INC BURLINGTON MA 01803 (855) 934-4488 INTERNAL MEDICINE 01YP36991MA02 MULCHANDANI NEETU MD LAHEY CLINIC INC PEABODY MA 01960 (978) 538-4033 INTERNAL MEDICINE 04YP23468MA01 MULLAH FARAH DO STEWARD MEDICAL GROUP INC HAVERHILL MA 01830 (978) 521-8377 FAMILY MEDICINE 04YP23468MA02 MULLAH FARAH DO STEWARD MEDICAL GROUP INC METHUEN MA 01844 (800) 488-5959 FAMILY MEDICINE 23YP41556NH01 MULLANEY CAITLIN APRN APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 436-6115 FAMILY NURSE PRACTITIONERS 01YP03211NH02 MULLANEY STEVEN MD CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 382-4972 FAMILY MEDICINE 23YP24978NH01 MULLEN LAURA APRN CROSSROADS FAMILY MEDICINE PLLC CONCORD NH 03301 (603) 856-8828 FAMILY NURSE PRACTITIONERS 23YP34568NH01 MULLINS SARAH APRN CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7555 FAMILY NURSE PRACTITIONERS 04YP12183ME01 MUNROE CHRISTINE DO YORK HOSPITAL SOUTH BERWICK ME 03908 (207) 384-9212 INTERNAL MEDICINE 01YP12152NH01 MURAI SARAH MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP12152NH02 MURAI SARAH MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP12152NH03 MURAI SARAH MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP12152NH04 MURAI SARAH MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP12152NH05 MURAI SARAH MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0103985YPNH02 MURAKAMI NOBORU MD LRGHEALTHCARE LACONIA NH 03246 (603) 934-5500 GENERAL PRACTICE 0103985YPNH03 MURAKAMI NOBORU MD LRGHEALTHCARE FRANKLIN NH 03235 (603) 934-5500 GENERAL PRACTICE 01YP28421NH01 MURALITHARAN PUSHKALA MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 INTERNAL MEDICINE PEDIATRIC ASSOCIATES OF HAMPTON & 01YP27560NH01 MURCIN SCOTT MD PORTSMOUTH NH 03801 (603) 436-7171 PEDIATRICS PORTSMOUTH PC Page 41 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP39589NH01 MURPHY REBECCA MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 PEDIATRICS 01YP39589NH02 MURPHY REBECCA MD DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2500 PEDIATRICS 23YP32566MA01 MURPHY ERIN APRN LAHEY CLINIC INC PEABODY MA 01960 (978) 538-4300 INTERNAL MEDICINE NURSE PRACTITIONER 23YP32566MA02 MURPHY ERIN APRN LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE NURSE PRACTITIONER 01YP36008NH01 MURPHY BRENDAN MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY MEDICINE 01YP36008NH02 MURPHY BRENDAN MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 FAMILY MEDICINE 0103106YPNH02 MURRAY SUSAN MD APPLEDORE MEDICAL GROUP INC DURHAM NH 03824 (603) 430-0060 FAMILY MEDICINE 0103106YPNH03 MURRAY SUSAN MD APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY MEDICINE 01YP38792NH01 MURRAY KYLE MD HUGGINS HOSPITAL OSSIPEE NH 03864 (603) 539-6996 FAMILY MEDICINE 01YP38792NH02 MURRAY KYLE MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7574 FAMILY MEDICINE 01YP38792NH03 MURRAY KYLE MD HUGGINS HOSPITAL ALTON NH 03809 (603) 875-6151 FAMILY MEDICINE 01YP38792NH04 MURRAY KYLE MD HUGGINS HOSPITAL MOULTONBORO NH 03254 (603) 476-2216 FAMILY MEDICINE 01YP38792NH05 MURRAY KYLE MD HUGGINS HOSPITAL TAMWORTH NH 03886 (603) 323-3311 FAMILY MEDICINE 01YP38792NH06 MURRAY KYLE MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7500 FAMILY MEDICINE 01YP38792NH07 MURRAY KYLE MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7508 FAMILY MEDICINE 23YP41274NH01 MURTHI JULIANNE APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 ADULT NURSE PRACTITIONERS 01YP14007NH02 MUSHTAQ SAFANA MD ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3014 FAMILY MEDICINE 01YP14007NH03 MUSHTAQ SAFANA MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 921-6022 FAMILY MEDICINE 01YP32658NH01 MUSSHORN EMMA MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 FAMILY MEDICINE 0105807YPNH02 MYERS MARK MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-5860 PEDIATRICS 23YP30257NH01 MYERS SAMANTHA APRN APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 436-6115 FAMILY NURSE PRACTITIONERS 23YP26693NH02 MYERS LORI APRN SUSAN KROLEWSKI MD PLLC PORTSMOUTH NH 03801 (603) 319-8767 FAMILY NURSE PRACTITIONERS 04YP33854VT01 MYRTER THOMAS DO NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-7500 FAMILY MEDICINE 01YP02977NH01 NABI-TREMBLAY SUZANNE MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 0107423YPNH01 NACKMAN LOUIS MD ELLIOT PHYSICIANS NETWORK WINDHAM NH 03087 (603) 685-0150 PEDIATRICS 23YP34563NH01 NADEAU KATE APRN CAROL A PELLETIER, APRN, DNP NASHUA NH 03062 (603) 577-1613 FAMILY NURSE PRACTITIONERS 23YP17728NH01 NADIR CHERESSE APRN ELLIOT PHYSICIANS NETWORK WINDHAM NH 03087 (603) 894-0063 FAMILY NURSE PRACTITIONERS 01YP13863NH01 NAGARAJ VASUKI MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY MEDICINE 01YP13863NH02 NAGARAJ VASUKI MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY MEDICINE 01YP24956MA01 NAHAR SHAMSUN MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 2309204YPNH01 NAIVA DENISE APRN LRGHEALTHCARE BELMONT NH 03220 (603) 528-0990 FAMILY NURSE PRACTITIONERS 2309204YPNH02 NAIVA DENISE APRN LRGHEALTHCARE LACONIA NH 03246 (603) 527-2946 FAMILY NURSE PRACTITIONERS 23YP30793MA01 NANKOOLE PAMELA APRN LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 FAMILY NURSE PRACTITIONERS 01YP00477MA01 NAPOLITANA GUY MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP03762MA02 NASEER-GHIASUDDIN SAIRA MD SEACOAST AFFILIATED GROUP PRACTICE NEWBURYPORT MA 01950 (978) 465-7719 INTERNAL MEDICINE 01YP28422NH01 NATH ARURU MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 FAMILY MEDICINE 01YP04691MA01 NAVARRA GUIDO MD SEACOAST MEDICAL ASSOC NEWBURYPORT MA 01950 (978) 462-1555 INTERNAL MEDICINE 23YP20575ME01 NEEL KERRI NP YORK HOSPITAL YORK ME 03909 (207) 363-8430 FAMILY NURSE PRACTITIONERS 0104631YPNH01 NEILLEY GREGORY MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4680 INTERNAL MEDICINE 0106477YPMA01 NELKEN ROBERT MD ANDOVER PEDIATRICS PC ANDOVER MA 01810 (978) 475-4522 PEDIATRICS 23YP21048NH01 NELSON MELISSA APRN NEW LONDON HOSPITAL ASSOCIATION NEWPORT NH 03773 (603) 863-4100 FAMILY NURSE PRACTITIONERS 0109650YPNH02 NELSON RICHARD MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 04YP03956NH05 NELSON DAVID DO AMMONOOSUC COMMUNITY HEALTH SERVICES INC LITTLETON NH 03561 (603) 444-2464 FAMILY MEDICINE 01YP23647NH01 NEUPANEY ANJANA MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 PEDIATRICS 01YP23647NH02 NEUPANEY ANJANA MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 PEDIATRICS 23YP29031NH01 NEVES HOLLY APRN CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8052 FAMILY NURSE PRACTITIONERS

Page 42 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP39611NH01 NEWELL HEATHER APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 622-6491 FAMILY NURSE PRACTITIONERS 23YP27964NH01 NEWTON ELIZABETH APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC WOODSVILLE NH 03785 (603) 747-3740 FAMILY NURSE PRACTITIONERS 23YP40834NH01 NGUYEN LOC APRN FRISBIE MEMORIAL HOSPITAL FARMINGTON NH 03835 (603) 755-9801 FAMILY NURSE PRACTITIONERS 23YP41951NH01 NGUYEN LOC APRN APPLEDORE MEDICAL GROUP INC FARMINGTON NH 03835 (603) 755-9801 FAMILY NURSE PRACTITIONERS 04YP14006NH02 NGUYEN PATRICK DO FOUNDATION MEDICAL PARTNERS INC MERRIMACK NH 03054 (603) 429-3155 FAMILY MEDICINE 04YP02055NH01 NGUYEN PHAT DO DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 INTERNAL MEDICINE 0105490YPNH01 NIEGISCH CAROL MD CONCORD HOSPITAL INC PENACOOK NH 03303 (603) 753-4302 FAMILY MEDICINE 0105528YPNH02 NIEGISCH ROBERT MD CONCORD HOSPITAL INC PEMBROKE NH 03275 (603) 485-8441 FAMILY MEDICINE 0108991YPNH01 NIEMELA LARA MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-7101 PEDIATRICS 01YP03375MA01 NIGBOROWICZ THADDEUS MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP14683MA01 NILSON ELIZABETH MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 0102598YPMA01 NITZBERG MARK MD MARK C NITZBERG PC METHUEN MA 01844 (978) 681-1977 INTERNAL MEDICINE 23YP13921NH03 NOBLE ALEXANDRIA APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC WARREN NH 03279 (603) 764-5704 FAMILY NURSE PRACTITIONERS 23YP41525VT01 NOBLE ALEXANDRIA APRN LITTLE RIVERS HEALTH CARE INC EAST CORINTH VT 05040 (802) 439-5321 FAMILY NURSE PRACTITIONERS 23YP41525VT02 NOBLE ALEXANDRIA APRN LITTLE RIVERS HEALTH CARE INC WELLS RIVER VT 05081 (802) 757-2325 FAMILY NURSE PRACTITIONERS 23YP41525VT03 NOBLE ALEXANDRIA APRN LITTLE RIVERS HEALTH CARE INC BRADFORD VT 05033 (802) 222-9317 FAMILY NURSE PRACTITIONERS 23YP42041NH01 NOLTE KERRY APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP08253NH01 NOONAN-TIMMERMAN JULIANNE APRN MERRIMACK VILLAGE FAMILY PRACTICE CTR MERRIMACK NH 03054 (603) 424-8120 FAMILY NURSE PRACTITIONERS 04YP29949MA01 NORMAN MAUREEN DO MEDICAL CARE OF BOSTON MANAGEMENT CORP METHUEN MA 01844 (978) 688-1220 FAMILY MEDICINE 0104640YPNH01 NORTHCUTT ALBERT MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0104640YPNH02 NORTHCUTT ALBERT MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 0104640YPNH03 NORTHCUTT ALBERT MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 0104640YPNH04 NORTHCUTT ALBERT MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 0104640YPNH05 NORTHCUTT ALBERT MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP15629NH02 NOWRIN SAZIA MD ST JOSEPH HOSPITAL HUDSON NH 03051 (603) 882-6700 FAMILY MEDICINE 01YP31758MA01 NUGENT KARA MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 04YP05350MA01 OBERTI III FRANK DO FRANK OBERTI III DO BRADFORD MA 01835 (978) 374-1700 FAMILY MEDICINE 01YP32959MA01 O'BRIEN GAIL MD LAHEY CLINIC INC LEXINGTON MA 02421 (781) 372-7100 INTERNAL MEDICINE 01YP03540MA01 O'BRIEN MAUREEN MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 0107919YPNH01 O'BRIEN JR RICHARD MD LRGHEALTHCARE BELMONT NH 03220 (603) 528-0990 FAMILY MEDICINE 0107919YPNH02 O'BRIEN JR RICHARD MD LRGHEALTHCARE GILFORD NH 03249 (603) 524-5816 FAMILY MEDICINE 23YP04709VT02 OCONNOR ALISON APRN LITTLE RIVERS HEALTH CARE INC WELLS RIVER VT 05081 (802) 275-2325 FAMILY NURSE PRACTITIONERS 01YP04785NH06 O'DONNELL CAITLIN MD AMMONOOSUC COMMUNITY HEALTH SERVICES INC WARREN NH 03279 (603) 764-5704 FAMILY MEDICINE 23YP23034NH02 O'DONNELL CATHY APRN ST JOSEPH HOSPITAL MERRIMACK NH 03054 (603) 424-4181 FAMILY NURSE PRACTITIONERS 23YP33753NH01 O'DONOVAN JADE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3664 GERIATRIC NURSE PRACTITIONERS 23YP33753NH02 O'DONOVAN JADE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 GERIATRIC NURSE PRACTITIONERS 23YP33753NH03 O'DONOVAN JADE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 GERIATRIC NURSE PRACTITIONERS 23YP33753NH04 O'DONOVAN JADE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 GERIATRIC NURSE PRACTITIONERS 01YP05377MA03 OETTINGER JANA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (888) 227-3762 INTERNAL MEDICINE 01YP37079NH01 OGDEN SAMUEL MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 444-3122 PEDIATRICS 01YP40910NH01 OJUTALAYO AYOBAMI MD GENESIS ELDERCARE PHYSICIAN SERVICES INC BEDFORD NH 03110 (603) 623-8805 FAMILY MEDICINE 04YP37989ME01 OKUN-LANGLAIS AUDREY DO JONATHAN SHILL MD PHD LLC KENNEBUNK ME 04043 (207) 502-7074 FAMILY MEDICINE 23YP16620NH01 OLDEN ABIGAIL APRN LRGHEALTHCARE MEREDITH NH 03253 (603) 279-7433 FAMILY NURSE PRACTITIONERS 01YP42424VT01 OLESON EMILY MD LITTLE RIVERS HEALTH CARE INC WELLS RIVER VT 05081 (802) 757-2325 FAMILY MEDICINE 01YP39080NH01 OLIVE LOUIE MD ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 552-1400 FAMILY MEDICINE 01YP08320NH03 OLIVE STEVEN MD FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 FAMILY MEDICINE

Page 43 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP08320NH04 OLIVE STEVEN MD FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 755-9801 FAMILY MEDICINE 01YP08320NH05 OLIVE STEVEN MD APPLEDORE MEDICAL GROUP INC FARMINGTON NH 03835 (603) 755-9801 FAMILY MEDICINE 23YP32847NH01 OLIVEIRA CHRISTINE APRN CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY NURSE PRACTITIONERS 01YP28424NH01 OLIVEIRA THERESA MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRICS 01YP41594ME01 OLIVER ANDREW MD YORK HOSPITAL WELLS ME 04090 (207) 646-5211 PEDIATRICS 01YP41594ME02 OLIVER ANDREW MD YORK HOSPITAL YORK ME 03909 (207) 351-1708 PEDIATRICS 23YP41021VT01 OLIVIER ANNA APRN BRATTLEBORO MEMORIAL HOSPITAL PUTNEY VT 05346 (802) 387-5581 FAMILY NURSE PRACTITIONERS 01YP33080NH01 OLLENDIECK MICHAEL MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 889-3667 INTERNAL MEDICINE 01YP22435NH01 OLSEN BRIDGET MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 891-0083 PEDIATRICS 01YP28975VT01 OLSEN SUSAN MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 INTERNAL MEDICINE 01YP07929NH01 OLSON ELIZABETH MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2750 PEDIATRICS 23YP27655NH01 OLSSON JEREMY APRN DOVER PEDIATRICS PLLC DOVER NH 03820 (603) 742-4048 FAMILY NURSE PRACTITIONERS 23YP30537NH02 O'MAHONEY KIMBERLEY APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP30537NH03 O'MAHONEY KIMBERLEY APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP30537NH04 O'MAHONEY KIMBERLEY APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP30537NH05 O'MAHONEY KIMBERLEY APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP30537NH06 O'MAHONEY KIMBERLEY APRN GREATER SEACOAST COMMUNITY HEALTH SEABROOK NH 03874 (603) 766-2626 FAMILY NURSE PRACTITIONERS 23YP37569NH01 O'MAHONEY KIMBERLEY APRN LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY NURSE PRACTITIONERS 04YP41638NH01 OMERHI EDWARD DO FOUNDATION MEDICAL PARTNERS INC MILFORD NH 03055 (603) 672-7600 FAMILY MEDICINE 01YP18557NH02 ONG MARICHI MD ALLIANCE HEALTH SERVICES BEDFORD NH 03110 (603) 629-1793 FAMILY MEDICINE 01YP00488MA01 OOI WINNIE MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP00488MA02 OOI WINNIE MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 01YP00489MA01 ORFANOS GERRY MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 01YP40833NH01 ORLAN RICHARD MD VANTAGE HEALTHCARE LLC PELHAM NH 03076 (781) 867-2050 INTERNAL MEDICINE 23YP41804NH01 OSANYA EVERLINE APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 ADULT NURSE PRACTITIONERS 01YP22147VT01 OUTWATER KRISTAN MD PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 PEDIATRICS 04YP25639NH01 OWEN REBECCA DO CONCORD HOSPITAL INC CONCORD NH 03301 (603) 244-4004 INTERNAL MEDICINE 23YP39936NH01 OWERS ZOE APRN CONCORD HOSPITAL INC PENACOOK NH 03303 (603) 753-4302 FAMILY NURSE PRACTITIONERS 01YP02641VT02 PAASCHE DENISE MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 254-1311 FAMILY MEDICINE 04YP34127NH01 PACE MARK DO STEWARD MEDICAL GROUP INC SALEM NH 03079 (603) 893-3900 FAMILY MEDICINE 23YP13258NH01 PACIULAN PAULINE APRN FOUNDATION MEDICAL PARTNERS INC HUDSON NH 03051 (603) 886-3979 ADULT NURSE PRACTITIONERS 01YP20768NH01 PACKARD JENNIFER MD CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8052 INTERNAL MEDICINE 0107327YPNH04 PAGE JENNIFER MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 889-6671 PEDIATRICS 0107327YPNH05 PAGE JENNIFER MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 PEDIATRICS 0107327YPNH06 PAGE JENNIFER MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 PEDIATRICS 23YP32066NH01 PAGE AMY APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC WHITEFIELD NH 03598 (603) 837-2333 FAMILY NURSE PRACTITIONERS 0108354YPNH01 PAICOPOLIS MARY-CLAIRE MD LACONIA CARDIOLOGY GILFORD NH 03249 (603) 528-8555 INTERNAL MEDICINE 01YP02328MA03 PAJELA REX MD STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 687-6355 PEDIATRICS 01YP02328MA04 PAJELA REX MD STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 687-6355 PEDIATRICS 04YP17175NH02 PALMER KAREN DO APPLEDORE MEDICAL GROUP INC DURHAM NH 03824 (603) 430-0060 FAMILY MEDICINE 04YP17175NH03 PALMER KAREN DO APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY MEDICINE 23YP36390NH01 PALMER TRAVIS APRN WHOLE LIFE HEALTH CARE NEWINGTON NH 03801 (603) 431-6677 FAMILY NURSE PRACTITIONERS 01YP19010NH01 PALUMBO ANDREA MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-5860 PEDIATRICS 01YP12073NH01 PANESAR MAHENDRA MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8350 PEDIATRICS 01YP02390NH02 PANGAN MICHAEL MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 FAMILY MEDICINE 01YP02551NH02 PANGAN PATRICIA MD CORE PHYSICIANS LLC HAMPTON NH 03842 (603) 929-1195 INTERNAL MEDICINE

Page 44 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP04696MA01 PAPANICOLAOU GEORGE DO CORNERSTONE FAMILY PRACTICE PC ROWLEY MA 01969 (978) 948-3902 FAMILY MEDICINE 23YP16767NH01 PARE DONNA APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 FAMILY NURSE PRACTITIONERS 01YP35720MA01 PARIKH KRUTI MD COMMUNITY MEDICAL ASSOCIATES INC LAWRENCE MA 01841 (978) 946-8550 INTERNAL MEDICINE 01YP38223MA01 PARIKH KRUTI MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8700 INTERNAL MEDICINE 01YP38223MA02 PARIKH KRUTI MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (978) 521-3200 INTERNAL MEDICINE 01YP07223VT02 PARK DAVID MD WHITE RIVER FAMILY PRACTICE PC WHITE RIVER JUNCTION VT 05001 (802) 295-6132 FAMILY MEDICINE 01YP35680MA01 PARKER-MELLO KELLY MD RIVERSIDE PEDIATRICS NEWBURYPORT MA 01950 (978) 465-0322 PEDIATRICS 01YP25253NH01 PASCU DIANA MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 INTERNAL MEDICINE 01YP11092NH04 PASHA MUHAMMAD MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 FAMILY MEDICINE 01YP10307NH01 PASTEL LISA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 01YP05314ME01 PATEL HARENDRABABU MD HARENDRABABU N PATEL MD SANFORD ME 04073 (207) 324-7126 INTERNAL MEDICINE 01YP20468NH01 PATEL SUNIT MD LITTLETON HOSPITAL ASSOCIATION LITTLETON NH 03561 (603) 444-7070 PEDIATRICS 01YP14957NH01 PATEL KALPESH MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 INTERNAL MEDICINE 23YP42439NH01 PATENAUDE THERESA APRN VANTAGE HEALTHCARE LLC PELHAM NH 03076 (781) 867-2050 ADULT NURSE PRACTITIONERS 01YP07814MA02 PATIL SAVITA MD LAHEY CLINIC INC N BILLERICA MA 01862 (978) 663-6666 INTERNAL MEDICINE 0102934YPVT03 PATNO KARYN MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-5131 PEDIATRICS 2308206YPNH02 PATTAVINA MARIA APRN ADVANCED FOOT AND ANKLE SPECIALISTS PC KEENE NH 03431 (603) 352-2944 FAMILY NURSE PRACTITIONERS 23YP36886NH01 PATTERSON WHITNEY APRN KEADY FAMILY PRACTICE CHARLESTOWN NH 03603 (603) 863-7777 ACUTE CARE NURSE PRACTITIONER 23YP36886NH02 PATTERSON WHITNEY APRN KEADY FAMILY PRACTICE NEWPORT NH 03773 (603) 863-7777 ACUTE CARE NURSE PRACTITIONER 23YP36886NH03 PATTERSON WHITNEY APRN KEADY FAMILY PRACTICE CLAREMONT NH 03743 (603) 863-7777 ACUTE CARE NURSE PRACTITIONER 01YP22795ME01 PAUL SUSAN MD BRIDGTON HOSPITAL BRIDGTON ME 04009 (207) 647-2311 INTERNAL MEDICINE 23YP42267NH01 PAYEUR SHANNON APRN APPLEDORE MEDICAL GROUP INC BARRINGTON NH 03825 (603) 664-0955 FAMILY NURSE PRACTITIONERS 01YP10207NH01 PAYTON JESSICA MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 PEDIATRICS 04YP21284NH01 PEARSON KATHLEEN DO LITTLETON HOSPITAL ASSOCIATION LITTLETON NH 03561 (603) 444-7070 FAMILY MEDICINE 23YP31864NH01 PEARSON JENNIFER APRN LRGHEALTHCARE MEREDITH NH 03253 (603) 527-2792 FAMILY NURSE PRACTITIONERS 23YP32901NH01 PEARSON JENNIFER APRN LRGHEALTHCARE LACONIA NH 03246 (603) 527-2946 FAMILY NURSE PRACTITIONERS 23YP32901NH02 PEARSON JENNIFER APRN LRGHEALTHCARE LACONIA NH 03246 (603) 527-2969 FAMILY NURSE PRACTITIONERS 23YP32901NH03 PEARSON JENNIFER APRN LRGHEALTHCARE LACONIA NH 03246 (603) 527-2792 FAMILY NURSE PRACTITIONERS 23YP32901NH04 PEARSON JENNIFER APRN LRGHEALTHCARE MEREDITH NH 03253 (603) 279-7464 FAMILY NURSE PRACTITIONERS 0402142YPNH01 PEARSON MARY DO NEW CREATION HEALING CENTER INC KINGSTON NH 03848 (603) 642-6700 FAMILY MEDICINE 01YP05070VT01 PELLETIER JOSEPH MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 PEDIATRICS 23YP18788NH01 PELLETIER CAROL APRN CAROL A PELLETIER, APRN, DNP NASHUA NH 03062 (603) 577-1613 FAMILY NURSE PRACTITIONERS 23YP41373NH01 PELLETIER KELLY APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC PORTSMOUTH NH 03801 (603) 431-2530 FAMILY NURSE PRACTITIONERS 23YP41383NH01 PELLETIER KELLY APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 23YP42269NH01 PELLETIER DONNA APRN APPLEDORE MEDICAL GROUP INC SOMERSWORTH NH 03878 (603) 692-6066 FAMILY NURSE PRACTITIONERS 01YP12391NH02 PEREZ ALFREDO MD CATHOLIC MEDICAL CENTER HOOKSETT NH 03106 (603) 663-1990 INTERNAL MEDICINE 01YP15027NH01 PERNYESZI GABOR MD CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 382-4972 FAMILY MEDICINE 01YP15027NH02 PERNYESZI GABOR MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY MEDICINE 01YP15027NH03 PERNYESZI GABOR MD CORE PHYSICIANS LLC KINGSTON NH 03848 (603) 642-3910 FAMILY MEDICINE 23YP38528VT01 PERREAULT ALEXANDRA APRN LITTLE RIVERS HEALTH CARE INC WELLS RIVER VT 05081 (802) 757-2325 FAMILY NURSE PRACTITIONERS 23YP38528VT02 PERREAULT ALEXANDRA APRN LITTLE RIVERS HEALTH CARE INC BRADFORD VT 05033 (802) 222-9317 FAMILY NURSE PRACTITIONERS 23YP38528VT03 PERREAULT ALEXANDRA APRN LITTLE RIVERS HEALTH CARE INC EAST CORINTH VT 05040 (802) 439-5321 FAMILY NURSE PRACTITIONERS 23YP41444NH01 PERRY MERIDITH APRN SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-3500 OB/GYN NURSE PRACTITIONERS 23YP41225NH01 PERRY ALICIA APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 23YP37585VT01 PERRY MARY APRN LITTLE RIVERS HEALTH CARE INC EAST CORINTH VT 05040 (802) 439-5321 FAMILY NURSE PRACTITIONERS 23YP39432NH01 PETALAS VICKI APRN PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY NURSE PRACTITIONERS

Page 45 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP37737NH01 PETERS KATHERINE DO AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 04YP37737NH02 PETERS KATHERINE DO AMOSKEAG HEALTH MANCHESTER NH 03103 (603) 626-9500 FAMILY MEDICINE 04YP37737NH03 PETERS KATHERINE DO AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 668-6629 FAMILY MEDICINE 04YP37737NH04 PETERS KATHERINE DO AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 663-5382 FAMILY MEDICINE 04YP37737NH05 PETERS KATHERINE DO AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 626-9500 FAMILY MEDICINE 0107429YPNH01 PETERSON CHRISTOPHER MD LONDONDERRY PEDIATRICS PA LONDONDERRY NH 03053 (603) 437-1003 PEDIATRICS 04YP17804NH01 PETRON ALEXANDER DO ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8300 PEDIATRICS 23YP40992MA01 PETROSINO LEAH APRN PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8700 FAMILY NURSE PRACTITIONERS 0105592YPNH15 PETTINARI NANCY MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE 04YP41823NH01 PHANEUF GABRIELLE DO CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY MEDICINE 04YP38786NH01 PHELAN DOUGLAS DO ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 FAMILY MEDICINE 23YP41275NH01 PHILLIPS PAULA APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 01YP03904NH03 PHO KEVIN MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4400 INTERNAL MEDICINE 23YP37680NH01 PICHE LORNA APRN LRGHEALTHCARE LACONIA NH 03246 (603) 527-2792 ADULT NURSE PRACTITIONERS 23YP37769NH01 PIERCE STEPHANIE APRN CONCORD HOSPITAL INC PENACOOK NH 03303 (603) 753-4302 FAMILY NURSE PRACTITIONERS 01YP22951MA01 PIKUS ANTHONY MD LAHEY CLINIC INC BEVERLY MA 01915 (978) 927-1919 INTERNAL MEDICINE 01YP05162MA01 PILZ MICHAEL MD RIVERSIDE PEDIATRICS NEWBURYPORT MA 01950 (978) 465-0322 PEDIATRICS 23YP29231ME01 PILZER ANNA APRN YORK HOSPITAL SOUTH BERWICK ME 03908 (207) 384-9212 FAMILY NURSE PRACTITIONERS 23YP07872NH03 PINARD JENNIFER APRN HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7588 FAMILY NURSE PRACTITIONERS 23YP33426NH01 PINEO CHERYL APRN MONADNOCK COMMUNITY HOSPITAL JAFFREY NH 03452 (603) 899-9563 FAMILY NURSE PRACTITIONERS 23YP34222NH01 PINEO CHERYL APRN MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 FAMILY NURSE PRACTITIONERS 23YP34222NH02 PINEO CHERYL APRN MONADNOCK COMMUNITY HOSPITAL RINDGE NH 03461 (603) 924-7191 FAMILY NURSE PRACTITIONERS 01YP30761MA01 PINTO SUZETTE MD LAHEY CLINIC INC IPSWICH MA 01938 (978) 356-5522 FAMILY MEDICINE 0105862YPNH01 PINTO POWELL ROSHINI MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 653-9500 INTERNAL MEDICINE 0100216YPNH01 PITTS LESLIE MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 23YP40363NH01 PITTS STACIE APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC CONCORD NH 03301 (603) 226-6561 ADULT NURSE PRACTITIONERS 23YP41119NH01 PITTS STACIE APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 ADULT NURSE PRACTITIONERS 01YP35541NH01 PIVOR MITCHELL MD GREATER SEACOAST COMMUNITY HEALTH ROCHESTER NH 03867 (603) 749-2345 PEDIATRICS 04YP29980NH01 PLAUM JUSTIN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 04YP29980NH02 PLAUM JUSTIN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 04YP29980NH03 PLAUM JUSTIN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 04YP29980NH04 PLAUM JUSTIN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 04YP29980NH05 PLAUM JUSTIN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP07507NH01 PLOTNIK LISA MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 INTERNAL MEDICINE 01YP37090NH01 PLUMB ELLEN MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 01YP25264VT01 POFCHER ERIC MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 275-3674 INTERNAL MEDICINE 23YP30296NH01 POITRAS NICOLE APRN ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 FAMILY NURSE PRACTITIONERS 0107230YPNH02 POLLAK ERIC MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 01YP31576ME01 POLLARD DOUGLAS MD YORK HOSPITAL YORK ME 03909 (207) 351-3530 INTERNAL MEDICINE 23YP30320VT01 POOL-KROK-HORTON KARA APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-5131 FAMILY NURSE PRACTITIONERS 04YP30299NH01 PORBUNDERWALA DANIELLE DO CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 668-6489 INTERNAL MEDICINE 01YP33839NH01 PORET TODD MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-6100 PEDIATRICS 0100157YPNH02 PORTER SUSAN MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 FAMILY MEDICINE 0100157YPNH03 PORTER SUSAN MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-2981 FAMILY MEDICINE 23YP42157NH01 PORTER BRANDIE APRN BETTER LIFE PARTNERS INC HANOVER NH 03755 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP42157NH02 PORTER BRANDIE APRN BETTER LIFE PARTNERS INC JAFFREY NH 03452 (866) 679-0831 FAMILY NURSE PRACTITIONERS

Page 46 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP42157NH03 PORTER BRANDIE APRN BETTER LIFE PARTNERS INC KEENE NH 03431 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP42157NH04 PORTER BRANDIE APRN BETTER LIFE PARTNERS INC NEW IPSWICH NH 03071 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP42157NH05 PORTER BRANDIE APRN BETTER LIFE PARTNERS INC KEENE NH 03431 (866) 679-0831 FAMILY NURSE PRACTITIONERS 23YP41814NH01 PORTER JACQUELINE APRN APPLEDORE MEDICAL GROUP INC BARRINGTON NH 03825 (603) 664-9003 INTERNAL MEDICINE NURSE PRACTITIONER 01YP23796VT01 PORTER WILLIAM MD LITTLE RIVERS HEALTH CARE INC E CORINTH VT 05040 (802) 439-5321 FAMILY MEDICINE 23YP40903NH01 POTHIER HEATHER APRN MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4664 FAMILY NURSE PRACTITIONERS 23YP40903NH02 POTHIER HEATHER APRN MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4680 FAMILY NURSE PRACTITIONERS 23YP40903NH03 POTHIER HEATHER APRN MONADNOCK COMMUNITY HOSPITAL ANTRIM NH 03440 (603) 588-4200 FAMILY NURSE PRACTITIONERS 01YP37549NH01 POTTHOFF TROY MD APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY MEDICINE 23YP38315NH01 POUDRETTE NICOLE APRN NEW LONDON HOSPITAL ASSOCIATION NEWPORT NH 03773 (603) 863-4100 FAMILY NURSE PRACTITIONERS 23YP05378NH03 POULIOS CASEY APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4400 FAMILY NURSE PRACTITIONERS 04YP30787MA02 POULOSE SINI DO LAHEY PHYSICIAN COMMUNITY ORGANIZATION I INC LYNNFIELD MA 01940 (781) 213-4040 FAMILY MEDICINE 01YP18327NH01 POWELL KENTON MD DARTMOUTH HITCHCOCK CLINIC LYME NH 03768 (603) 650-1070 INTERNAL MEDICINE 0108932YPNH01 PRASAD ANIL MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 595-0063 INTERNAL MEDICINE 0104616YPNH02 PRATT PATRICIA MD AMMONOOSUC COMMUNITY HEALTH SERVICES INC WOODSVILLE NH 03785 (603) 747-3740 FAMILY MEDICINE 01YP29042NH01 PRAZAR GREGORY MD AMOSKEAG HEALTH MANCHESTER NH 03102 (603) 626-9500 PEDIATRICS 01YP29042NH02 PRAZAR GREGORY MD AMOSKEAG HEALTH MANCHESTER NH 03101 (603) 668-6629 PEDIATRICS 23YP34590NH01 PRAZAR KAREN APRN LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY NURSE PRACTITIONERS 23YP23111NH01 PRESCOTT JEANNE APRN LRGHEALTHCARE MEREDITH NH 03253 (603) 279-7433 FAMILY NURSE PRACTITIONERS 01YP41567MA01 PRICE DANA MD LAHEY CLINIC INC BURLINGTON MA 01803 (781) 744-8000 INTERNAL MEDICINE 0108539YPVT02 PRICE MARK MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC SAINT JOHNSBURY VT 05819 (802) 748-5131 PEDIATRICS 01YP36595NH01 PRICE CHRISTOPHER MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 624-4380 INTERNAL MEDICINE 23YP41822NH01 PRICOP PAUL APRN ADVANCED CARE HOUSE CALLS OF NH LLC EPPING NH 03042 (603) 686-6204 ADULT NURSE PRACTITIONERS 23YP37842VT01 PRIESTLEY AYLA APRN LITTLE RIVERS HEALTH CARE INC BRADFORD VT 05033 (802) 222-9317 FAMILY NURSE PRACTITIONERS 23YP37842VT02 PRIESTLEY AYLA APRN LITTLE RIVERS HEALTH CARE INC EAST CORINTH VT 05040 (802) 439-5321 FAMILY NURSE PRACTITIONERS 23YP37842VT03 PRIESTLEY AYLA APRN LITTLE RIVERS HEALTH CARE INC WELLS RIVER VT 05081 (802) 757-2325 FAMILY NURSE PRACTITIONERS 01YP23225NH01 PRISCH STEPHANIE MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 653-9500 INTERNAL MEDICINE 01YP10535MA01 PRITCHARD ELIZABETH MD ANDOVER PEDIATRICS PC ANDOVER MA 01810 (978) 475-4522 PEDIATRICS 23YP23612NH01 PROFETTO LISA APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 01YP36887NH01 PRUETTE DAVID MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 PEDIATRICS 23YP12651NH01 PRZYDZIELSKI ALICIA APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY NURSE PRACTITIONERS 0104098YPNH01 PULASKI MARY MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8350 PEDIATRICS 2305503YPNH01 PULLIN DEBORAH APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 PEDIATRIC NURSE PRACTITIONERS 01YP25739MA01 PUROHIT SAROJ MD STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 687-0151 PEDIATRICS 04YP32821NH01 QUINTERO NANCY DO SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-1881 INTERNAL MEDICINE 0108095YPNH02 QUIRBACH ROBERT MD ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3014 FAMILY MEDICINE 01YP38550NH01 RABIDEAU RAYMOND MD THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5461 FAMILY MEDICINE 23YP40428NH01 RAFTER JILLIAN APRN VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-6700 FAMILY NURSE PRACTITIONERS 23YP40428NH02 RAFTER JILLIAN APRN VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-1251 FAMILY NURSE PRACTITIONERS 01YP28402NH01 RAJANNA SUMATHI MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4440 FAMILY MEDICINE 01YP25004NH02 RAJANNA PREETHI MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY MEDICINE 23YP13328NH02 RAJCHEL LINDA APRN HEALTHY LIVING FAMILY PRACTICE PA RAYMOND NH 03077 (603) 895-1658 FAMILY NURSE PRACTITIONERS 23YP36688NH01 RAJI RAJAE APRN LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY NURSE PRACTITIONERS 23YP40460NH01 RALSTON SHELLY APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC FRANKLIN NH 03235 (603) 934-2541 FAMILY NURSE PRACTITIONERS 23YP40460NH02 RALSTON SHELLY APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 04YP28616NH01 RAMANATHAN SHEILA DO DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE

Page 47 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP29954NH01 RAMAS MARIE-ELIZABETH MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY MEDICINE 01YP29954NH02 RAMAS MARIE-ELIZABETH MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY MEDICINE 01YP28779MA01 RAMENENI ANURADHA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8800 INTERNAL MEDICINE 01YP27176MA02 RANCIER-PEREZ MOSHE MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8700 INTERNAL MEDICINE 01YP05534MA02 RANDALL CHARLES MD PARTNERS COMMUNITY PHYS ORGANIZATION INC NEWBURYPORT MA 01950 (978) 499-7200 INTERNAL MEDICINE 01YP31052NH01 RANSMEIER PETER MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 FAMILY MEDICINE 01YP07131MA01 RAO DURGA MD NORTHEAST NEPHROLOGY AND INTERNAL MEDICINE METHUEN MA 01844 (978) 689-2500 INTERNAL MEDICINE 01YP30065VT01 RASER JOHN MD NORTHERN COUNTIES HEALTH CARE INC ST JOHNSBURY VT 05819 (802) 748-5041 FAMILY MEDICINE 01YP35119VT01 RATTE MARC-OLIVIER MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8455 FAMILY MEDICINE 04YP10033ME01 RAY JEFFREY DO SACOPEE VALLEY HEALTH CENTER PORTER ME 04068 (207) 625-8126 FAMILY MEDICINE 01YP29322MA01 RAY CHAYA MD MEDICAL CARE OF BOSTON MANAGEMENT CORP HAVERHILL MA 01830 (978) 521-2106 FAMILY MEDICINE 04YP35627NH01 RAYMAN SHANNON DO CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 04YP35627NH02 RAYMAN SHANNON DO CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 778-1620 FAMILY MEDICINE 01YP02406NH02 REALL DAVID MD FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 335-2401 FAMILY MEDICINE 01YP02406NH03 REALL DAVID MD FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 FAMILY MEDICINE 01YP02406NH04 REALL DAVID MD FRISBIE MEMORIAL HOSPITAL FARMINGTON NH 03835 (603) 755-9801 FAMILY MEDICINE 01YP08600NH02 REAPE DONALD MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 INTERNAL MEDICINE 01YP08600NH03 REAPE DONALD MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 921-6022 INTERNAL MEDICINE 0106732YPMA02 REDDI VANI MD ESSEX MEDICAL ASSOCIATES PLLC NORTH ANDOVER MA 01845 (978) 725-3636 INTERNAL MEDICINE 23YP25154VT01 REDFIELD NANCY APRN BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-2611 FAMILY NURSE PRACTITIONERS 01YP32450NH01 REED CLAIRE MD MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY MEDICINE 23YP39404NH01 REEDENAUER MICHELLE APRN HEALTH FIRST FAMILY CARE CENTER LACONIA NH 03246 (603) 366-1070 FAMILY NURSE PRACTITIONERS 23YP39404NH02 REEDENAUER MICHELLE APRN HEALTH FIRST FAMILY CARE CENTER FRANKLIN NH 03235 (603) 934-1464 FAMILY NURSE PRACTITIONERS 01YP05456NH03 REEDER MARK MD CORE PHYSICIANS LLC KINGSTON NH 03848 (603) 642-3910 FAMILY MEDICINE 01YP05456NH05 REEDER MARK MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-8900 FAMILY MEDICINE 01YP05456NH06 REEDER MARK MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 999-9999 FAMILY MEDICINE 01YP05456NH07 REEDER MARK MD CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 382-4972 FAMILY MEDICINE 01YP05456NH08 REEDER MARK MD CORE PHYSICIANS LLC EPPING NH 03042 (603) 658-0190 FAMILY MEDICINE 01YP25079MA01 REES PETER MD STEWARD MEDICAL GROUP INC HAVERHILL MA 01830 (978) 521-8377 FAMILY MEDICINE 01YP08440NH02 REEVES REBEKAH MD LITTLETON INTERNAL MEDICINE PC LITTLETON NH 03561 (603) 444-2002 INTERNAL MEDICINE 01YP42014NH01 REGAN STEPHEN MD MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 INTERNAL MEDICINE 23YP32091ME01 REGAN JENNIFER APRN YORK HOSPITAL KITTERY ME 03904 (207) 439-4430 FAMILY NURSE PRACTITIONERS 01YP00415MA01 REHM JENNIFER MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP00415MA02 REHM JENNIFER MD LAHEY CLINIC INC IPSWICH MA 01938 (978) 356-5522 INTERNAL MEDICINE 23YP17820NH01 REID SUZANNE APRN SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-2555 FAMILY NURSE PRACTITIONERS 2304165YPNH01 REID KATHLEEN APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-7338 FAMILY NURSE PRACTITIONERS 2304165YPNH03 REID KATHLEEN APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY NURSE PRACTITIONERS 2304165YPNH14 REID KATHLEEN APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 749-0973 FAMILY NURSE PRACTITIONERS 2304165YPNH15 REID KATHLEEN APRN WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 749-0913 FAMILY NURSE PRACTITIONERS 01YP02346NH01 REIMER ALEXIS MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8300 PEDIATRICS 01YP23327MA01 REINHOLD LARS MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 04YP20865NH01 REISERT JEFFREY DO LITTLETON HOSPITAL ASSOCIATION LITTLETON NH 03561 (603) 444-7070 INTERNAL MEDICINE 23YP12229NH15 REMBISZ NICOLE APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 FAMILY NURSE PRACTITIONERS 01YP39560NH01 REMILLARD MEEGAN MD MEDICAL CARE OF BOSTON MANAGEMENT CORP SALEM NH 03079 (603) 870-5452 INTERNAL MEDICINE 01YP11255NH03 REMILLONG ELIZABETH MD MARTIN'S POINT HEALTH CARE PORTSMOUTH NH 03801 (603) 431-5154 FAMILY MEDICINE 01YP38527NH01 RENNER TUESDAY MD HUGGINS HOSPITAL ALTON NH 03809 (603) 515-2093 FAMILY MEDICINE

Page 48 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP38527NH02 RENNER TUESDAY MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7588 FAMILY MEDICINE 01YP38527NH03 RENNER TUESDAY MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7574 FAMILY MEDICINE 01YP38527NH04 RENNER TUESDAY MD HUGGINS HOSPITAL OSSIPEE NH 03864 (603) 539-6996 FAMILY MEDICINE 01YP38527NH05 RENNER TUESDAY MD HUGGINS HOSPITAL MOULTONBORO NH 03254 (603) 476-2216 FAMILY MEDICINE 01YP38527NH06 RENNER TUESDAY MD HUGGINS HOSPITAL TAMWORTH NH 03886 (603) 323-3311 FAMILY MEDICINE 01YP38527NH07 RENNER TUESDAY MD HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7500 FAMILY MEDICINE 01YP13746VT01 REYNOLDS JESSIE MD LITTLE RIVERS HEALTH CARE INC BRADFORD VT 05033 (802) 222-9317 FAMILY MEDICINE 23YP40576NH01 RHODES TIFFANY APRN VANTAGE HEALTHCARE LLC PELHAM NH 03076 (781) 867-2050 FAMILY NURSE PRACTITIONERS 04YP32760MA01 RHODES JAMIE DO PARTNERS COMMUNITY PHYS ORGANIZATION INC NEWBURYPORT MA 01950 (978) 499-7200 INTERNAL MEDICINE 23YP02070ME03 RHYNE STACEY APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 610-8095 FAMILY NURSE PRACTITIONERS 23YP36846NH01 RHYNE STACEY APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 610-8095 FAMILY NURSE PRACTITIONERS 01YP15631NH01 RIBNER CAROL MD CAROL RIBNER MD JEFFERSON NH 03583 (603) 586-4482 FAMILY MEDICINE 01YP11618MA01 RICCARDI CHRISTINE MD CHILDRENS HEALTHCARE NEWBURYPORT MA 01950 (978) 465-7121 PEDIATRICS 01YP11618MA02 RICCARDI CHRISTINE MD CHILDRENS HEALTHCARE HAVERHILL MA 01830 (978) 373-6557 PEDIATRICS 01YP07154NH02 RICCIO CHRISTOPHER MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 594-6337 INTERNAL MEDICINE 01YP39360NH01 RICE JOHN MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03104 (603) 668-6489 INTERNAL MEDICINE 01YP19962NH01 RICH DAVID MD DOVER PEDIATRICS PLLC DOVER NH 03820 (603) 742-4048 PEDIATRICS 0109600YPNH03 RICHARD MARK MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 INTERNAL MEDICINE 0109600YPNH04 RICHARD MARK MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC WINDHAM NH 03087 (603) 216-0400 INTERNAL MEDICINE 01YP34178ME01 RICHARDS JACLYN MD YORK HOSPITAL WELLS ME 04090 (207) 646-5211 PEDIATRICS 01YP12099VT01 RICHARDS ELIZABETH MD PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 PEDIATRICS 01YP16659NH01 RICHARDSON RORY MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 01YP38773NH01 RICHARDSON RORY MD APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 431-2516 FAMILY MEDICINE 23YP34497VT01 RICITELLI DIANA APRN BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8455 FAMILY NURSE PRACTITIONERS 2304076YPNH01 RIFORGIATO MARGARET MARY APRN WHITE MOUNTAIN COMMUNITY HEALTH CENTER CONWAY NH 03818 (603) 447-8900 INTERNAL MEDICINE NURSE PRACTITIONER 04YP30804MA01 RIGALI LESLIE DO LAHEY CLINIC INC PEABODY MA 01960 (978) 538-4300 INTERNAL MEDICINE 01YP30514VT01 RILEY COURTNEY MD GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-2420 PEDIATRICS 23YP40415NH01 RIOUX JENNIFER APRN THRIVEE PC MANCHESTER NH 03102 (603) 622-8665 ADULT NURSE PRACTITIONERS 0100345YPNH02 RISS DAVID MD THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-4949 FAMILY MEDICINE 01YP25435MA01 RISTIC VIOLETA MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 0107272YPNH01 RIZKALLA-HANNA MAGUED MD MAGUED RIZKALLA-HANNA MD PORTSMOUTH NH 03801 (603) 436-5533 INTERNAL MEDICINE 01YP40362NH01 RIZKALLA-HANNA MAGUED MD GENESIS ELDERCARE PHYSICIAN SERVICES INC PORTSMOUTH NH 03801 (603) 431-2530 INTERNAL MEDICINE 01YP41249NH01 RIZKALLA-HANNA MAGUED MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 01YP42163NH01 ROBATOR CAITLIN MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRICS 23YP37853ME01 ROBERGE BARBARA APRN YORK HOSPITAL YORK ME 03909 (207) 351-3715 FAMILY NURSE PRACTITIONERS 23YP26835NH01 ROBERTS ALEXANDRA APRN FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 330-3404 FAMILY NURSE PRACTITIONERS 23YP26835NH02 ROBERTS ALEXANDRA APRN FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 335-2401 FAMILY NURSE PRACTITIONERS 01YP41893NH01 ROBICHAUD-FUENTES KYLE MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 INTERNAL MEDICINE 01YP41893NH02 ROBICHAUD-FUENTES KYLE MD DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2500 INTERNAL MEDICINE 2309370YPVT02 ROBINSON ELAINE APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-7500 FAMILY NURSE PRACTITIONERS 2302569YPNH01 ROBINSON ELISABETH APRN WHOLE LIFE HEALTH CARE NEWINGTON NH 03801 (603) 431-6677 FAMILY NURSE PRACTITIONERS 04YP22867ME01 ROBINSON ELIZABETH DO YORK HOSPITAL YORK ME 03909 (207) 363-8430 FAMILY MEDICINE 23YP38236NH01 ROBUSTELLI MICHAEL APRN GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY NURSE PRACTITIONERS 23YP38236NH02 ROBUSTELLI MICHAEL APRN GREATER SEACOAST COMMUNITY HEALTH SEABROOK NH 03874 (603) 766-2626 FAMILY NURSE PRACTITIONERS 23YP38236NH03 ROBUSTELLI MICHAEL APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP38236NH04 ROBUSTELLI MICHAEL APRN GREATER SEACOAST COMMUNITY HEALTH ROCHESTER NH 03867 (603) 516-9300 FAMILY NURSE PRACTITIONERS

Page 49 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP38236NH05 ROBUSTELLI MICHAEL APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 01YP14219NH04 RODRIGUEZ MARIA MD WENTWORTH DOUGLASS PHYSICIAN CORP LEE NH 03861 (603) 868-3300 FAMILY MEDICINE 23YP37840NH01 RODRIGUEZ-LAPAGE GEORGINA APRN GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY NURSE PRACTITIONERS 23YP37840NH02 RODRIGUEZ-LAPAGE GEORGINA APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 04YP23480NH02 ROGERS ALAN DO VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-6700 FAMILY MEDICINE 04YP23480NH03 ROGERS ALAN DO VALLEY REGIONAL HOSPITAL NEWPORT NH 03773 (603) 542-7855 FAMILY MEDICINE 04YP23480NH05 ROGERS ALAN DO VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-7771 FAMILY MEDICINE 23YP32707NH01 ROGERS GREGG APRN WHITE MOUNTAIN COMMUNITY HEALTH CENTER CONWAY NH 03818 (603) 448-8900 FAMILY NURSE PRACTITIONERS 0101067YPNH05 ROMANOWSKY MICHAEL MD MICHAEL P ROMANOWSKY MD HAMPSTEAD NH 03841 (603) 329-4040 FAMILY MEDICINE 0101067YPNH06 ROMANOWSKY MICHAEL MD MICHAEL P ROMANOWSKY MD SALEM NH 03079 (603) 893-4119 FAMILY MEDICINE 2304482YPNH01 ROMBOLI JOAN APRN LANDMARK FAMILY HEALTHCARE LONDONDERRY NH 03053 (603) 425-6494 FAMILY NURSE PRACTITIONERS 23YP15770NH01 ROMBOLI-HILL JOANNE APRN LANDMARK FAMILY HEALTHCARE LONDONDERRY NH 03053 (603) 425-6494 FAMILY NURSE PRACTITIONERS 23YP05275NH04 ROOKS SUSAN APRN FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 FAMILY NURSE PRACTITIONERS 23YP05275NH05 ROOKS SUSAN APRN APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 335-2401 FAMILY NURSE PRACTITIONERS 0105020YPVT03 ROONEY VALERIE MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8626 PEDIATRICS 0104902YPNH01 RORK DENNIS MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0104902YPNH02 RORK DENNIS MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 0104902YPNH03 RORK DENNIS MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 0104902YPNH04 RORK DENNIS MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 0104902YPNH05 RORK DENNIS MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP31456MA01 ROSADO RODRIGUEZ ALIDA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC ANDOVER MA 01810 (978) 783-5000 INTERNAL MEDICINE 01YP37937NH01 ROSE DONALD MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 FAMILY MEDICINE 01YP28296NH01 ROSEN BERNARD MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-1251 FAMILY MEDICINE 01YP28296NH02 ROSEN BERNARD MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-7771 FAMILY MEDICINE 01YP02564NH02 ROSEN ANDREW MD ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 552-1400 INTERNAL MEDICINE 23YP32000NH01 ROSEN PAMELA APRN ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 472-7233 FAMILY NURSE PRACTITIONERS 0107526YPNH01 ROSEN ALAN MD MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY MEDICINE 01YP31025NH01 ROSENBAUM DANIEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP31025NH02 ROSENBAUM DANIEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP31025NH03 ROSENBAUM DANIEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP31025NH04 ROSENBAUM DANIEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP31025NH05 ROSENBAUM DANIEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP24968MA01 ROSENBERG BRIAN MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 0104802YPNH04 ROSENFELD MICHAEL MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 889-6671 PEDIATRICS 0104802YPNH05 ROSENFELD MICHAEL MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 PEDIATRICS 0104802YPNH06 ROSENFELD MICHAEL MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 PEDIATRICS 01YP35885NH01 ROSIC GREGORY MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 INTERNAL MEDICINE 01YP40170NH01 ROSIC GREGORY MD FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 330-3404 INTERNAL MEDICINE 23YP41250NH01 ROSS-FITZGIBBONS BRIDGET APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 ADULT NURSE PRACTITIONERS 2305215YPNH02 ROSSIGNOL MONIQUE APRN LIFE LONG CARE OF NEW LONDON PLLC NEW LONDON NH 03257 (603) 526-4144 FAMILY NURSE PRACTITIONERS 01YP00508MA01 ROTHCHILD JOSEPH MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 23YP04163VT05 ROY JACKIE APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 FAMILY NURSE PRACTITIONERS 23YP04163VT06 ROY JACKIE APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 885-1166 FAMILY NURSE PRACTITIONERS 01YP37714NH02 ROY JERRY MD APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 332-0238 PEDIATRICS 01YP12962ME01 ROY III HENRY MD BRIDGTON HOSPITAL BRIDGTON ME 04009 (207) 647-2311 INTERNAL MEDICINE 01YP12039MA01 ROY-BORNSTEIN CAROLYN MD MERRIMACK VALLEY CHILD & ADOLESCENT HLTH LLC HAVERHILL MA 01830 (978) 521-8108 PEDIATRICS

Page 50 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP12967ME01 ROYER GENE DO BRIDGTON HOSPITAL FRYEBURG ME 04037 (207) 935-3383 FAMILY MEDICINE 0106298YPNH01 RUBIN GERALDINE MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 PEDIATRICS 23YP36733VT01 RURY SARAH APRN PRIMARY CARE HEALTH PARTNERS - VERMONT LLP BRATTLEBORO VT 05301 (802) 258-3905 FAMILY NURSE PRACTITIONERS 0103715YPNH02 RUSH LAWRENCE MD LRGHEALTHCARE LACONIA NH 03246 (603) 527-2792 INTERNAL MEDICINE 2301541YPNH01 RUSSELL ERICA CNM LRGHEALTHCARE GILFORD NH 03249 (603) 527-7114 FAMILY NURSE PRACTITIONERS 2301541YPNH02 RUSSELL ERICA CNM LRGHEALTHCARE LACONIA NH 03246 (603) 527-2847 FAMILY NURSE PRACTITIONERS 23YP31380NH01 RUSSELL KIMBERLEY APRN WHOLE LIFE HEALTH CARE NEWINGTON NH 03801 (603) 431-6677 ADULT NURSE PRACTITIONERS 04YP12972ME01 RYAN LISA DO BRIDGTON HOSPITAL BRIDGTON ME 04009 (207) 647-4232 PEDIATRICS 04YP35880MA01 RYER ELIZABETH DO LAHEY CLINIC INC PEABODY MA 01960 (781) 744-7000 INTERNAL MEDICINE 23YP29710MA01 SACCO MARIE APRN TODAY'S WELLNESS PLLC NORTH ANDOVER MA 01845 (978) 687-2273 INTERNAL MEDICINE NURSE PRACTITIONER 01YP36090NH01 SADEGHI ERIKA MD ELLIOT PHYSICIANS NETWORK AMHERST NH 03031 (603) 249-3000 FAMILY MEDICINE 01YP49187NH01 SAENZ CYNTIA MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY MEDICINE 01YP00514MA01 SAINI PRITINDER MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-5100 INTERNAL MEDICINE 01YP37035MA01 SAIYED SHAMILA MD LAHEY CLINIC INC PEABODY MA 01960 (781) 744-8000 INTERNAL MEDICINE 23YP36841NH01 SALIE ELIZABETH APRN ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 FAMILY NURSE PRACTITIONERS 23YP36841NH02 SALIE ELIZABETH APRN ST JOSEPH HOSPITAL HUDSON NH 03051 (603) 882-6700 FAMILY NURSE PRACTITIONERS 23YP36841NH03 SALIE ELIZABETH APRN ST JOSEPH HOSPITAL MERRIMACK NH 03054 (603) 424-4181 FAMILY NURSE PRACTITIONERS 23YP36841NH04 SALIE ELIZABETH APRN ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3014 FAMILY NURSE PRACTITIONERS 23YP36841NH05 SALIE ELIZABETH APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4804 FAMILY NURSE PRACTITIONERS 23YP30475VT01 SALLOWAY RACHEL APRN GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY NURSE PRACTITIONERS 04YP33743NH01 SALMON OLIVER DO SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-3700 PEDIATRICS 0104799YPME01 SALTER BARRY MD BARRY SALTER MD YORK ME 03909 (207) 363-6008 INTERNAL MEDICINE 0109657YPNH01 SALVATORE DONALD MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8300 PEDIATRICS 23YP40837NH01 SAMANTHA BLAISDELL APRN GENESIS ELDERCARE PHYSICIAN SERVICES INC PORTSMOUTH NH 03801 (603) 431-2539 FAMILY NURSE PRACTITIONERS 23YP40148ME01 SANCLEMENTE HARRIET APRN YORK HOSPITAL YORK ME 03909 (207) 351-2116 FAMILY NURSE PRACTITIONERS 23YP40148ME02 SANCLEMENTE HARRIET APRN YORK HOSPITAL WELLS ME 04090 (207) 351-2116 FAMILY NURSE PRACTITIONERS 0101066YPNH03 SARKIS MARLENE MD COTTAGE HOSPITAL WOODSVILLE NH 03785 (603) 747-2900 INTERNAL MEDICINE 01YP14283MA01 SATHAMBAKAM DILIP MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 01YP28403NH01 SATHYANARAYANAGOWDA RAVI MD DARTMOUTH HITCHCOCK CLINIC HUDSON NH 03051 (603) 577-3410 FAMILY MEDICINE 01YP40861NH01 SATTI KOMAL MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 PEDIATRICS 01YP12971ME01 SAUNDERS WENDA MD BRIDGTON HOSPITAL BRIDGTON ME 04009 (207) 647-4232 PEDIATRICS 01YP37512NH01 SAUNDERS WENDA MD THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 PEDIATRICS 01YP10971NH01 SAWYER MATHEW MD CONCORD HOSPITAL INC PENACOOK NH 03303 (603) 753-4302 FAMILY MEDICINE 23YP32816NH01 SCAGNELLI KATELYN APRN SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 FAMILY NURSE PRACTITIONERS 01YP24618MA01 SCANLAN VICTORIA MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 23YP31244NH01 SCANLON MICHAEL APRN MICHAEL SCANLON APRN LITTLETON NH 03561 (603) 236-9230 FAMILY NURSE PRACTITIONERS 04YP41919ME01 SCARPONI KYLA DO HARBOR PEDIATRICS PA YORK ME 03909 (207) 606-2032 PEDIATRICS 23YP31074NH01 SCHACHTNER SHANNON APRN NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 FAMILY NURSE PRACTITIONERS 23YP31074NH02 SCHACHTNER SHANNON APRN NEW LONDON HOSPITAL ASSOCIATION NEWPORT NH 03773 (603) 863-4100 FAMILY NURSE PRACTITIONERS 01YP02472NH03 SCHEIB LISA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 889-3667 INTERNAL MEDICINE 01YP14211NH01 SCHERPA MALINDA MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 PEDIATRICS 0109083YPNH03 SCHIAVONI JR EDMUND MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 INTERNAL MEDICINE 0109083YPNH04 SCHIAVONI JR EDMUND MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC WINDHAM NH 03087 (603) 216-0400 INTERNAL MEDICINE 01YP42349NH01 SCHISSEL ERICA MD ELLIOT PHYSICIANS NETWORK BEDFORD NH 03110 (603) 314-6500 INTERNAL MEDICINE 01YP17861MA01 SCHISSEL STEPHEN MD LAHEY CLINIC INC AMESBURY MA 01913 (978) 388-5050 FAMILY MEDICINE 0108032YPNH01 SCHISSEL LAWRENCE MD NEW LONDON HOSPITAL ASSOCIATION NEWPORT NH 03773 (603) 863-4100 FAMILY MEDICINE

Page 51 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP20890NH01 SCHMIDT AMBER DO WEEKS MEDICAL CENTER LANCASTER NH 03584 (603) 788-2521 FAMILY MEDICINE 01YP10634NH02 SCHNEEBAUM RONALD MD DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2500 PEDIATRICS 01YP30681ME01 SCHNEIDER ERIC MD YORK HOSPITAL YORK ME 03909 (207) 363-8430 FAMILY MEDICINE 01YP25983NH01 SCHNEIDER AMY MD NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-2911 FAMILY MEDICINE 01YP02566NH01 SCHOEL SUZANNE MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-7101 PEDIATRICS 01YP05504MA02 SCHOONMAKER JESSICA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC NEWBURYPORT MA 01950 (978) 499-7200 INTERNAL MEDICINE 23YP02534NH01 SCHREIBER L JOCELYN APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 653-9663 PEDIATRIC NURSE PRACTITIONERS 23YP29471NH01 SCHROEDER JODI APRN CONCORD HOSPITAL INC EPSOM NH 03234 (603) 736-6200 FAMILY NURSE PRACTITIONERS 23YP16063NH01 SCHUERMAN GABRIELLE APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 01YP29325MA01 SCHULMAN RISA MD MEDICAL CARE OF BOSTON MANAGEMENT CORP AMESBURY MA 01913 (978) 388-1400 FAMILY MEDICINE 0105633YPNH02 SCHULTZE PAMELA MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3664 INTERNAL MEDICINE 0105633YPNH03 SCHULTZE PAMELA MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE 01YP18519NH01 SCHUMAN ANDREW MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 PEDIATRICS 01YP14541MA02 SCHWARTZ MARY MD PARTNERS COMMUNITY PHYS ORGANIZATION INC GEORGETOWN MA 01833 (978) 352-8375 INTERNAL MEDICINE 0104334YPNH02 SCHWARTZ IRA MD APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 436-6115 INTERNAL MEDICINE 01YP08494VT04 SCHWARTZ ROBERT MD SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 FAMILY MEDICINE 0107897YPNH01 SCHWARTZBERG MARTIN MD RIVER ROAD PEDIATRICS PLLC BEDFORD NH 03110 (603) 622-8619 PEDIATRICS 0103815YPNH02 SCHWARZ ADAM MD HANOVER CONTINUITY CLINIC LLC HANOVER NH 03755 (603) 643-3320 INTERNAL MEDICINE 01YP39834NH01 SCOTT DEBORAH MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 442-5630 INTERNAL MEDICINE 01YP22710MA02 SCOTT TATIANA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8900 INTERNAL MEDICINE 01YP22710MA03 SCOTT TATIANA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC ANDOVER MA 01810 (978) 783-5000 INTERNAL MEDICINE 01YP16060VT01 SCOTT JOHN MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 FAMILY MEDICINE 23YP24865NH01 SCOVILLE KATHRYN APRN DARTMOUTH HITCHCOCK CLINIC WINCHESTER NH 03470 (603) 239-6351 FAMILY NURSE PRACTITIONERS 23YP24865NH02 SCOVILLE KATHRYN APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 23YP41253NH01 SCRIMGER MARGARET APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 01YP25570NH01 SCULL MELISSA MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03102 (603) 625-6198 INTERNAL MEDICINE 01YP25570NH02 SCULL MELISSA MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03102 (603) 663-7377 INTERNAL MEDICINE 01YP35370VT01 SCZESNY-ALESHNICK MARTINA MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8455 FAMILY MEDICINE 01YP27387NH01 SEABORG BARBARA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 01YP14510NH02 SEBASTYAN ANDREW MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4804 FAMILY MEDICINE 01YP14510NH03 SEBASTYAN ANDREW MD ST JOSEPH HOSPITAL HUDSON NH 03051 (603) 882-6700 FAMILY MEDICINE 01YP14037VT01 SEGAL LORISSA MD WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 INTERNAL MEDICINE 01YP32711MA01 SEIBERT RYAN MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP32711MA02 SEIBERT RYAN MD LAHEY CLINIC INC PEABODY MA 01960 (781) 744-8000 INTERNAL MEDICINE 01YP18405NH01 SEICHEPINE KELLY MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 INTERNAL MEDICINE 0401494YPVT01 SEYMOUR MARK DO GIFFORD MEDICAL CENTER BETHEL VT 05032 (802) 234-9913 FAMILY MEDICINE 23YP35448NH01 SHADALLAH SARAH APRN ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4804 GERIATRIC NURSE PRACTITIONERS 01YP02835VT01 SHAFER TIMOTHY MD CARLOS G OTIS HEALTHCARE CTR TOWNSHEND VT 05353 (802) 365-4331 FAMILY MEDICINE 01YP36467NH01 SHAFER HEATHER MD FOUNDATION MEDICAL PARTNERS INC MILFORD NH 03055 (603) 672-7600 FAMILY MEDICINE 23YP40520NH01 SHAFFER CASEY APRN MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 FAMILY NURSE PRACTITIONERS 01YP28438NH01 SHAH JASMINE MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 INTERNAL MEDICINE 01YP16692MA01 SHAH BHUMI MD LAHEY CLINIC INC N BILLERICA MA 01862 (978) 663-6666 INTERNAL MEDICINE 01YP41270NH01 SHAHU KHAL RAVI MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 01YP31955NH01 SHAMANSKY ERIC MD SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-3700 PEDIATRICS 23YP37257NH01 SHANAHAN DELIA APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY NURSE PRACTITIONERS 01YP40567NH01 SHARMA AMIT MD PELHAM HEALTHCARE ASSOCIATES PLLC PELHAM NH 03076 (603) 635-2802 INTERNAL MEDICINE

Page 52 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 0101716YPNH02 SHARMA DEEPAK MD DEEPAK SHARMA MD PC SALEM NH 03079 (603) 893-8030 PEDIATRICS 23YP42266NH01 SHARP DAYLE APRN APPLEDORE MEDICAL GROUP INC BARRINGTON NH 03825 (603) 644-0955 FAMILY NURSE PRACTITIONERS 01YP03823MA01 SHEEHAN STACEY MD CHILDRENS HEALTHCARE HAVERHILL MA 01830 (978) 373-6557 PEDIATRICS 01YP03823MA02 SHEEHAN STACEY MD CHILDRENS HEALTHCARE NEWBURYPORT MA 01950 (978) 465-7121 PEDIATRICS 01YP13892NH01 SHESSLER ERIK MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 PEDIATRICS 01YP26739MA01 SHIH SHIAO-ANG MD HAVERHILL FAMILY PRACTICE HAVERHILL MA 01830 (978) 521-6555 INTERNAL MEDICINE 04YP27192NH02 SHILLING TAMARA DO APPLEDORE MEDICAL GROUP INC BARRINGTON NH 03825 (603) 664-9003 FAMILY MEDICINE 23YP20220NH01 SHIPLEY SARA APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 888-5573 FAMILY NURSE PRACTITIONERS 04YP08628NH01 SHIPPEE LUCAS DO MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4680 INTERNAL MEDICINE 04YP08628NH02 SHIPPEE LUCAS DO MONADNOCK COMMUNITY HOSPITAL ANTRIM NH 03440 (603) 588-4200 INTERNAL MEDICINE 01YP36981NH01 SHOEMAKER ALENA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY MEDICINE 01YP36981NH02 SHOEMAKER ALENA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 FAMILY MEDICINE 01YP41273NH01 SHRESTHA SHANTA MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 01YP41549NH01 SHRESTHA SUJATA MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE 01YP41272NH01 SHRESTHA MONISHA MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 01YP13987NH01 SHUBKIN CATHERINE MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 PEDIATRICS 04YP13369NH01 SHUGOL MARGARITA DO CONCORD HOSPITAL INC CONCORD NH 03301 (603) 226-3400 FAMILY MEDICINE 01YP05116ME01 SHUMAN KENNETH MD WENTWORTH DOUGLASS PHYSICIAN CORP SOUTH BERWICK ME 03908 (207) 384-4949 FAMILY MEDICINE 01YP05116ME03 SHUMAN KENNETH MD WENTWORTH DOUGLASS PHYSICIAN CORP DURHAM NH 03824 (603) 868-5080 FAMILY MEDICINE 01YP38559NH01 SHUMAN JOLENE MD PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY MEDICINE 23YP29013NH01 SHUPE MARY APRN RIVER ROAD PEDIATRICS PLLC BEDFORD NH 03110 (603) 622-8619 PEDIATRIC NURSE PRACTITIONERS 2300984YPNH01 SHUTE PATRICIA APRN COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2040 FAMILY NURSE PRACTITIONERS 0109410YPNH02 SHUTE KEITH MD COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2900 FAMILY MEDICINE 01YP34106NH01 SIDDIQUI SOHAIB MD THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY MEDICINE 01YP40982NH01 SIDDIQUI SOHAIB MD CRANMORE HEALTH PARTNERS LLC NORTH CONWAY NH 03860 (603) 387-4523 FAMILY MEDICINE 01YP40504NH01 SIDDIQUI SANA MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 INTERNAL MEDICINE 01YP23281NH01 SILANG RIETA MD INTERNAL MEDICINE & KIDNEY PARTNERS PA NASHUA NH 03060 (603) 880-3122 INTERNAL MEDICINE 01YP42168NH01 SILVA BRITTANY MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRICS 01YP05048NH03 SILVA KEVIN MD LITTLETON INTERNAL MEDICINE PC LITTLETON NH 03561 (603) 444-2002 INTERNAL MEDICINE 01YP34902ME01 SILVERI PAUL MD YORK HOSPITAL WELLS ME 04090 (207) 646-5211 FAMILY MEDICINE 04YP22783MA01 SILVERMAN MARIANNA DO LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP28706NH01 SILVERMAN ELAINE MD NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 INTERNAL MEDICINE 01YP07506NH01 SILVERSTEIN MARNI MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-6666 PEDIATRICS 01YP41248NH01 SINGH GURPINDER MD GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 INTERNAL MEDICINE 01YP34790NH01 SIRONICH-KALKAN GRACIELA-SILVIA MD HARBOR HOMES INC NASHUA NH 03060 (603) 821-7788 GENERAL PRACTICE 01YP34787MA01 SITZER ALON MD PARTNERS COMMUNITY PHYS ORGANIZATION INC NEWBURYPORT MA 01950 (978) 499-7200 FAMILY MEDICINE 01YP41632NH01 SIXON JONATHAN MD ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3014 FAMILY MEDICINE 01YP41632NH02 SIXON JONATHAN MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 881-7970 FAMILY MEDICINE 01YP41632NH03 SIXON JONATHAN MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 FAMILY MEDICINE 01YP41632NH04 SIXON JONATHAN MD ST JOSEPH HOSPITAL MERRIMACK NH 03054 (603) 424-4181 FAMILY MEDICINE 01YP41632NH05 SIXON JONATHAN MD ST JOSEPH HOSPITAL HUDSON NH 03051 (603) 882-6700 FAMILY MEDICINE 23YP39269NH01 SKOCZYLAS JENNIFER APRN COMPASS FAMILY HEALTH LLC DOVER NH 03820 (603) 749-0001 FAMILY NURSE PRACTITIONERS 23YP40202NH01 SKOCZYLAS JENNIFER APRN CORE PHYSICIANS LLC EPPING NH 03042 (603) 693-2100 FAMILY NURSE PRACTITIONERS 01YP07190MA02 SKORUPKA MIROSLAWA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8700 INTERNAL MEDICINE 23YP36387NH01 SLATE TALLEY APRN PMC MEDICAL GROUP LLC SOMERSWORTH NH 03878 (603) 692-4018 FAMILY NURSE PRACTITIONERS 04YP14282ME01 SLAYTON ERIC DO BRIDGTON HOSPITAL NAPLES ME 04055 (207) 693-6106 FAMILY MEDICINE

Page 53 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP14282ME02 SLAYTON ERIC DO BRIDGTON HOSPITAL FRYEBURG ME 04037 (207) 935-3383 FAMILY MEDICINE 0103548YPVT02 SLOWINSKI SUSAN MD BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8626 PEDIATRICS 23YP31282NH01 SLYNE TAI APRN AMODEUS HEALTHCARE LONDONDERRY NH 03053 (603) 305-7076 FAMILY NURSE PRACTITIONERS 23YP31282NH02 SLYNE TAI APRN AMODEUS HEALTHCARE LONDONDERRY NH 03053 (603) 305-7076 FAMILY NURSE PRACTITIONERS 23YP37544NH01 SMITH CAROLEE APRN NEW CREATION HEALING CENTER INC KINGSTON NH 03848 (603) 642-6700 FAMILY NURSE PRACTITIONERS 04YP12969ME01 SMITH JENNIFER DO BRIDGTON HOSPITAL BRIDGTON ME 04009 (207) 647-9021 FAMILY MEDICINE 04YP41381NH01 SMITH JENNIFER DO THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY MEDICINE 04YP27428NH01 SMITH IRVING DO LITTLETON HOSPITAL ASSOCIATION LITTLETON NH 03561 (603) 444-7070 INTERNAL MEDICINE 2301543YPNH01 SMITH ROSEMARY APRN LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 INTERNAL MEDICINE NURSE PRACTITIONER 2301543YPNH02 SMITH ROSEMARY APRN LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 INTERNAL MEDICINE NURSE PRACTITIONER 2301543YPNH03 SMITH ROSEMARY APRN LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 INTERNAL MEDICINE NURSE PRACTITIONER 01YP13710VT01 SMITH STEVEN MD WINDSOR HOSPITAL CORP WOODSTOCK VT 05091 (802) 457-3030 INTERNAL MEDICINE PEDIATRIC ASSOCIATES OF HAMPTON & 01YP42467NH01 SMITH ALYSSA MD PORTSMOUTH NH 03801 (603) 436-7171 INTERNAL MEDICINE PORTSMOUTH PC 23YP36491NH01 SMITH JENNY APRN ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 FAMILY NURSE PRACTITIONERS 23YP36491NH02 SMITH JENNY APRN ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3014 FAMILY NURSE PRACTITIONERS 23YP36658NH01 SMITH RACHAEL APRN DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 FAMILY NURSE PRACTITIONERS 01YP03047NH01 SMITH JOAN MD WENTWORTH DOUGLASS PHYSICIAN CORP BARRINGTON NH 03825 (603) 664-2135 FAMILY MEDICINE 01YP03047NH15 SMITH JOAN MD WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8050 FAMILY MEDICINE 04YP12970ME01 SMITH CRAIG DO BRIDGTON HOSPITAL BRIDGTON ME 04009 (207) 647-9021 FAMILY MEDICINE 04YP36864NH01 SMITH CRAIG DO THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY MEDICINE 23YP19908NH01 SMITH MATTHEW APRN FAMILY HEALTH CENTER LEBANON NH 03766 (603) 448-1941 FAMILY NURSE PRACTITIONERS 01YP21439NH01 SMITH KATHLEEN MD AMMONOOSUC COMMUNITY HEALTH SERVICES INC LITTLETON NH 03561 (603) 444-2464 FAMILY MEDICINE 0107231YPNH02 SOBELSON GARY MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 0107231YPNH03 SOBELSON GARY MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 01YP22939MA01 SODERLAND CARL MD LAHEY CLINIC INC IPSWICH MA 01938 (978) 356-5522 INTERNAL MEDICINE 01YP18177MA01 SODERLAND PETER MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8430 INTERNAL MEDICINE 23YP03567NH01 SOKUL CYNTHIA APRN ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03104 (603) 663-7030 FAMILY NURSE PRACTITIONERS 0109392YPNH03 SOLNIT LOREN MD AMMONOOSUC COMMUNITY HEALTH SERVICES INC WOODSVILLE NH 03785 (603) 747-3740 PEDIATRICS 0109286YPNH02 SOLNIT AARON MD AMMONOOSUC COMMUNITY HEALTH SERVICES INC WOODSVILLE NH 03785 (603) 747-3740 FAMILY MEDICINE 01YP29712MA01 SOMESWARANANTHAN JANARTHANAN MD TODAY'S WELLNESS PLLC NORTH ANDOVER MA 01845 (978) 687-2273 INTERNAL MEDICINE 0102610YPNH01 SONG LIJUN MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 INTERNAL MEDICINE 01YP05143NH02 SORSCHER ADAM MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-4000 FAMILY MEDICINE 23YP40862NH01 SOTTAK MEGAN APRN LRGHEALTHCARE GILFORD NH 03249 (603) 527-7114 FAMILY NURSE PRACTITIONERS 23YP24146ME01 SOVETSKY-CHABOT NATACHA APRN YORK HOSPITAL SOUTH BERWICK ME 03908 (207) 384-9212 FAMILY NURSE PRACTITIONERS 0102999YPNH02 SPENCER MICHELLE MD CONCORD HOSPITAL INC PENACOOK NH 03303 (603) 753-4302 FAMILY MEDICINE 01YP23104MA01 SPIEGELMAN DAVID MD FOUNDATION MEDICAL PARTNERS INC PEPPERELL MA 01463 (978) 433-6317 FAMILY MEDICINE 0106021YPMA01 SPIELER PHYLLIS MD PHYLLIS SPIELER MD ANDOVER MA 01810 (978) 470-1902 INTERNAL MEDICINE 01YP30399MA01 SPIRES ANN MD KRONOS HEALTH PLLC LAWRENCE MA 01843 (978) 655-6652 FAMILY MEDICINE 23YP35044NH01 SPIRITO LINDSAY APRN DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 PEDIATRIC NURSE PRACTITIONERS 01YP03528NH02 SPIRO AMANDA MD ALLIANCE HEALTH SERVICES BEDFORD NH 03110 (603) 695-2572 PEDIATRICS 01YP25319MA02 SRIVASTAVA TAPASYA MD PARTNERS COMMUNITY PHYS ORGANIZATION INC ANDOVER MA 01810 (978) 783-5000 INTERNAL MEDICINE 23YP32412NH01 ST PIERRE GRACE APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC CHARLESTOWN NH 03603 (603) 826-5711 FAMILY NURSE PRACTITIONERS 23YP34254NH01 STACY LAUREN APRN MONADNOCK COMMUNITY HOSPITAL JAFFREY NH 03452 (603) 532-8775 FAMILY NURSE PRACTITIONERS 23YP34254NH03 STACY LAUREN APRN MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 FAMILY NURSE PRACTITIONERS 23YP34254NH04 STACY LAUREN APRN MONADNOCK COMMUNITY HOSPITAL RINDGE NH 03461 (603) 899-9563 FAMILY NURSE PRACTITIONERS 01YP16876NH02 STADLER DANIEL MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 653-9500 INTERNAL MEDICINE

Page 54 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 0109561YPNH02 STAHL KEITH MD CATHOLIC MEDICAL CENTER BEDFORD NH 03110 (603) 663-8052 INTERNAL MEDICINE 01YP28244NH01 STAHL JAMES MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 INTERNAL MEDICINE 01YP33712VT01 STALEY PATRICIA MD WINDSOR HOSPITAL CORP WOODSTOCK VT 05091 (802) 457-3030 PEDIATRICS 23YP36569VT01 STANFORD KARL APRN WHITE RIVER FAMILY PRACTICE PC WHITE RIVER JUNCTION VT 05001 (802) 295-6132 FAMILY NURSE PRACTITIONERS 23YP30580NH01 STANLEY NICOLE APRN THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-4949 FAMILY NURSE PRACTITIONERS 23YP37529NH01 STANLEY NICOLE APRN SACO RIVER MEDICAL GROUP PC CONWAY NH 03818 (603) 447-3500 FAMILY NURSE PRACTITIONERS 0104122YPNH03 STARK JOHN MD MARTIN'S POINT HEALTH CARE PORTSMOUTH NH 03801 (603) 431-5154 FAMILY MEDICINE 23YP30468NH01 STARK CHRISTINA APRN APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 433-8434 FAMILY NURSE PRACTITIONERS 23YP30468NH02 STARK CHRISTINA APRN APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 436-6115 FAMILY NURSE PRACTITIONERS 0100451YPVT02 STASNY ELAINE MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-5131 PEDIATRICS 23YP28193NH01 STEELE TAMMY APRN STEWARD MEDICAL GROUP INC SALEM NH 03079 (603) 685-6977 FAMILY NURSE PRACTITIONERS 23YP28194MA01 STEELE TAMMY APRN STEWARD MEDICAL GROUP INC METHUEN MA 01844 (978) 683-9177 FAMILY NURSE PRACTITIONERS 01YP31719NH01 STEIN MICHAEL MD PINNACLE PERSONALIZED HEALTHCARE SALEM NH 03079 (603) 458-2233 FAMILY MEDICINE 04YP42591NH01 STEIN DAVID DO APPLEDORE MEDICAL GROUP INC PORTSMOUTH NH 03801 (603) 436-6115 INTERNAL MEDICINE 01YP22004NH01 STEIN ALAN MD ELLIOT PHYSICIANS NETWORK ALLENSTOWN NH 03275 (603) 485-7861 FAMILY MEDICINE 23YP36869VT01 STEPHANI PASCALE APRN GIFFORD MEDICAL CENTER RANDOLPH VT 05060 (802) 728-7000 FAMILY NURSE PRACTITIONERS 0107410YPNH01 STEPHENS MARGARET MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 FAMILY MEDICINE 23YP41000NH01 STEPHENS CHRISTINA APRN WAKEFIELD FAMILY MEDICINE LLC SANBORNVILLE NH 03872 (603) 871-8227 FAMILY NURSE PRACTITIONERS 01YP32216NH02 STETTMEIER MARY MD APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 335-2401 FAMILY MEDICINE 04YP08801NH02 STEVENS MICHAEL DO CORE PHYSICIANS LLC EXETER NH 03833 (603) 775-0000 FAMILY MEDICINE 04YP08801NH03 STEVENS MICHAEL DO CORE PHYSICIANS LLC PORTSMOUTH NH 03801 (603) 658-2344 FAMILY MEDICINE 23YP14296NH02 STEVENS KRISTEN APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 ADULT NURSE PRACTITIONERS 23YP19914VT01 STEWART BRENDA APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC SAINT JOHNSBURY VT 05819 (802) 748-5131 PEDIATRIC NURSE PRACTITIONERS 23YP31119NH04 STEWART JULIE APRN VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-7771 FAMILY NURSE PRACTITIONERS 23YP38622NH01 STEWART JULIE APRN KEADY FAMILY PRACTICE CLAREMONT NH 03743 (603) 863-7777 FAMILY NURSE PRACTITIONERS 23YP38622NH02 STEWART JULIE APRN KEADY FAMILY PRACTICE NEWPORT NH 03773 (603) 863-7777 FAMILY NURSE PRACTITIONERS 0108642YPNH02 STIDWILL ROBB MD CONCORD HOSPITAL INC PEMBROKE NH 03275 (603) 485-8441 FAMILY MEDICINE 23YP41012NH01 STILES KERI APRN NORTH COUNTRY MEDICAL AND WELLNESS LLC COLEBROOK NH 03576 (603) 331-0500 FAMILY NURSE PRACTITIONERS 2301192YPNH01 STONE DEBORAH APRN HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7620 PEDIATRIC NURSE PRACTITIONERS 23YP31450VT01 STRESSENGER MARITA APRN NORTHERN COUNTIES HEALTH CARE INC DANVILLE VT 05828 (802) 684-2275 FAMILY NURSE PRACTITIONERS 01YP29977NH01 STRZALKA ALEXIA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP29977NH02 STRZALKA ALEXIA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP29977NH03 STRZALKA ALEXIA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP29977NH04 STRZALKA ALEXIA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP29977NH05 STRZALKA ALEXIA MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 2306134YPNH02 STUCKER HEIDI APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE NURSE PRACTITIONER 2306134YPNH15 STUCKER HEIDI APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 740-3330 INTERNAL MEDICINE NURSE PRACTITIONER 01YP14097MA02 STUPNYTSKYI OLEKSANDR MD EAGLE MEDICINE ASSOCIATES LAWRENCE MA 01841 (978) 725-5913 INTERNAL MEDICINE 01YP41652NH01 STURMY LUKE MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-0071 FAMILY MEDICINE 23YP32425NH01 STUTTS HANNAH APRN HEALTH FIRST FAMILY CARE CENTER FRANKLIN NH 03235 (603) 934-1464 FAMILY NURSE PRACTITIONERS 01YP25456MA01 SU MARK MD PERSONAL CARE PHYSICIANS PC NEWBURYPORT MA 01950 (978) 225-0378 FAMILY MEDICINE 04YP35628NH01 SULLIVAN JAMES DO FOUNDATION MEDICAL PARTNERS INC AMHERST NH 03031 (603) 673-5885 FAMILY MEDICINE 01YP23155NH01 SULLIVAN CORINNE MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-7771 PEDIATRICS 01YP23155NH04 SULLIVAN CORINNE MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-6700 PEDIATRICS 01YP23155NH06 SULLIVAN CORINNE MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-7771 PEDIATRICS 01YP23155NH07 SULLIVAN CORINNE MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-1251 PEDIATRICS

Page 55 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP31765NH04 SULLIVAN KATHRYN APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP31765NH05 SULLIVAN KATHRYN APRN GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY NURSE PRACTITIONERS 23YP31765NH06 SULLIVAN KATHRYN APRN GREATER SEACOAST COMMUNITY HEALTH SEABROOK NH 03874 (603) 766-2626 FAMILY NURSE PRACTITIONERS 23YP38181NH01 SULLIVAN KATHRYN APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 782-7414 FAMILY NURSE PRACTITIONERS 23YP38181NH02 SULLIVAN KATHRYN APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 663-8718 FAMILY NURSE PRACTITIONERS 23YP38181NH03 SULLIVAN KATHRYN APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 665-7450 FAMILY NURSE PRACTITIONERS 01YP26141VT01 SULLIVAN MITCHELL MD NORTHEASTERN VERMONT REGIONAL HOSPITAL INC LYNDONVILLE VT 05851 (802) 748-9501 FAMILY MEDICINE 23YP38482NH01 SUTPHIN LORRAINE APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 650-5000 ADULT NURSE PRACTITIONERS 01YP03906NH03 SUTTON SHAWN MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 23YP21378NH01 SWAN ANNA APRN WHOLE LIFE HEALTH CARE NEWINGTON NH 03801 (603) 431-6677 FAMILY NURSE PRACTITIONERS 04YP42293NH01 SWEENEY ELIZABETH DO WEEKS MEDICAL CENTER NORTH STRATFORD NH 03590 (603) 922-5039 FAMILY MEDICINE 04YP42293NH02 SWEENEY ELIZABETH DO WEEKS MEDICAL CENTER LANCASTER NH 03584 (603) 788-2521 FAMILY MEDICINE 04YP42293NH03 SWEENEY ELIZABETH DO WEEKS MEDICAL CENTER GROVETON NH 03582 (603) 636-1101 FAMILY MEDICINE 04YP31101NH01 SWIFT-CROFT CINDI DO NEW DIMENSIONS FAMILY CARE CONCORD NH 03301 (603) 275-9585 FAMILY MEDICINE 23YP19544NH01 SYKES TIFFANY APRN LIFE LONG CARE OF NEW LONDON PLLC NEW LONDON NH 03257 (603) 526-4144 FAMILY NURSE PRACTITIONERS 01YP12086MA02 SYLVAN JR GOSLYN MD PARTNERS COMMUNITY PHYS ORGANIZATION INC NORTH ANDOVER MA 01845 (978) 794-2112 INTERNAL MEDICINE 01YP28797NH01 SYNAN THOMAS MD ST JOSEPH HOSPITAL NASHUA NH 03062 (603) 595-3614 INTERNAL MEDICINE 23YP35000NH01 SZCZESNY MARIE APRN THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY NURSE PRACTITIONERS 0101824YPNH01 SZNYCER LILIANE MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4400 PEDIATRICS 04YP38479MA01 TABIT JEAN DO PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8700 FAMILY MEDICINE 23YP08818VT01 TAFT LEESA APRN WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 INTERNAL MEDICINE NURSE PRACTITIONER 01YP39079NH01 TAMANAHA BOYD MD ELLIOT PHYSICIANS NETWORK ALLENSTOWN NH 03275 (603) 485-7861 FAMILY MEDICINE 0109797YPNH03 TAN SHIRLEY MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-6700 PEDIATRICS 0109797YPNH04 TAN SHIRLEY MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 542-6777 PEDIATRICS 0109797YPNH05 TAN SHIRLEY MD VALLEY REGIONAL HOSPITAL CLAREMONT NH 03743 (603) 543-1251 PEDIATRICS 2306947YPVT01 TANEY SUSAN APRN NORTHERN COUNTIES HEALTH CARE INC CONCORD VT 05824 (802) 695-2512 ADULT NURSE PRACTITIONERS 01YP05352MA02 TANGUAY WILLIAM MD PARTNERS COMMUNITY PHYS ORGANIZATION INC HAVERHILL MA 01830 (888) 227-3762 INTERNAL MEDICINE 0106676YPVT03 TANNER TIMOTHY MD NORTHERN COUNTIES HEALTH CARE INC DANVILLE VT 05828 (802) 698-2275 INTERNAL MEDICINE 01YP08569NH01 TANSKI SUSANNE MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03756 (603) 653-6041 PEDIATRICS 01YP35371NH01 TANUR MARCIA MD HARBOR HOMES INC NASHUA NH 03060 (603) 821-7788 FAMILY MEDICINE 23YP34422MA01 TAPPER DAVID APRN LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE NURSE PRACTITIONER 23YP34422MA02 TAPPER DAVID APRN LAHEY CLINIC INC PEABODY MA 01960 (781) 744-8000 INTERNAL MEDICINE NURSE PRACTITIONER 01YP17193NH01 TARASEVICH DMITRY MD MONADNOCK COMMUNITY HOSPITAL PETERBOROUGH NH 03458 (603) 924-4680 INTERNAL MEDICINE 23YP28129NH01 TAYLOR JENNIFER APRN NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 ADULT NURSE PRACTITIONERS 01YP36074NH01 TEABOLDT BRIANNE MD COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2040 FAMILY MEDICINE 0109545YPNH02 TEDESCO RICHARD MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03103 (603) 663-8200 INTERNAL MEDICINE 01YP40216NH01 TEKELENBURG SAIRA MD LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY MEDICINE 01YP40216NH02 TEKELENBURG SAIRA MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY MEDICINE 01YP40216NH03 TEKELENBURG SAIRA MD LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY MEDICINE 01YP40216NH04 TEKELENBURG SAIRA MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 659-3106 FAMILY MEDICINE 0104866YPNH02 TEMME THOMAS MD COOS COUNTY FAMILY HEALTH SERVICES INC GORHAM NH 03581 (603) 466-2741 FAMILY MEDICINE 0107018YPMA02 TENNEY SUETTA MD KRONOS HEALTH PLLC LAWRENCE MA 01843 (978) 655-6652 INTERNAL MEDICINE 23YP29940ME01 TETLER DEVIN APRN YORK HOSPITAL MOODY ME 04054 (207) 646-8386 ADULT NURSE PRACTITIONERS 23YP29940ME02 TETLER DEVIN APRN YORK HOSPITAL YORK ME 03909 (207) 351-3530 ADULT NURSE PRACTITIONERS 0104827YPME02 THALER FREDERICK MD YORK HOSPITAL KITTERY ME 03904 (207) 439-4430 FAMILY MEDICINE 23YP21558NH01 THATCHER ANNE APRN SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-1881 INTERNAL MEDICINE NURSE PRACTITIONER

Page 56 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 0101137YPMA01 THAVASEELAN PERIN MD PLEASANT VALLEY INTERNISTS METHUEN MA 01844 (978) 689-0869 INTERNAL MEDICINE 0402655YPNH03 THERIAULT ROBERT DO ROBERT A THERIAULT DO PLLC NASHUA NH 03063 (603) 880-1511 FAMILY MEDICINE 01YP20669NH02 THERMITUS SERAPHINE MD ST JOSEPH HOSPITAL MILFORD NH 03055 (603) 673-3870 PEDIATRICS 01YP20669NH03 THERMITUS SERAPHINE MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 PEDIATRICS 01YP20669NH04 THERMITUS SERAPHINE MD ST JOSEPH HOSPITAL NASHUA NH 03063 (603) 883-7970 PEDIATRICS 0103007YPNH01 THESING GREGORY MD CONCORD HOSPITAL INC HILLSBORO NH 03244 (603) 464-3434 FAMILY MEDICINE 2302245YPNH01 THIBODEAU JESSICA APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC WARREN NH 03279 (603) 764-5704 ADULT NURSE PRACTITIONERS 2302245YPNH02 THIBODEAU JESSICA APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC LITTLETON NH 03561 (603) 444-2464 ADULT NURSE PRACTITIONERS 2302245YPNH03 THIBODEAU JESSICA APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC WOODSVILLE NH 03785 (603) 747-3740 ADULT NURSE PRACTITIONERS 2302245YPNH04 THIBODEAU JESSICA APRN AMMONOOSUC COMMUNITY HEALTH SERVICES INC FRANCONIA NH 03580 (603) 823-7078 ADULT NURSE PRACTITIONERS 23YP28440NH01 THIBODEAU SUSAN APRN DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRIC NURSE PRACTITIONERS 23YP28440NH02 THIBODEAU SUSAN APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 PEDIATRIC NURSE PRACTITIONERS 23YP28440NH03 THIBODEAU SUSAN APRN DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2500 PEDIATRIC NURSE PRACTITIONERS 23YP03551NH02 THIEVON SUSAN APRN HUGGINS HOSPITAL WOLFEBORO NH 03894 (603) 569-7574 FAMILY NURSE PRACTITIONERS 23YP25362NH01 THOMASSEN ANNE APRN SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 INTERNAL MEDICINE NURSE PRACTITIONER 23YP27409NH01 THOMPSON JANNA APRN HARBOR HOMES INC NASHUA NH 03060 (603) 821-7788 PEDIATRIC NURSE PRACTITIONERS 23YP27409NH02 THOMPSON JANNA APRN HARBOR HOMES INC NASHUA NH 03063 (603) 821-7788 PEDIATRIC NURSE PRACTITIONERS 01YP05535MA02 THOMPSON JANE MD PARTNERS COMMUNITY PHYS ORGANIZATION INC LAWRENCE MA 01843 (978) 557-8700 INTERNAL MEDICINE 01YP04013NH03 THOMPSON MICHAEL MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE 01YP04013NH04 THOMPSON MICHAEL MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 01YP04013NH05 THOMPSON MICHAEL MD GREATER SEACOAST COMMUNITY HEALTH ROCHESTER NH 03867 (603) 516-9300 FAMILY MEDICINE 23YP12520NH01 THOMPSON KATHLEEN APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2750 PEDIATRIC NURSE PRACTITIONERS 23YP40106NH01 THOMPSON KATHLEEN APRN CHESHIRE MEDICAL CENTER KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 0109069YPNH04 THOMSON GEORGE MD GEORGE THOMSON MD PETERBOROUGH NH 03458 (603) 924-3644 FAMILY MEDICINE 01YP03828MA02 THUMSER CAROLYN MD CHILDRENS HEALTHCARE NEWBURYPORT MA 01950 (978) 388-9880 PEDIATRICS 01YP03828MA04 THUMSER CAROLYN MD CHILDRENS HEALTHCARE HAVERHILL MA 01830 (978) 373-6557 PEDIATRICS 0101818YPNH02 THYNG DARLA MD DARTMOUTH HITCHCOCK CLINIC MILFORD NH 03055 (603) 673-2515 FAMILY MEDICINE 01YP28405NH01 THYNG JONATHAN MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4440 FAMILY MEDICINE 23YP39808NH01 TIERNEY KRISTIN APRN VANTAGE HEALTHCARE LLC PELHAM NH 03076 (781) 867-2050 FAMILY NURSE PRACTITIONERS 0103422YPNH01 TIMMERMAN MARK MD MERRIMACK VILLAGE FAMILY PRACTICE CTR MERRIMACK NH 03054 (603) 424-8120 FAMILY MEDICINE 23YP22965NH02 TKACZYK ANN GIRLIE APRN ST JOSEPH HOSPITAL NASHUA NH 03061 (603) 595-3722 ADULT NURSE PRACTITIONERS 01YP03183MA01 TLUCKO ALENA MD LAHEY CLINIC INC AMESBURY MA 01913 (978) 388-5050 INTERNAL MEDICINE 23YP22345VT01 TODD JOHN APRN BRATTLEBORO MEMORIAL HOSPITAL PUTNEY VT 05346 (802) 387-5581 FAMILY NURSE PRACTITIONERS 23YP18811NH01 TOKA FRANCOIS APRN GLOBAL FAMILY HEALTH LLC NASHUA NH 03060 (603) 943-7064 FAMILY NURSE PRACTITIONERS 23YP38247NH01 TOLENTINO NICHOLAS APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 FAMILY NURSE PRACTITIONERS 23YP38247NH02 TOLENTINO NICHOLAS APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 FAMILY NURSE PRACTITIONERS 23YP38247NH03 TOLENTINO NICHOLAS APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 FAMILY NURSE PRACTITIONERS 23YP38247NH04 TOLENTINO NICHOLAS APRN WENTWORTH DOUGLASS PHYSICIAN CORP SOMERSWORTH NH 03878 (603) 692-6676 FAMILY NURSE PRACTITIONERS 01YP29334NH01 TOLL JOSHUA MD DARTMOUTH HITCHCOCK CLINIC WALPOLE NH 03608 (603) 756-3960 FAMILY MEDICINE 01YP02633NH02 TOMS ANGELA MD WHITE RIVER FAMILY PRACTICE PC WHITE RIVER JUNCTION VT 05001 (802) 295-6132 FAMILY MEDICINE 01YP33366NH01 TOSHACH DENISE MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 772-8900 PEDIATRICS 01YP33366NH02 TOSHACH DENISE MD CORE PHYSICIANS LLC STRATHAM NH 03885 (603) 658-1823 PEDIATRICS 23YP33234NH01 TOUSSAINT CAROLINE APRN FOUNDATION MEDICAL PARTNERS INC AMHERST NH 03031 (603) 673-5885 FAMILY NURSE PRACTITIONERS 23YP34937NH01 TRACY JODI APRN THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY NURSE PRACTITIONERS 01YP35783MA01 TRAMPOSCH HELEN MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 0405647YPNH01 TRANCHEMONTAGNE TERESA DO FOUNDATION MEDICAL PARTNERS INC AMHERST NH 03031 (603) 673-5885 INTERNAL MEDICINE

Page 57 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP18372NH01 TRAVASSOS RENEE DO DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 PEDIATRICS 23YP39760NH01 TRAVERS DD APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 782-7414 FAMILY NURSE PRACTITIONERS 23YP39760NH02 TRAVERS DD APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 663-8718 FAMILY NURSE PRACTITIONERS 23YP39760NH03 TRAVERS DD APRN CATHOLIC MEDICAL CENTER MANCHESTER NH 03103 (603) 665-7450 FAMILY NURSE PRACTITIONERS 01YP02978NH01 TREMBLAY ANDREW MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 01YP02978NH02 TREMBLAY ANDREW MD DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY MEDICINE 04YP12182ME01 TREMBLAY CHRISTINE DO WELLS FAMILY PRACTICE LLC WELLS ME 04090 (207) 646-0676 FAMILY MEDICINE 01YP05298NH01 TRUEBE SANDRA MD ELLIOT PHYSICIANS NETWORK MANCHESTER NH 03109 (603) 663-8300 PEDIATRICS 23YP35082NH01 TRULAND JACLYN APRN ELLIOT PHYSICIANS NETWORK LONDONDERRY NH 03053 (603) 552-1400 FAMILY NURSE PRACTITIONERS 0109029YPMA03 TSYPKIN LUBA MD LUBA TSYPKIN MD NORTH ANDOVER MA 01845 (978) 975-2300 INTERNAL MEDICINE 0106760YPMA05 TURIANO ANTHONY MD STEWARD MEDICAL GROUP INC ANDOVER MA 01810 (978) 269-0017 FAMILY MEDICINE 01YP21094NH01 TURKINGTON NANCY MD MONTSHIRE PEDIATRICS PC WEST LEBANON NH 03784 (603) 643-6700 PEDIATRICS PEDIATRIC ASSOCIATES OF HAMPTON & 0104988YPNH01 TURNER HENRY MD PORTSMOUTH NH 03801 (603) 436-7171 PEDIATRICS PEDIATRICPORTSMOUTH ASSOCIATES PC OF HAMPTON & 0104988YPNH02 TURNER HENRY MD HAMPTON NH 03842 (603) 929-3838 PEDIATRICS PORTSMOUTH PC 01YP39942MA01 TUSINI ALTA MD CHILDRENS HEALTHCARE HAVERHILL MA 01830 (978) 374-5096 PEDIATRICS 0109442YPMA02 TZVETANOV TZVETAN MD TZVELAN TZVELANOV INTERNAL MEDICINE LLC N ANDOVER MA 01845 (978) 258-3355 INTERNAL MEDICINE 01YP26361NH02 UDOMPRASERT PAMELA MD APPLEDORE MEDICAL GROUP INC ROCHESTER NH 03867 (603) 332-0238 PEDIATRICS 01YP18511NH02 ULLAL RITU MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4440 FAMILY MEDICINE 01YP05388NH01 UPADRASTA VIJAYA MD DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 INTERNAL MEDICINE 01YP34592NH01 VAID SMRITI MD CATHOLIC MEDICAL CENTER GOFFSTOWN NH 03045 (603) 314-4500 INTERNAL MEDICINE 01YP36860NH01 VALDES ERNESTO MD THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY MEDICINE 23YP39311MA01 VALENTE LAURENA APRN MERRIMACK VALLEY MEDICAL ASSOCIATES PC METHUEN MA 01844 (978) 725-4822 FAMILY NURSE PRACTITIONERS 04YP20949NH01 VALERAS ANDREW DO CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 01YP36499VT01 VALLARIO RONALD MD CARLOS G OTIS HEALTHCARE CTR TOWNSHEND VT 05353 (802) 365-4331 GERIATRIC MEDICINE 23YP40008NH01 VALLEE LYNDSEY APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC AMHERST NH 03031 (603) 249-8883 FAMILY NURSE PRACTITIONERS 01YP34466NH01 VALMASSOI JANICE MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 PEDIATRICS 23YP41120NH01 VAN ALSTYNE PENNY APRN GPS PHYSICIAN GROUP PC LACONIA NH 03246 (603) 524-3340 FAMILY NURSE PRACTITIONERS 0105030YPNH01 VAN DER LAAN PANCRAS MD WEEKS MEDICAL CENTER LANCASTER NH 03584 (603) 788-2521 INTERNAL MEDICINE 0105030YPNH02 VAN DER LAAN PANCRAS MD WEEKS MEDICAL CENTER WHITEFIELD NH 03598 (949) 852-3400 INTERNAL MEDICINE 0105030YPNH03 VAN DER LAAN PANCRAS MD WEEKS MEDICAL CENTER GROVETON NH 03582 (603) 788-6213 INTERNAL MEDICINE 23YP34046VT01 VAN SICKLE DOUGLAS APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 FAMILY NURSE PRACTITIONERS 01YP33795NH01 VAN VRANKEN NANCY MD DARTMOUTH HITCHCOCK CLINIC CONCORD NH 03301 (603) 226-2200 PEDIATRICS 0104688YPNH02 VANDERLINDE TANJA MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 224-4003 INTERNAL MEDICINE 0105521YPNH01 VANTUIL SHARON MD RIVER ROAD PEDIATRICS PLLC BEDFORD NH 03110 (603) 622-8619 PEDIATRICS 01YP03448NH01 VELAZQUEZ-EVANS MARIA MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4000 INTERNAL MEDICINE 0404543YPNH02 VELLA JR SALVATORE DO FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 577-3300 INTERNAL MEDICINE 23YP25340VT01 VENMAN-CLAY CLAIRE APRN SOJOURNS COMMUNITY HEALTH CLINIC WESTMINSTER VT 05158 (802) 722-4023 FAMILY NURSE PRACTITIONERS 01YP31089MA01 VENO DANIEL MD LAHEY CLINIC INC SOUTH HAMILTON MA 01982 (978) 468-7346 FAMILY MEDICINE 01YP31089MA02 VENO DANIEL MD LAHEY CLINIC INC IPSWICH MA 01938 (978) 356-5522 FAMILY MEDICINE 0105124YPNH01 VERANI DANIELA MD DANIELA E VERANI, MD PA LONDONDERRY NH 03053 (603) 434-4363 FAMILY MEDICINE 23YP36842NH01 VESEY JACLYN APRN HARBOR HOMES INC NASHUA NH 03060 (603) 821-7788 FAMILY NURSE PRACTITIONERS 23YP20862NH01 VICUNA-KEADY CECILIA APRN KEADY FAMILY PRACTICE CHARLESTOWN NH 03603 (603) 826-3434 FAMILY NURSE PRACTITIONERS 23YP20862NH02 VICUNA-KEADY CECILIA APRN KEADY FAMILY PRACTICE NEWPORT NH 03773 (603) 863-7777 FAMILY NURSE PRACTITIONERS 23YP20862NH03 VICUNA-KEADY CECILIA APRN KEADY FAMILY PRACTICE CLAREMONT NH 03743 (603) 863-7777 FAMILY NURSE PRACTITIONERS 23YP30685MA01 VIEL KARA APRN FOUNDATION MEDICAL PARTNERS INC PEPPERELL MA 01463 (978) 433-6317 FAMILY NURSE PRACTITIONERS 23YP42043NH01 VIENS MOLLY APRN CORE PHYSICIANS LLC HAMPTON NH 03842 (603) 929-1195 FAMILY NURSE PRACTITIONERS

Page 58 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP00579MA01 VILLANUEVA ANDREW MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP00579MA02 VILLANUEVA ANDREW MD LAHEY CLINIC INC PEABODY MA 01960 (978) 538-4654 INTERNAL MEDICINE 01YP00579MA03 VILLANUEVA ANDREW MD LAHEY CLINIC INC BEVERLY MA 01915 (978) 922-3000 INTERNAL MEDICINE 23YP29806VT01 VITALE JOYCE APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-7500 INTERNAL MEDICINE NURSE PRACTITIONER 04YP27317NH01 VOGT CHRISTOPHER DO DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY MEDICINE 04YP10885NH02 VORE JON MICHAEL DO FOUNDATION MEDICAL PARTNERS INC AMHERST NH 03031 (603) 673-5885 FAMILY MEDICINE 01YP37274NH01 VUPPULA SHARON MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 889-6671 PEDIATRICS 23YP25755VT01 WAGEMAN KATE APRN BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-2611 FAMILY NURSE PRACTITIONERS 01YP17577NH01 WAGGETT IAN MD CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7555 INTERNAL MEDICINE 01YP31386NH01 WAGNER TRACI MD COOS COUNTY FAMILY HEALTH SERVICES INC BERLIN NH 03570 (603) 752-2040 PEDIATRICS 04YP33819VT01 WAJID FAIZA DO WINDSOR HOSPITAL CORP WINDSOR VT 05089 (802) 674-7300 FAMILY MEDICINE 23YP37582NH01 WALDEN SHERRI APRN MONADNOCK COMMUNITY HOSPITAL ANTRIM NH 03440 (603) 588-4200 FAMILY NURSE PRACTITIONERS 01YP35500NH01 WALLACE CHRISTI MD THE MEMORIAL HOSPITAL NORTH CONWAY NH 03860 (603) 356-5472 FAMILY MEDICINE 23YP39567NH01 WALSH SARAH APRN DOVER PEDIATRICS PLLC DOVER NH 03820 (603) 742-4048 PEDIATRIC NURSE PRACTITIONERS 04YP29625ME01 WALSH MARY DO WATERBORO VILLAGE PEDIATRICS LLC PA EAST WATERBORO ME 04030 (207) 247-6742 PEDIATRICS 01YP02388MA01 WALSHE EDWARD MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8430 INTERNAL MEDICINE 01YP02388MA02 WALSHE EDWARD MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 01YP00584MA01 WARNER ANDREW MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8740 INTERNAL MEDICINE 01YP00584MA02 WARNER ANDREW MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 01YP31718NH01 WARNER ASHLEY MD NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 FAMILY MEDICINE 23YP26612VT01 WARREN TAMMY APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 886-8900 ADULT NURSE PRACTITIONERS 23YP33523ME01 WARRICK CHRISTINE APRN BRIDGTON HOSPITAL BRIDGTON ME 04009 (207) 647-2311 FAMILY NURSE PRACTITIONERS 01YP02769NH02 WASZKOWSKI DANIEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP02769NH03 WASZKOWSKI DANIEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 01YP02769NH04 WASZKOWSKI DANIEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 01YP02769NH05 WASZKOWSKI DANIEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 01YP02769NH06 WASZKOWSKI DANIEL MD DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 23YP28090NH01 WATKINS KELLEY APRN MID-STATE HEALTH CENTER BRISTOL NH 03222 (603) 744-6200 ADULT NURSE PRACTITIONERS 23YP28090NH02 WATKINS KELLEY APRN MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 ADULT NURSE PRACTITIONERS 23YP25453VT01 WATSON SABINE APRN NORTHERN COUNTIES HEALTH CARE INC ST JOHNSBURY VT 05819 (802) 748-5041 FAMILY NURSE PRACTITIONERS 23YP30771NH01 WATTERSON DALE APRN FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 595-0063 FAMILY NURSE PRACTITIONERS 04YP27783NH01 WATTO MICHAEL DO SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-1881 FAMILY MEDICINE 23YP42466NH01 WATTS ISABEL APRN LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY NURSE PRACTITIONERS 01YP36466MA01 WAX JENNE MD MEDICAL CARE OF BOSTON MANAGEMENT CORP AMESBURY MA 01913 (978) 388-1400 FAMILY MEDICINE 23YP40245VT01 WEAVER LINDSEY APRN BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 251-8455 FAMILY NURSE PRACTITIONERS 01YP39424NH01 WEBBER CARRIE MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 FAMILY MEDICINE 01YP39424NH02 WEBBER CARRIE MD ST JOSEPH HOSPITAL MERRIMACK NH 03054 (603) 424-4181 FAMILY MEDICINE 01YP12487NH01 WEBER DENISE MD NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 INTERNAL MEDICINE 01YP30353VT01 WEIDHAAS SARAH MD SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 886-8900 PEDIATRICS 01YP30353VT02 WEIDHAAS SARAH MD SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 885-5155 PEDIATRICS 01YP30353VT03 WEIDHAAS SARAH MD SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 885-5154 PEDIATRICS 01YP30353VT04 WEIDHAAS SARAH MD SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 885-7901 PEDIATRICS 01YP30353VT05 WEIDHAAS SARAH MD SPRINGFIELD MEDICAL CARE SYSTEMS INC SPRINGFIELD VT 05156 (802) 885-8490 PEDIATRICS 0107467YPNH03 WEINSTEIN MICHAEL MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 889-6671 PEDIATRICS 23YP42574VT01 WELSH MEREDITH APRN WHITE RIVER FAMILY PRACTICE PC WHITE RIV JCT VT 05001 (802) 295-6132 FAMILY NURSE PRACTITIONERS 04YP03546NH01 WELTER JOHN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE

Page 59 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 04YP03546NH02 WELTER JOHN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 04YP03546NH03 WELTER JOHN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 04YP03546NH04 WELTER JOHN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 04YP03546NH05 WELTER JOHN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP04040MA01 WERNER ALAIN-MARC MD HIGHLAND PRIMARY CARE NEWBURYPORT MA 01950 (978) 463-7770 INTERNAL MEDICINE 01YP33379NH01 WERTH JEREMY MD CONCORD HOSPITAL INC WARNER NH 03278 (603) 456-6106 FAMILY MEDICINE 0101986YPME02 WESTINGHOUSE ANDREA MD CORE PHYSICIANS LLC PLAISTOW NH 03865 (603) 257-4000 PEDIATRICS 04YP36507NH01 WETHERBEE KATHARINE DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 04YP36507NH02 WETHERBEE KATHARINE DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 04YP36507NH03 WETHERBEE KATHARINE DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-1300 FAMILY MEDICINE 04YP36507NH04 WETHERBEE KATHARINE DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 04YP36507NH05 WETHERBEE KATHARINE DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0408451YPNH01 WHEELER JOHN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 0408451YPNH02 WHEELER JOHN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC LONDONDERRY NH 03053 (603) 537-1300 FAMILY MEDICINE 0408451YPNH05 WHEELER JOHN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC WINDHAM NH 03087 (603) 537-3053 FAMILY MEDICINE 0408451YPNH06 WHEELER JOHN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC BEDFORD NH 03110 (603) 537-1300 FAMILY MEDICINE 0408451YPNH07 WHEELER JOHN DO DERRY MEDICAL CENTER PROFESSIONAL ASSOC DERRY NH 03038 (603) 537-1300 FAMILY MEDICINE 01YP41723NH01 WHIPPLE CLARE MD APPLEDORE MEDICAL GROUP INC HAMPTON NH 03842 (603) 929-2137 INTERNAL MEDICINE 23YP16050NH01 WHITE KELLY APRN CONCORD HOSPITAL INC EPSOM NH 03234 (603) 736-6200 FAMILY NURSE PRACTITIONERS 01YP14353NH01 WHITE KELLEY MD MID-STATE HEALTH CENTER PLYMOUTH NH 03264 (603) 536-4000 PEDIATRICS 23YP31891VT01 WHITFIELD MARTHA APRN NORTHERN COUNTIES HEALTH CARE INC HARDWICK VT 05843 (802) 472-3300 FAMILY NURSE PRACTITIONERS 01YP19094NH01 WIDNESS CRAIG MD ELLIOT PHYSICIANS NETWORK HOOKSETT NH 03106 (603) 641-5386 INTERNAL MEDICINE 23YP26012NH01 WIEMER KELLY APRN CONCORD HOSPITAL INC WARNER NH 03278 (603) 456-6106 FAMILY NURSE PRACTITIONERS 01YP37885NH01 WIESE FREDERICK MD MASCOMA COMMUNITY HEALTHCARE INC CANAAN NH 03741 (603) 523-4343 INTERNAL MEDICINE 23YP29449NH01 WILDER PAIGE APRN GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 953-0065 FAMILY NURSE PRACTITIONERS 01YP41569NH01 WILKINS TERRA MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE 01YP41569NH02 WILKINS TERRA MD GREATER SEACOAST COMMUNITY HEALTH PORTSMOUTH NH 03801 (603) 422-8208 FAMILY MEDICINE 23YP14477NH01 WILLARD JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP BARRINGTON NH 03825 (603) 664-2135 ADULT NURSE PRACTITIONERS 23YP14477NH13 WILLARD JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6930 ADULT NURSE PRACTITIONERS 23YP14477NH14 WILLARD JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-2263 ADULT NURSE PRACTITIONERS 23YP14477NH15 WILLARD JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 ADULT NURSE PRACTITIONERS 23YP14477NH16 WILLARD JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP PORTSMOUTH NH 03801 (603) 610-8051 ADULT NURSE PRACTITIONERS 23YP14477NH17 WILLARD JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-3174 ADULT NURSE PRACTITIONERS 23YP41668ME01 WILLARD JENNIFER APRN WENTWORTH DOUGLASS PHYSICIAN CORP SOUTH BERWICK ME 03908 (207) 384-4949 ADULT NURSE PRACTITIONERS 0101497YPNH01 WILLIAMS LINDA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03060 (603) 594-6030 PEDIATRICS 0104124YPNH01 WILLIAMSON DOUGLAS MD ALICE PECK DAY MEMORIAL HOSPITAL LEBANON NH 03766 (603) 448-3122 PEDIATRICS 01YP33436MA01 WILLIFORD SARA MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 04YP36298VT01 WILSON TOLLER DO BRATTLEBORO MEMORIAL HOSPITAL BRATTLEBORO VT 05301 (802) 257-2611 INTERNAL MEDICINE 23YP33662VT03 WILSON LINDA APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC LUDLOW VT 05149 (802) 228-8867 FAMILY NURSE PRACTITIONERS 23YP33662VT04 WILSON LINDA APRN SPRINGFIELD MEDICAL CARE SYSTEMS INC BELLOWS FALLS VT 05101 (802) 463-9000 FAMILY NURSE PRACTITIONERS 23YP34123VT01 WILSON JANET APRN NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-5131 FAMILY NURSE PRACTITIONERS 04YP17178NH01 WILT III RAY DO FRISBIE MEMORIAL HOSPITAL BARRINGTON NH 03825 (603) 664-9003 FAMILY MEDICINE 01YP02578MA01 WINGER CHRISTINE MD LAHEY CLINIC INC LEXINGTON MA 02421 (781) 372-7100 INTERNAL MEDICINE 04YP15282NH01 WINIECKI MARC DO MONADNOCK COMMUNITY HOSPITAL JAFFREY NH 03452 (603) 532-8775 FAMILY MEDICINE 04YP15282NH02 WINIECKI MARC DO MONADNOCK COMMUNITY HOSPITAL NEW IPSWICH NH 03071 (603) 878-1092 FAMILY MEDICINE 04YP15282NH03 WINIECKI MARC DO MONADNOCK COMMUNITY HOSPITAL RINDGE NH 03461 (603) 899-9563 FAMILY MEDICINE

Page 60 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 23YP39397NH01 WINN STEPHANIE APRN DARTMOUTH HITCHCOCK CLINIC MANCHESTER NH 03104 (603) 695-2500 FAMILY NURSE PRACTITIONERS 04YP29203ME01 WINN GARY DO PROVIDERS CARE PA BIDDEFORD ME 04005 (207) 286-2273 FAMILY MEDICINE 04YP29203ME02 WINN GARY DO PROVIDERS CARE PA SANFORD ME 04073 (207) 459-7768 FAMILY MEDICINE 01YP40355NH01 WITKIN RONALD MD LRGHEALTHCARE LACONIA NH 03246 (603) 524-9201 INTERNAL MEDICINE 01YP14770ME04 WOO KINGSON MD APPLEDORE MEDICAL GROUP INC SANBORNVILLE NH 03872 (603) 522-0186 FAMILY MEDICINE 01YP33635NH01 WOOD REBECCA MD NEW LONDON HOSPITAL ASSOCIATION NEWPORT NH 03773 (603) 863-4100 INTERNAL MEDICINE 01YP33635NH02 WOOD REBECCA MD NEW LONDON HOSPITAL ASSOCIATION NEW LONDON NH 03257 (603) 526-5544 INTERNAL MEDICINE 2301232YPNH03 WOOD LORI APRN FRISBIE MEMORIAL HOSPITAL SANBORNVILLE NH 03872 (603) 522-0186 FAMILY NURSE PRACTITIONERS 2301232YPNH04 WOOD LORI APRN APPLEDORE MEDICAL GROUP INC FARMINGTON NH 03835 (603) 755-9801 FAMILY NURSE PRACTITIONERS 23YP11396NH01 WOOD-FRIEND AMANDA APRN LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY NURSE PRACTITIONERS 23YP11396NH03 WOOD-FRIEND AMANDA APRN LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY NURSE PRACTITIONERS 23YP29356NH01 WOOD-FRIEND AMANDA APRN FRISBIE MEMORIAL HOSPITAL ROCHESTER NH 03867 (603) 994-7679 FAMILY NURSE PRACTITIONERS 23YP36893NH01 WOODSIDE TERESA APRN DARTMOUTH HITCHCOCK CLINIC KEENE NH 03431 (603) 354-5400 FAMILY NURSE PRACTITIONERS 23YP36692NH01 WORDEN JILL APRN LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY NURSE PRACTITIONERS 23YP36692NH02 WORDEN JILL APRN LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY NURSE PRACTITIONERS 0407491YPNH01 WORRELL KAREEN DO YOUR MEDICAL HOME LLC EXETER NH 03833 (603) 418-6310 FAMILY MEDICINE 01YP13454ME01 WRIGHT ERINN MD BRIDGTON HOSPITAL NAPLES ME 04055 (207) 693-6106 FAMILY MEDICINE 23YP39803NH01 WRIGHT WENDY APRN DERRY MEDICAL CENTER PROFESSIONAL ASSOC AMHERST NH 03031 (603) 249-8883 FAMILY NURSE PRACTITIONERS 23YP20216NH01 WRIGHT VIRGINIA APRN CROSSROADS FAMILY MEDICINE PLLC CONCORD NH 03301 (603) 856-8828 FAMILY NURSE PRACTITIONERS 01YP27770NH02 WRIGHT WILLIAMS HEATHER MD DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2500 PEDIATRICS 01YP12177NH02 WU MICHAEL MD CORE PHYSICIANS LLC EXETER NH 03833 (603) 778-2899 FAMILY MEDICINE 01YP39995NH01 WU DIANA MD DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY MEDICINE 01YP00603MA01 WU TIMOTHY MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP00603MA02 WU TIMOTHY MD LAHEY CLINIC INC WINCHESTER MA 01890 (781) 756-2260 INTERNAL MEDICINE 01YP00603MA03 WU TIMOTHY MD LAHEY CLINIC INC PEABODY MA 01960 (978) 538-4654 INTERNAL MEDICINE 01YP00603MA04 WU TIMOTHY MD LAHEY CLINIC INC BEVERLY MA 01915 (978) 922-3000 INTERNAL MEDICINE 23YP42285NH01 WULFF KIERSTEN APRN DARTMOUTH HITCHCOCK CLINIC LEBANON NH 03766 (603) 650-5000 FAMILY NURSE PRACTITIONERS 01YP04244NH01 YAGER ROBERT MD KING MEDICAL ASSOCIATES NASHUA NH 03060 (603) 595-2300 FAMILY MEDICINE 0102659YPME03 YARIAN DAVID MD YORK HOSPITAL SOUTH BERWICK ME 03908 (207) 384-9212 FAMILY MEDICINE 0101014YPNH01 YEGHIAZARIANS VARTAN MD SALEM NH PHYSICIANS NETWORK PC METHUEN MA 01844 (978) 685-5627 INTERNAL MEDICINE 0101014YPNH02 YEGHIAZARIANS VARTAN MD SALEM NH PHYSICIANS NETWORK PC SALEM NH 03079 (603) 898-6363 INTERNAL MEDICINE 01YP05083MA01 YEH KEVIN MD LAHEY CLINIC INC PEABODY MA 01960 (978) 977-6336 INTERNAL MEDICINE 01YP03075MA02 YEH CHIH MD AUTUMN GRACE MEDICAL ASSOCIATES PC METHUEN MA 01844 (978) 682-3939 INTERNAL MEDICINE 01YP24777NH01 YEHLING HILARY MD ELLIOT PHYSICIANS NETWORK RAYMOND NH 03077 (603) 895-8000 PEDIATRICS 04YP08848NH01 YERDON MCLEOD ANGELA DO CONCORD HOSPITAL INC CONCORD NH 03301 (603) 228-7200 FAMILY MEDICINE 01YP00606MA01 YING CHRISTOPHER MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-8000 INTERNAL MEDICINE 01YP00606MA02 YING CHRISTOPHER MD LAHEY CLINIC INC PEABODY MA 01960 (781) 744-8000 INTERNAL MEDICINE 01YP34049NH01 YOUNG KEVIN MD SPEARE MEMORIAL HOSPITAL PLYMOUTH NH 03264 (603) 536-1881 FAMILY MEDICINE 01YP30397MA01 YOUNG CHRISTINE MD KRONOS HEALTH PLLC LAWRENCE MA 01843 (978) 655-6652 INTERNAL MEDICINE 0102325YPNH02 YOUNG MITCHELL MD DARTMOUTH HITCHCOCK CLINIC BEDFORD NH 03110 (603) 695-2940 FAMILY MEDICINE 0102325YPNH03 YOUNG MITCHELL MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4188 FAMILY MEDICINE 23YP36490NH01 YOUNG RICHARD APRN HEALTH FIRST FAMILY CARE CENTER FRANKLIN NH 03235 (603) 934-1464 FAMILY NURSE PRACTITIONERS 01YP29506MA01 YOUNG JANET MD LAHEY CLINIC INC BURLINGTON MA 01805 (781) 744-7000 INTERNAL MEDICINE 01YP03582NH02 YOUNG-XU SARAH MD AMMONOOSUC COMMUNITY HEALTH SERVICES INC WOODSVILLE NH 03785 (603) 747-3740 FAMILY MEDICINE 0108637YPNH03 YOURTEE EDWARD MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC DERRY NH 03038 (603) 216-0400 INTERNAL MEDICINE 0108637YPNH04 YOURTEE EDWARD MD SOUTHERN NEW HAMPSHIRE INTERNAL MED ASSOC WINDHAM NH 03087 (603) 216-0400 INTERNAL MEDICINE

Page 61 of 62 ANTHEM PARTICIPATING PRIMARY CARE PROVIDER (PCP) LIST - 2021 This list includes PCPs who participate with Anthem BCBS in New Hampshire. Please note this is not an all-inclusive list for Access Blue New England, BlueChoice New England or HMO Blue New England plans. To search for participating PCPs or providers in other New England states, visit www.healthtrustnh.org and click on the orange Medical icon, then follow the simple instructions located under Medical Plan Provider Directories in the box on the right side of the page. PCP# LAST NAME FIRST NAME TITLE PROVIDER LOCATION/PRACTICE NAME CITY STATE ZIP PHONE PRIMARY SPECIALTY 01YP04111NH01 YOUSSEF DENISE MD DARTMOUTH HITCHCOCK CLINIC NASHUA NH 03063 (603) 577-4400 PEDIATRICS 01YP14099MA02 YOUSSEF RULA MD NEW ENGLAND PRIMARY CARE ASSOCIATES PC LAWRENCE MA 01843 (978) 685-2455 FAMILY MEDICINE 01YP41933NH01 YU ALICE MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 888-5573 FAMILY MEDICINE 0103259YPMA02 YUIL GABRIEL MD YUIL MEDICAL ASSOCIATES PLLC LAWRENCE MA 01841 (978) 682-3233 FAMILY MEDICINE 04YP27246VT01 YUKICA REBECCA DO UPPER VALLEY PEDIATRICS PLLC BRADFORD VT 05033 (802) 222-4722 PEDIATRICS 0100386YPNH01 ZACHOS SARAH MD LAMPREY HEALTH CARE INC RAYMOND NH 03077 (603) 895-3351 FAMILY MEDICINE 0100386YPNH02 ZACHOS SARAH MD LAMPREY HEALTH CARE INC NEWMARKET NH 03857 (603) 659-3106 FAMILY MEDICINE 0100386YPNH03 ZACHOS SARAH MD LAMPREY HEALTH CARE INC NASHUA NH 03060 (603) 883-1626 FAMILY MEDICINE 23YP37291MA01 ZAEDER LISA APRN LAHEY CLINIC INC IPSWICH MA 01938 (978) 356-5522 ADULT NURSE PRACTITIONERS 01YP24850MA01 ZAHEEN ASIA MD MERRIMACK MEDICAL & WALK IN S LAWRENCE MA 01841 (978) 688-3100 FAMILY MEDICINE 23YP30678ME01 ZAKORCHEMNY LAURA APRN YORK HOSPITAL WELLS ME 04090 (207) 646-5211 FAMILY NURSE PRACTITIONERS 04YP41738VT01 ZALDIVAR MARJEL DO NORTHEASTERN VERMONT REGIONAL HOSPITAL INC ST JOHNSBURY VT 05819 (802) 748-5131 PEDIATRICS 01YP03165MA01 ZANGARA RICHARD MD LAHEY CLINIC INC LEXINGTON MA 02421 (781) 372-7100 INTERNAL MEDICINE 01YP19694NH02 ZDRNJA VLASTA MD CATHOLIC MEDICAL CENTER MANCHESTER NH 03102 (603) 625-6198 INTERNAL MEDICINE 01YP18423NH01 ZENT KEVIN MD GREATER SEACOAST COMMUNITY HEALTH SOMERSWORTH NH 03878 (603) 749-2346 FAMILY MEDICINE 01YP12542NH02 ZHAO CHUN-RUI MD ST JOSEPH HOSPITAL NASHUA NH 03061 (603) 595-3722 FAMILY MEDICINE 01YP12535NH02 ZIADA IHAB MD ST JOSEPH HOSPITAL NASHUA NH 03060 (603) 891-4500 INTERNAL MEDICINE 01YP10869NH01 ZIELINSKA ANNA MD FOUNDATION MEDICAL PARTNERS INC NASHUA NH 03062 (603) 888-5573 FAMILY MEDICINE 0109235YPNH01 ZIELINSKI RANDALL MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 742-7222 INTERNAL MEDICINE 0109235YPNH13 ZIELINSKI RANDALL MD WENTWORTH DOUGLASS PHYSICIAN CORP DOVER NH 03820 (603) 609-6800 INTERNAL MEDICINE 01YP14507MA01 ZILBER DMITRIY MD LAHEY CLINIC INC BEVERLY MA 01915 (978) 927-1919 INTERNAL MEDICINE 0101848YPNH01 ZINNES ROBERT MD FOUNDATION MEDICAL PARTNERS INC AMHERST NH 03031 (603) 673-5885 FAMILY MEDICINE 01YP05271MA01 ZUSER LYDIA MD LYDIA ZUSER MD HAVERHILL MA 01830 (978) 373-1591 INTERNAL MEDICINE 0103291YPNH02 ZWAAN ANTHONY MD ANTHONY C ZWAAN MD PLLC EXETER NH 03833 (603) 773-2225 FAMILY MEDICINE

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