Primary Care Committee Program Year 2015 David Wilner, M.D. CHAIR Silvia Arizaga, MD MBR Medical Director Medical Director Summit ElderCare Sutter SeniorCare PACE 10 Chestnut Street 1234 U Street Worcester, MA 01608 Sacramento, CA 95818-1433 Phone: (508) 368-9675 Phone: (916) 742-0714 Fax: (508) 368-9981 Fax: (916) 446-3699 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE George Brett, M.D. CHAIR-VICE Phyllis Baer, M.D. MBR Medical Director LIFE Programs Medical Director Lutheran SeniorLife Harbor Health Services, Inc. 150 Pleasant Drive #201 1135 Morton Street Aliquippa, PA 15001 Mattapan, MA 02126-2834 Phone: (412) 974-7692 Phone: (617) 533-2400 Fax: (724) 302-2093 Fax: (617) 533-2401 E-mail: [email protected] E-mail: [email protected] Member Organization Type: PARNT Member Organization Type: P PACE Tahir Ahmed MBR Liliya Balabanova, M.D. MBR Medical Director Primary Care Physician AllCARE for Seniors Sentara PACE PO Box 765 665 Newtown Road Cedar Bluff, VA 24609 Virginia Beach, VA 23462 Phone: (276) 964-4915 Phone: (757) 502-7800 Fax: (276) 963-0130 Fax: E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Rafael Amezcua MBR Nancy Barkowski, MD MBR Medical Director Medical Director Brandman Centers for Senior Care Eddy SeniorCare 7150 Tampa Avenue 504 State Street Reseda, CA 91335-3700 Schenectady, NY 12305-2414 Phone: (559) 392-4175 Phone: (518) 382-3290 Fax: (818) 774-3248 Fax: (518) 382-8001 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Page 1 of 10 8/15/2014 Tim Beittel, MD MBR Adam Burrows, M.D. MBR Medical Director Medical Director LIFE St. Joseph of the Pines, Inc. Upham's Elder Service Plan/PACE 4900 Raeford Road 36 Dearborn Street Fayetteville, NC 28304 Boston, MA 02119-2552 Phone: (910) 429-7229 Phone: (617) 440-1615 Fax: (910) 429-7230 Fax: (617) 442-2589 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Debra Berg, MD MBR Amy Callaghan MBR Medical Director Medical Director ArchCare Senior Life Siouxland PACE 520 E. 76th St. 9D 309 Cook Street New York, NY 10021 Sioux City, IA 51103 Phone: (646) 770-6097 Phone: (712) 224-7223 Fax: (718) 732-7183 Fax: (712) 224-7254 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Iris Boettcher, M.D. MBR Madeline Castro MBR Medical Director Medical Director Life Circles Florida PACE Centers, Inc. 560 Seminole Road 60 East 3rd Street, 2nd Floor Muskegon, MI 49444-3720 Hialeah, FL 33010 Phone: (231) 733-8686 Phone: (786) 347-2040 Fax: (231) 733-8683 Fax: (786) 347-2047 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Elisabeth Broderick, M.D. MBR Rengena Chan-Ting, D.O. MBR Medical Director Medical Director Element Care LIFE at Lourdes 37 Friend Street 2475 McClellan Avenue, Building C Lynn, MA 01902 Pennsauken, NJ 08109 Phone: (781) 715-2390 Phone: (856) 669-9363 Fax: (781) 715-2423 Fax: (856) 675-3686 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Rachel Broudy, MD MBR Clayton Chau MBR Medical Director Medical Director Mercy LIFE - Holyoke CalOptima 2112 Riverdale Street, Suite 1 505 City Parkway West West Springfield, MA 01089 Orange, CA 92868-2924 Phone: (413) 827-4318 Phone: (714) 347-3287 Fax: (413) 493-2024 Fax: (714) 481-6524 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Page 2 of 10 8/15/2014 Alan Clark MBR Peter DeGolia, M.D. MBR Medical Director Medical Director Senior Total Life Care McGregor PACE 1875 Remount Road 1648 Compton Road Gastonia, NC 28054 Cleveland, OH 44118 Phone: (704) 874-0600 Phone: (216) 371-8623 Fax: Fax: E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Elizabeth Cogbill MBR Norman Desbiens, MD MBR Medical Director Medical Director CentraCare Alexian Brothers Community Services-Chattanooga 200 W. Michigan Ave., Suite 103 425 Cumberland Street, Suite 110 Battle Creek, MI 49017-3602 Chattanooga, TN 37404-1905 Phone: (269) 441-9300 Phone: (423) 698-0802 Fax: (269) 441-3492 Fax: (423) 622-6048 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Valencia Covington, M.D. MBR Stephan Deutsch MBR Medical Director Chief Medical Officer PACE of the Southern Piedmont CenterLight Healthcare 6133 The Plaza 1250 Waters Place, Tower 1, Suite 602 Charlotte, NC 28215 Bronx, NY 10461 Phone: (704) 877-3840 Phone: (347) 640-6215 Fax: (704) 877-3884 Fax: (718) 944-1181 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Bickley Craven, M.D. MBR Joel Dickerman MBR Medical Director Medical Director Mountain Empire PACE Rocky Mountain PACE Block 1A, Industrial Park Road 2335 Robinson Street Big Stone Gap, VA 24219-0888 Colorado Springs, CO 80904-3751 Phone: (276) 523-0599 Phone: (719) 314-2327 Fax: Fax: (719) 457-0766 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Elizabeth Dalton MBR Lisa Duckett MBR CRNP Interim Medical Director LIFE - University of Pennsylvania School of Nursing Cherokee Elder Care 4508 Chestnut Street 1387 West 4th Street Philadelphia, PA 19139-3608 Tahlequah, OK 74464 Phone: (215) 573-7208 Phone: (918) 453-5554 Fax: (215) 746-2149 Fax: (918) 431-4112 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Page 3 of 10 8/15/2014 John Egbert, MD MBR Alan Forshey MBR Medical Director Medical Director Palmetto SeniorCare PACE @ Home, Inc. 15 Richland Medical Park, Suite 203 1915 Fairgrove Church Road SE Columbia, SC 29203-6843 Newton, NC 28658-8531 Phone: (803) 434-3770 Phone: (828) 469-2224 Fax: (803) 434-3773 Fax: (828) 466-8897 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Paul Evans, III MBR Bradley Fox, M.D. MBR Medical Director Medical Director Riverside PACE LIFE NWPA 4107 West Mercury Blvd. 149 West 22nd Street Hampton, VA 23666-3729 Erie, PA 16502-2899 Phone: (757) 234-8100 Phone: (814) 456-5433 Fax: (757) 969-6836 Fax: (814) 456-9232 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Anne Fabiny MBR Dory Funk, M.D. MBR Medical Director Medical Director Elder Service Plan of Cambridge Health Alliance Senior CommUnity Care of Colorado 270 Green Street 2377 Robins Way Cambridge, MA 02139-3312 Montrose, CO 81401 Phone: (617) 575-5850 Phone: (970) 252-0522 Fax: (617) 575-5860 Fax: (970) 252-0166 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Ahmad Farooq, MD MBR Mary Gavinski, MD MBR Medical Director Chief Medical Officer Lutheran Senior LIFE at Jersey City Community Care, Inc. 6 Terri Lane, Suite 300 205 Bishops Way Burlington, NJ 08016 Brookfield, WI 53005 Phone: (201) 706-2091 Phone: (262) 207-9318 Fax: (201) 706-2092 Fax: (262) 827-7051 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Pamela Fenstemacher MBR Brad Goad MBR Medical Director Medical Director LIFE - University of Pennsylvania School of Nursing Kissito PACE of Roanoke, Inc. 4508 Chestnut Street 5228 Valley Pointe Parkway, Bldg B Ste 1 Philadelphia, PA 19139-3608 Roanoke, VA 24019-3052 Phone: (215) 746-2157 Phone: (540) 265-0322 Fax: (215) 746-2150 Fax: (540) 265-0305 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Page 4 of 10 8/15/2014 Gwendolyn Graddy-Dansby, M.D. MBR Daniel Haimowitz, M.D. MBR Medical Director Medical Director Center for Senior Independence LIFE St. Mary 7800 West Outer Drive, Suite 240 1 Gardenia Road Detroit, MI 48235-3461 Levittown, PA 19057-3411 Phone: (313) 543-6320 Phone: (215) 943-2222 Fax: (313) 543-6795 Fax: (215) 943-2223 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Tom Graf MBR James Hammett, D.O. MBR Interim Medical Director Medical Director LIFE Geisinger LIFE Lutheran Services, Inc. 1100 Spruce Street, Suite 100 840 Fifth Avenue Kulpmont, PA 17834-1239 Chambersburg, PA 17201-4219 Phone: (570) 373-2100 Phone: (717) 709-2344 Fax: (570) 373-2101 Fax: (717) 217-2314 E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Ruth Ann Guilinger, M.D. MBR Abeer Hanna MBR Medical Director Physician LIFE Pittsburgh LIFE Butler County 681 Anderson Drive, Bldg. 6, 5th Floor 231 W. Diamond Street Pittsburgh, PA 15220 Butler, PA 16001-5784 Phone: (412) 388-8042 Phone: (724) 287-5433 Fax: (412) 388-8055 Fax: E-mail: [email protected] E-mail: [email protected] Member Organization Type: P PACE Member Organization Type: P PACE Delia Gutierrez, M.D.