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Anthony T Vennik

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

1 Medical Plaza Dr, Roseville, CA 95661-3037

PECOS Enrollment

This provider is enrolled in PECOS as ANTHONY VENNIK.

Based on the most recent information from CMS, provider Anthony T Vennik is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 6 days ago.

Profile Details

Provider ID
1629018965
Provider Type
Individual
Full Name
Vennik, Anthony T
Credential
P.A.-C

Gender
Male
Sole Proprietor
No
Enumeration Date
6/7/2006
Last Updated
7/8/2007

Contact Information

Practice Location

1 Medical Plaza Dr, Roseville, CA 95661-3037

(916) 781-1000

Unlisted Fax

Mailing Location

2100 Powell Street, Suite 900, Emeryville, CA 94608-1803

(510) 350-2600

(510) 879-9100

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License PA17912 California

Anthony T Vennik

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Thompson, Tolya Lashawn

Reyes, Florita

Seleh, Daniela

Novick, Jacob Adam

Carson, Cindy C

Suliman, Geraldine Ann

Moradi, Shaian

Vue, Jessica

Gold, Christine L

Nemolyaev, Sergey A.