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Prospective & Enrolled Members: 800-405-9681 (TTY 711)

Provider Inquiries: 1-855-969-5907 (TTY 711)

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Location Name Primary Specialty Address City State Zip County Phone Health Plan
Aaranson, R Podiatry 1502 West Meyer Road Wentzville MO 63385 St. Charles (636) 332-3381 Provider Partners Missouri Advantage Plan
Aaron, Joshua Pulmonology 12502 Willowbrook Road Cumberland MD 21502 Allegany (240) 964-8342 Provider Partners Maryland Advantage Plan
Provider Partners Maryland Community Plan
Provider Partners Pennsylvania Advantage Plan
Provider Partners Pennsylvania Community Plan
Abai, Babak Vascular Surgery 1300 Wolf Street Philadelphia PA 19148 Philadelphia (215) 551-0360 Provider Partners Maryland Advantage Plan
Provider Partners Maryland Community Plan
Provider Partners Pennsylvania Advantage Plan
Provider Partners Pennsylvania Community Plan
Abalihi, Carol Internal Medicine 12350 Paseo Nuevo Drive El Paso TX 79928 El Paso (915) 225-4470 Provider Partners Texas Advantage Plan
Provider Partners Texas Community Plan
Aballay, Ariel General Surgery 4815 Liberty Avenue Pittsburgh PA 15224 Allegheny (412) 578-1448 Provider Partners Pennsylvania Advantage Plan
Provider Partners Pennsylvania Community Plan
Abascal, Aliana Psychiatry 930 Chestnut Ridge Road Morgantown WV 26505 Monongalia (304) 598-4214 Provider Partners Maryland Advantage Plan
Provider Partners Maryland Community Plan
Provider Partners Pennsylvania Advantage Plan
Provider Partners Pennsylvania Community Plan
Abate, Kelly Dermatology 1890 Silver Cross Boulevard New Lenox IL 60451-9596 Will (708) 424-0656 Provider Partners Illinois Advantage Plan
Provider Partners Illinois Community Plan
Abate, Mallory Dermatology 2315 Dougherty Ferry Road St. Louis MO 63122 St. Louis City (314) 977-9666 Provider Partners Missouri Advantage Plan
Abate, Matthew Vascular Surgery 10012 Kennerly Road Saint Louis MO 63128 St. Louis (314) 525-4325 Provider Partners Missouri Advantage Plan
Abbas, Abbas Cardiothoracic Surgery 7600 Central Avenue Philadelphia PA 19111 Philadelphia (215) 214-4100 Provider Partners Pennsylvania Advantage Plan
Provider Partners Pennsylvania Community Plan
Results found: 16517
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Disclaimer

Provider Directory Disclaimer

This directory provides a list of Provider Partners Illinois Advantage HMO I-SNP, Provider Partners Illinois Community HMO I-SNP, Provider Partners Maryland Advantage HMO I-SNP, Provider Partners Maryland Community HMO I-SNP, Provider Partners Missouri Advantage HMO I-SNP, Provider Partners Pennsylvania Advantage HMO I-SNP, Provider Partners Pennsylvania Community HMO I-SNP, Provider Partners Texas Advantage HMO I-SNP, and Provider Partners Texas Community HMO I-SNP current network providers and facilities. To get detailed information about your health care coverage, please see your Evidence of Coverage (EOC).

The directory covers the following counties under our plans:

For Provider Partners Illinois Advantage and Community- Our service area includes the following county in Illinois: Cook, DuPage, Kane, McHenry, Will, Winnebago.

For Provider Partners Maryland Advantage and Community- Our service area includes the following counties in Maryland: Allegany, Anne Arundel, Baltimore, Baltimore City, Carroll, Dorchester, Frederick, Garrett, Harford, Howard, Kent, Queen Anne’s, Washington

For Provider Partners Missouri Advantage- Our service area includes the following counties in Missouri: Audrain, Barry, Boone, Butler, Caldwell, Callaway, Camden, Carroll, Chariton, Christian, Clay, Clinton, Cole, Crawford, Dade, Dallas, DeKalb, Douglas, Greene, Henry, Hickory, Howard, Jackson, Jasper, Jefferson, Laclede, Lafayette, Lawrence, Lincoln, Livingston, McDonald, Madison, Maries, Miller, Mississippi, Moniteau, Montgomery, New Madrid, Pulaski, Ray, Reynolds, Ripley, St. Charles, St. Louis, St. Louis City, Saline, Scott, Stoddard, Stone, Taney, Vernon, Warren, Washington, Webster, Wright

For Provider Partners Pennsylvania Advantage and Community- Our service area includes the following counties in Pennsylvania: Allegheny, Armstrong, Beaver, Bucks, Butler, Chester, Delaware, Fayette, Greene, Lancaster, Lawrence, Mercer, Montgomery, Philadelphia, Washington, Westmoreland

For Provider Partners Texas Advantage and Community- Our service area includes the following counties in Texas: Anderson, Angelina, Bandera, Bexar, Cherokee, Concho, Delta, Denton, Ector, El Paso, Falls, Fannin, Freestone, Goliad, Gregg, Grimes, Guadalupe, Hardin, Hood, Hopkins, Howard, Jefferson, Jim Wells, Karnes, Limestone, Madison, Medina, Navarro, Orange, Palo Pinto, Refugio, Robertson, Runnels, Smith, Somervell, Titus, Trinity, Tyler, Upshur, Wise, Young

You will have to choose one of our network providers who are listed in this directory to be your Primary Care Provider (PCP). The term “PCP” will be used throughout this directory. Generally, you must get your health care services from your PCP. Provider Partners Illinois Advantage HMO I-SNP, Provider Partners Illinois Community HMO I-SNP, Provider Partners Maryland Advantage HMO I-SNP, Provider Partners Maryland Community HMO I-SNP, Provider Partners Missouri Advantage HMO I-SNP, Provider Partners Pennsylvania Advantage HMO I-SNP, Provider Partners Pennsylvania Community HMO I-SNP, Provider Partners Texas Advantage HMO I-SNP, and Provider Partners Texas Community HMO I-SNP are an Institutional Special Needs Plan (I-SNP) Health Maintenance Organization (HMO). Since we are an HMO, it is necessary for you to select a PCP to utilize while on the plan. We do not guarantee that each provider is still accepting new members.

The “network providers” listed in this directory have agreed to provide you with your health care. You may go to any of our network providers listed in this directory. If you have been going to one network provider, you are not required to continue to go to that same provider. In some cases, you may get covered services from non-network providers. If you get a bill from a non-network provider, please submit it to Provider Partners Health Plans for processing. We can help determine how much you are responsible for paying if any.

Emergency care can always be obtained in or out of the service area from the nearest available provider. When in the service area you must use plan providers for urgent care. When out of the service area, urgent care may be obtained from the first available provider. In addition, when out of the service area, you can obtain dialysis treatment from any qualified dialysis provider. You must use plan providers except in emergency or urgent care situations. If you obtain routine care from out-of-network providers neither Medicare nor Provider Partners Illinois Advantage HMO I-SNP, Provider Partners Illinois Community HMO I-SNP, Provider Partners Maryland Advantage HMO I-SNP, Provider Partners Maryland Community HMO I-SNP, Provider Partners Missouri Advantage HMO I-SNP, Provider Partners Pennsylvania Advantage HMO I-SNP, Provider Partners Pennsylvania Community HMO I-SNP, Provider Partners Texas Advantage HMO I-SNP, and Provider Partners Texas Community HMO I-SNP will be responsible for the costs.

How do you find the providers in your area?

This is a searchable online document and is updated monthly, but can change at any time. First, select the plan you are searching for. Then, select how you want to search. This can be by specialty, county, state, keyword, etc… Once you select your option, prompts will guide you to the results page.

If you have questions about any of our plans or require assistance in selecting a PCP, please call our Member Service Department at 1-800-405-9681.

We are open 8:00 A.M to 8:00 P.M., seven days a week from October 1 through March 31; 8:00 A.M. to 8:00 P.M. Monday to Friday from April 1 through September 30. TTY users should call 711. Or, visit www.pphealthplan.com.

You may request a hard-copy of Provider Partners Health Plan’s Provider Directory by calling Member Services at 800-405-9681 (TTY users call 711) 8:00 A.M. to 8:00 P.M., seven days a week from October 1 through March 31 and 8:00 A.M. to 8:00 P.M. Monday to Friday from April 1 through September 30.

You may request a hard-copy of Provider Partners Health Plan’s Provider Directory by calling Member Services at 800-405-9681 (TTY users call 711) 8:00 A.M. to 8:00 P.M., seven days a week from October 1 through March 31 and 8:00 A.M. to 8:00 P.M. Monday to Friday from April 1 through September 30.

Click here to access a printable PDF of this directory.

Click here If you would like to join our provider network
Click here if you are currently a Provider and need to update your account information .

Provider Partner Health Plans are HMO-SNPs with Medicare contracts. Enrollment in Provider Partner Health Plans depends on contract renewal. Y0135_PPHPWEB_2022