UNIVERSITY MEDICAL CENTER OF EL PASO Medical Staff Services Credentials Report. March 14, 2017

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1 I. MEDICAL STAFF INITIAL APPLICATIONS FOR APPROVAL: Practitioner Practice Type Department Salim Bharwani, MD EPCH Locum / Neonatology Jose Gutierrez Contreras, MD Contract Neurology Lisa Gutierrez Villalobos, MD TX Tech Radiology Joseph Krainin, MD Contract Neurology Vanessa Ruiz, MD Private Daniel Vande Lune, MD Private Orthopedics BOM Credentials Report Page 1 of 24

2 II. ALLIED HEALTH INITIAL STAFF APPLICATIONS FOR APPROVAL: Practitioner Practice Type Department Jaime Acosta, FNP UMC Employee Community Medicine Hilda Licon, FNP UMC Employee Community Medicine Edwin Lopez, AGACNP TX Tech Neurology Guillermina Nelson, AGACNP TX Tech Neurology Sandra Parra, FNP UMC Community Medicine BOM Credentials Report Page 2 of 24

3 III. ADVANCEMENT FROM PROVISIONAL STATUS: Practitioner Department/Category Appointment Period Zoraya M. Parrilla, MD Orthopedics/Provisional 03/14/ /28/2019 BOM Credentials Report Page 3 of 24

4 IV. MEDICAL STAFF REAPPOINTMENTS AND RENEWAL OF PRIVILEGES: Practitioner Department/Category Appointment Period Francisco Agullo, MD Surgery/Active 03/31/ /31/2019 Humera Chaudhary, MD Radiology/Active 03/31/ /31/2019 Scott Crawford, MD Emergency Medicine/Active 03/31/ /31/2019 Alison Days, MD /Associate 03/31/ /31/2019 Amanbir Dhade, MD Anesthesiology/Active 03/31/ /31/2019 Marc Ellman, MD Surgery/Associate 03/31/ /31/2019 Gilberto Gonzalez Trevizo, MD Orthopedics/Active 03/31/ /31/2019 Enrique Gonzalez, MD Community Medicine/Active 03/31/ /31/2019 David Isaac, MD /Associate 03/31/ /31/2019 Angela Jones-Allen, MD Community Medicine/Active 03/31/ /31/2019 Ian Lyn, MD Surgery/Active 03/31/ /31/2019 Rajendra Marwah, MD Internal Medicine/Courtesy 03/31/ /31/2019 Sireesha Y. Reddy, MD OB GYN/Active 03/31/ /31/2019 Steven Ross, MD Radiology/Active 03/31/ /31/2019 Eric Weber, MD Surgery/Active 03/31/ /31/2019 BOM Credentials Report Page 4 of 24

5 V. ALLIED HEALTH PROFESSIONAL REAPPOINTMENT AND RENEWAL OF PRIVILIGES: Practitioner Department Appointment Period Bindu Poudel, CNM 03/31/ /31/2019 Elizabeth Reyes, FNP Community Medicine 03/31/ /31/2019 Ruth Samble, CPNP 03/31/ /31/2019 BOM Credentials Report Page 5 of 24

6 VI. FOCUS PROFESSIONAL PRACTICE EVALUATIONS: INITIALS Practitioner Leo Altenberg, MD Hans Brockhoff, MD Lang Chhour, FNP-C Joanne Clark, FNP- Sylvia De La Rosa, FNP-C Homero Guaderrama, FNP-C David Hyde, PA-C Rakesh Khatri, MD Zachary Klett, MD Desiree Martinez, PA-C Edwin Martinez, CRNA Sanjay Misra, MD Jess Nelson, MD Erik Nordquist, MD Ruben Ramirez, MD Daniel Solomin, MD Department Community Medicine Surgery Community Medicine Community Medicine Community Medicine Community Medicine Surgery Neurology Surgery Emergency Medicine Anesthesiology Surgery Anesthesiology Emergency Medicine Internal Medicine Emergency Medicine ADDITIONAL PRIVILEGES Practitioner Procedure Department Sandeep Patel, MD Radiofrequency Ablation (RFA) Internal Medicine ISSUES None BOM Credentials Report Page 6 of 24

7 VII. ONGOING PROFESSIONAL EVALUATIONS: Practitioner Richard Arms Sushila Arya, MD Jose Aun, MD Harvey Greenberg, MD Mary Groening-Wang, DO Maria Larrazaleta, MD Sandra Lopez, MD Heidi Lyn, MD Veronica Mallett, MD Carla Martinez, MD Melissa Mendez, MD Teodoro Montoya, MD Lisa Moore, MD Sireesha Reddy, MD Carmen Rojas-Mendez, MD Salvador Saldivar, MD Michael Schaffer, MD Claudia Suarez, MD Franz Theard, MD Jose Jorge Villarreal Garcia, MD Akinjaiyeju Akintoluwa, MD Cenan Antowan, MD Maria Asiain, MD Srinivasa Badugu, MD Oscar Blanc, MD Benjamin Carcamo, MD Angelica Chavez, MD Sadhana Chheda, MD Alison Days, MD Rodolfo Fierro-Stevens, MD Blanca Garcia, MD Gilberto Gomez, MD John Guggedahl, MD Gilbert Handal, MD Elyse Hodler, PA Merle Ipson, MD David Isaac, MD Garrett Levin, MD Johanan Levine, MD Sitratullah Maiyegun, MD Jagdish Patel, MD Department BOM Credentials Report Page 7 of 24

8 Indu Pathak, MD Jesus Peinado-Fragoso, MD John Plowden, MD Carmen Prieto-Jimenez, MD Nicolas Rich, MD Michael Romano, MD Lewis Rubin, MD Hassan Salloum, MD Devaraj Sambalingam, MD Ruth Samble, CPNP Jeffrey Schuster, MD Pratibha Shirsat, MD Namrata Singh, MD Leigh Ann Torres, NNP Maria Villanos, MD Clinton Woosley, MD BOM Credentials Report Page 8 of 24

9 VIII. ADDITIONAL PRIVILEGES REQUEST: Practitioner Procedure/Privileges Department None BOM Credentials Report Page 9 of 24

10 IX. CHANGE IN CATEGORY STATUS/PRIVILEGES: Practitioner Department Reason Reo Pugao, MD Surgery Change from courtesy to provisional Anuradha Gupta, MD Internal Medicine Change from courtesy to provisional BOM Credentials Report Page 10 of 24

11 X. LEAVE OF ABSENCE/RESIGNATION/RELOCATION: Practitioner Department Reason Bankin Bhatt, MD Internal Medicine Resigned effective 2/1/2017 Ashish Loomba, MD Resigned effective 1/22/2017 David Mansfield, MD Orthopedics Reappointment not submitted (Privileges expire 03/31/2017) Neha Vashishtha, MD Resigned effective 1/22/2017 BOM Credentials Report Page 11 of 24

12 XI. SUSPENSIONS AND REINSTATEMENTS: Practitioner Department Reason XII. AUTOMATIC TERMINATION FOR EXPIRED LICENSE, INSURANCE, ETC PER BYLAWS ARTICLE VIII 8.1.6: Practitioner Department Reason None BOM Credentials Report Page 12 of 24

13 XIII. Delineation of Privileges A. Revision of the Allied Health DOP - After the BBRN meeting, the following AHP delineation of Privileges have been revised to state: For the Anesthesia CRNAs delineation of privileges will read: Perform anesthesia peri-operative assessments and document reports The following DOPs will read: Perform history & complete physicals and discharge summaries. The Supervising Physician or Clinical Chief will review, update as appropriate and co-sign history and physical exam. Internal Medicine APNs & PA Obstetrics & Gynecology APNs & PAs Obstetrics & Gynecology WHNPs, CNMs Orthopedics APNs & PAs APNs & PAs NNPs, PICU-NPs Psychiatry APNs Surgery APNs & PAs Neurosurgery APNs & PAs B. Revision of Community Medicine DOPs - Attached 1. Physician Assistant 2. Advanced Practice Nurse 3. Ambulatory 4. Sports Medicine 5. Specialists BOM Credentials Report Page 13 of 24

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