Doctor Facility Specialty

Group Hospital Laboratory Suppliers

specialty ABDOMINAL SURGERY ACUPUNCTURE ADDICTIONS & SUBSTANCE ABUSE ADOLESCENT COUNSELING (see also PSYCHOLOGICAL COUNSELING-CHILD/ADOLESCENT) ADOLESCENT MEDICINE (see also PEDIATRICS) ADOLESCENT SUBSTANCE ABUSE ADULT BOWEL TRANSPLANT (see Transplant Surgery) ADULT HEALTH ADULT KIDNEY TRANSPLANT (see Transplant Surgery) ADULT LIVER TRANSPLANT (see Transplant Surgery) ADULT/ADOLESCENT PSYCHIATRIC FACILITY ALCOHOL/CHEMICAL DEPENDENCY REHAB-ADULT & ADOLESCENT ALCOHOL/CHEMICAL DEPENDENCY-ADULT ALLERGY ASTHMA & IMMUNOLOGY AMBULANCE/AMBULETTE AMBULATORY CARDIAC MONITORING AMBULATORY SURGERY CENTER ANATOMIC & CLINICAL PATHOLOGY ANATOMIC PATHOLOGY – (OUTPATIENT) ANATOMIC PATHOLOGY/CYTOPATHOLOGY ANESTHESIOLOGY ANESTHESIOLOGY & PAIN MGT ANESTHESIOLOGY/CRITICAL CARE ANTICOAGULATION MANAGEMENT AUDIOLOGY AUDIOLOGY & HEARING AIDS DME AUTISM BARIATRIC MEDICINE BARIATRIC SURGERY (see Surgery - Bariatric BEHAVIORAL THERAPIES TO DEVEL DISABLED BEHAVIORAL/ DEVELOPMENTAL PEDIATRICS BEREAVEMENT COUNSELING BIRTHING CENTER BLOOD BANK TRANSFUSIONS BONE DENSITY TESTING BONE GROWTH STIMULATORS BONE MARROW TRANSPLANTS BREAST CENTERS BREAST IMAGING BURNS & CRITICAL CARE CARDIAC MONITORING CARDIAC REHABILITATION CARDIO/THORACIC SURGERY CARDIOLOGY DIAGNOSTICS CARDIOLOGY/EKG CARDIO-THORACIC SURGERY CARDIOVASCULAR DISEASES CERTIFIED SOCIAL WORKER CHEMOTHERAPY CHILD PSYCHIATRY (see PSYCHIATRY-CHILD) CHILD PSYCHOLOGY (see PSYCHOLOGICAL COUNSELING-CHILD) CHILD/ADOLESCENT PSYCH FACILITY/HOSPITAL CHIROPRACTIC NEUROLOGY CHIROPRACTOR CLINICAL IMMUNOLOGY CLINICAL PSYCHOLOGY (see PSYCHOLOGICAL COUNSELING) COGNITIVE BEHAVIORAL THERAPY CORNEA AND EXTERNAL EYE DISEASE CRITICAL CARE CT SCAN SINUS ONLY CT SCANS CYSTIC FIBROSIS CYTOPATHOLOGY DENTAL - T.M.J. DENTAL ANESTHESIOLOGY & PAIN MGT DENTISTRY-GENERAL DENTISTRY-PEDIATRIC DERMATOLOGY DERMATOPATHOLOGY DETOX DEVELOPMENTAL/BEHAVIORAL PSYCHOLOGY DIABETES (SEE ALSO ENDOCRINOLOGY) DIABETES EDUCATOR DIABETIC SUPPLIES DIAGNOSTIC IMAGING (SEE RADIOLOGY) DIAGNOSTIC RADIOLOGY (see RADIOLOGY) DIALECTICAL BEHAVIOR THERAPY DIALYSIS-INPATIENT DIALYSIS-OUTPATIENT DIETICIAN (SEE NUTRITIONIST) DME-RESPIRATORY SUPPLIES DRUG TESTING/TOXICOLOGY DUAL DIAGNOSIS FACILITY/HOSPITAL DURABLE MEDICAL EQUIPMENT EAR, NOSE & THROAT (SEE OTOLARYNGOLOGY) EATING DISORDERS EEG & EKG ELECTROPHYSIOLOGY & ARRHYTHMIA EMERGENCY MEDICINE/CRITICAL CARE ENDOCRINOLOGY & METABOLISM ENDOCRINOLOGY-REPRODUCTIVE ENDODONTIST ENDOSCOPY FAMILY PRACTICE MEDICINE GASTROENTEROLOGY GENERAL PRACTICE MEDICINE GENETICS GERIATRIC MEDICINE GYNECOLOGIC ONCOLOGY GYNECOLOGY - NO OBSTETRICS GYNECOLOGY & OBSTETRICS HAND THERAPY HEAD & NECK SURGERY (SEE OTOLARYNGOLOGY) HEARING AIDS HEMATOLOGY & ONCOLOGY HEMATOLOGY (SEE ALSO ONCOLOGY) HEMOPHILIA HEPATOLOGY HOME HEALTH CARE/ HOME INFUSION HOME HEALTH CARE-NURSING HOME INFUSION SERVICES HOSPICE HOSPICE & PALLIATIVE MEDICINE HOSPITALIST (IN HOSPITAL ONLY) HOSPITALIST- NURSE PRACTITIONER HOSPITALIST -PEDIATRIC NEUROLOGY HOSPITALIST- PEDIATRICS NURSE PRACTIONER HOSPITALIST- PHYSICIAN ASSISTANT HOSPITALIST-CARDIOLOGY HOSPITALIST-CHILD PSYCHIATRY HOSPITALIST-CRITICAL CARE HOSPITALIST-EMERGENCY & CRITICAL CARE HOSPITALIST-ENDOCRINOLOGY HOSPITALIST-FAMILY PRACTICE MEDICINE HOSPITALIST-GASTROENTEROLOGY HOSPITALIST-HEMATOLOGY/ONCOLOGY HOSPITALIST-INFECTIOUS DISEASES HOSPITALIST-INTERNAL MEDICINE HOSPITALIST-NEONATOLOGY/PEDIATRICS HOSPITALIST-NEPHROLOGY HOSPITALIST-NEUROLOGY HOSPITALIST-OPHTHALMOLOGY HOSPITALIST-PEDIATRIC CARDIOLOGY HOSPITALIST-PEDIATRIC CRITICAL CARE HOSPITALIST-PEDIATRIC EMERGENCY MEDICINE HOSPITALIST-PEDIATRIC HEMATOLOGY/ONCOLOGY HOSPITALIST-PEDIATRIC INFECTIOUS DISEASE HOSPITALIST-PEDIATRICS HOSPITALIST-PSYCHIATRY HOSPITALIST-PSYCHOLOGY HOSPITALIST-PULMONARY & CRITICAL CARE HOSPITALIST-PULMONARY MEDICINE HOSPITALIST-RADIATION ONCOLOGY HOSPITAL-PARTICIPATING (TRPN) HOSPITALS PARTICIPATING HYPERBARIC MEDICINE HYPERTENSION IMMEDIATE MEDICAL CARE IN HOME SERVICE INCONTINENCE THERAPY INFECTIOUS DISEASES INFERTILITY INTENSIVIST INTERNAL MEDICINE INTERNAL MEDICINE/CARDIOLOGY INTERNAL MEDICINE/ENDOCRINOLOGY INTERNAL MEDICINE/GASTROENTEROLOGY INTERNAL MEDICINE/GERIATRICS INTERNAL MEDICINE/INFECTIOUS DISEASE INTERNAL MEDICINE/NEPHROLOGY INTERNAL MEDICINE/ONCOLOGY INTERNAL MEDICINE/PEDIATRICS INTERNAL MEDICINE/PULMONARY MEDICINE INTERVENTIONAL CARDIOLOGY IV THERAPY LABORATORIES LANGUAGE & SPEECH THERAPY LAPARSOCOPIC SURGERY LITHOTRIPSY-ESWL LYMPHEDEMA LYMPHEDEMA THERAPY MAMMOGRAPHY (SEE RADIOLOGY) MASTECTOMY PROSTHESES MATERNAL – FETAL MEDICINE MEDICAL GENETICS MEDICAL ONCOLOGY MENTAL HEALTH COUNSELOR - SEE PSYCHOLOGICAL COUNSELING METHADONE MAINTENANCE/BUPRENORPHINE MIDWIFE MOHS SURGERY & RECONSTRUCTION MRI (SEE ALSO RADIOLOGY) MULTI-SPECIALTY NEONATOLOGY NEPHROLOGY NERVE OPHTHALMOLOGY NEUROANESTHESIOLOGY NEUROLOGICAL COMMUNICATION DISORDERS NEUROLOGY NEUROLOGY - PEDIATRIC NEUROLOGY & EMG NEURO-OPHTHALMOLOGY NEUROPATHOLOGY NEUROPHYSIOLOGY/NEUROMUSCULAR NEUROPSYCHIATRY NEUROPSYCHOLOGICAL TESTING NEUROPSYCHOLOGY NEURORADIOLOGY NEUROSURGERY NON-INVASIVE VASCULAR LAB NUCLEAR CARDIOLOGY NUCLEAR MEDICINE NUCLEAR SPECTRAL IMAGING NURSE PRACTITIONER NUTRITIONIST OBSTETRICS & GYNECOLOGY (see GYNECOLOGY & OBSTETRICS) OCCUPATIONAL MEDICINE OCCUPATIONAL THERAPY OCULAR PLASTIC & RECONSTRUCTIVE SURGERY OCULAR PROSTHESES ONCOLOGY (SEE ALSO HEMATOLOGY) ONCOLOGY/HEMATOLOGY OPEN MRI OPHTHALMIC MICROSURGERY OPHTHALMIC PLASTIC & RECONSTRUCTIVE SURGERY OPHTHALMOLOGY-CORNEAL & EXTERNAL DISEASES OPHTHALMOLOGY-FACIAL & OCULOPLASTICS OPHTHALMOLOGY-GENERAL OPHTHALMOLOGY-RETINAL & VITREORETINAL DISORDERS OPTOMETRY ORAL & MAXILLOFACIAL SURGERY ORAL SURGEON ORTHOPAEDICS-HAND SPECIALTY ORTHOPEDICS & ORTHOPEDIC SURGERY ORTHOPEDICS/SPORTS MEDICINE ORTHOTICS & PROSTHETICS OSTEOPATHIC MEDICINE OSTEOPATHY / PEDIATRICS OTOLARYNGOLOGY (EAR, NOSE & THROAT) OTOLARYNGOLOGY-HEAD & NECK SURGERY OUTPATIENT SURGERY CENTER (see AMBULATORY SURGERY CENTER) OXYGEN & OXYGEN SYSTEMS (SEE RESPIRATORY EQUIPMENT) P.E.T. SCANS PAIN MANAGEMENT PALLIATIVE CARE PATHOLOGY PEDIATRIC A.D.D.-CLINIC PEDIATRIC ALLERGY, ASTHMA & IMMUNOLOGY PEDIATRIC BEHAVIORAL MEDICINE PEDIATRIC CARDIOLOGY PEDIATRIC CARDIOTHORACIC SURGERY PEDIATRIC CRITICAL CARE PEDIATRIC DENTIST PEDIATRIC DERMATOLOGY PEDIATRIC DEVELOPMENTAL/BEHAVIORAL PSYCHOLOGY PEDIATRIC EMERGENCY CARE PEDIATRIC EMERGENCY MEDICINE PEDIATRIC ENDOCRINOLOGY PEDIATRIC GASTROENTEROLOGY PEDIATRIC HEMATOLOGY & ONCOLOGY PEDIATRIC INFECTIOUS DISEASES PEDIATRIC INTENSIVE CARE (PICU) PEDIATRIC INTESTINAL TRANSPLANT PEDIATRIC KIDNEY TRANSPLANT PEDIATRIC LABORATORY PEDIATRIC LIVER TRANSPLANT PEDIATRIC MEDICAL GENETICS PEDIATRIC NEPHROLOGY PEDIATRIC NEUROLOGY PEDIATRIC NEUROSURGERY PEDIATRIC NURSE PRACTITIONER PEDIATRIC NUTRITION PEDIATRIC NUTRITIONIST/DIETICIAN PEDIATRIC OCCUPATION/PHYSICAL THERAPY PEDIATRIC OCCUPATIONAL THERAPY PEDIATRIC OPHTHALMOLOGY PEDIATRIC OPTOMETRY PEDIATRIC ORTHOPEDIC SURGERY PEDIATRIC ORTHOPEDICS PEDIATRIC OTOLARYNGOLOGY PEDIATRIC PATHOLOGY PEDIATRIC PHYSICAL THERAPY PEDIATRIC PODIATRY PEDIATRIC PREVENTIVE MEDICINE PEDIATRIC PSYCHIATRY (see PSYCHIATRY-CHILD) PEDIATRIC PSYCHOLOGY (see PSYCHOLOGICAL COUNSELING-CHILD) PEDIATRIC PULMONARY MEDICINE PEDIATRIC RADIOLOGY PEDIATRIC RHEUMATOLOGY PEDIATRIC SPEECH THERAPY PEDIATRIC SPORTS MEDICINE PEDIATRIC SURGERY PEDIATRIC URGENT CARE PEDIATRIC URGENT CARE CENTER PEDIATRIC UROLOGY PEDIATRICS AND ADOLESCENT MEDICINE PEDIATRICS/PEDIATRIC MEDICINE PEDIATRICS-DEVELOPMENTAL PELVIC SURGERY PERINATAL SERVICES PERIODONTIST PHYS THERAPY-MYOFASCIAL RELEASE PHYSICAL MEDICINE & REHABILITATION PHYSICAL THERAPY PHYSICAL THERAPY-NEURO & TBI PHYSICIANS ASSISTANT PLAY THERAPY/BEHAVIORAL INTERVENTION PODIATRIC PATHOLOGY PODIATRIC WOUND CARE PODIATRY/PODIATRIC SURGERY POLYSOMOGRAPHY PRENATAL SCREENING PREVENTATIVE MEDICINE PRIMARY CARE PROSTHODONTIST PSYCH COUNSELING-CHILD/ADOLESCENT WITH DISABILITIES PSYCHIATRIC FACILITY/HOSPITAL PSYCHIATRY PSYCHIATRY-ADULT PSYCHIATRY-ADULT & ADOLESCENT PSYCHIATRY-ADULT & GERIATRIC PSYCHIATRY-CHILD PSYCHIATRY-CHILD OR ADULT PSYCHIATRY-CHILD/ADOLESCENT PSYCHOLOGICAL COUNSELING-CHILD PSYCHOLOGICAL COUNSELING-CHILD/ADOLESCENT PSYCHOLOGICAL COUNSELING-GENERAL PSYCHOLOGICAL COUNSELING-PEDIATRIC PSYCHOLOGICAL COUNSELING-SUBSTANCE ABUSE PSYCHOTHERAPY/HYPNOTHERAPY PULMONARY & CRITICAL CARE MEDICINE PULMONARY MEDICINE PULMONARY REHAB PULMONARY/CRITICAL CARE/ SLEEP DISORDERS RADIATION ONCOLOGY RADIOLOGY (MRI, XRAY, MAMMOGRAPHY, ULTRASOUND, CT SCAN, ETC) REGISTERED NURSE REHABILITATION REHABILITATION & NURSING RESPIRATORY EQUIPMENT & OXYGEN RESPIRATORY THERAPY RHEUMATOLOGY SKILLED NURSING FACILITY SLEEP DISORDERS SONOGRAMS-OB/GYN SPEECH & LANGUAGE THERAPY/PATHOLOGY SPORTS MEDICINE STAND-UP MRI STEREOTACTIC BREAST BIOPSIES SUB-ACUTE DETOX SUBSTANCE ABUSE - INPATIENT SUBSTANCE ABUSE - OUTPATIENT CENTERS SUBSTANCE ABUSE/ADOLESCENTS SUBSTANCE ABUSE-SEXUAL ABUSE/GAY ISSUES SUPPLIER SURGERY - AMBULATORY SURGERY - BARIATRIC SURGERY - GENERAL & VASCULAR SURGERY - ORTHOPAEDIC SURGERY - SURGICAL ONCOLOGY SURGERY- BREAST SURGERY- CARDIOVASCULAR & THORACIC SURGERY- COLORECTAL SURGERY- GENERAL SURGERY- HAND RECONSTRUCTION SURGERY- OTOLARYNGOLOGY SURGERY- PLASTIC & RECONSTRUCTIVE SURGERY/FIRST ASSISTANT SURGERY/GENERAL LAPAROSCOPIC & SCLERO SURGERY/VASCULAR/LAPAROSCOPIC SURGERY-CRITICAL CARE SURGERY-GENERAL & BREAST SURGERY-SPINE SURGERY-VASCULAR SURGICAL ONCOLOGY SWALLOWING DISORDER TMJ/TEMPEROMANDIBULAR JOINT DISORDERS TRANSPLANT SURGERY TRAUMA CENTER TRAUMA SURG-ORTHOPAEDICS TRAUMATIC SURGICAL SERVICES ULTRASOUND CENTER FOR OBSTETRICS URGENT CARE UROGYNECOLOGY UROLOGIC CATHETERS UROLOGIC ONCOLOGY UROLOGICAL DIAGNOSTICS-LAB-PATHOLOGY UROLOGY & UROLOGIC SURGERY VASCULAR LABORATORY VEIN SCLEROTHERAPY WIGS/HAIR PROSTHESES AFTER CHEMOTHERAPY WOMEN’S PSYCHIATRIC FACILITY WOMEN’S SUBSTANCE ABUSE FACILITY WOMEN'S HEALTH SUPPLIES (SEE ALSO MASTECTOMY PROSTHESES) WOUND CARE

state AK AL AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY

-or-     within 5 miles within 10 miles within 15 miles within 30 miles within 60 miles within 100 miles within 200 miles

General Information
File Name	File Size
Sample Explanation of Benefits Form	553 KB
H.I.P.P.A. Privacy Policy	764 KB
Island Group Injury Form	123 KB
Student Verification Form	586 KB
Injury/Accident Report	1534 KB
Lein Agreement	633 KB
Authorization for Release of Informaion - H.I.P.P.A.	669 KB

Claim Forms
File Name	File Size
Dental Claim Form	1254 KB
Vision Claim Form	820 KB
Island 65 Claim Form	572 KB
Medical Claim Form	804 KB

Applications
File Name	File Size
Participating Provider Network Application	56 KB
Provider Request Form	286 KB

Clients
File Name	File Size

Co-Payment Information
File Name	File Size
Co-Pay Sheet 2012	527 KB

Providers
File Name	File Size
Initial Mental Health Treatment Report	572 KB
Mental Health Treatment Report	1033 KB