The Medical Home Approach

Lamprey Health Care’s team approach to your care is based on the Medical Home model. The Medical Home approach to health care is designed to transform primary care into “what patients want it to be.”  Lamprey Health Care is recognized as a level III Patient Centered Medical Home through the National Association of Quality Assurance.  This is the highest level possible. But what exactly does this mean?

Patient Centered Medical Home
A Patient Centered Medical Home is a medical office where a team of health care providers work together to provide care for patients. In addition to Physicians, this team can include professionals such as Nurse Practitioners, Physician Assistants, Nurse Educators, Care Coordinators, Social Workers, Registered Dieticians and Behavioral Health Counselors. The team works together to:

  • Provide access to care 24 hours a day / 7 days a week. At Lamprey Health Care we are open evenings and weekends, all so we can be there when you need us. When our office is closed, patients have access to an after hours call service.
  • Know your personal health history and family situation. This information allows providers to suggest treatment options and lifestyle changes that will make the most sense for each patient.
  • Educate you about your health conditions and how you can be an active member of your health care team. By understanding all you can about your health, we empower patients to take control of their health.
  • Coordinate your health services. We will help you find specialists, assist with appointments, and make sure specialists participating in your health care have all the information they need.

All About You

Providing care for YOU is the most important job of a Medical Home. The care provided in a Medical Home is personal and the team’s goal is to make sure you receive the health care you need.  You are also an important member of the team. Patients are encouraged to actively participate in their care. What can you do to get the most out of your health care?

  • Learn about preventive care for yourself.
  • Learn about your condition, what you can do to manage it and stay as healthy as possible.
  • As best as you can, follow the plan that you and your team have agreed upon.
  • Bring a list of questions to each of your appointments.
  • Bring a list of medications, vitamins and remedies you use to each of your appointments.
  • Always tell your team if you don’t understand something they said.
  • Let your team know if you are receiving any care from other professionals.
  • Talk openly with your team about your experiences.
  • If you have any questions, ask!

A Leader in the State

Lamprey Health Care is proud to have been part of the pilot program for Patient Centered Medical Homes in New Hampshire. The video below gives an overview of the beginning of this approach to care in our state. For additional information on Patient Centered Medical Homes, please visit the American College of Physicians or the National Committee for Quality Assurance.

Nashua Providers

VNagaraj FINAL WEB 2015
Vasuki Nagaraj, MD, MPH, FAAFP – Chief Medical Officer/Medical Director and Family Physician

Dr. Nagaraj joined Lamprey Health Care in 2008, and currently serves as the Medical Director for the Nashua Center. He received his MD from J.J.M. Medical College in Davangere in 2001 and completed his M.P.H. degree from Texas A&M University in College Station, TX in 2003. He completed his residency at Central Maine Medical Center in Lewiston, ME. Dr. Nagaraj’s areas of clinical interest include chronic disease management and pediatrics. “I enjoy providing the best care possible to my patients and their families, keeping their cultural sensitivities and beliefs at the center of their care.” Dr. Nagaraj speaks Hindi and Kannada.
IN MY FREE TIME: “I have made my home with my family in Nashua, since 2008. I am an avid tennis player and love playing cricket, an Indian sport much like baseball.”

 

 

 DDeifik FINAL WEB 2015
David Deifik, MD FACOG – OB/GYN

Dr. Deifik joined Lamprey Health Care as a part time OB/GYN Physician in 2015. He graduated from Baylor College of Medicine in Houston, TX in 1976 and completed specialty training in Obstetrics and Gynecology at the Brown University affiliated hospitals in 1980. Dr. Deifik’s areas of interest are normal obstetrics and well woman care. “I enjoy helping guide moms in having the happiest and healthiest pregnancy possible.”
FAVORITE HOBBY: “Cycling, when there isn’t four feet of snow on the ground.”

 

 

 

 

Photo Currently Not Available
 Ryan Gilbert, MS, ACNP, FNP – Family Nurse Practitioner

Mr. Gilbert joined Lamprey Health Care in 2015 as a Board Certified Nurse Practitioner in Acute Care and Family Medicine.received his Master’s in Nurse Practitioner from the University of Massachusetts Graduate School of Nursing in Worcester and his Post-Master’s Certificate from the University of Massachusetts Boston.. Gilbert also holds a Master’s degree in Biomedical Engineering for Virology, a Master’s in Regional Economic and Social Development, and a Bachelor’s degree in Business Management.clinical areas of interest include pediatrics, neuromuscular disorders, diabetes and cardiology in high-risk settings.
IN MY FREE TIME: I enjoy studying foreign languages including Arabic, Portuguese and Spanish. Along with my wife I run a nationwide non-profit, working in schools with high-risk youth to counter gang violence, drugs and bullying using martial arts and physical fitness programs.

BLanga FINAL WEB 2015 
 Bridget Langa, APRN – Family Nurse Practitioner

Ms. Langa joined Lamprey Health Care as a Family Nurse Practitioner in 2012. She received her Master of Science degree in Nursing from the University of Massachusetts in Lowell and completed her undergraduate degrees at Rivier University in Nashua, NH. She began working in the health care field over 20 years ago. Ms. Langa enjoys seeing patients of all ages and multiple generations within each family. Her areas of interest include asthma management, pediatrics, women’s health, and prenatal care.
IN MY FREE TIME: “I enjoy reading, walks on the beach, and time with family.”

 

 

 

KMcA'nulty FINAL WEB 2015
 Kaleigh McA’Nulty, PA-C – Physician Assistant

Ms. McA’Nulty joined Lamprey Health Care as a Physician Assistant in 2015. She received her Master of Physician Assistant Studies degree from the Massachusetts College of Pharmacy and Health Sciences in Manchester, NH. Her areas of interest include chronic disease management, behavioral health, and women’s health. “I enjoy getting to know my patients and their families. As a primary care provider, I feel that my job is done if my patients see me as both an ally and a resource in their journey to better health.”

 

 

 

 

 

Anjana Neupaney, MD – Pediatrician

Dr. Neupaney joined Lamprey Health Care in 2014. She is a graduate of Manipal College of Medical Sciences in Nepal and completed her Residency in Pediatrics at Western Michigan University School of Medicine in Kalamazoo, MI. Dr. Neupaney is a Board Certified Pediatrician with her clinical area of interest in the well-being of children within the community. She also speaks Hindi and Nepali.

 

 

 

 

 

Melba Quitayen 
Melba Quitayen, PA-C – Physician Assistant

Ms. Quitayen joined Lamprey Health Care in 2014. She completed her Master’s of Physician Assistant studies from the Massachusetts College of Pharmacy and Health Science with a B.S. in Clinical Laboratory Science. Her area of clinical interest is preventative medicine. “What I enjoy most about being a health care provider is the privilege of earning a patient’s trust, along with the life lessons they impart when they battle with medical conditions.”
IN MY FREE TIME: “I love dogs, gardening and dream of a society where we have time to grow our own produce from the backyard.”

 

 

 

 

mramos-2016-cropped

Marie-Elizabeth Ramas, MD – Family Physician

Dr. Ramas joined Lamprey Health Care in 2016. She completed her undergraduate degree at Washington University in St. Louis, MO and received her Doctor of Medicine degree from Case Western Reserve University in Cleveland, OH. She completed her residency at Lonestar Family Medicine in Conroe, TX. Dr. Ramas enjoys providing a full scope of care from cradle to adult. “I enjoy being an advocate for the families I serve.” Dr.  Ramas speaks Spanish, French and Haitian Creole.
IN MY FREE TIME: “I enjoy the outdoors and spending time with my husband and three children. I also love being a leader within the American Academy of Family Physicians.”

 

 

 

Nashua Residency Program

In the Nashua Center, we house a division of the Dartmouth OB/GYN Residency Program. The Residency Program provides OB rotations for family practice residents from Dartmouth Maine and Dartmouth New Hampshire Family Practice Residency programs.

 

Newmarket Providers

 

Sarah Oxnard, MD – Medical Director and Pediatrician

“What I enjoy most about being a health care provider is watching my patients grow and blossom over time.” say Dr. Oxnard. She joined Lamprey Health Care in 1976 as a pediatrician and has helped thousands of patients do just that. Her clinical interests include pediatric development, behavioral health, and ADHD. Dr. Oxnard received a B.A. from Vassar College and her M.D. from the University of Rochester Medical School. She completed her Pediatric Residency and Pediatric Cardiology Fellowship at the University of Utah Medical Center in Salt Lake City.
IN MY FREE TIME: “I spend time with my husband Tom Oxnard, my 4 adult children and 5 grandchildren, in addition to riding and breeding Connemara ponies.”

 

 

 

 

KBergeron FINAL WEB 2015

Katrin Bergeron, MD – Family Physician

Dr. Bergeron joined Lamprey Health Care in 2007as a Board Certified Family Physician. She is a graduate of Brown Medical School and completed her Family Medicine residency at Maine Medical Center in Portland, Maine. Her areas of clinical interest included obstetrics and pediatrics. Dr. Bergeron is Board Certified in Integrative and Holistic Medicine. “I enjoy helping patients make positive changes in order to lead healthier lives.” Dr. Bergeron is interested in how emotional and spiritual health impacts our physical well being.
IN MY FREE TIME: “You can find me raising my four children or running with my husband.”

 

 

 

Anna Brand, MSN, FNP-C, APRN

Ms. Brand joined Lamprey Health Care in 2017 as a nationally certified Family Nurse Practitioner. She received her undergraduate degree from the University Connecticut and her Masters of Science in Nursing from Simmons College. Ms. Brand’s areas of clinical interest include adolescent and young adult health, and diabetes management. “I feel a duty to educate my patients so I can become a partner in their healthcare; and they can become an advocate for their own well being.”
IN MY FREE TIME: “I enjoy exploring New England’s woods and waterways with my husband and dog.”

 

 

Mary Braun, MD, Family Physician 

Mary Braun, MD – Primary Care Physician

Dr. Braun joined Lamprey Health Care in 2017 as a Board Certified Internal Medicine doctor. She also has a speciality level qualification in Hospice and Palliative Medicine. She received her degree from the University of Minnesota and completed her residency at Hennepin County Medical Center in Minneapolis, MN. “I love getting to know my patients as people and helping them make decisions that are right for them based on their individual values and preferences in the context of their families and physical health.” Her areas of clinical interest include palliative care, chronic disease management, complex medical patients and hospice.

IN MY FREE TIME: “I enjoy hiking and cross country skiing as well as being with my family, including my dog. I am interested in philosophy and have written on Stoicism and Mindfulness. I have also spoken publicly on aspects of palliative care as well as what I’ve learned about being a doctor from being a patient.”

 

Heidi Crusberg, MD – Family Physician

Dr. Crusberg joined Lamprey Health Care in 1998 as a Board Certified Family Physician. After graduating from Vanderbilt University, she attended The Johns Hopkins School of Medicine where she received her M.D. She completed her family practice residency at The University of Colorado Health Sciences in Lafayette, CO. Dr. Crusberg’s areas of clinical interest include supporting and educating patients on healthy lifestyle choices and chronic disease management. Dr. Crusberg also speaks Spanish.

 

 

 

 

 

Cora Donahue, MS, APRN – Family Nurse Practitioner

Mrs. Donahue joined Lamprey Health Care in 2014 as a Family Nurse Practitioner, after completing a M.S. in Nursing from the University of New Hampshire and a B.S. in Nursing from the University of Southern Maine. Mrs. Donahue has a passion for getting kids moving. Her clinical area of interest is childhood obesity and she is a strong advocate of healthy eating and exercise. “I love helping patients meet their health goals! Preventative practice helps patients feel great and live longer, healthier lives.” In her free time she is an avid runner, and proud wife and mother of two active children.
DID YOU KNOW? Mrs. Donahue was inducted into the Hall of Fame for soccer at the University of Southern Maine.

 

 

 

Paul Friedrichs, MD – Family Physician

Dr. Friedrichs joined Lamprey Health Care in 1986 as a Board Certified Family Physician. He is a graduate of Yale University and the University of Pennsylvania Medical School, and completed his Family Practice Residency at Brown University. Dr. Friedrichs’ clinical interests include obstetrics, pediatrics, geriatrics, hospital medicine, diabetes and cholesterol management, and preventative medicine. Dr. Friedrichs’ practice has limited new patient openings.
DID YOU KNOW? In 2007 Dr. Friedrichs was named the New Hampshire Family Physician of the Year by the New Hampshire Academy of Family Practice and in 2015 he published his first book of poetry, “Facing the Elements”.

 

 

 

 

  

Susan Nichols, PA-C – Physician Assistant

Ms. Nichols joined Lamprey Health Care in 2006. as a Physician Assistant. She received her Bachelor in Public Health from the University of Massachusetts, and her Physician Assistant Certificate from Northeastern University in Boston, MA. Ms. Nichols is proficient in Spanish and her areas of clinical interest are pediatrics, diabetes and women’s health. “I enjoy empowering my patients and teaching them how to use physical activity as a means to longevity.”
IN MY FREE TIME: “You can find me biking, skiing or enjoying the company of my two amazing daughters.”

 

 

 

 

Sirona Pruna, MD, FACOG – OB/GYN

Dr. Pruna joined Lamprey Health Care in 2006 as a Board Certified OB/GYN. She graduated from the University of Medicine Timisoara, Romania and completed her residency programs at University of Medicine Carol Davilla Obstetrics and Gynecology in Romania and the University of South Alabama, Obstetrics and Gynecology in Mobile, AL. She spent over 15 years practicing in Romania and speaks Romanian and French. Dr. Pruna’s clinical interests include Obstetrical Care, including high risk patients and working with patients with endometriosis, polycystic ovary syndrome, pelvic prolapse repair and urinary incontinence procedures.

 

 

 

Raymond Providers

Ana Goubert, MD – Associate Medical Director and Family Physician

Dr. Goubert joined Lamprey Health Care in 2013 as a Family Physician. She completed her undergraduate and graduate degrees from Boston University and attended the University at Buffalo School of Medicine and Biochemical Sciences. She completed her family practice residency at the UMASS Worcester Family Medicine Residency Program. Her areas of interest are women’s health, newborn care and community health.

 

 

 

 

 

 

Kristy Blundell, APRN – Family Nurse Practitioner

Ms. Blundell joined Lamprey Health Care in 2016 as a licensed Family Nurse Practitioner. She received undergraduate degrees from the University Massachusetts and Saint Elizabeth Medical Center School of Nursing. She received her Masters of Science in Nursing from Rivier University. Ms. Blundell’s areas of clinical interest are diabetes management and palliative care.

 

 

 

 

 

Kate Bonafede, MD – Family Physician

Dr. Bonafede joined Lamprey Health Care in 2011 as a Board-Certified Physician, after completing her family practice residency at Greater Lawrence Family Health Center. She graduated from the University of Rochester with a dual major in Biology and Environmental Science and attended Dartmouth Medical School in Hanover, NH. Dr. Bonafede is fluent in Spanish and has some knowledge of French and American Sign Language.

 

 

 

 

 

 

Jeremy James, MD – Family Physician

Dr. James joined Lamprey Health Care in 1996 as a Family Physician. After graduating from Stanford University, he attended the University of Washington School of Medicine and completed his Family Medicine Residency at the University of Rochester. Prior to his arrival at Lamprey Health Care, he practiced in New Mexico for two years and then completed a fellowship at SeaMar Community Health Center in Seattle, WA. Dr. James’ clinical specialty interests include the care of newborns and children as well as the elderly and end of life care. In 2012 Dr. James and his wife Dr. Zachos shared the Outstanding Clinician Award from Bi-State Primary Care Association, recognizing their contributions to clinical primary care services in the NH/VT region.

 

 

 

Mary Ann Johnson, APRN – Family Nurse Practitioner

Ms. Johnson has been a nurse practitioner at Lamprey Health Care since 1989. She is a graduate of the University of Massachusetts and the Family Nurse Practitioner program at the University of Southern Maine. Prior to joining Lamprey Health Care, she worked as a nurse practitioner in the Seacoast Area since 1978. Her clinical interests are pediatrics, adolescents, and women’s health.

 

 

 

 

Sirona Pruna, MD, FACOG – OB/GYN

Dr. Pruna joined Lamprey Health Care in 2006 as a Board Certified OB/GYN. She graduated from the University of Medicine Timisoara, Romania and completed her residency programs at University of Medicine Carol Davilla Obstetrics and Gynecology in Romania and the University of South Alabama, Obstetrics and Gynecology in Mobile, AL. She spent over 15 years practicing in Romania and speaks Romanian and French. Dr. Pruna’s clinical interests include Obstetrical Care, including high risk patients and working with patients with endometriosis, polycystic ovary syndrome, pelvic prolapse repair and urinary incontinence procedures.

 

 

 

Rosemary Smith, APRN – Family Nurse Practitioner

Ms. Smith joined Lamprey Health Care in 1999. She received her Master of Science in Nursing degree from The Pennsylvania State University and is certified as a Family Nurse Practitioner. She spent 19 years in clinical practices in Dover, NH, working in internal medicine, endocrinology, and gastroenterology. Prior to returning to New Hampshire, she served as faculty for the Women’s Health Nurse Practitioner Program in Milwaukee, WI and taught at the University of New Hampshire and Pennsylvania State University.

 

 

 

 

Sarah Zachos, MD – Family Physician

Dr. Zachos joined Lamprey Health Care in 1996 as a Family Physician. She attended the University of Pennsylvania School of Medicine and completed a Family Practice Residency at the University of Rochester in Rochester, NY. After practicing in New Mexico for two years, she spent a year doing a Rural Medicine Fellowship in Tacoma, WA.  Her clinical interests are obstetrics, women’s health care, and pediatrics. In 2012 Dr. Zachos and her husband Dr. James shared the Outstanding Clinician Award from Bi-State Primary Care Association, recognizing their contributions to clinical primary care services in the NH/VT region.

 

 

 

Behavioral Health Providers

 

John LeBow, MSW, LICSW, MLADC – Nashua Center

Mr. LeBow joined Lamprey Health Care as a Licensed Clinical Social Worker in 2016. He received his Bachelor of Arts from SUNY at Cortland and completed the Master of Social Work program from Boston University. He has also studied at Heidelberg and Tubingen in Germany. Mr. LeBow’s areas of clinical interest include addiction treatment, trauma therapy and treating people with anxiety and depression. “I enjoy being a part of people making positive changes in their lives as both a witness and a supporter.”
IN MY FREE TIME: “I love literature, poetry, book collecting and publishing. For about 25 years I spent a significant amount of my spare time buying and selling rare books and materials, including working with University libraries to place and find important material.

 

  

Mark Phillips, MSW, LICSW – Nashua and Raymond Centers

Mr. Phillips joined Lamprey Health Care in 2015. He received his Bachelor of Arts in Psychology from Rivier University, in Nashua, NH and his Master’s in Clinical Social Work from Boston College in Chestnut Hill, MA. Mr. Phillips has counseled many different populations over his 30 year career and enjoys working with children, adolescents and adults.
WHAT I ENJOY MOST ABOUT MY JOB: “I enjoy doing speaking engagements on many different behavioral health issues and love working with families to help their children reach their maximum potential. I also love animals and have 2  Llasho Apso’s.”

 

 

 

 

Understanding Provider Credentials

Family Physicians

Family physicians serve as primary care physicians, providing comprehensive and preventive medical care for all ages and body systems. All of our physicians are Board Certified. Family doctors take care of the physical, mental and emotional health of both their patients and their patients’ families. Family doctors are trained in all areas of medicine, from childbirth to adulthood. They diagnose, treat and help you manage your health and wellbeing.

OB/GYN

An obstetrician/gynecologist is a physician who provides medical and surgical care to women, with particular expertise in pregnancy, childbirth, and disorders of the reproductive system. All of our Health Centers have access to an on-site OB/GYN who works very closely with our family physicians, nurse practitioners and medical assistants. Along with our family physicians and midwives, our OB/GYNs provide comprehensive women’s health care for all female patients, including high-risk pregnancies and women needing specialized care. They focus on women-specific health care, such as sexual and reproductive care, cervical screenings (PAP test), breast exams, family planning and prenatal care.

Pediatricians

Pediatrics is a branch of medicine dedicated to the physical, emotional, and social health of infants, children, and adolescents. Like family physicians, pediatricians provide health examinations and practice preventive medicine. They immunize children against infectious diseases, such as influenza, meningitis, measles, mumps, and chicken pox. They also assist parents in guiding children through emotional and social developmental milestones.

Family Nurse Practitioners & Physician Assistants

Nurse practitioners (NPs) are registered nurses who have advanced education (Master’s Degree) and clinical training. Certified Physician Assistants (PA-C) are health professionals licensed to practice medicine with physician supervision. At Lamprey Health Care our Nurse Practitioners and Physician Assistants provide a variety of services such as:

Physical examinations
Diagnose and treat many common acute and chronic problems
Interpret laboratory results and X-rays
Prescribe and manage medications and other therapies
Provide health teaching and supportive counseling
Refer patients to other health professionals as needed

Behavioral Health Providers

Behavioral Health Providers at Lamprey Health Care provide integrated care, allowing our team of health professionals to coordinate primary and behavioral health care to meet your needs. Behavioral Health services are provided by Psychiatric Mental Health Nurse Practitioners, Licensed Clinical Social Workers, and Licensed Clinical Mental Health Counselors. The behavioral health team coordinates care with your Primary Care Provider, Care Coordinators, and other health professionals.