Physician Compare National (NPI:1003107285)

HEALTHCARE PROVIDER: GABRIEL E YACOB M.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1003107285
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1759523038
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130815000839
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	YACOB
	Individual professional last name
Provider First Name	GABRIEL
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	PAIN MANAGEMENT
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ANESTHESIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ANESTHESIOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	ST JAMES HOSPITAL
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0345154480
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	118
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	7309 SENECA RD N
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	HORNELL
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	148439691
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6073853820
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330151
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JAMES MERCY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330238
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NICHOLAS H NOYES MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330096
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JONES MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y