Physician Compare National (NPI:1003175142)

HEALTHCARE PROVIDER: MARIANA GOMEZ DE LA ESPRIELLA MD

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

Individual Professional Information
NPI	1003175142
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991076010
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170809000242
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GOMEZ DE LA ESPRIELLA
	Individual professional last name
Provider First Name	MARIANA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CARILION HEALTHCARE CORPORATION
	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	5890607253
	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	415
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	159 HARTLEY WAY
	Group Practice or individual's line 1 address
City	PEARISBURG
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	241342471
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	491302
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CARILION GILES COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y