Physician Compare National (NPI:1003896796)

HEALTHCARE PROVIDER: RAFAEL EVENCIO MOLINA 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	1003896796
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2860423951
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050829000571
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MOLINA
	Individual professional last name
Provider First Name	RAFAEL
	Individual professional first name
Provider Middle Name	EVENCIO
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	JC EDWARDS SCHOOL OF MEDICINE, MARSHALL UNIVERSITY
	Individual professional's medical school
Graduation Year	2000
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	VALLEY HEALTH SYSTEMS INC
	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	9931017969
	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	42
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1340 HAL GREER BLVD
	Group Practice or individual's line 1 address
City	HUNTINGTON
	Group Practice or individual's city
State	WV
	Group Practice or individual's state
Zip Code	257013800
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3045262000
	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	510055
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CABELL HUNTINGTON HOSPITAL INC
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y