Physician Compare National (NPI:1003980566)

HEALTHCARE PROVIDER: PETER BERNARD ALBERT PAPPAS 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	1003980566
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6002728425
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110105000263
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PAPPAS
	Individual professional last name
Provider First Name	PETER
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	76 BROOKWOOD AVE
	Group Practice or individual's line 1 address
City	SANTA ROSA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	954044312
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050301
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADVENTIST HEALTH UKIAH VALLEY
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	051317
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ADVENTIST HEALTH CLEARLAKE
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050174
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SANTA ROSA MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	051310
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ADVENTIST HEALTH HOWARD MEMORIAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	050136
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	PETALUMA VALLEY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1003980566)

HEALTHCARE PROVIDER: PETER BERNARD ALBERT PAPPAS M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information