Physician Compare National (NPI:1013101054)

HEALTHCARE PROVIDER: WAYNE PLOOSTER DO

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

Individual Professional Information
NPI	1013101054
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052472503
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100902000032
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PLOOSTER
	Individual professional last name
Provider First Name	WAYNE
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ADDICTION MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	GENERAL PRACTICE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 3	GERIATRIC MEDICINE
	Third secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ADDICTION MEDICINE, GENERAL PRACTICE, GERIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	RAPID CITY MEDICAL CENTER LLP
	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	5890691075
	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	79
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	717 SAINT FRANCIS ST
	Group Practice or individual's line 1 address
City	RAPID CITY
	Group Practice or individual's city
State	SD
	Group Practice or individual's state
Zip Code	577014677
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6053422880
	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	430077
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	REGIONAL HEALTH RAPID CITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y