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Physician Compare National (NPI:1013574425)

HEALTHCARE PROVIDER: JUDE HALL APRN

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

Individual Professional Information

NPI 1013574425
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 8527392273
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20190628001889
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name HALL
Individual professional last name
Provider First Name JUDE
Individual professional first name
Provider Middle Name MARTINE
Individual professional middle 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 2012
Individual professional's medical school graduation year
Primary Specialty NURSE PRACTITIONER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name PRIME HEALTHCARE, PC
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 6709787930
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 62
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 75 GREAT POND RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 200
Group Practice or individual's line 2 address
City SIMSBURY
Group Practice or individual's city
State CT
Group Practice or individual's state
Zip Code 060701980
Group Practice or individual's zip code (9 digits when available)
Phone Number 8604540303
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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