Physician Compare National (NPI:1043203698)

HEALTHCARE PROVIDER: SCOTT E EVELOFF 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	1043203698
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284620410
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040422001570
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EVELOFF
	Individual professional last name
Provider First Name	SCOTT
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
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	WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	PULMONARY DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	SLEEP MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	SLEEP MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2600 MILLER ST
	Group Practice or individual's line 1 address
City	BETHANY
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	644242701
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6604252211
	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	261312
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HARRISON COUNTY COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	261332
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CARROLL COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	260097
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	WESTERN MISSOURI MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	170182
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MENORAH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y