Physician Compare National (NPI:1043256605)

HEALTHCARE PROVIDER: PETER J CLAGNAZ 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	1043256605
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466535240
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190917001496
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CLAGNAZ
	Individual professional last name
Provider First Name	PETER
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY
	Individual professional's medical school
Graduation Year	1977
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SACRED HEART HOSPITAL OF THE HOSPITAL SISTERS-3RD ORDER OF ST FRANCIS
	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	8729072418
	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	136
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1109 W CLAIREMONT AVE
	Group Practice or individual's line 1 address
City	EAU CLAIRE
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	547016105
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7157175225
	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	520013
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SACRED HEART HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y