Physician Compare National (NPI:1053379420)

HEALTHCARE PROVIDER: EDWARD P OBRIEN III 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	1053379420
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5395644744
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040105000513
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	O BRIEN
	Individual professional last name
Provider First Name	EDWARD
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Name Suffix Text	III
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
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	OTHER
	Individual professional's medical school
Graduation Year	1999
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	300 CTR RD
	Group Practice or individual's line 1 address
City	WEST SENECA
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	142241946
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7166741001
	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	330279
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERCY HOSPITAL OF BUFFALO
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330188
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MOUNT ST. MARY'S HOSPITAL & HEALTH CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330078
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	SISTERS OF CHARITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y