Physician Compare National (NPI:1063668119)

HEALTHCARE PROVIDER: BRIAN VAN LE M.D.

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

Individual Professional Information
NPI	1063668119
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0446490296
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20141031000397
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LE
	Individual professional last name
Provider First Name	BRIAN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STANFORD UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	UNIVERSITY OF WISCONSIN MEDICAL FOUNDATION INC
	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	6608785464
	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	1835
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	800 COMPASSION WAY
	Group Practice or individual's line 1 address
City	DODGEVILLE
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	535331956
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6089307230
	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	520089
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERITER HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	520098
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	UNIVERSITY OF WI HOSPITALS & CLINICS AUTHORITY
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	521352
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	UPLAND HILLS HEALTH
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y