Physician Compare National (NPI:1073505061)

HEALTHCARE PROVIDER: JUAN BAEZ 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	1073505061
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7214062033
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100318000730
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BAEZ
	Individual professional last name
Provider First Name	JUAN
	Individual professional first name
Provider Middle Name	CARLOS
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1991
	Individual professional's medical school graduation year
Primary Specialty	INFECTIOUS DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	10 MOUNTAIN BLVD
	Group Practice or individual's line 1 address
City	WARREN
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	070592639
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310024
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ROBERT WOOD JOHNSON UNIVERSITY HOSPITAL AT RAHWAY
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	310051
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	OVERLOOK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	310108
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JFK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y