Physician Compare National (NPI:1073601852)

HEALTHCARE PROVIDER: JOSE IGNACIO GONZALEZ 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	1073601852
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183640014
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20051020000456
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GONZALEZ
	Individual professional last name
Provider First Name	JOSE
	Individual professional first name
Provider Middle Name	IGNACIO
	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	UNIVERSITY OF FLORIDA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1983
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	157 N CORONADO DR A
	Group Practice or individual's line 1 address
City	SIERRA VISTA
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	856356343
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5204581208
	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	030043
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CANYON VISTA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	031312
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	COPPER QUEEN COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	030064
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BANNER - UNIVERSITY MEDICAL CENTER TUCSON CAMPUS
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y