Physician Compare National (NPI:1073786448)

HEALTHCARE PROVIDER: MICHAEL COREY CRICCHIO APRN

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

Individual Professional Information
NPI	1073786448
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3678697927
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100824000570
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CRICCHIO
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first 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	2008
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ASCENSION SETON
	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	5193634293
	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	36
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1205 CENTRAL TEXAS EXPY
	Group Practice or individual's line 1 address
City	LAMPASAS
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	765503388
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5125565362
	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	451323
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ROLLINS BROOK COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	451365
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SETON HIGHLAND LAKES
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y