Physician Compare National (NPI:1073808200)

HEALTHCARE PROVIDER: DEANDREA YVONNE DUFFUS D.P.M

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

Individual Professional Information
NPI	1073808200
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466755251
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160128001901
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DUFFUS
	Individual professional last name
Provider First Name	DEANDREA
	Individual professional first name
Provider Middle Name	YVONNE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	BARRY UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	955 TOWN CTR DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	ORANGE CITY
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	327638255
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100072
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FLORIDA HOSPITAL FISH MEMORIAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100045
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	FLORIDA HOSPITAL DELAND
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y