Physician Compare National (NPI:1073860979)

HEALTHCARE PROVIDER: CHELSEA JEAN VAN HORN BROWN PA

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

Individual Professional Information
NPI	1073860979
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496074981
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200708003112
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BROWN
	Individual professional last name
Provider First Name	CHELSEA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SOUTHERN MONO HEALTH CARE DISTRICT
	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	9830002401
	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	34
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	85 SIERRA PARK RD
	Group Practice or individual's line 1 address
City	MAMMOTH LAKES
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	935462073
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7609244084
	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	500148
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CONFLUENCE HEALTH- WENATCHEE VALLEY HOSP & CLINICS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	500016
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CENTRAL WASHINGTON HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y