Physician Compare National (NPI:1083672919)

HEALTHCARE PROVIDER: JONATHAN E ALLEY D.O.

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

Individual Professional Information
NPI	1083672919
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1355342247
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080606000017
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ALLEY
	Individual professional last name
Provider First Name	JONATHAN
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	DES MOINES UNIVERSITY OF OSTEOPATHIC MEDICINE AND HEALTH SCIENCES
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ANESTHESIOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ANESTHESIOLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	424 WILLIAMS ST
	Group Practice or individual's line 1 address
City	ANGOLA
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	467031556
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	151315
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CAMERON MEMORIAL COMMUNITY HOSPITAL INC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360068
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PROMEDICA TOLEDO HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y