Physician Compare National (NPI:1083683783)

HEALTHCARE PROVIDER: BRETT J. GUINN 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	1083683783
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375541568
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20061122000455
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GUINN
	Individual professional last name
Provider First Name	BRETT
	Individual professional first name
Provider Middle Name	JOSEPH
	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	WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	LUTHERAN MEDICAL GROUP LLC
	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	4981751617
	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	232
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	7916 W JEFFERSON BLVD
	Group Practice or individual's line 1 address
City	FORT WAYNE
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	468044140
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2604322297
	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	150017
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LUTHERAN HOSPITAL OF INDIANA
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150047
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST JOSEPH HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	150150
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	DUPONT HOSPITAL LLC
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y