Physician Compare National (NPI:1093079451)

HEALTHCARE PROVIDER: GIAN-PAUL VIDAL M.D.

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

Individual Professional Information
NPI	1093079451
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7517395486
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200309000857
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VIDAL
	Individual professional last name
Provider First Name	GIAN-PAUL
	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	2012
	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	CAPITOL SURGEONS 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	4284653023
	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	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8630 FENTON ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 122
	Group Practice or individual's line 2 address
City	SILVER SPRING
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	209103803
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3015880057
	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	210004
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOLY CROSS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	210065
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HOLY CROSS GERMANTOWN HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	210016
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ADVENTIST HEALTHCARE WASHINGTON ADVENTIST HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M