Physician Compare National (NPI:1104807981)

HEALTHCARE PROVIDER: NEIL SMITH 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	1104807981
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9133250582
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100713000536
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SMITH
	Individual professional last name
Provider First Name	NEIL
	Individual professional first name
Provider Middle Name	THEODORE
	Individual professional middle 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	1996
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ARSENIO MEDICAL, P.C.
	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	7810886215
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	215 ROCKAWAY TPKE
	Group Practice or individual's line 1 address
City	LAWRENCE
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	115591216
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y