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Physician Compare National (NPI:1114149523)

HEALTHCARE PROVIDER:

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

Individual Professional Information

NPI 1114149523
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 6800011784
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20190723001427
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MENGES
Individual professional last name
Provider First Name JOB
Individual professional first name
Provider Middle Name F
Individual professional middle name
Provider Name Suffix Text JR.
The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name TEMPLE UNIVERSITY SCHOOL OF MEDICINE
Individual professional's medical school
Graduation Year 1962
Individual professional's medical school graduation year
Primary Specialty ORTHOPEDIC SURGERY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2201 RIDGEWOOD RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 200
Group Practice or individual's line 2 address
City WYOMISSING
Group Practice or individual's city
State PA
Group Practice or individual's state
Zip Code 196101196
Group Practice or individual's zip code (9 digits when available)
Phone Number 6103756226
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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