Physician Compare National (NPI:1114241619)

HEALTHCARE PROVIDER: JORGE BETANCOR 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	1114241619
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668609157
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20131206001495
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BETANCOR
	Individual professional last name
Provider First Name	JORGE
	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	2009
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	PARTNERS IN IMAGING INC
	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	6901886092
	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	10
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	18851 NE 29 AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 103
	Group Practice or individual's line 2 address
City	AVENTURA
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	331802811
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3058901839
	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	100209
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	KENDALL REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100167
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PLANTATION GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	100131
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	AVENTURA HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y