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Physician Compare National (NPI:1134145675)

HEALTHCARE PROVIDER: LISA A. DUCHAMP 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 1134145675
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 7416930870
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20040608001065
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name DUCHAMP
Individual professional last name
Provider First Name LISA
Individual professional first name
Provider Middle Name ANN
Individual professional middle name
Provider Gender F
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 UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Individual professional's medical school
Graduation Year 1994
Individual professional's medical school graduation year
Primary Specialty INTERNAL MEDICINE
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name MEDICAL CENTER EMERGENCY PHYSICIANS PA
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 3870582067
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 33
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 17200 ST LUKES WAY
Group Practice or individual's line 1 address
Line 2 Street Address ST LUKES COMMUNITY MED CTR
Group Practice or individual's line 2 address
City THE WOODLANDS
Group Practice or individual's city
State TX
Group Practice or individual's state
Zip Code 773848007
Group Practice or individual's zip code (9 digits when available)
Phone Number 9362663900
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 670031
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 CHI ST LUKE'S PATIENTS MEDICAL CENTER
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 450193
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 CHI BAYLOR ST LUKES MEDICAL CENTER
Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment Y

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