Physician Compare National (NPI:1154634780)

HEALTHCARE PROVIDER: AMANDA ANN WINTERBOER OD

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

Individual Professional Information
NPI	1154634780
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0244423705
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101018000442
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WINTERBOER
	Individual professional last name
Provider First Name	AMANDA
	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.

Medical School Information
Medical School Name	UNIVERSITY OF MISSOURI ST LOUIS - SCHOOL OF OPTOMETRY
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1104 W 18TH ST
	Group Practice or individual's line 1 address
City	SPENCER
	Group Practice or individual's city
State	IA
	Group Practice or individual's state
Zip Code	513012815
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y