Physician Compare National (NPI:1164463725)

HEALTHCARE PROVIDER: DAVID EUGENE FUMO

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

Individual Professional Information
NPI	1164463725
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7618879453
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100219000632
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FUMO
	Individual professional last name
Provider First Name	DAVID
	Individual professional first name
Provider Middle Name	EUGENE
	Individual professional middle name
Provider Name Suffix Text	SR.
	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	LOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1982
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	FRANCISCAN PHYSICIAN NETWORK
	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	3072790682
	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	979
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3500 FRANCISCAN WAY
	Group Practice or individual's line 1 address
City	MICHIGAN CITY
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	463600021
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150015
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FRANCISCAN ST ANTHONY HEALTH - MICHIGAN CITY
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150006
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LA PORTE HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y