Physician Compare National (NPI:1164477584)

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	1164477584
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901859701
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050221000632
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MARTINEZ MERCADO
	Individual professional last name
Provider First Name	FELIX
	Individual professional first name
Provider Gender	M
	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	OTHER
	Individual professional's medical school
Graduation Year	1963
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	NEUROPSYCHIATRY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	NEUROPSYCHIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2310 ANDERSON AVE
	Group Practice or individual's line 1 address
City	MANHATTAN
	Group Practice or individual's city
State	KS
	Group Practice or individual's state
Zip Code	665022967
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7855379600
	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