Physician Compare National (NPI:1164500245)

HEALTHCARE PROVIDER: WILLIAM LEE ELZI 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	1164500245
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224211263
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160209001808
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ELZI
	Individual professional last name
Provider First Name	WILLIAM
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
	Individual professional's medical school
Graduation Year	1992
	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
Line 1 Street Address	400 S 15TH ST
	Group Practice or individual's line 1 address
City	WORLAND
	Group Practice or individual's city
State	WY
	Group Practice or individual's state
Zip Code	824013531
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	291306
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	CARSON VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	061344
	Medicare CCN of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y