Physician Compare National (NPI:1164795068)

HEALTHCARE PROVIDER: STEPHEN DERRINGTON DO, INC

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

Individual Professional Information
NPI	1164795068
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840507190
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150918000301
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DERRINGTON
	Individual professional last name
Provider First Name	STEPHEN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KANSAS CITY COLLEGE OF MEDICINE AND SURGERY
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PAIN MANAGEMENT
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PAIN MANAGEMENT
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	HEALTH LINK MEDICAL GROUP INC
	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	4284929910
	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	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3142 VISTA WAY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 206
	Group Practice or individual's line 2 address
City	OCEANSIDE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	920563628
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7607214000
	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	M