Physician Compare National (NPI:1174529291)

HEALTHCARE PROVIDER: ROBERTO PONCE 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	1174529291
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0345348686
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110421000587
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PONCE
	Individual professional last name
Provider First Name	ROBERTO
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1969
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GASTROENTEROLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GASTROENTEROLOGY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2449 BOCA CHICA BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE B
	Group Practice or individual's line 2 address
City	BROWNSVILLE
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	785212368
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	450028
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	VALLEY BAPTIST MEDICAL CENTER - BROWNSVILLE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450662
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	VALLEY REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y