Physician Compare National (NPI:1194776286)

HEALTHCARE PROVIDER: MARK D BORCHELT MD, FACE

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

Individual Professional Information
NPI	1194776286
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8729158167
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20151130000718
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BORCHELT
	Individual professional last name
Provider First Name	MARK
	Individual professional first name
Provider Middle Name	D
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NORTHEASTERN OHIO UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1983
	Individual professional's medical school graduation year
Primary Specialty	ENDOCRINOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	19289 C SAINT JOSEPH RD
	Group Practice or individual's line 1 address
City	BILOXI
	Group Practice or individual's city
State	MS
	Group Practice or individual's state
Zip Code	395329248
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	250019
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEMORIAL HOSPITAL AT GULFPORT
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	250040
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SINGING RIVER HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	250117
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HIGHLAND COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	250162
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	HANCOCK MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y