Physician Compare National (NPI:1205944303)

HEALTHCARE PROVIDER: JOSEPH RANDALL LYNCH 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	1205944303
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284733023
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160608001197
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LYNCH
	Individual professional last name
Provider First Name	JOSEPH
	Individual professional first name
Provider Middle Name	R
	Individual professional middle 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	OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	THE SHOULDER CLINIC OF IDAHO PLLC
	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	5698860021
	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	7
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	8854 W EMERALD ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	BOISE
	Group Practice or individual's city
State	ID
	Group Practice or individual's state
Zip Code	837044845
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2083234747
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	130063
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TREASURE VALLEY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	130007
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SAINT ALPHONSUS REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	130006
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST LUKE'S REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y