Physician Compare National (NPI:1225192818)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1225192818
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2961558317
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090925000574
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STARRETT
	Individual professional last name
Provider First Name	PETER
	Individual professional first name
Provider Middle Name	J
	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 ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
	Individual professional's medical school
Graduation Year	1956
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1300 N HIGHLAND AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 10
	Group Practice or individual's line 2 address
City	AURORA
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	605061470
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y