Physician Compare National (NPI:1245229178)

HEALTHCARE PROVIDER: GARY RICHARD SNELLER II PHYSICIAN ASSISTANT

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

Individual Professional Information
NPI	1245229178
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7012153729
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130425000496
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SNELLER
	Individual professional last name
Provider First Name	GARY
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Name Suffix Text	II
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ORTHOPAEDIC ASSOCIATES, PA
	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	5294823084
	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	18
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	554 D TWIN CITIES BLVD
	Group Practice or individual's line 1 address
City	NICEVILLE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	325781058
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8503159210
	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	100292
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SACRED HEART HOSPITAL ON THE EMERALD COAST
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100223
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	FORT WALTON BEACH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y