Physician Compare National (NPI:1245292556)

HEALTHCARE PROVIDER: PAULA RICKARD BENNETT 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	1245292556
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183763907
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20091211000318
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BENNETT
	Individual professional last name
Provider First Name	PAULA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	JEFFERSON MEDICAL COLLEGE OF THOMAS JEFFERSON UNIVERSITY
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	WAYNE MEMORIAL COMMUNITY HEALTH CENTERS
	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	3072598937
	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	23
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	600 MAPLE AVE
	Group Practice or individual's line 1 address
City	HONESDALE
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	184311459
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5702538635
	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	390125
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	WAYNE MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	390001
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	GEISINGER-COMMUNITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	390270
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	GEISINGER WYOMING VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y