Physician Compare National (NPI:1255425948)

HEALTHCARE PROVIDER: NELSON SOCORRO MENEZES M.D.

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

Individual Professional Information
NPI	1255425948
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385742402
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070613000093
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MENEZES
	Individual professional last name
Provider First Name	NELSON
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1979
	Individual professional's medical school graduation year
Primary Specialty	VASCULAR SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GENERAL SURGERY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GENERAL SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	240 WILLOUGHBY ST
	Group Practice or individual's line 1 address
City	BROOKLYN
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	112015465
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	330056
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BROOKLYN HOSPITAL CENTER AT DOWNTOWN CAMPUS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330101
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	NEW YORK-PRESBYTERIAN HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y