Physician Compare National (NPI:1255775797)

HEALTHCARE PROVIDER: WILLIAM CHEUNG 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	1255775797
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0244559730
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200303002812
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHEUNG
	Individual professional last name
Provider First Name	WILLIAM
	Individual professional first name
Provider Middle Name	Y
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
	Individual professional's medical school
Graduation Year	2013
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ST LUKE'S CLINIC LLC
	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	1052217478
	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	226
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	775 POLE LINE RD W
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	TWIN FALLS
	Group Practice or individual's city
State	ID
	Group Practice or individual's state
Zip Code	833015823
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	130002
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST LUKES MAGIC VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	350002
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHI ST ALEXIUS HEALTH
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	131302
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	NORTH CANYON MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	351334
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	CHI ST ALEXIUS HEALTH WILLISTON
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y