Physician Compare National (NPI:1265639777)

HEALTHCARE PROVIDER: JUAN J MARTIN 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	1265639777
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7810138153
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140908001079
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MARTIN
	Individual professional last name
Provider First Name	JUAN
	Individual professional first name
Provider Middle Name	JOSE
	Individual professional middle 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	1997
	Individual professional's medical school graduation year
Primary Specialty	NEUROSURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	8811 VILLAGE DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 301
	Group Practice or individual's line 2 address
City	SAN ANTONIO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	782175415
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	670102
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	AD HOSPITAL EAST, LLC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450610
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEMORIAL HERMANN MEMORIAL CITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y