Physician Compare National (NPI:1275557563)

HEALTHCARE PROVIDER: MARIAN DE JESUS 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	1275557563
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496948275
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101025001219
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DE JESUS
	Individual professional last name
Provider First Name	MARIAN
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1979
	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
Line 1 Street Address	EXT VILLAMAR
	Group Practice or individual's line 1 address
Line 2 Street Address	1025 CALLE MARGINAL VILLAMAR
	Group Practice or individual's line 2 address
City	CAROLINA
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	009796348
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7877263901
	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	400019
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOSPITAL PAVIA SANTURCE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	400001
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PRESBYTERIAN COMMUNITY HOSP
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y