Physician Compare National (NPI:1275582744)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1275582744
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1557445897
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080226000564
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VISCO
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Middle Name	P
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	100 HIGH ST
	Group Practice or individual's line 1 address
City	BUFFALO
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	142031126
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7168592748
	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	330005
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	KALEIDA HEALTH
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330111
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BERTRAND CHAFFEE HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330229
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BROOKS MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	330096
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	JONES MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	330008
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	WYOMING COUNTY COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1275582744)

HEALTHCARE PROVIDER:

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information