Physician Compare National (NPI:1275980237)

HEALTHCARE PROVIDER: YIDONG CHEN 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	1275980237
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7719211036
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190620000694
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHEN
	Individual professional last name
Provider First Name	YIDONG
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2016
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CHI ST VINCENT HOSPITAL HOT SPRINGS
	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	1153231758
	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	14
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	300 WERNER ST
	Group Practice or individual's line 1 address
City	HOT SPRINGS
	Group Practice or individual's city
State	AR
	Group Practice or individual's state
Zip Code	719136406
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5016221043
	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	370034
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MCALESTER REGIONAL HEALTH CENTER AUTHORITY
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	040026
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST VINCENT HOT SPRINGS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y