Physician Compare National (NPI:1285658815)

HEALTHCARE PROVIDER: DR. ANDREW SCOTT GRIVAS JR.

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

Individual Professional Information
NPI	1285658815
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6901829506
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130802000821
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRIVAS
	Individual professional last name
Provider First Name	ANDREW
	Individual professional first name
Provider Middle Name	SCOTT
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
	Individual professional's medical school
Graduation Year	1972
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1406 MISSOURI BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1
	Group Practice or individual's line 2 address
City	JEFFERSON CITY
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	651091737
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	M