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Physician Compare National (NPI:1295817112)

HEALTHCARE PROVIDER: GREGORIO A SICARD JR. 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 1295817112
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 7618978032
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20070126000315
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name SICARD
Individual professional last name
Provider First Name GREGORIO
Individual professional first name
Provider Middle Name A
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.
Provider Credential Text MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information

Medical School Name RUTGERS NEW JERSEY MEDICAL SCHOOL
Individual professional's medical school
Graduation Year 1998
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

Organization Legal Name LEGACY EMANUEL HOSPITAL AND HEALTH CENTER
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 4587573639
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 141
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 500 N COLUMBIA RIVER HWY
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 6
Group Practice or individual's line 2 address
City SAINT HELENS
Group Practice or individual's city
State OR
Group Practice or individual's state
Zip Code 970511201
Group Practice or individual's zip code (9 digits when available)
Phone Number 5033665101
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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