Physician Compare National (NPI:1316138506)

HEALTHCARE PROVIDER: ALEXA LYNNE ROSE 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	1316138506
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3971826272
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20141217001446
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SMITH
	Individual professional last name
Provider First Name	ALEXA
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2006
	Individual professional's medical school graduation year
Primary Specialty	NEUROSURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4150 REGENTS PARK ROW
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 321
	Group Practice or individual's line 2 address
City	LA JOLLA
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	920379124
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050324
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SCRIPPS MEMORIAL HOSPITAL LA JOLLA
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050503
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SCRIPPS MEMORIAL HOSPITAL - ENCINITAS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y