Physician Compare National (NPI:1336367226)

HEALTHCARE PROVIDER: EUGENE EVRA 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	1336367226
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7416191580
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130912000127
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	EVRA
	Individual professional last name
Provider First Name	EUGENE
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PAIN MANAGEMENT
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PAIN MANAGEMENT
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	12380 DE PAUL DR
	Group Practice or individual's line 1 address
City	BRIDGETON
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	630442511
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	260020
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERCY HOSPITAL ST LOUIS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	260091
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SSM HEALTH ST MARY'S HOSPITAL - ST LOUIS
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	260105
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST LOUIS UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	260052
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	MERCY HOSPITAL WASHINGTON
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	260077
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	ST ANTHONY'S MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1336367226)

HEALTHCARE PROVIDER: EUGENE EVRA M.D.

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information