Physician Compare National (NPI:1336404748)

HEALTHCARE PROVIDER: CHISAROKA WOBIARERI ECHENDU M.D., PH.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	1336404748
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5092088245
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170908003259
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ECHENDU
	Individual professional last name
Provider First Name	CHISAROKA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	BAYLOR COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	RADIATION ONCOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	BAPTIST PHYSICIAN NETWORK
	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	0547333890
	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	40
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	310 N 11TH ST
	Group Practice or individual's line 1 address
City	BEAUMONT
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	777021802
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4099815510
	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	450346
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BAPTIST BEAUMONT HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y