Physician Compare National (NPI:1336460872)

HEALTHCARE PROVIDER: JAKE MICHAEL CHANIN M.S., 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	1336460872
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8123398633
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170717001219
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHANIN
	Individual professional last name
Provider First Name	JAKE
	Individual professional first name
Provider Middle Name	MICHAEL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	INTERVENTIONAL CARDIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SCL HEALTH MEDICAL GROUP DENVER LLC
	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	0840513552
	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	269
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1960 N OGDEN ST
	Group Practice or individual's line 1 address
Line 2 Street Address	110 SCL HEALTH HEART AND VASCULAR INSTITUTE DENVER
	Group Practice or individual's line 2 address
City	DENVER
	Group Practice or individual's city
State	CO
	Group Practice or individual's state
Zip Code	802183667
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3033182460
	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	060028
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT JOSEPH HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	060009
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LUTHERAN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	060116
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	GOOD SAMARITAN MEDICAL CENTER LLC
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y