Physician Compare National (NPI:1346309168)

HEALTHCARE PROVIDER: GLENN JAMES SCHULTES 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	1346309168
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4284788837
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20161215001896
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SCHULTES
	Individual professional last name
Provider First Name	GLENN
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	RUSH MEDICAL COLLEGE OF RUSH UNIVERSITY
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	DIAGNOSTIC RADIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	VIRTUAL RADIOLOGIC PROFESSIONALS 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	4981608817
	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	287
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	60879 OASIS PL
	Group Practice or individual's line 1 address
City	BEND
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	977023902
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9525951100
	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	230195
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST JOHN MACOMB-OAKLAND HOSPITAL-MACOMB CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	021314
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MT EDGECUMBE HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	330241
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	UNIVERSITY HOSPITAL S U N Y HEALTH SCIENCE CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y