Physician Compare National (NPI:1356583173)

HEALTHCARE PROVIDER: NICOLE MARIE CHRISTIN 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	1356583173
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2264747351
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171107002248
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CHRISTIN
	Individual professional last name
Provider First Name	NICOLE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF MIAMI, LM MILLER SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	PEDIATRIC SPECIALTY GROUP, INC.
	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	5395020507
	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	2
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3100 SW 62ND AVE
	Group Practice or individual's line 1 address
City	MIAMI
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	331553009
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7866245876
	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	103301
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NICKLAUS CHILDREN'S HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y