Physician Compare National (NPI:1366094823)

HEALTHCARE PROVIDER: MATRACA GUNNOE APRN

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1366094823
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426389057
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20191209002750
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	HOVATTER
	Individual professional last name
Provider First Name	MATRACA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2019
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	WEST VIRGINIA UNIVERSITY MEDICAL CORPORATION
	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	1052224565
	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	1180
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	311 N 4TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	UHA OAKLAND PRIMARY CARE
	Group Practice or individual's line 2 address
City	OAKLAND
	Group Practice or individual's city
State	MD
	Group Practice or individual's state
Zip Code	215501371
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3013348171
	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	210017
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GARRETT COUNTY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	510001
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WEST VIRGINIA UNIVERSITY HOSPITALS
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y