Physician Compare National (NPI:1386886943)

HEALTHCARE PROVIDER: RONI BENJAMIN PRUCZ MD

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

Individual Professional Information
NPI	1386886943
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9133487457
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171222000724
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PRUCZ
	Individual professional last name
Provider First Name	RONI
	Individual professional first name
Provider Middle Name	BENJAMIN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	9250 N 3RD ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1003
	Group Practice or individual's line 2 address
City	PHOENIX
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	850202402
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	030087
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HONORHEALTH SCOTTSDALE SHEA MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	030038
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SCOTTSDALE OSBORN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	030014
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HONORHEALTH JOHN C LINCOLN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	030065
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BANNER DESERT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	030037
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	ST LUKE'S MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1386886943)

HEALTHCARE PROVIDER: RONI BENJAMIN PRUCZ MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information