Physician Compare National (NPI:1396890133)

HEALTHCARE PROVIDER: LILLIAN PADILLA COSTOSO 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	1396890133
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7810077153
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20071228000060
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PADILLA COSTOSO
	Individual professional last name
Provider First Name	LILLIAN
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1996
	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	LP RENAL SERVICES, CSP
	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	6305999475
	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	1 CALLE MARGINAL
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 307
	Group Practice or individual's line 2 address
City	VEGA ALTA
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	006926797
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7879304077
	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	400114
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MANATI MEDICAL CENTER DR OTERO LOPEZ
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	400118
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	DOCTORS' CENTER HOSPITAL, INC
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y