Physician Compare National (NPI:1417068198)

HEALTHCARE PROVIDER: ANN MARIE MACASA 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	1417068198
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496752958
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20061026000586
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MACASA
	Individual professional last name
Provider First Name	ANNA MARIE
	Individual professional first name
Provider Middle Name	Q
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1998
	Individual professional's medical school graduation year
Primary Specialty	RHEUMATOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	402 VILLA RD
	Group Practice or individual's line 1 address
City	NEWBERG
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	971321831
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	380061
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PROVIDENCE PORTLAND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	380037
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PROVIDENCE NEWBERG MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	380071
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	WILLAMETTE VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	381302
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SAMARITAN NORTH LINCOLN HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y