Physician Compare National (NPI:1437348950)

HEALTHCARE PROVIDER: PHILEMON THEOLOGOS SPENCER 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	1437348950
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1052443694
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20170809003570
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SPENCER
	Individual professional last name
Provider First Name	PHILEMON
	Individual professional first name
Provider Middle Name	THEOLOGOS
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	ARIZONA ACUTE MEDICAL SERVICES 1 PC
	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	6204113970
	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	15
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5750 E BASELINE RD
	Group Practice or individual's line 1 address
City	MESA
	Group Practice or individual's city
State	AZ
	Group Practice or individual's state
Zip Code	852064806
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	030030
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ABRAZO CENTRAL CAMPUS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	030094
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ARROWHEAD HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y