Physician Compare National (NPI:1447272299)

HEALTHCARE PROVIDER: EDWIN PEREZ-LOPEZ 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	1447272299
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4587609417
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050622000236
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PEREZ-LOPEZ
	Individual professional last name
Provider First Name	EDWIN
	Individual professional first name
Provider Gender	M
	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	UNIVERSITY OF PUERTO RICO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2002
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MERCY HEALTH PHYSICIANS KENTUCKY LLC
	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	1153488648
	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	113
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1530 LONE OAK RD
	Group Practice or individual's line 1 address
City	PADUCAH
	Group Practice or individual's city
State	KY
	Group Practice or individual's state
Zip Code	420037901
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2704442444
	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	180102
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LOURDES HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	181327
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MARSHALL COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	180104
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BAPTIST HEALTH PADUCAH
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	180116
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	JACKSON PURCHASE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y