Physician Compare National (NPI:1447480645)

HEALTHCARE PROVIDER: OMAR E SOTO-AVILES 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	1447480645
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7416265061
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150930002102
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SOTO-AVILES
	Individual professional last name
Provider First Name	OMAR
	Individual professional first name
Provider Gender	M
	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	2009
	Individual professional's medical school graduation year
Primary Specialty	UROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	VHS PHYSICIANS OF MICHIGAN
	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	8921289760
	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	204
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4160 JOHN R
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1021
	Group Practice or individual's line 2 address
City	DETROIT
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	482012017
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3137454001
	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	400032
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOSPITAL HERMANOS MELENDEZ INC
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y