Physician Compare National (NPI:1457389058)

HEALTHCARE PROVIDER: JAMES MARK STAFFORD DO

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1457389058
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274632989
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101022000564
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STAFFORD
	Individual professional last name
Provider First Name	JAMES
	Individual professional first name
Provider Middle Name	M
	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	1986
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	601 UNIVERSITY BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 102
	Group Practice or individual's line 2 address
City	JUPITER
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	334582788
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100253
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	JUPITER MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100176
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	PALM BEACH GARDENS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y