Physician Compare National (NPI:1467447623)

HEALTHCARE PROVIDER: OTTO R. DUENO 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	1467447623
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1456488204
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100427000461
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DUENO
	Individual professional last name
Provider First Name	OTTO
	Individual professional first 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	1992
	Individual professional's medical school graduation year
Primary Specialty	PSYCHIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC PSYCHIATRY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC PSYCHIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	DAYTON BEHAVIORAL CARE, 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	0446390926
	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	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	627 EDWIN C MOSES BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2C
	Group Practice or individual's line 2 address
City	DAYTON
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	454173445
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9372810900
	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	360133
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GRANDVIEW AND SOUTHVIEW HOSPITALS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	360239
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	KETTERING MEDICAL CENTER - SYCAMORE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y