Physician Compare National (NPI:1477621662)

HEALTHCARE PROVIDER: JEFFREY C PITTS 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	1477621662
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6406844562
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050119000546
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PITTS
	Individual professional last name
Provider First Name	JEFFREY
	Individual professional first name
Provider Middle Name	C
	Individual professional middle 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	STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1978
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	269 SW 19TH ST
	Group Practice or individual's line 1 address
City	ONTARIO
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	979141972
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5418893106
	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	380052
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT ALPHONSUS MEDICAL CENTER - ONTARIO, INC
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	130006
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST LUKE'S REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	131307
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	WEISER MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	M