Physician Compare National (NPI:1487852422)

HEALTHCARE PROVIDER: SANDRA ESPERANZA RODRIGUEZ 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	1487852422
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022101435
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20171127002832
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RODRIGUEZ
	Individual professional last name
Provider First Name	SANDRA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	INTEGRIS AMBULATORY CARE CORPORATION
	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	2365408465
	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	423
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1500 DODSON AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 60
	Group Practice or individual's line 2 address
City	FORT SMITH
	Group Practice or individual's city
State	AR
	Group Practice or individual's state
Zip Code	729015182
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4057139900
	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	370049
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	STILLWATER MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	370028
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INTEGRIS BAPTIST MEDICAL CENTER, INC
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	370018
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JANE PHILLIPS MEMORIAL MEDICAL CENTER, INC
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y