Physician Compare National (NPI:1487946042)

HEALTHCARE PROVIDER: RANDEL LYNN SWANSON II DO, PHD

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

Individual Professional Information
NPI	1487946042
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0143532473
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150630000482
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SWANSON
	Individual professional last name
Provider First Name	RANDEL
	Individual professional first name
Provider Middle Name	LYNN
	Individual professional middle name
Provider Name Suffix Text	II
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	RUTGERS SCHOOL OF DENTAL MEDICINE
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	UNIVERSITY OF PENN MEDICAL GROUP
	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	6204730955
	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	2472
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3400 SPRUCE ST
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	PHILADELPHIA
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	191044206
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y