Physician Compare National (NPI:1497041370)

HEALTHCARE PROVIDER: JORGE ERNESTO PEREZ TORRES 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	1497041370
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3173824760
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20151228001104
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PEREZ TORRES
	Individual professional last name
Provider First Name	JORGE
	Individual professional first name
Provider Middle Name	ERNESTO
	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	2010
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PREVENTATIVE MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PREVENTATIVE MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	HNI MEDICAL SERVICES OF WISCONSIN SC
	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	5193153997
	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	11
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	801 BRAXTON PL
	Group Practice or individual's line 1 address
City	MADISON
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	537151415
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6082602700
	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	390233
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HANOVER HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450011
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CHI ST JOSEPH HEALTH
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y