Physician Compare National (NPI:1497726210)

HEALTHCARE PROVIDER: JOSE SEPULVEDA

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

Individual Professional Information
NPI	1497726210
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991927840
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20141110002526
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SEPULVEDA
	Individual professional last name
Provider First Name	JOSE
	Individual professional first name
Provider Middle Name	A
	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	1999
	Individual professional's medical school graduation year
Primary Specialty	GENERAL PRACTICE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	J11 AVE BETANCES
	Group Practice or individual's line 1 address
City	BAYAMON
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	009595108
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y