Physician Compare National (NPI:1497861405)

HEALTHCARE PROVIDER: JOHN WILLIAM RATHJENS O.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	1497861405
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830417179
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150416000872
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RATHJENS
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Middle Name	W
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	NEW ENGLAND COLLEGE OF OPTOMETRY
	Individual professional's medical school
Graduation Year	1996
	Individual professional's medical school graduation year
Primary Specialty	OPTOMETRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	1201 BOSTON POST RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2063
	Group Practice or individual's line 2 address
City	MILFORD
	Group Practice or individual's city
State	CT
	Group Practice or individual's state
Zip Code	064609014
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y