Physician Compare National (NPI:1508979493)

HEALTHCARE PROVIDER: MICHAEL JUSTIN SIROTT 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	1508979493
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6204079692
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130904000660
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SIROTT
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
	Individual professional's medical school
Graduation Year	2002
	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	902 ENGH RD
	Group Practice or individual's line 1 address
City	OMAK
	Group Practice or individual's city
State	WA
	Group Practice or individual's state
Zip Code	988419473
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y