Physician Compare National (NPI:1518036714)

HEALTHCARE PROVIDER: JIM HISAO NISHIMINE MD

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

Individual Professional Information
NPI	1518036714
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375700206
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120206000270
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NISHIMINE
	Individual professional last name
Provider First Name	JIM
	Individual professional first name
Provider Middle Name	H
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	IRVINE CALIFORNIA COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	1969
	Individual professional's medical school graduation year
Primary Specialty	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2507 ASHBY AVE
	Group Practice or individual's line 1 address
City	BERKELEY
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	947052243
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5106443000
	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	050305
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ALTA BATES SUMMIT MEDICAL CENTER - ALTA BATES CAMP
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050043
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ALTA BATES SUMMIT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	050180
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	JOHN MUIR MEDICAL CENTER - WALNUT CREEK CAMPUS
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y