Physician Compare National (NPI:1518120435)

HEALTHCARE PROVIDER: JAVIER MARQUEZ GRACIANI 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	1518120435
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8022233683
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140716000841
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MARQUEZ GRACIANI
	Individual professional last name
Provider First Name	JAVIER
	Individual professional first name
Provider Middle Name	RAMON
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PONCE SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2007
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	15 CALLE DR BASORA N
	Group Practice or individual's line 1 address
City	MAYAGUEZ
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	006804833
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	400123
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOSPITAL PEREA
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y