Physician Compare National (NPI:1548263668)

HEALTHCARE PROVIDER: JAVIER MUNIZ D.O.

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

Individual Professional Information
NPI	1548263668
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0143223297
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060810000429
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MUNIZ
	Individual professional last name
Provider First Name	JAVIER
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	DO
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	AT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	315 S 13TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 2
	Group Practice or individual's line 2 address
City	HERRIN
	Group Practice or individual's city
State	IL
	Group Practice or individual's state
Zip Code	629483666
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	140011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SOUTHERN ILLINOIS HOSPITAL SERVICES DBA HERRIN HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	140184
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HEARTLAND REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140164
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MEMORIAL HOSPITAL OF CARBONDALE
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y