Physician Compare National (NPI:1548331689)

HEALTHCARE PROVIDER: RONALD JAMES MAKUTA D.P.M.

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

Individual Professional Information
NPI	1548331689
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294916151
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20110224000782
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MAKUTA
	Individual professional last name
Provider First Name	RONALD
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WILLIAM M. SCHOLL COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1979
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2 BROOKHILL RD
	Group Practice or individual's line 1 address
City	SUGARLOAF
	Group Practice or individual's city
State	PA
	Group Practice or individual's state
Zip Code	182491045
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5707882776
	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	390185
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LEHIGH VALLEY HOSPITAL - HAZLETON
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M