Physician Compare National (NPI:1548557747)

HEALTHCARE PROVIDER: INES SOFIA NATIVIDAD CARPIO 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	1548557747
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4082858188
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130911000208
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	NATIVIDAD
	Individual professional last name
Provider First Name	INES
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2006
	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
Organization Legal Name	PROVIDENCE HEALTH SERVICES INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	4385541622
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	33
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1140 VARNUM ST NE
	Group Practice or individual's line 1 address
Line 2 Street Address	PMB 200
	Group Practice or individual's line 2 address
City	WASHINGTON
	Group Practice or individual's city
State	DC
	Group Practice or individual's state
Zip Code	200172149
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2026834355
	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	090011
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEDSTAR WASHINGTON HOSPITAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	090003
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HOWARD UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y