Physician Compare National (NPI:1548572696)

HEALTHCARE PROVIDER: STEFANIE RUFFOLO M.D.

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

Individual Professional Information
NPI	1548572696
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4981920899
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150311000847
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RUFFOLO
	Individual professional last name
Provider First Name	STEFANIE
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF WISCONSIN
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	CRITICAL CARE (INTENSIVISTS)
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PEDIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PEDIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	ZENITH HEALTHCARE SC
	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	3476774001
	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	16
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	6121 GREEN BAY RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 100
	Group Practice or individual's line 2 address
City	KENOSHA
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	531422931
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2623591652
	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	520021
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	UNITED HOSPITAL SYSTEM
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y