Physician Compare National (NPI:1548767098)

HEALTHCARE PROVIDER: SPENSER JAMES RENTZ

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

Individual Professional Information
NPI	1548767098
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0840527602
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190816000896
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RENTZ
	Individual professional last name
Provider First Name	SPENSER
	Individual professional first name
Provider Middle Name	JAMES
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	PACIFIC MEDICAL COLLEGE
	Individual professional's medical school
Graduation Year	2018
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SOUTH CENTRAL EMERGENCY SERVICES, PC
	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	8224212949
	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	29
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	200 2ND AVE SW
	Group Practice or individual's line 1 address
City	MIAMI
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	743546830
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9185426611
	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	370019
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GREAT PLAINS REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	370004
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INTEGRIS MIAMI HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	370026
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST MARY'S REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	370054
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	GRADY MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y