Physician Compare National (NPI:1568467413)

HEALTHCARE PROVIDER: RICHARD J. GRISOLI 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	1568467413
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274627773
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080619000265
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	GRISOLI
	Individual professional last name
Provider First Name	RICHARD
	Individual professional first name
Provider Middle Name	R
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	ANESTHESIOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4485 FURLING LN
	Group Practice or individual's line 1 address
City	DESTIN
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	325415331
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	190015
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NORTH OAKS MEDICAL CENTER, L L C
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y