Physician Compare National (NPI:1588675870)

HEALTHCARE PROVIDER: STANLEY JAY ZIMMERMAN 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	1588675870
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5294861829
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100414000722
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ZIMMERMAN
	Individual professional last name
Provider First Name	STANLEY
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
	Individual professional's medical school
Graduation Year	1955
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ENDOCRINOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	GERIATRIC MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ENDOCRINOLOGY, GERIATRIC MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	MEDICORP PA
	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	2466355185
	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	13
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1315 ST JOSEPH PKWY
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1309
	Group Practice or individual's line 2 address
City	HOUSTON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	770028236
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3469809427
	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	450184
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEMORIAL HERMANN HOSPITAL SYSTEM
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	M