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Physician Compare National (NPI:1588876148)

HEALTHCARE PROVIDER: LYNN MARIE MISKOVICH APN

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

Individual Professional Information

NPI 1588876148
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 2163741448
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20150508000196
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MISKOVICH
Individual professional last name
Provider First Name LYNN
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 2011
Individual professional's medical school graduation year
Primary Specialty NURSE PRACTITIONER
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Organization Legal Name COMMUNITY HEALTHNET 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 6305852344
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 11
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 1021 W 5TH AVE
Group Practice or individual's line 1 address
Line 2 Street Address GARY COMM HEALTH CENTER
Group Practice or individual's line 2 address
City GARY
Group Practice or individual's city
State IN
Group Practice or individual's state
Zip Code 464021703
Group Practice or individual's zip code (9 digits when available)
Phone Number 2198801190
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 150002
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 METHODIST HOSPITALS INC
Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment Y

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