Physician Compare National (NPI:1598085979)

HEALTHCARE PROVIDER: MICHAEL JAMES COLEMAN JR. 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	1598085979
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8820239478
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20190726001820
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	COLEMAN
	Individual professional last name
Provider First Name	MICHAEL
	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	UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MIDWEST EYE CONSULTANTS OHIO, 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	3072812676
	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	3509 BRIARFIELD BLVD
	Group Practice or individual's line 1 address
City	MAUMEE
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	435379383
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4198653866
	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	150012
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT JOSEPH REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	150076
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SAINT JOSEPH REGIONAL MEDICAL CENTER - PLYMOUTH
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y