Physician Compare National (NPI:1598782039)

HEALTHCARE PROVIDER: DANIEL M. STORMONT 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	1598782039
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4688759087
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080310000458
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STORMONT
	Individual professional last name
Provider First Name	DANIEL
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF WISCONSIN
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	ORTHOPEDIC SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	800 CLAY ST
	Group Practice or individual's line 1 address
City	DARLINGTON
	Group Practice or individual's city
State	WI
	Group Practice or individual's state
Zip Code	535301228
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	521312
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEMORIAL HOSPITAL OF LAFAYETTE COUNTY
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	520028
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	THE MONROE CLINIC
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y