Physician Compare National (NPI:1598909376)

HEALTHCARE PROVIDER: ANTHONY ROBERT STARK D.O.

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

Individual Professional Information
NPI	1598909376
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4981846797
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20160531002375
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STARK
	Individual professional last name
Provider First Name	ANTHONY
	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	OTHER
	Individual professional's medical school
Graduation Year	2009
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ALPINE ORTHOPEDICS AND SPORTS MEDICINE
	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	7113993577
	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	9
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	536 S COTTONWOOD RD
	Group Practice or individual's line 1 address
Line 2 Street Address	100 ALPINE ORTHOPEDICS AND SPORTS MEDICINE PC
	Group Practice or individual's line 2 address
City	BOZEMAN
	Group Practice or individual's city
State	MT
	Group Practice or individual's state
Zip Code	597189529
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4065868029
	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	271389
	Medicare CCN of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y