Physician Compare National (NPI:1619084605)

HEALTHCARE PROVIDER: MIGUEL FERNANDEZ MD

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

Individual Professional Information
NPI	1619084605
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1850449497
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090508000151
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FERNANDEZ
	Individual professional last name
Provider First Name	MIGUEL
	Individual professional first name
Provider Middle Name	C
	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	1985
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	2013 PEARL ER PHYSICIANS PLLC
	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	6406287770
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2015 BROADWAY ST
	Group Practice or individual's line 1 address
City	SAN ANTONIO
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	782151117
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2109614118
	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	670191
	Medicare CCN of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y