Physician Compare National (NPI:1619949229)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1619949229
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2466462437
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060504000737
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VICTORES
	Individual professional last name
Provider First Name	LEONARDO
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	UNIVERSITY OF KANSAS SCHOOL OF MED (KC/WICH/SAL)
	Individual professional's medical school
Graduation Year	1992
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SUNSET CARDIOLOGY LLC
	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	6305935701
	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	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	9193 SUNSET DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 210
	Group Practice or individual's line 2 address
City	MIAMI
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	331733487
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3055955558
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y