Physician Compare National (NPI:1619972635)

HEALTHCARE PROVIDER: HUMBERTO SIMONETTI 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	1619972635
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5991897134
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070817000501
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SIMONETTI
	Individual professional last name
Provider First Name	HUMBERTO
	Individual professional first name
Provider Middle Name	F
	Individual professional middle name
Provider Name Suffix Text	SR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	SAN JUAN BAUTISTA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1984
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	909 AVE TITO CASTRO
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 517
	Group Practice or individual's line 2 address
City	PONCE
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	007164721
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7872597727
	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	400044
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAN LUKE'S MEMORIAL HOSPITAL INC
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y