Physician Compare National (NPI:1639104227)

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	1639104227
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4183671886
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050405000810
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AUSTIN
	Individual professional last name
Provider First Name	SUZANNE
	Individual professional first name
Provider Middle Name	M
	Individual professional middle name
Provider Gender	F
	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	CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
	Individual professional's medical school
Graduation Year	1983
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	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	2498 STEVENS CREEK BLVD
	Group Practice or individual's line 1 address
City	SAN JOSE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	951281652
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4089985400
	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