Physician Compare National (NPI:1639395221)

HEALTHCARE PROVIDER: BARNIE P. RODRIGUEZ P.A.

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

Individual Professional Information
NPI	1639395221
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3678628336
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20090901000396
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RODRIGUEZ
	Individual professional last name
Provider First Name	BARNIE
	Individual professional first name
Provider Middle Name	P
	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	1992
	Individual professional's medical school graduation year
Primary Specialty	PHYSICIAN ASSISTANT
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	405 W COUNTRY CLUB RD
	Group Practice or individual's line 1 address
City	ROSWELL
	Group Practice or individual's city
State	NM
	Group Practice or individual's state
Zip Code	882015209
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	320006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	EASTERN NEW MEXICO MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	320086
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LOVELACE REGIONAL HOSPITAL - ROSWELL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y