Physician Compare National (NPI:1659304418)

HEALTHCARE PROVIDER: MARY COLLEEN FALLON LISW

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

Individual Professional Information
NPI	1659304418
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4587857578
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101022000438
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FALLON
	Individual professional last name
Provider First Name	MARY
	Individual professional first name
Provider Middle Name	COLLEEN
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
	Individual professional's medical school
Graduation Year	1993
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	METROHEALTH SYSTEM
	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	8628982949
	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	915
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	20575 CTR RIDGE RD
	Group Practice or individual's line 1 address
City	ROCKY RIVER
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	441163422
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2162658810
	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	360059
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	METROHEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y