Physician Compare National (NPI:1659342004)

HEALTHCARE PROVIDER: TIMOTHY ALLEN JANZ MD

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

Individual Professional Information
NPI	1659342004
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3173599040
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20101129000019
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	JANZ
	Individual professional last name
Provider First Name	TIMOTHY
	Individual professional first name
Provider Middle Name	A
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	INDIANA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	522 E MARION AVE
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 201
	Group Practice or individual's line 2 address
City	PUNTA GORDA
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	339503803
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	100047
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BAYFRONT HEALTH PUNTA GORDA
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100077
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BAYFRONT HEALTH PORT CHARLOTTE
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y