Physician Compare National (NPI:1659637668)

HEALTHCARE PROVIDER: BENJAMIN REISS 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	1659637668
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9537451315
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180727001849
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	REISS
	Individual professional last name
Provider First Name	BENJAMIN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OHIO STATE UNIVERSITY COLLEGE OF MEDICINE
	Individual professional's medical school
Graduation Year	2012
	Individual professional's medical school graduation year
Primary Specialty	OPHTHALMOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RETINA INSTITUTE, PLLC
	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	9436302122
	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	4
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	4300 TALBOT RD S
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 300
	Group Practice or individual's line 2 address
City	RENTON
	Group Practice or individual's city
State	WA
	Group Practice or individual's state
Zip Code	980556291
	Group Practice or individual's zip code (9 digits when available)
Phone Number	4252286262
	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	500129
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TACOMA GENERAL ALLENMORE HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	500088
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y