Physician Compare National (NPI:1659723120)

HEALTHCARE PROVIDER: TOM FISHER PA-C

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

Individual Professional Information
NPI	1659723120
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7911290036
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180215002243
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	FISHER
	Individual professional last name
Provider First Name	TOM
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF COLORADO SCHOOL OF MEDICINE, DENVER
	Individual professional's medical school
Graduation Year	2016
	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
Organization Legal Name	LANE COUNTY OREGON
	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	7416853833
	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	33
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	151 W 7TH AVE
	Group Practice or individual's line 1 address
Marker of address line 2 suppression	Y
	Marker that address as reported may be incomplete
City	EUGENE
	Group Practice or individual's city
State	OR
	Group Practice or individual's state
Zip Code	974012676
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y