Physician Compare National (NPI:1669529400)

HEALTHCARE PROVIDER: SCOTT JOHN MISCOVICH 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	1669529400
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9931098506
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100924000505
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MISCOVICH
	Individual professional last name
Provider First Name	SCOTT
	Individual professional first name
Provider Middle Name	JOHN
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	YALE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	45-1144 KAMEHAMEHA HWY 500
	Group Practice or individual's line 1 address
City	KANEOHE
	Group Practice or individual's city
State	HI
	Group Practice or individual's state
Zip Code	967443226
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	120006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ADVENTIST HEALTH CASTLE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y