Physician Compare National (NPI:1669805099)

HEALTHCARE PROVIDER: SIGURDUR THOR SIGURDARSON 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	1669805099
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9032345160
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20131120001284
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SIGURDARSON
	Individual professional last name
Provider First Name	SIGURDUR
	Individual professional first name
Provider Middle Name	THOR
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	PULMONARY DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CRITICAL CARE (INTENSIVISTS)
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CRITICAL CARE (INTENSIVISTS)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	ULTIMATE HEALTH SERVICES INC
	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	8921912536
	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	80
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5170 RT 60
	Group Practice or individual's line 1 address
City	HUNTINGTON
	Group Practice or individual's city
State	WV
	Group Practice or individual's state
Zip Code	25705
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3045284600
	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	510007
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST MARY'S MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y