Physician Compare National (NPI:1679568570)

HEALTHCARE PROVIDER: THOMAS J. STAUDER 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	1679568570
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3375518681
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040831000447
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STAUDER
	Individual professional last name
Provider First Name	THOMAS
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	ALLERGY/IMMUNOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	EMERGENCY MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	INTERNAL MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	EMERGENCY MEDICINE, INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	IRON COUNTY HOSPITAL DISTRICT
	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	0941207526
	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	19
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	301 N HWY 21
	Group Practice or individual's line 1 address
City	PILOT KNOB
	Group Practice or individual's city
State	MO
	Group Practice or individual's state
Zip Code	636630548
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5735461260
	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	261336
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	IRON COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y