Physician Compare National (NPI:1679581425)

HEALTHCARE PROVIDER: ADDY SQUARER 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	1679581425
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8123181674
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120717000526
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SQUARER
	Individual professional last name
Provider First Name	ADDY
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CALIFORNIA, DAVIS SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	NEPHROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INTERNAL MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	SILICON VALLEY MEDICAL DEVELOPMENT LLC
	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	6103115183
	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	88
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	828 S WINCHESTER BLVD
	Group Practice or individual's line 1 address
City	SAN JOSE
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	951282930
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050038
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SANTA CLARA VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050308
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	EL CAMINO HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y