Physician Compare National (NPI:1689672313)

HEALTHCARE PROVIDER: SAMUEL JONAS STAGG III 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	1689672313
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3779684857
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100225000753
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	STAGG
	Individual professional last name
Provider First Name	SAMUEL
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Name Suffix Text	III
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CARDIOVASCULAR INSTITUTE OF THE SOUTH, APMC
	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	3779497441
	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	116
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	225 DUNN ST
	Group Practice or individual's line 1 address
City	HOUMA
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	703604413
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9858760300
	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	190008
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TERREBONNE GENERAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	191325
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LADY OF THE SEA GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	190036
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	OCHSNER MEDICAL CENTER NEW ORLEANS
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y