Physician Compare National (NPI:1689997397)

HEALTHCARE PROVIDER: JERRY L MARLIN ARNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1689997397
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5698916435
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130722000096
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MARLIN
	Individual professional last name
Provider First Name	JERRY
	Individual professional first name
Provider Middle Name	LEE
	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	2009
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	SAMERAH RAZUMAN MD PLLC
	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	2769742808
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2000 HARTMAN RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 1
	Group Practice or individual's line 2 address
City	FORT PIERCE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	349474413
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7724651170
	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	100246
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	LAWNWOOD REGIONAL MEDICAL CENTER & HEART INSTITUTE
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	100044
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MARTIN MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y