Physician Compare National (NPI:1699832667)

HEALTHCARE PROVIDER: IGNATIUS DANIEL ROGER 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	1699832667
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0941276851
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040902000495
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ROGER
	Individual professional last name
Provider First Name	IGNATIUS
	Individual professional first name
Provider Middle Name	D
	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	ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
	Individual professional's medical school
Graduation Year	1980
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	9131 QUEENS BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 301
	Group Practice or individual's line 2 address
City	ELMHURST
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	113735540
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7182052100
	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	330055
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NEW YORK-PRESBYTERIAN/QUEENS
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330221
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WYCKOFF HEIGHTS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y