Physician Compare National (NPI:1700327962)

HEALTHCARE PROVIDER: BRIAN CERMAK

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

Individual Professional Information
NPI	1700327962
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	3274803598
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200625002347
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CERMAK
	Individual professional last name
Provider First Name	BRIAN
	Individual professional first name
Provider Middle Name	MARSHALL
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KANSAS CITY UNIVERSITY OF PHYSICIANS AND SURGEONS
	Individual professional's medical school
Graduation Year	2017
	Individual professional's medical school graduation year
Primary Specialty	EMERGENCY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	QUESTCARE MEDICAL SERVICES 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	6204739402
	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	127
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3301 MATLOCK RD
	Group Practice or individual's line 1 address
City	ARLINGTON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	760152908
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8174653241
	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	450675
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MEDICAL CITY ARLINGTON
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450672
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	MEDICAL CITY FORT WORTH
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	140223
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ADVOCATE LUTHERAN GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y