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Physician Compare National (NPI:1700981503)

HEALTHCARE PROVIDER: JAIME L VIVAS 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 1700981503
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 0840485736
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20101117001232
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name VIVAS
Individual professional last name
Provider First Name JAIME
Individual professional first name
Provider Middle Name LUIS
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name UNIVERSITY CENTRAL DEL CARIBE ESCUELA DE MEDICINA
Individual professional's medical school
Graduation Year 1980
Individual professional's medical school graduation year
Primary Specialty RHEUMATOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 2200 HAMILTON RD
Group Practice or individual's line 1 address
Line 2 Street Address SUITE A
Group Practice or individual's line 2 address
City COLUMBUS
Group Practice or individual's city
State GA
Group Practice or individual's state
Zip Code 319048889
Group Practice or individual's zip code (9 digits when available)
Phone Number 7066601711
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 110129
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 ST FRANCIS HOSPITAL
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 110064
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 MIDTOWN MEDICAL CENTER
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 010029
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 EAST ALABAMA MEDICAL CENTER AND SNF
Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4 111316
Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4 WARM SPRINGS MEDICAL CENTER
Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5 110002
Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5 UPSON REGIONAL MEDICAL CENTER
Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment Y

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