Physician Compare National (NPI:1710016241)

HEALTHCARE PROVIDER: LORIN S BRANDON DPM

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

Individual Professional Information
NPI	1710016241
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9335259340
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20180131002458
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BRANDON
	Individual professional last name
Provider First Name	LORIN
	Individual professional first name
Provider Middle Name	S
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	KENT STATE UNIVERSITY COLLEGE OF PODIATRIC MEDICINE
	Individual professional's medical school
Graduation Year	1994
	Individual professional's medical school graduation year
Primary Specialty	PODIATRY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	RYAN K ANDERSON DPM PC
	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	7517999121
	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	13
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3600 RODEO LN
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE A1 A4
	Group Practice or individual's line 2 address
City	SANTA FE
	Group Practice or individual's city
State	NM
	Group Practice or individual's state
Zip Code	875076400
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5054748111
	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	321310
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOLY CROSS HOSPITAL A DIV OF TAOS HEALTH SYSTEMS
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y