Physician Compare National (NPI:1710913736)

HEALTHCARE PROVIDER: STAFFORD MICHAEL SMITH 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	1710913736
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2163321654
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20151120001373
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SMITH
	Individual professional last name
Provider First Name	STAFFORD
	Individual professional first name
Provider Middle Name	M
	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	PERELMAN SCHOOL OF MED AT THE UNIVERSITY OF PENNSYLVANIA
	Individual professional's medical school
Primary Specialty	CARDIOVASCULAR DISEASE (CARDIOLOGY)
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	5136 FAR OAK CIR
	Group Practice or individual's line 1 address
City	SARASOTA
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	342383303
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	390001
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GEISINGER-COMMUNITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	390125
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	WAYNE MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	390119
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MOSES TAYLOR HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	390137
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	WILKES-BARRE GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y