Physician Compare National (NPI:1720048630)

HEALTHCARE PROVIDER: RICHARD ALLEN BLOSSER JR. 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	1720048630
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6204898570
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120425000516
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BLOSSER
	Individual professional last name
Provider First Name	RICHARD
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	EASTERN VIRGINIA MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	1988
	Individual professional's medical school graduation year
Primary Specialty	GASTROENTEROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	GASTROINTESTINAL MEDICINE ASSOCIATES, 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	5395707665
	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	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3620 JOSEPH SIEWICK DR
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 307
	Group Practice or individual's line 2 address
City	FAIRFAX
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	220331760
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7032811023
	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	490101
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	INOVA FAIR OAKS HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	490043
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	INOVA LOUDOUN HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y