Physician Compare National (NPI:1720379498)

HEALTHCARE PROVIDER: CASEY L DELCOCO MD

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

Individual Professional Information
NPI	1720379498
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8224261912
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140924000251
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	DELCOCO
	Individual professional last name
Provider First Name	CASEY
	Individual professional first name
Provider Middle Name	LORAINE
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	TULANE UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	GERIATRIC MEDICINE
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	INTERNAL MEDICINE
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	GERIATRIC MEDICINE, INTERNAL MEDICINE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	5455 W 86TH ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 210
	Group Practice or individual's line 2 address
City	INDIANAPOLIS
	Group Practice or individual's city
State	IN
	Group Practice or individual's state
Zip Code	462681530
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	150084
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST. VINCENT HOSPITALS AND HEALTH SERVICES
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y