Physician Compare National (NPI:1730278862)

HEALTHCARE PROVIDER:

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

Individual Professional Information
NPI	1730278862
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4981796067
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20070821000176
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SUTKIN
	Individual professional last name
Provider First Name	HOWARD
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF CHICAGO, PRITZKER SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1989
	Individual professional's medical school graduation year
Primary Specialty	PLASTIC AND RECONSTRUCTIVE SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	555 KNOWLES DR
	Group Practice or individual's line 1 address
City	LOS GATOS
	Group Practice or individual's city
State	CA
	Group Practice or individual's state
Zip Code	950321549
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	050038
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SANTA CLARA VALLEY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	050308
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	EL CAMINO HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y