Physician Compare National (NPI:1730488453)

HEALTHCARE PROVIDER: CANAAN BAER 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	1730488453
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4981840097
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200728000744
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BAER
	Individual professional last name
Provider First Name	CANAAN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
	Individual professional's medical school
Graduation Year	2011
	Individual professional's medical school graduation year
Primary Specialty	GENERAL SURGERY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	HOLZER CLINIC LLC
	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	5890606008
	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	237
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2131 E STATE ST
	Group Practice or individual's line 1 address
City	ATHENS
	Group Practice or individual's city
State	OH
	Group Practice or individual's state
Zip Code	457012138
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7405893100
	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	380009
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OHSU HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	380025
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	LEGACY MOUNT HOOD MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	360054
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HOLZER MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y