Physician Compare National (NPI:1740255587)

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	1740255587
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8921082173
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20081113000196
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	ROGERS
	Individual professional last name
Provider First Name	KENT
	Individual professional first name
Provider Middle Name	E
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
	Individual professional's medical school
Graduation Year	1971
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	MEDICAL AND SURGIAL ASSOCIATES OF CORSICANA PLLC
	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	7113015793
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	401 HOSPITAL DR
	Group Practice or individual's line 1 address
City	CORSICANA
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	751102415
	Group Practice or individual's zip code (9 digits when available)
Phone Number	9036544604
	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	450447
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NAVARRO REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450658
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	FREESTONE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	450400
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	PARKVIEW REGIONAL HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	450101
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	BAYLOR SCOTT & WHITE MEDICAL CENTER HILLCREST
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y