Physician Compare National (NPI:1740271998)

HEALTHCARE PROVIDER: RONALD J POBLETE 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	1740271998
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	0042206393
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20080410000251
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	POBLETE
	Individual professional last name
Provider First Name	RONALD
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1985
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	INFECTIOUS DISEASE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	INFECTIOUS DISEASE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	502 HAMBURG TPKE
	Group Practice or individual's line 1 address
City	WAYNE
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	074708431
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	310006
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	ST MARY'S GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	310019
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ST JOSEPH'S HOSPITAL AND MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	310001
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	HACKENSACK UNIVERSITY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	310050
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SAINT CLARE'S HOSPITAL/ DENVILLE CAMPUS
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y