Physician Compare National (NPI:1750382339)

HEALTHCARE PROVIDER: WARREN C BOTNICK M.D.

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

Individual Professional Information
NPI	1750382339
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2365543576
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20150713001538
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	BOTNICK
	Individual professional last name
Provider First Name	WARREN
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1986
	Individual professional's medical school graduation year
Primary Specialty	PULMONARY DISEASE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	CRITICAL CARE (INTENSIVISTS)
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	CRITICAL CARE (INTENSIVISTS)
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	NRMC PHYSICIAN IPA INC
	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	9234400300
	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	13
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	213 S DR
	Group Practice or individual's line 1 address
City	NATCHITOCHES
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	714575003
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3183542493
	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	190007
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	NATCHITOCHES REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	190218
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SABINE MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y