Physician Compare National (NPI:1760443162)

HEALTHCARE PROVIDER: ALBERT JAMES PAINE JR. 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	1760443162
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7214989862
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100928001528
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	PAINE
	Individual professional last name
Provider First Name	ALBERT
	Individual professional first name
Provider Middle Name	JAMES
	Individual professional middle name
Provider Name Suffix Text	JR.
	The name suffix of the provider if the provider is an individual. The name suffix is a ''generation-related'' suffix, such as Jr., Sr., II, III, IV, or V.
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	WEST VIRGINIA UNIVERSITY SCHOOL OF MEDICINE
	Individual professional's medical school
Graduation Year	1981
	Individual professional's medical school graduation year
Primary Specialty	OTOLARYNGOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	ALLERGY/IMMUNOLOGY
	First secondary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 2	PLASTIC AND RECONSTRUCTIVE SURGERY
	Second secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	ALLERGY/IMMUNOLOGY, PLASTIC AND RECONSTRUCTIVE SURGERY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Organization Legal Name	MOUNTAIN STATE ENT AND FACIAL PLASTIC SURGERY, 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	4789636333
	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	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	86 BROOKSHIRE LN
	Group Practice or individual's line 1 address
City	BECKLEY
	Group Practice or individual's city
State	WV
	Group Practice or individual's state
Zip Code	258016765
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3042552341
	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	510070
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	RALEIGH GENERAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y