Physician Compare National (NPI:1770540304)

HEALTHCARE PROVIDER: NICOLAS C CASELLAS CASTILLO 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	1770540304
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6507002375
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20130424000104
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	CASELLAS CASTILLO
	Individual professional last name
Provider First Name	NICOLAS
	Individual professional first name
Provider Middle Name	C
	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	OBSTETRICS/GYNECOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	FERNANDEZ ST
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 302
	Group Practice or individual's line 2 address
City	SAN JUAN
	Group Practice or individual's city
State	PR
	Group Practice or individual's state
Zip Code	00909
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7877267975
	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	400019
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	HOSPITAL PAVIA SANTURCE
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y