Physician Compare National (NPI:1770573958)

HEALTHCARE PROVIDER: ELAINA VAYNTRUB 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	1770573958
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	7416984687
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20050719001010
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	VAYNTRUB
	Individual professional last name
Provider First Name	ELAINA
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1998
	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
Line 1 Street Address	135 S PROSPECT DR
	Group Practice or individual's line 1 address
City	YPSILANTI
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	481987914
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230144
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	FOREST HEALTH MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230130
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	BEAUMONT HOSPITAL, ROYAL OAK
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230029
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	ST JOSEPH MERCY OAKLAND
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	230156
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	ST JOSEPH MERCY HOSPITAL
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y