Physician Compare National (NPI:1770933731)

HEALTHCARE PROVIDER: CESAR LUIS MERINO 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	1770933731
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1850727025
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200206001413
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MERINO
	Individual professional last name
Provider First Name	CESAR
	Individual professional first name
Provider Middle Name	LUIS
	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	2011
	Individual professional's medical school graduation year
Primary Specialty	HOSPITALIST
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	VICKSBURG HEALTHCARE LLC
	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	4688575129
	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	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2100 HWY 61 N
	Group Practice or individual's line 1 address
City	VICKSBURG
	Group Practice or individual's city
State	MS
	Group Practice or individual's state
Zip Code	391838211
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6018835001
	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	250031
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	MERIT HEALTH RIVER REGION
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	251320
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	CLAIBORNE COUNTY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	250084
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	MERIT HEALTH NATCHEZ
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	251338
	Medicare CCN of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y