Physician Compare National (NPI:1780731802)

HEALTHCARE PROVIDER: JAVIER GUSTAVO TABOADA 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	1780731802
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	1658382346
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060509000673
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TABOADA
	Individual professional last name
Provider First Name	JAVIER
	Individual professional first name
Provider Middle Name	G
	Individual professional middle name
Provider Gender	M
	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	1966
	Individual professional's medical school graduation year
Primary Specialty	NEUROLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PSYCHIATRY
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PSYCHIATRY
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	1 HAMILTON HEALTH PL
	Group Practice or individual's line 1 address
City	HAMILTON
	Group Practice or individual's city
State	NJ
	Group Practice or individual's state
Zip Code	086903599
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6095867900
	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	310021
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	SAINT FRANCIS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y