Physician Compare National (NPI:1790754976)

HEALTHCARE PROVIDER: JONATHAN L RAANAN 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	1790754976
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8426086364
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060918000496
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	RAANAN
	Individual professional last name
Provider First Name	JONATHAN
	Individual professional first name
Provider Middle Name	LEE
	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	RUTGERS NEW JERSEY MEDICAL SCHOOL
	Individual professional's medical school
Graduation Year	2001
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	NEW YORK SPINE AND BRAIN SURGERY, UNIVERSITY FACULTY PRACTICE CORPORAT
	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	7719876796
	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	44
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	1500 ROUTE 112
	Group Practice or individual's line 1 address
Line 2 Street Address	BLDG 5
	Group Practice or individual's line 2 address
City	PORT JEFFERSON STATION
	Group Practice or individual's city
State	NY
	Group Practice or individual's state
Zip Code	117768055
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6318283400
	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	330107
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	PECONIC BAY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	330393
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	SUNY/STONY BROOK UNIVERSITY HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y