Physician Compare National (NPI:1790765816)

HEALTHCARE PROVIDER: J TRACE WORRELL 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	1790765816
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4385739317
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20120503000498
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	WORRELL
	Individual professional last name
Provider First Name	JOHN
	Individual professional first name
Provider Middle Name	TRACE
	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	1988
	Individual professional's medical school graduation year
Primary Specialty	PATHOLOGY
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ARLINGTON PATHOLOGY ASSOCIATION 501A CORPORATION
	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	4981688256
	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	5
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	800 W RANDOL MILL RD
	Group Practice or individual's line 1 address
City	ARLINGTON
	Group Practice or individual's city
State	TX
	Group Practice or individual's state
Zip Code	760122504
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8174604366
	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	450064
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TEXAS HEALTH ARLINGTON MEMORIAL HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	450872
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	U S M D HOSPITAL AT ARLINGTON L P
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	670071
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	TEXAS HEALTH HEART & VASCULAR HOSPITAL ARLINGTON
	Legal business name of hospital where individual professional provides service 3
Professional Accepts Medicare Assignment	Y